TOPIC.  Concept analysis and self‐efficacy. PURPOSE.  This paper provides an in‐depth analysis of the concept self‐efficacy through the use of Rodger's model. SOURCES.  Published research. CONCLUSION.  Self‐efficacy beliefs influence how people think, feel, motivate themselves, and act. Self‐efficacy is concerned about the perception or judgment of being able to accomplish a specific goal and cannot be sensed globally. In order to gain a sense of self‐efficacy, a person can complete a skill successfully, observe someone else doing a task successfully, acquire positive feedback about completing a task, or rely on physiological cues.

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Novice clinicians should be supported by educators and nurse managers to note when their intuitions are likely to be valid. Our findings emphasize the integrated nature of intuition and analysis in clinical decision-making.

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The number of deaths from carbon monoxide (CO) poisoning remained constant for many years but has recently started to fall. There are three reasons. Firstly, it has become more fashionable to commit suicide by more sophisticated methods, particularly now that tranquillisers and antidepressants are widely prescribed. Secondly, Britain's domestic gas supply is being changed over from coal gas to natural gas, which contains no carbon monoxide-though so far only an eighth of the country has actually been converted to the new gas. Thirdly, and perhaps most significant, is the changeover which has taken place in the manufacture of gas for domestic use, coal carbonization having given way to oil reforming. Techniques for reducing the amount of CO present have also been introduced, but as G. Thurston' has shown, inadequate combustion or ventilation can be lethal even when the original fuel contains no CO. So in about eight years, when the whole country has been converted to natural gas, there will still be numbers of patients with CO poisoning needing resuscitation.Recently J. S. Smith and S. Brandon2 reviewed 206 episodes of CO poisoning in Newcastle. The mortality rate was 3900. In 20% of patients recovery was complicated by prolonged delirium suggesting that "all degrees of functional or structural neurological damage may have occurred, yet oxygen therapy was given in only 43.8% of suicidal and 32-5% of accidental exposures." They suggest that in view of the risk of persistent neuropsychiatric sequelae current patterns of management should be revised.In selecting a form of therapy there are two aspects to consider: firstly, the prevention of death and, secondly, the reduction of neuropsychiatric sequelae such as those described by H. Garland and J. Pearce.3 Carboxyhaemoglobin should be eliminated as quickly as possible because its presence alters the dissociation curve of the remaining oxyhaemoglobin, impeding oxygen release to the tissues.4 J. S. Haldane5 was the first to describe the use of hyperbaric oxygen in CO poisoning, when he failed to poison a mouse placed in a jar containing two atmospheres of oxygen and one of CO. This was all the more remarkable for the fact that the affinity of haemoglobin for CO is about 250 times that for oxygen. Hyperbaric oxygen keeps the patient's tissues oxygenated by the oxygen physically dissolved in the plasma at a time when his haemoglobin is not available to him for oxygen transport. It is also the most efficient means of reducing the carboxyhaemoglobin level, as was shown by T. A. Douglas and his colleagues6 in 1962 when they compared the efficiencies of oxygen at one atmosphere's pressure, oxygen at two atmospheres' pressure, and of 50/% and 70 % carbon dioxide in oxygen.

The care of a patient with Guillain-Barré syndrome is challenging for the healthcare team. By incorporating both physical and psychological care in a patient with Guillain-Barré syndrome, the critical care nurse can adapt to the changing plan of care that accompanies this diagnosis. Because the disease normally starts with a motor weakness and ends with the patient requiring months or even years of rehabilitation, the patient should be prepared for this extended period of treatment. It is only by collaboration of the entire healthcare team that such tasks as diagnosis, treatment, therapy, and pharmaceutical interventions are performed in such a way to help the patient regain a previous level of independence.

Background: Educational opportunities for health care professional students to learn collaborative communication and the roles and responsibilities of other disciplines are minimal unless faculty are intentional about facilitating this interdisciplinary learning. Objectives: The aim of this study was to determine how a simulation-enhanced interprofessional education (Sim-IPE) teaching strategy fostered communication and interdisciplinary awareness between students from multiple disciplines. Method: This pretest-posttest design surveyed undergraduate students from 5 disciplines. The Student Perceptions of Interprofessional Clinical Education-Revised tool examined students' perceptions of teamwork and roles after an in-depth, multistate critical care simulation experience. Results: All students' perceptions of teamwork increased after the Sim-IPE. More experience in the health care field is associated with an increased perception of teamwork and roles/responsibilities. Discussion: On the basis of these findings, the critical care Sim-IPE was an effective teaching strategy to increase the perception of roles and responsibilities of 174

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