Clinical Nursing Research current issue

How Do We as Nurses Move the Science Forward?: One Step at a Time

Cacchione, P. Z. — 2008-10-16

Comparison of Upper Arm and Forearm Blood Pressure

Domiano, K. L., Hinck, S. M., Savinske, D. L., Hope, K. L. — 2008-10-16

The upper arm is the primary site used to obtain a blood pressure measurement (BPM); however, when it is not possible to use the upper arm, the forearm is a commonly used alternate site. This study determines if there is a significant difference between upper arm and forearm BPMs among adults and examines the relationship of participant characteristics to the BPM difference. A convenience sample was recruited from a low-income, independent-living, 104-apartment complex in the Midwest. Of the 106 participants, 64% were female and 89% were White. Ages ranged from 20 to 85 years (M = 50.7). The investigators calculated the BMIs (range = 18 to 42, M = 29.3, SD = 5.4) for the 89% (n = 94) of participants who reported their weight. The forearm tended to have higher BPMs than the upper arm (M difference = 4.0 mm Hg systolic, 2.3 mm Hg diastolic). However, site differences were greatest for men, obese adults, and middle aged (36 to 65) adults.

Equivalence of Earlobe Site Blood Glucose Testing With Finger Stick

Anzalone, P. — 2008-10-16

This study determines if there are significant differences in blood glucose sampled at the earlobe relative to fingertip sites. A 50-participant cross-sectional comparative design was conducted at a 480-bed community hospital. Four trained data collectors obtained demographic information and blood glucose samples from both the fingertip and earlobe sites. Data analysis included descriptive statistics, paired t test, and the Bland Altman technique, assessing agreement between two methods of clinical measurements. Results indicate that the mean finger stick glucose result was statistically significantly greater than the mean earlobe glucose result. The Bland Altman plot did not demonstrate clinical significance. Results suggest that the earlobe may be a viable alternative to exclusive fingertip site when frequent sampling is necessary in acutely ill patients and demonstrate the importance of the role of the clinical bedside nurse in implementing evidence-based nursing practice related to diabetes treatment and management.

Examining Oral Intake Temperature in Cardiac Surgery Patients

King, K. M., Donahue, M., Dowey, H., Bayes, A., Cuff, L., Korol, N. — 2008-10-16

The effect of restricting the temperature of cardiac surgery patients' oral intake to room temperature or warmer, over the first 3 postoperative days, on gastrointestinal (GI) symptoms was examined. In all, 57 patients were randomly assigned to receive the intervention or usual care. GI symptoms were measured daily over the first 5 postoperative days. Following hospital discharge, GI symptoms and return to function data were collected over 4 postoperative weeks. On Postoperative Day 1, 41% of patients reported having GI symptoms, and they were significantly associated with higher cross-clamp time. Symptoms dissipated over time. There were no differences between the study groups in GI symptoms or return to function. Nearly 70% of patients who withdrew from the study were randomized to the intervention group. Difficulty associated with adhering to the study protocol was their primary reason for withdrawing. Given these findings, a large-scale clinical trial may not be warranted.

Coping Difficulties After Hospitalization

Fitzgerald Miller, J., Piacentine, L. B., Weiss, M. — 2008-10-16

Coping difficulties of 113 adults 3 weeks after hospital discharge were identified using the Post-Discharge Coping Difficulty Scale and a brief focused telephone interview (11-item guide). Overall, low difficulty scores were reported (M = 23.9, SD = 18.2, range = 0 to 100). Qualitative data reveal specific coping difficulties in the categories of stressors, specific difficulties, caring for self, managing the condition, family, advice needed, contact with the health care system, and what they wished they knew before discharge. A core theme of biographical reconstruction emerged.

Family Involvement in Inpatient Care in Taiwan

Tzeng, H.-M., Yin, C.-Y. — 2008-10-16

This descriptive, cross-sectional survey study illustrates the roles for and motives of being a family visitor to accompany a hospitalized loved one during hospitalization in a Taiwanese hospital. Family visitors were approached by research assistants on a random basis in acute inpatient units. Among the 1,034 participants, 91% were relatives. About 80.0% of them were present to attend to the patient's physical care, 61.0% to offer psychological support, and 63.5% to express their desire to learn more about the patient's medical condition and illness in time. Their primary motives included fulfilling one of their responsibilities, coming to help voluntarily, showing filial piety for their parent, and being afraid that the patient could not obtain appropriate care. The family involvement culture in Taiwan may have placed pressure on family members to be present at the bedside and contributed to families' psychological and financial burden.