Writing for publication: it's a matter of personal style.

One of the best ways a nurse practitioner can make a lasting contribution is through the published word. A nurse writer publishes to inform, instruct, challenge, and inspire. This sharing of ideas is critical for professional growth and visibility. The writing process may appear at first glance to be difficult, yet the tips and techniques described in this article demonstrate that writing is a craft which can be learned. Although the process that results in a final, published manuscript may, at times, appear lengthy, the approach to preparing a manuscript is simple, requiring a modicum of skill and a strong desire to share knowledge.

Chemical abuse in nurses. We must no longer enable, ignore, deny, or excuse this growing public and professional epidemic.

Chemical abuse is a symptom of a deep and complex physical, psychosocial, and spiritual problem which, in the nurse, can have particularly disastrous results. Clearly there is no "quick fix," nor one solution. Education is a crucial element in the prevention, early identification, and timely treatment of chemical abuse. When awareness is increased, nurses will be better prepared to recognize, prevent, and confront the growing problem of chemical abuse in the profession and in society at large.

Infection control practices in gastrointestinal endoscopy in the United States: a national survey.

OBJECTIVE: To ascertain current infection control practices, endoscope cleaning procedures, perceived risks of infection, and implementation of universal precautions in gastrointestinal endoscopy units in the United States. DESIGN: National mailed survey of gastroenterology nurses and associates conducted anonymously in March 1988. SETTING: Completed surveys were received from all 50 states and Puerto Rico and from all practice settings. The most common practice setting was private/community hospitals (66%). PARTICIPANTS: Of the 4,952 survey forms mailed to all members and to interested nonmembers of the Society of Gastrointestinal Nurses and Associates, 2, 158 (44%) were returned and 2,030 (41%) were completed and evaluable. Of the respondents, 1,487 (73%) were registered nurses. RESULTS: Sixty-seven percent (n = 1,358) of the respondents routinely used an enzymatic cleaner as a step in the instrument decontamination process; 93% (n = 1,879) chemically disinfected instruments after each case; and 88% (n = 1,779) disinfected endoscopes with an aqueous glutaraldehyde product. Respondents reported that they and a significantly smaller proportion of physicians (p less than .001) employed barrier precautions for all endoscopic cases involving possible contact with blood/body fluids of patients known (66% versus 57%, respectively) and not known (12% versus 8%, respectively) to have a bloodborne infection. Endoscopy-related infections, usually bacterial, were reported to have occurred at their institutions by 6% (n = 116) of respondents. CONCLUSIONS: We conclude that cleaning, disinfection, and sterilization procedures for gastrointestinal endoscopic instruments vary, that appropriate protective apparel is not always worn, and that some practices may lead to preventable endoscopy-related infection in patients.

Infection control practices in gastrointestinal endoscopy in the United States: a national survey.

OBJECTIVE: To ascertain current infection control practices, endoscope cleaning procedures, perceived risks of infection, and implementation of universal precautions in gastrointestinal endoscopy units in the United States. DESIGN: National mailed survey of gastroenterology nurses and associates conducted anonymously in March 1988. SETTING: Completed surveys were received from all 50 states and Puerto Rico and from all practice settings. The most common practice setting was private/community hospitals (66%). PARTICIPANTS: Of the 4,952 survey forms mailed to all members and to interested nonmembers of the Society of Gastrointestinal Nurses and Associates, 2,158 (44%) were returned and 2,030 (41%) were completed and evaluable. Of the respondents, 1,487 (73%) were registered nurses. RESULTS: Sixty-seven percent (n = 1,358) of the respondents routinely used an enzymatic cleaner as a step in the instrument decontamination process; 93% (n = 1,879) chemically disinfected instruments after each case; and 88% (n = 1,779) disinfected endoscopes with an aqueous glutaraldehyde product. Respondents reported that they and a significantly smaller proportion of physicians (p less than .001) employed barrier precautions for all endoscopic cases involving possible contact with blood/body fluids of patients known (66% versus 57%, respectively) and not known (12% versus 8%, respectively) to have a bloodborne infection. Endoscopy-related infections, usually bacterial, were reported to have occurred at their institutions by 6% (n = 116) of respondents. CONCLUSIONS: We conclude that cleaning, disinfection, and sterilization procedures for gastrointestinal endoscopic instruments vary, that appropriate protective apparel is not always worn, and that some practices may lead to preventable endoscopy-related infection in patients.

Effect of admission nutritional status on length of hospital stay.

Malnutrition is a large problem among patients admitted to U.S. hospitals and is an area of increasing concern for GI health care professionals. We conducted a prospective assessment of the admission nutritional status of 500 consecutive patients admitted to the Huntington Veterans Affairs Medical Center. Admission nutritional status was compared to the length of hospital stay (LOS). Nutritional status was calculated based on three equally weighted and easily obtained parameters--serum albumin, total peripheral blood lymphocyte counts and unintentional weight loss over time. A significant difference (p less than 0.01) was noted for the LOS between patients with normal, mildly abnormal and moderately abnormal nutritional status as compared with the patients with severe malnutrition. The length of hospital stay progressively increased with deterioration of nutritional status. The GI practitioner is in a key position to assess nutritional status of hospitalized patients. If malnutrition can be documented on hospital admission, attempts can be made to reverse the malnutrition and hopefully diminish LOS.