• Background Ventilator-associated pneumonia accounts for 47% of infections in patients in intensive care units. Adherence to the best nursing practices recommended in the 2003 guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention should reduce the risk of ventilator-associated pneumonia. • Objective To evaluate the extent to which nurses working in intensive care units implement best practices when managing adult patients receiving mechanical ventilation. • Methods Nurses attending education seminars in the United States completed a 29-item questionnaire about the type and frequency of care provided. • Results Twelve hundred nurses completed the questionnaire. Most (82%) reported compliance with hand-washing guidelines, 75% reported wearing gloves, half reported elevating the head of the bed, a third reported performing subglottic suctioning, and half reported having an oral care protocol in their hospital. Nurses in hospitals with an oral care protocol reported better compliance with hand washing and maintaining head-of-bed elevation, were more likely to regularly provide oral care, and were more familiar with rates of ventilator-associated pneumonia and the organisms involved than were nurses working in hospitals without such protocols. • Conclusions The guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention are not consistently or uniformly implemented. Practices of nurses employed in hospitals with oral care protocols are more often congruent with the guidelines than are practices of nurses employed in hospitals without such protocols. Significant reductions in rates of ventilator-associated pneumonia may be achieved by broader implementation of oral care protocols.
This study aimed to develop and validate a death attitude scale which would be applicable to Christians, non-Christians, and atheists alike. A sample of 147 medical students and a sample of 115 Buddhists completed a fifty-sixitem questionnaire in order to empirically test generality across samples. Four conceptual aspects of death and dying were investigated. The results of three principle components analyses provided evidence for three of the a priori labeled factors: Fear and anxiety about death and dying; Fear and anxiety about personal extinction; and Positive attitude to death and dying.Seventeen items which loaded satisfactorily across both samples were retained for the orthogonal three factor solution. Construct validity was considered to be high and reliability was found to be good. This study provided empirical support for at least two orthogonal factors requiring further attention from thanatological researchers. Results highlighted the importance of sampling non-Christian populations; of sampling populations who have experience of aspects of death and dying and of using questionnaire items which have no religious bias.Fear of death-thanatophobia-does not appear to be a simple or unidimensional concept. It encompasses, at the very least: a fear of the dying process; a fear of ceasing to be (personal extinction); and a fear of what comes after death (Choron, 1964, cited in Pollak, 1979. Kastenbaum (1992) regards fear of personal extinction as the basic and most distinctive variety of death fear. Freud (1959, cited in Kastenbaum, 1992 considered fear of death to be abnormal, on the basis that it is
Co-bathing is a gentle, low risk, low stress, high touch, non-invasive and non-interfering intervention for breastfeeding problems that cannot be addressed by optimal attachment The mother and baby are given a familiar environment, and the opportunity for the baby to learn to breastfeed. This method of overcoming breastfeeding problems encourages a baby to self-attach and suckle well. The Office for National Statistics (1997) showed that in 1995, the three most common reasons given for stopping breastfeeding initially were a perceived insufficient milk supply, failure to suckle or rejection of the breast, and painful breasts and nipples. These problems can all reflect back to a baby who will not attach and suckle properly.
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