Certification. Hospital versus national standards.

"Certification" and "credential" are frequently used terms in nursing. How these terms are used and what they mean to nursing practice is the focus of this article. Definitions, history, and application of these concepts are explored. Recommendations are made that a hospital not assume responsibility for the granting of certification or credentials to nursing staff members. Nurses and nursing administrators are urged to support nationally recognized certification programs.

Patients with long-term vascular access devices: care and complications.

Orthopaedic nurses will be dealing with more long-term vascular access devices, such as tunneled catheters, implanted ports, and peripherally inserted central catheters as antibiotic and other supportive intravenous therapy is administered over longer periods. Caring for patients with these devices requires an understanding of the purpose and design of the device, use and maintenance of the catheter or port, and actions to take if complications arise. Knowing the cause and response to the most common clinical problems, such as infection, occlusion, and thrombosis, will help in problem solving and support a variety of teaching strategies for patients. Nurses who are familiar with these central venous devices will be able to provide safe and effective care for patients in the hospital and at home.

Racial perspectives on kidney transplant donors and recipients.

Prior to undertaking a campaign to increase organ donation, demographic patterns of kidney recipients and donors were examined for our transplant center--the city and state in which it is located (Detroit and Michigan respectively). From 1984 to 1986 there were 964 kidney recipients in Michigan; 28% were black and 69% were white, whereas only 13% of the population in Michigan is black. As has been shown elsewhere in the United States, blacks have more end-stage renal disease than whites and thus require renal transplantation more often. There were 413 kidney donors from Michigan during the same period, 13% were black and 85% were white. In contrast to studies from other parts of the United States, our data show that blacks and whites in Michigan donate kidneys at a similar rate--i.e., 1.5 per 100,000 population. Data such as these should be obtained for areas where campaigns are to be conducted to increase organ donation. This information can be used to educate the public about the needs of the community.

Clinical nurse researchers: strategies for success.

One response to nursing's growing commitment to grounding practice in a research base has been the development of clinical nurse researcher positions in hospitals throughout the country. Drawing on data from a nationwide survey, the authors describe goals and strategies that clinical nurse researchers and their chief nurse executives identify as contributing to successfully carrying out the clinical nurse researcher role.