A prospective study of early ambulation 90 minutes post-left heart catheterization using a retrospective comparison group.

BACKGROUND: Despite a trend toward a reduction in bedrest time after left heart catheterization (LHC) in many Canadian centres, an evidence-based standard of practice has not been established. Canadian bedrest times range from two to four hours post-LHC. Two recent prospective non-randomized studies (n = 1,000) indicate safety of ambulation at 60 and 90 minutes post-LHC. PURPOSE: The purpose of this study was to determine safety of ambulating patients at 90 minutes post-LHC sheath removal compared to the current practice of ambulation at three to four hours post-sheath removal. DESIGN: The study was a prospective non-concurrent design with a retrospective control. METHOD/SAMPLE: Retrospective data from the APPROACH database and chart reviews were analyzed for a period of six months for the control group on the traditional three- to four-hour ambulation protocol (n = 402). Prospective data were gathered for six months for the experimental group (n = 193). RESULTS: There was no difference in complication rates for the two groups. CONCLUSIONS: The results suggest that early ambulation for selected patients at 90 minutes is safe and has the potential to increase both patient comfort and quality of care.

Promoting safe drinking water.

Ensuring access to safe drinking water is a major public health concern. The outbreaks of disease from water-borne pathogens in communities like Walkerton and North Battleford alerted the federal government to the need for a standardized multi-barrier approach to managing public drinking water distribution systems. Although many provinces and territories have adopted such an approach, there are problems with water quality throughout Canada. Between 1997 and 2004, the authors conducted a community health needs and resources assessment study in Newfoundland and Labrador to assess health beliefs and practices, satisfaction with health and community services and concerns in relation to community health. The data collection methods used were a random household survey (N = 2,842), key informant interviews (N = 86) and focus group sessions (N = 22). The results indicated that the quality of drinking water was of serious concern. In this article, the authors discuss the study findings and the implications for nursing practice in relation to developing healthy public policy and population health initiatives.

Struggling to understand: the experience of nonsmoking parents with adolescents who smoke.

Smoking among adolescents is a major public health concern. Most parents would not want their children engaged in this risk-taking behavior. Although a majority of parents of smokers are themselves smokers, many are nonsmokers. The purpose of this grounded theory study was to understand what nonsmoking parents experience due to their adolescent children 's smoking behavior. The purposive sample consisted of 25 parents. The interview data generated the theory that nonsmoking parents struggle to understand their adolescents' smoking. They experienced four stages: discovering the smoking, facing the problem, reflecting, and waiting it out. Their experience can be examined from a stress paradigm. Programs are needed that provide parents with the knowledge and skills required for effective prevention and intervention strategies.