Making sense of the technique of venepuncture.

Venepuncture is a skill being undertaken by an increasing number of nurses. This paper describes the steps to be taken together with some of the measures employed to avoid problems.

Use of distraction with children during an acute pain experience.

The purpose of this study was to investigate the effectiveness of a distraction technique in reducing a child's perceived pain and behavioral distress during an acute pain experience. A convenience sample of 100 children, ages 3 years 6 months through 12 years 11 months, scheduled for routine blood draws, was recruited and randomly assigned to an experimental or control group. During venipuncture, the control subjects received standard preparation, which consisted of being comforted by physical touch and soft voices, while experimental subjects were encouraged to use a kaleidoscope as a distraction technique. Results of the MANCOVA, with age as a covariate, indicated a significant difference between the groups. Univariate post hoc tests confirmed that the experimental group perceived less pain and demonstrated less behavioral distress than the control group.

An analysis of a behavioral intervention for children undergoing venipuncture.

An examination of factors was conducted to determine the effectiveness of the distraction component of a behavioral intervention (use of a party blower). In one condition, parents were instructed to coach children in the use of a party blower and to praise child cooperation. In a second condition, nurses were instructed to assist parents in coaching the child. Parents used the coaching skills they learned and got their children to use the distraction technique. Use of the distraction technique was associated with less crying. Encouragement from a health care professional and intervention early in the procedure did not enhance the intervention's effectiveness. Older children and children who were less distressed during the initial phase of the procedure were less likely to reject the intervention.

Rocking and pacifiers: two comforting interventions for heelstick pain.

The effects of behavioral interventions in reducing the stress of infant pain are not well documented. Two comfort interventions, rocking and pacifiers, were compared with routine care administered to 60 newborn infants randomly assigned to the three conditions following a neonatal screening heelstick. Heart rate, state of arousal, and crying were recorded continuously. Both pacifiers and rocking reduced crying, but pacifiers predominantly produced sleep states and rocking predominantly produced alert states. Pacifiers reduced heart rate levels significantly more than did rocking. Thus, newborns clearly benefit from both comforting methods. Several mechanisms are proposed to account for these findings.

Teaching venipuncture in an outpatient surgery unit.

In the spring of 1992, the skill of venipuncture, inserting an intravenous (IV) needle, was added to the last quarter in an associate degree nursing curriculum. After theory and demonstration, 71 graduating students were rotated through an 8-hour venipuncture practice laboratory in an outpatient surgery unit. The instructor worked with a single student to start an IV line on a client. The personalized instructional method and sequencing of events resulted in a positive learning experience.

Realistic venipuncture simulation.

Both educators and nursing administrators are eager to find instruction methods that prepare practitioners for skillful venipuncture. A second concern, shared by everyone, is providing such instruction in the most cost-effective manner possible. The authors present a plan that enhances the teaching of venipuncture, through stimulation, using inexpensive, easily obtained equipment.

[Discourse, institution, power: an analysis of the nurse-patient interaction]. / Discurso, instituição, poder: análise de interação enfermeiro-paciente.

The present investigation is an analysis of nurse patient interaction in a situation of blood collection. The body of this study consists twenty dialogues among five nurses and twenty patients. The "mechanics" of conversation was analyzed using the turn-taking sistem, as well as the formal marks that constitute and individualize the discoursive formation. The results showed an asymmetry in the interaction, a fact that qualifies the nurse-patient interaction as one of control, domination and effacement of individuality. These factors show that ideology of the hospital institution with respect to the patient is characterized by imposition of authority and alienation.