Self-administered versus nurse-administered epidural analgesia after cesarean section.

OBJECTIVE: To compare two methods of administering analgesia by the epidural route after cesarean sections. DESIGN: Quasi-experimental. SETTING: The postpartum area of a large community hospital. PARTICIPANTS: Fifty women undergoing planned cesarean sections with epidural anesthesia. INTERVENTIONS: The control group received continuous epidural analgesia with nurse-administered boluses and the experimental group with self-administered boluses. MAIN OUTCOME MEASURES: Pain control, side effects from medication, amount of medication required, postoperative activity levels, and patient satisfaction. RESULTS: Subjects receiving continuous epidural analgesia with self-administered boluses of analgesic used significantly less fentanyl and fewer supplemental intravenous pain medications than subjects receiving continuous epidural analgesia with nurse-administered boluses of analgesic. CONCLUSIONS: Subjects in self-administered group required less pain medication than subjects in nurse-administered group.

Preventing day-care--related illnesses.

The number of children enrolled in out-of-home day care has increased dramatically. One of the concerns expressed about the use of day care is the contribution of group settings to childhood morbidity. Children who are placed in groups of other children experience more illnesses than their peers who remain at home. However, disease transmission can be minimized by infection control behaviors. Unfortunately, day-care staff and parents are often inadequately prepared in such behaviors. Consequently, by becoming involved in day care, nurses can play a role in reducing the number of day-care--related illnesses.

Clinical experiences in day care settings.

Day care settings offer many opportunities for students to participate in comprehensive primary healthcare and preventive health education. Additionally, day care sites provide experiences beyond those typically associated with well-child healthcare. The author discusses practical issues for faculty members to address when seeking experiences for their students in day care environments.

A developmental approach to childhood safety education.

Injuries are the leading cause of childhood mortality in the United States. Both susceptibility to injuries and understanding of safety issues are significantly influenced by a child's developmental level. Knowledge of developmentally based teaching strategies will enable nurses to provide effective safety education to parents and children.

Examining management of pain for infants following cardiothoracic surgery.

Pain management for infants continues to be inadequate despite evidence that infants do experience pain. Some health professionals fear that the risks of administering medication for pain outweigh the benefits. In caring for infants thought to be in pain, nurses often choose to administer a minimal dosage of analgesia; administer a sedative for its calming effects; or try to maximize relief by combining the analgesics and sedatives prescribed. Findings from this study indicate that the administration of analgesics and sedatives to relieve pain or calm an infant may be too conservative.

A model of health care delivery in a child day-care setting.

Many children in our country spend all or part of their days in group day care while their parents work or go to school. These children are not only at risk for day-care-related illnesses, but also may lack preventive health care because their parents have time constraints or financial barriers. A group of nursing faculty members found that by collaborating with early childhood educators, accessible and cost-effective health care could be provided to children at a campus day-care site. This collaboration allowed for the early detection of problems, thereby reducing barriers to learning. Furthermore, by entering a day-care system, nurses found opportunities to conduct health education and promotion that had a positive impact on children, parents, and day-care staff. This model, or components of it, could be replicated in similar settings.