American Journal of Nursing Research

In hospitals and other health settings expert nurses are central to ensure the efficacy and efficiency of patient care. Hospital quality and safety policies contribute in promoting and ensuring expertise among their staff to improve patient health outcomes. To allow design of these policies, research is currently needed to understand how to apply two well-established definitions of expert nurse: (i) the influence of hospital contextual factors, as well as (ii) nursing practice levels. The former were previously studied in a large nurse sample of a hospital in Pennsylvania (USA). The later were characterized in P Benner’s theory. In spite of their key importance, these two criteria are not yet standardized in nurse staffing policies. Here, the nurse expertise level following these two criteria was assessed in a University Hospital of Catalonia (Spain). To that end, we acquired primary data on the individual nurse education and experience, thereby contributing to define nurse expertise. Our findings of this cross‐sectional study from 167 registered nurses showed that the hospital indeed adheres to the two definitions of expert nurse. Further, we characterized key markers such as a statistically significant association found between a nurse reporting a more advanced expertise level and a threshold of at least five years of experience and at least one year of postgraduate studies. This result is supported in current literature. In the future, further research along these lines will hopefully aid to clarify the relationship between nurse expertise and patient health outcome.

American Journal of Nursing Research. 2014, 2(3), 50-56. DOI: 10.12691/ajnr-2-3-4
Pub. Date: December 08, 2014

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Isolation of Bacteria from Commonly Used Antiseptic and Disinfectant Solutions in Gondar University Hospital. North West Ethiopia

by Teshiwal Deress, Mekonnen Girma, Wubet Birhan, Belete Biadgo, Teklay G/cherkos and Agersew Alemu

Original Research

Background: Antiseptics and disinfectants are chemical agents that inhibit or destroy microorganisms on living tissue (antiseptics) and on inanimate surfaces and objects (disinfectants). These chemical agents have been used extensively in hospitals and other health care settings for a variety of topical and hard surface applications. Objective: The aim this study was to determine bacterial contamination of commonly used antiseptic and disinfectant solutions and to perform antimicrobial susceptibility test of isolates in Gondar University Hospital, Northwest Ethiopia. Methods: In this cross sectional study a total of 86 diluted antiseptic and disinfectant samples were collected and assessed for possible bacterial contamination. Isolation of bacterial contaminants was done by culturing for aerobic bacteria on blood and Mac Conkey agar plates using surface plating method. Preliminary identification of bacteria was made based on gram reaction and colony characteristics. Further identification of bacteria was made using a series of biochemical tests then antibiotic susceptibility patterns of bacterial isolates were determined as per the standard procedures using 7 antimicrobial agents. Finally data were calculated manually using scientific calculator. Results: Among 86 samples studied, 3 (3.5%) of them were contaminated by aerobic bacteria. All the bacterial isolates were Klepssilla species (3K. pneumonia and 1 K. ozanae). These bacterial contaminants were isolated from 2 samples of 0.05% bleach and 1 sample of 70% alcohol. All the three isolates of K. pneumonia were multi-drug resistant, while K. ozanaewas sensitive to all antimicrobial agents tested. Conclusion and recommendation: The contamination of diluted antiseptic and disinfectant solutions was as high 3(3.5%). All the bacterial contaminants of these antimicrobial substances were Klebsiellaspecies of which all K. pneumonia species were multidrug resistant that poses a health risk to patients. Periodic assessment of antiseptic and disinfectant solutions for possible microbial contamination should be conducted.

American Journal of Nursing Research. 2014, 2(3), 44-49. DOI: 10.12691/ajnr-2-3-3
Pub. Date: November 16, 2014

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Nursing Intervention for Management of Patients with Dyspnea at Emergency Units in Baghdad Hospitals

by Ali D. Abbas

Original Research

Objective(s): The study aims are to check the nursing intervention practices by nurses for management dyspnea for patients in emergency units and to find out the relationship between the nursing intervention and the demographic characteristics that includes (age, gender, level of education, years of experience, and training session). Methodology: Quantitative design (a descriptive study). The study was conducted in Baghdad Hospitals (Baghdad Teaching Hospital; Al - Shaheed Sadr General Hospital Education, and Al-Kindi Teaching Hospital) Starting from July 2^nd 2014 up to the 10^th of September 2014. To achieve aims the study, a non-probability (purposive) samples of (50) a nurse who was consisted of all nurses who provide emergency nursing care for patients which has a dyspnea and according to special criteria. The Data were collected by check list observation as a means of data collection. Nurses were observed while they are working at the emergency unit during three time periods divided by the 24 hours. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was determined by Pearson correlation coefficient for the researcher and co-observe reliability approach, which was (0.82). Data analysis were performed through descriptive statistics (frequency, percentage, mean of score, Relative sufficiency) and inferential statistics (Chi-square (x²) test). Results: The results of the study indicated the evaluation of relative sufficiency for nursing intervention for management dyspnea for patients at the emergency unit was low and there is no significant association between ages, gender, level of education, years of experience in emergency unit, training session of sample and nursing intervention scores. Conclusion: The study concluded that the most of nurses who work at emergency unit have inadequate skills to manage dyspnea. Recommendations: The study recommended the need to develop and carry out special training programs for nurses to enhance their skills in the field of nursing care for patients with dyspnea.

American Journal of Nursing Research. 2014, 2(3), 38-43. DOI: 10.12691/ajnr-2-3-2
Pub. Date: November 10, 2014

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Psychiatrics Disorders in Crack and Cocaine Addicts

by Selene Cordeiro Vasconcelos, Adrielle Rodrigues dos Santos, Ana Luisa Antunes Gonçalves Guerra, Vilmar da Silva Nascimento, Murilo Duarte da Costa Lima, José Francisco de Albuquerque and Iracema da Silva Frazão

Review Article

Objective: The aim of the present study was to determine the most common psychiatric comorbidities among crack/cocaine users. Materials and Methods: Integrative review. The following guiding question was defined: What are the most common psychiatric comorbidities among crack/cocaine users? The controlled descriptors were “Crack”, “Cocaine” and “Dual Diagnosis”. SCOPUS, PUBMED, LILACS and COCHRANE databases were searched by two independent researchers during August of 2014. Results: The most common psychiatric disorders among crack/cocaine users were the following: mood disorders, including depression; bipolar disorder; anxiety disorders, accompanied (or not) by panic attacks; post-traumatic stress disorder; personality disorders, with an emphasis on antisocial personality disorder and schizophrenia. Conclusions: There is a high prevalence of psychiatric disorders among crack/cocaine users and one disorder effects the other. In addition, the present study demonstrated the importance of the impact of a psychopathological comorbidity on the therapeutic success of treatment of cocaine/crack users.

American Journal of Nursing Research. 2014, 2(3), 31-37. DOI: 10.12691/ajnr-2-3-1
Pub. Date: September 15, 2014

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