Organ donation: comparison of nurses' participation in two states.

BACKGROUND: The number of organs available for transplantation in the United States is insufficient, and the donor rate in New Jersey is particularly low. OBJECTIVES: To explore reasons nurses do or do not refer organ donors and to identify factors that contribute to differences in referral rates in New Jersey and Pennsylvania. METHODS: Registered nurses (N = 976) in 57 nongovernmental acute care hospitals, primarily in emergency departments and intensive care units, completed a questionnaire that focused on their knowledge and participation in the organ procurement process. RESULTS: Two-thirds of the subjects said they had participated in organ procurement. Pennsylvania nurses had a significantly higher involvement rate than New Jersey nurses. Pennsylvania nurses were also slightly more knowledgeable about the process. A higher proportion of nurses in both states who attended continuing education programs participated. CONCLUSIONS: Nurses need more inservice education regarding policies and procedures for organ donation.

Myopotential inhibition of demand pacemakers.

Two patients are described in whom skeletal muscle potentials originating in the shoulder girdle muscles during isometric movement suppressed the discharge of a ventricular demand unipolar pacemaker, resulting in syncope. Converting the pulse generator into a fixed-rate mode with the magnet prevented the inhibition. Improved filters or wider use of bipolar electrodes should prevent this form of interference.

Nursing faculty--an endangered species?

A present faculty shortage has been documented, and the potential for an even worse shortage in the future is very real. Implications of a continued shortage for both nursing education and practice are serious. They include limitations on enrollments leading to future nursing shortages, burnout of present faculty, or possible decline in the quality of programs. Contributing factors such as aging of educators, fewer graduate students going into teaching, non-competitive salaries, and increased job opportunities for nurses with graduate degrees are explored. Possible solutions include adding more education courses or tracks in graduate programs, obtaining increased federal funds for graduate education, emphasizing the many rewards and benefits of the faculty role, recruiting faculty from new areas, mentoring people into teaching, giving flexible teaching assignments to older faculty members, and making changes in the ways that clinical instruction is performed.

Microbiological laboratory results from Haiti: June-October 1995.

From June to October 1995, the U.S. Army's 86th Combat Support Hospital was deployed in Haiti in support of the United Nations peacekeeping mission. The hospital's mission was to provide comprehensive health care to United Nations military and civilian personnel in Haiti. The hospital's laboratory, with microbiological and parasitological capability, was a critical asset in light of the infectious disease threats in Haiti. A total of 356 microbiological (5.4%) and 887 parasitological (13.4%) tests were performed, out of a total of 6628 laboratory tests. One finding was the discovery of antibiotic-resistant urinary isolates of Escherichia coli. These were from community-acquired infections and included strains resistant to ampicillin (6/15), trimethoprim+sulfamethoxazole (6/15), and ciprofloxacin (2/15). Ampicillin (8/15) and trimethoprim+sulfamethoxazole (3/15) resistance was also noted in Shigella spp. However, no chloroquine-resistant strains of malaria were encountered. Dengue virus, also mosquito borne, was a major pathogen. Antimicrobial-resistant nosocomial pathogens were also encountered. Deployed laboratories should be able to determine antimicrobial susceptibility and perform microbial identification to guide clinical management, conduct medical surveillance, and detect emerging resistance.