The Multiple Uses of Guided Imagery.

Guided imagery is a therapeutic approach that has been used for centuries. Through the use of mental imagery, the mind-body connection is activated to enhance an individual's sense of well-being, reduced stress, and reduced anxiety, and it has the ability to enhance the individual's immune system. There are research and data to support the use of guided imagery for these patient outcomes.

Making sense of multiple organ dysfunction syndrome.

Despite recent advances in critical care medicine, caring for patients with MODS remains one of the most challenging experience a critical care can encounter. New therapies that current exist and continue to be developed contribute to successful outcomes for patients with MODS, but there is no substitute for prevention and early intervention for persons at risk for developing MODS. Early and subtle changes in the patient who is at risk and has endured an initial insult can make a great difference in the patient's outcome and chances of mortality. Goal-directed therapy, supportive management, as well as an understanding of the inflammatory process are key to decreasing the mortality rate among patients with MODS.

Bacterial infections: management by acute and critical care nurses.

Acute and critical care nurses must maintain a current knowledge base for advancing science and providing direct care for patients. When an infectious process is involved, it is the practicing nurse who must be knowledgeable in treatment and prevention modalities. The integument is the body's first line of defense for invading bacteria. This barrier to bacteria is followed by inflammation and adaptive immunity, the second and third lines of defense against infectious bacteria. It is acute and critical care nurses, however, who should be the first line of defense in preventing the spread of infectious disease. Modern medicine and common sense interventions reviewed in this article are the patient's best defense to good health and wellness when used by nurses.

Avian influenza: are we ready?

We cannot be certain when the next influenza pandemic will emerge, or even whether it will be caused by avian influenza (H5N1) or some unrelated virus. However, we can be certain that an influenza pandemic will occur. The United States is leading the scientific effort to contain the pandemic through vaccine studies and antiviral studies. The need for pandemic influenza preparedness is extensive and expensive. Planning entails increased development of antivirals and vaccines, effective surveillance systems not only for people, but in agriculture, effective communication systems, plans to continue essential services, identification of health care priorities, and thorough guidelines for care. Critical care nurses, as well as all health care professionals, need to consider where their personal and professional obligations meet and end. There should already be discussions of contingency plan of the institution in which they are employed and the community in which they live. Additionally, a personal plan for their families with regard to economics, safety, and optimizing personal health outcomes during such a crisis should be considered. As many have said, "It is not a matter of if, but rather of when." Although the pandemic might not be the avian flu, history has taught us that pandemics surface with little warning and can have devastating effects on human lives, and can over tax the already fragile health care system.

The influence of technology in nursing education.

The complexity of the relationship between nursing and technology is not new. The complexity has increased with the advent of new technology and technological devices. For faculty who are in the clinical area on a limited basis, and for nurses who are not involved in decisions related to the adoption of technology, terms and concepts related to technology can be misconstrued or misunderstood. An overview of some major terms used in reference to technology and technological approaches can only enhance the intricate relationship between nursing and technology.

Nurse knowledge of intrahospital transport.

Preventable adverse events and other medical errors occur to hundreds of thousands of Americans every year. The financial burden of these preventable events is estimated to be $29 billion. According to the World Health Organization, reducing medical errors has become an international concern. Protecting patients from harm is a primary responsibility of all nurses regardless of whether the nurse works in the intensive care unit or operating room. Adherence to policies to maintain patient safety can be discerned once the level of knowledge of these policies among nurses is determined.

Perioperative nurses' knowledge of indicators for pressure ulcer development in the surgical patient population.

Despite focused attention to improve the quality and safety of patient care, and the financial impact pressure ulcers (PUs) can have on a health care provider or institution, evidence supports that PUs continue to occur in other patient populations during admission to the hospital. An example of a patient population in which evidence indicates that the development of PUs occurs, is patients who have a surgical procedure. The article discusses a project designed to identify potential knowledge deficits among perioperative nurses of indicators for PU development in the surgical patient population.

Working toward cultural competence in the workplace.

Once personal cultural characteristics are identified by the nurse, he/she can begin to hold in abeyance those preconceived beliefs and opinions that may impact a situation. By doing this, the participant deals with the situation in its purest form, and is open to people, ideas, and perspectives of a broader spectrum. These personal cultural characteristics contribute to delivering culturally competent care to a diverse society.

Cytochrome p450, part 1: what nurses really need to know.

Although knowledge about the impact of cytochrome p450 on individual variations in drug response has been known for decades, the transition to clinical practice has not evolved. Nurses who administer and prescribe medications have a responsibility to their patients to understand the responses to medications that are mediated by this family of enzymes. An overview of the variations seen in drug responses based on genetics is presented with discussion focusing on the current prescriptive practices and limitations in clinical drug trials.