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Inferential Set Adoption by Nursing Students
This study examines nursing students' adoption of inferential sets in a clinical situation. The investigation determines (1) the particular inferential set(s) nursing students adopt toward a patient in a clinical situation; (2) the particular inferential set(s) adopted by sophomore and senior nursing students in a clinical situation; and (3) whether or not inferential sets adopted by the sophomore and senior nursing students differ. Sophomore and senior nursing students at a woman's university in Texas were asked to complete a research tool designed to determine inferential set adoption
Prevalence and determinants of QT interval prolongation in medical inpatients.
BACKGROUND: QT interval prolongation carries an increased risk of torsade de pointes and death.
AIM: We sought to determine the prevalence of QT prolongation in medical inpatients and to identify determinants of this condition.
METHODS: We enrolled consecutive patients who were admitted to the internal medicine ward and who had an electrocardiogram performed within 24 h of admission. We collected information on baseline patient characteristics and the use of QT-prolonging drugs. Two blinded readers manually measured the QT intervals. QT intervals were corrected for heart rate using the traditional Bazett formula and the linear regression-based Framingham formula. We used logistic regression to identify patient characteristics and drugs that were independently associated with QTc prolongation.
RESULTS: Of 537 inpatients, 22.3% had a prolonged QTc based on the Bazett formula. The adjusted odds for QTc prolongation based on the Bazett correction were significantly higher in patients who had liver disease (OR 2.9, 95% CI: 1.5-5.6), hypokalaemia (OR 3.3, 95% CI: 1.9-5.6) and who were taking ≥1 QT-prolonging drug at admission (OR 1.7, 95% CI: 1.1-2.6). Overall, 50.8% of patients with QTc prolongation received additional QT-prolonging drugs during hospitalisation.
CONCLUSIONS: The prevalence of QTc prolongation was high among medical inpatients but depended on the method used to correct for heart rate. The use of QT-prolonging drugs, hypokalaemia and liver disease increased the risk of QTc prolongation. Many patients with QTc prolongation received additional QT-prolonging drugs during hospitalisation, further increasing the risk of torsade de pointes and death