Shared governance has been used as a framework that provides nurses with both the structure and the mechanism to enhance decision-making authority and improve level of satisfaction. This study examined the level of work satisfaction among nurses working at cardiovascular department after the implementation of Shared Governance Model in a tertiary hospital in the Kingdom of Saudi Arabia. A descriptive cross sectional study design was adopted using the Index of Work Satisfaction Part-B (IWS-Part-B). Non-random convenience sample of 168 nurses who have worked in the cardiovascular department for more than two years received self-administered questionnaire (IWS-Part-B) on level of satisfaction about tasks, autonomy, interaction, decision making, professional status and pay. 145 nurses returned the questionnaire with a response rate of 86.3%. Overall, nurses were moderately satisfied (IWS-Part-B: 181.10). They were moderately satisfied with autonomy, interaction, and professional status variables; while they were moderately unsatisfied with decision making, tasks requirements, and payment variables. Participation in decision making was the strongest predictor of work satisfaction, accounting for 71.4% of the explained variance (r = 0.845, R 2 = 0.714, p = .000), followed by autonomy variable (r = 0.821, R 2 = 0.671, p = .000) and interaction variable (r = 0.803, R 2 = 0.645, p = .000). The findings of this study supported the positive role that shared governance plays in empowering nurses and enhancing their participation in the decision making process. Another multi-centers study is needed recruiting a larger sample from different departments that adopt SGM to better detect the effect of SGM on level of satisfaction and decision making in particular.
Background: The implantable cardioverter defibrillator is a sophisticated and multifunctional device to treat life-threatening arrhythmias. With increasing numbers of recipients implanted due to rapid technical development of devices and enlarged implantation indications, the consequences for recipients with an implantable cardioverter defibrillator daily life has attracted increased attention during the last decade.
IntroductionWe previously showed that erythropoietin (EPO) attenuates the morphological signs of spinal cord ischemia/reperfusion (I/R) injury in swine [1] without, however, improving neurological function. The clinical use of EPO has been cautioned most recently due to serious safety concerns arising from an increased mortality in acute stroke patients treated with EPO and simultaneously receiving systemic thrombolysis [2]. Carbamylated EPO (cEPO) is an EPO derivative without erythropoietic activity and devoid of the EPO side eff ects, but with apparently well maintained cytoprotective qualities [3]. We therefore tested the hypothesis whether cEPO may be equally effi cient as EPO in reducing morphological as well as functional aortic occlusion-induced spinal cord I/R injury. Methods In a randomized and blinded trial pigs received either vehicle (control, n = 9), EPO or cEPO, respectively (n = 9 each; 5,000 IU/kg over 30 minutes before and during the fi rst 4 hours of reperfusion). Animals underwent 30 minutes of thoracic aortic balloon occlusion with catheters placed immediately downstream of the A. subclavia and upstream of the aortic trifurcation. Spinal cord function was assessed by motor evoked potentials (MEP as percentage of the amplitude before aortic occlusion) and lower limb refl exes (assessed as the subjective strength of response) for a period of 10 hours after reperfusion. Tissue damage was evaluated using Nissl staining. Results Both EPO-treated and cEPO-treated animals presented with attenuated spinal cord injury in the Nissl staining (median (quartile) percentage of damaged neurons in the thoracic segments: control 27 (25,44), cEPO 8 (4,10), and EPO 5 (5,7), P <0.001 vs control group; in the lumbar segments: control 26 (19,32), cEPO 7 (5,13), EPO 8 (5,10), P <0.001 vs control group). However, while only cEPO treatment was associated with recovery of the MEP amplitude to pre-occlusion values when compared with the control group (P <0.05), lower limb refl ex response was comparably restored stronger in both treatment groups (P <0.05 vs control). Conclusions In a clinically relevant porcine model mimicking aortic crossclamping during vascular surgery repair of thoracic aortic aneurysm, cEPO protected spinal cord function and integrity as eff ective as EPO when applied at equipotent doses. Acknowledgements Supported by the Deutsche Forschungs gemeinschaft (SCHE 899/2-2). References Introduction Unfolded protein response (UPR)-mediated apoptosis plays a pivotal role in ischemia-reperfusion injury. Sodium 4-phenylbutyrate (PBA) has been reported to act as a chemical chaperone inhibiting UPR-mediated apoptosis triggered by ischemia in various organs other than the heart. Therefore we investigated whether PBA reduces UPR-mediated apoptosis and protects against myocardial ischemia-reperfusion injury in mice. Methods C57BL/6 mice were subjected to 30 minutes LAD ischemia followed by reperfusion. PBA (100 mg/kg) or PBS (control) was administrated intraperitoneally just before ischemia. Apoptosis, infarct ...
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