Efficacy of Acupuncture/Acupressure in the Prevention and Treatment of Nausea and Vomiting Across Multiple Patient Populations: Implications for Practice.

Nausea and vomiting are complex symptoms related to many disease processes. With many pharmacologic interventions noted to have adverse effects, many patients are turning to alternative therapies, including acupuncture and acupressure. Their efficacy has been proven for nausea and vomiting related to pregnancy, in patients receiving chemotherapy, and in postoperative, pediatric, and female patients. There are minimal to no side effects with the use of acupuncture and acupressure for the treatment of nausea and vomiting. Providers should be encouraged to discuss the efficacy, benefits, and side-effect profile of acupuncture and acupressure with patients who suffer from nausea and vomiting.

Medicines management programme for non-medical prescribers.

The National Prescribing Centre has developed a single competency framework for all prescribers, including medical and dental prescribers. The framework demonstrates the need for keeping up to date with the knowledge and skills associated with medicines management and prescribing. The reorganisation of NHS community services in north west London led to the creation of an integrated care organisation, offering the opportunity to review the medicines management support provided to non-medical prescribers (NMPs) in the community and to develop a continuing professional development programme for community NMP staff. This article describes the design, delivery and evaluation of the programme, which is delivered by a team of pharmacists in collaboration with senior nurses.

The relationship between simulation in nursing education and medication safety.

This experimental study examined whether the use of clinical simulation in nursing education could help reduce medication errors. Fifty-four student volunteers were randomly assigned to an experimental (treatment) group (24 students) or a clinical control group (30 students). The treatment replaced some early-term clinical placement hours with a simulated clinical experience. The control group had all normally scheduled clinical hours. Treatment occurred prior to opportunities for medication administration.

The experience of massage during chemotherapy treatment in breast cancer patients.

This study aimed to describe the experience of massage for breast cancer patients during chemotherapy treatment. Ten patients received massage at five occasions. They were interviewed and analysis was conducted using Giorgi's ideas of phenomenological research. The essential meaning of getting massage during chemotherapy was described as a retreat from the feeling of uneasiness toward chemotherapy. Results revealed five themes: the patients experienced distraction from the frightening experience, a turn from negative to positive, a sense of relaxation, a confirmation of caring, and finally they just felt good. In conclusion, the findings of this study show that massage offered a retreat from uneasy, unwanted, negative feelings connected with chemotherapy treatment. It is a treatment that can be added to the arsenal of treatment choices available to the oncological staff.

Human patient simulators: a new face in baccalaureate nursing education at Brigham Young University.

Simulation has been used to augment learning in the health care professions. The human patient simulator (HPS) has been used primarily by medical students but is now being used by nursing students, as well. This study explored the benefits and limitations of using an HPS as a patient substitute for one day of actual clinical experience for junior nursing students. Learning outcomes included increased student knowledge, ability, and confidence in medication administration.

Flushing an i.v. line: a simple but potentially costly procedure for both patient and health unit.

This observational study investigated the intravenous (i.v.) medication administration technique of Registered Nurses (n = 47) using the injection port of a concurrent intravenous infusion. Study findings showed that the majority of nurses adhered to the most common although debatable recommended guideline in stopping the concurrent infusion and slowly administering the medication in the syringe over 3-5 minutes, prior to flushing the line quickly. Nurses failed to account for the dead space in the i.v. line when calculating the administration rate for pre and post medication flush. Similarly, the benefits of continuing the concurrent infusion when administering intravenous medication were not taken into consideration. Based upon these study findings, we recommend changes to procedural guidelines for i.v. medication.

Crown II: the implications of nurse prescribing for practice nursing.

Certain limited prescribing rights have now been granted to district nurses and health visitors. Proposals to extend prescribing rights to other health professionals have recently been put forward in the Review of Prescribing. Supply and Administration of Medicines (DoH, 1999). Practice nurses are one group who are likely to apply for such rights. This article reports on selected findings from a small-scale qualitative study designed to investigate the current and potential future of practice nurse in prescribing. It was found that practice nurses exercise considerable influence over prescribing in diverse therapeutic areas within general practice. However, it may be difficult to accommodate the prescribing requirements inherent in such a broad scope of practice within the framework of the present proposals. Important issues of accountability and patient safety are raised, and recommendations made for policy, research and education.

Managing i.v. therapy: "high-alert" drugs keep nurse managers ever watchful.

Learn techniques critical for safe i.v. infusion and the appropriate steps to take before, during, and after administration of five "high-alert" medications--potassium chloride, heparin, dopamine, theophylline, and insulin.

The placebo effect and the hidden benefits of oral medications.

The effectiveness of any drug involves many factors not just the pharmacological ingredients. The hidden benefits of a drug are termed the 'placebo effect', but because many of these factors cannot be explained scientifically they are often dismissed as irrelevant. However, factors including the attributes of the drug itself (shape, colour, taste), the relationship between the nurse dispensing the drug and the patient receiving it, the route of administration, the setting in which the drug is given and wider sociocultural beliefs surrounding the ingestion of medicines can all have a major influence on a drug's efficacy. This article explains the term 'placebo' and explores some of the factors contributing to the placebo effect in relation to oral medications. Nurses need to appreciate the influence of such factors in order to provide appropriate and holistic care to patients with different social and cultural beliefs and expectations.

Gaining strength: supplements revised.

Responding to concerns for weight loss and nutritional status of its patients, a Transitional Care Unit (TCU) began an intensive Medication Pass Supplement Program. It involves nurses administering a dietitian-reviewed and approved nutritional supplement for specified residents with every medication pass. As a result, 94% of discharged patients lost less than 5% of their admission weight.

Pharmacodynamics and drug therapy.

Medical pharmacology is the study of chemicals or drugs that interact with the human body. Knowledge of the molecular biology of drug action can enhance nursing practice and the provision of holistic patient care.

Ethical considerations in drug administration for critically ill patients.

The ethical dilemmas critical care nurses face in daily practice are increasing as treatments are weighed against the benefit in individual patients. Managing critically ill patients holistically creates ethical challenges on a daily basis. Determining how to assist patients and significant others in making sound ethical decisions is critical to optimal outcomes. Case studies are presented to illustrate further how cost effectiveness will continue to have a major role in determining patient care in the 21st century.