A core curriculum for the continuing professional development of nurses: Developed by the Education Committee on behalf of the Council on Cardiovascular Nursing and Allied Professions of the ESC

Background: The European Society of Cardiology and the Council on Cardiovascular Nursing and Allied Professions share a vision; to decrease the burden of cardiovascular disease in Europe. Nurses represent the largest sector of the health professional workforce and have a significant contribution to make, which has not yet been fully realised. Recent evidence highlights an association between the level of nurse education and inpatient mortality making this an important topic, particularly as the provision of nurse education in Europe is variable. Aim: To develop a core curriculum to inform the education of nurses following initial qualification for work in cardiovascular settings. Method: A syllabus was developed using published literature, policy documents and existing curricula with expert input from service users, specialist nurses, cardiologists, educationalists and academics. The syllabus formed the framework for the development of the core curriculum. Results: Eight key themes characterise the core curriculum which are presented together with an account of the development process. While the curriculum is not intended to cover all aspects of the highly complex role of the cardiovascular nurse, the themes do exemplify the science and art of nursing and are transferable across different levels of clinical practice and settings. The curriculum functions both as a ‘map’, which identifies key themes to include in nurse education, and as a ‘tool’ to inform educational provision that bridges’ the gap between initial nurse education and advanced specialist practice. Content can be adapted for use to fit the national context and reflects the specific needs, health priorities, legislative and regulatory standards that govern safe nursing practice across different countries. Conclusion: The core curriculum can be used as a learning framework to guide nurse education, in particular the continuing professional education of post-qualifying nurses working in cardiovascular settings. This represents a significant step towards streamlining cardiovascular nurse education in Europ

Predictors of Childhood Exposure to Parental Secondhand Smoke in the House and Family Car

Childhood exposure to secondhand smoke (SHS) is a serious threat to public health and can be influenced by parental lifestyle habits and beliefs. Taking the above into account we aimed at locating predictors of parental induced exposure to SHS in the house and family car among 614 children who visited the emergency department of two large pediatric hospitals in Athens, Greece. The multivariate analysis revealed that the factors found to mediate household exposure to paternal SHS were the number of cigarettes smoked per day (O.R 1.13, p<0.001) while, having a non-smoking spouse had a protective effect (O.R 0.44, p=0.026). Maternally induced household SHS exposure was related to cigarette consumption. For both parents, child exposure to SHS in the family car was related to higher numbers of cigarettes smoked (p<0.001), and for fathers was also more often found in larger families. Additionally, lower educated fathers were more likely to have a spouse that exposes their children to SHS inside the family car (O.R 1.38 95%C.I: 1.04–1.84, p=0.026). Conclusively, efforts must be made to educate parents on the effects of home and household car exposure to SHS, where smoke free legislation may be difficult to apply

A Core Curriculum for the Continuing Professional Development of Nurses Working in Cardiovascular Settings: Developed by the Education Committee of the Council on Cardiovascular Nursing and Allied Professions (CCNAP) on behalf of the European Society of Cardiology

status: publishe

The Relationship between Workplace, Job Stress and Nurses’ Tobacco Use: A Review of the Literature

The aim of this study was to provide a summary of the existing published knowledge on the possible relationship between the workplace as a stressor factor and nurses’ tobacco use. A systematic review of the literature from 1995 to 2009, using the MEDLINE database took place. Studies, that referred to nurses’ smoking habit exclusively or as a part of the study, were included in the review. 491 studies were retrieved and their titles/abstracts were examined systematically. Twenty one studies were retrieved for further consideration by a comprehensive literature review. Ten studies fulfilled the eligibility criteria and they were examined further. There is a conflict on the possible relationship between workplace as a stressor factor and nurses’ smoking habits, because there is no evidence on if the nurses’ work environment causes smoking initiation

Comparative evaluation of substance P levels in critically ill adults with acute pain

Introduction: The investigation of objective indicators for assessing pain in critically ill adults unable to communicate, is of great interest for intensive nursing. Substance P (SP) is a pain neuropeptide, which affects the release and production of cytokines. Aim: of the study was to investigate: a) the SP plasma levels in critically ills adults, b) the correlation between SP plasma levels of individuals with acute myocardial infarction with ST elevation and the intensity of pain c) potential correlations between the SP levels, the perception of pain and biochemical markers of tissue damage and patients’ clinical severity. Method: A prospective non-experimental study with repeated measurements and sectional comparisons was conducted in a convenience sample consisted of 40 patients with STEMI.in two groups of intubated critically ill adults, with and without apparent tissue injury (n = 40 and 40 respectively), and a group of healthy volunteers (n = 40), in which, blood plasma levels of SP, IL-6, IL-8, Fas and FasL were quantified by immunosorbent assay (ELISA). The numerical analog scale and pain scales Payen and Puntillo were used for the pain intensity assessment, while stress was measured using numeric 0-10 scale and scales ICUESS, HADS, Zung, and Hamilton. The statistical analysis was conducted with the SPSS 19.0. Results: The levels of SP in plasma showed no statistically significant differences between repeated measurements for each study group, nor between the groups. Instead, the group of patients with STEM I was found statistically significant variation in concentration of IL-6 and FasL at different times points of hospitalization and reduction of the concentration of IL-8, the Fas and FasL in plasma compared to controls. Also, there were found elevated levels of IL-6 and Fas, reduced levels of FasL and significant variation in plasma levels of IL-8 and FasL in intubated patients, with apparent tissue injury, compared to healthy volunteers. The intensity of the pain behavioral scales correlated with the concentration of IL-6 and markers Fas and FasL, for all patients and for both groups of intubated patients. Statistically significant correlation was found between both Fas and FasL and disease severity scores, as well as between SP plasma levels and depression. Conclusions: The SP plasma levels was not found as a pain intensity indicator, but the levels of IL-6, Fas and FasL appear to correlate with the subjective assessment of pain intensity. Further studies in this direction may reveal important findings for the objective measurement of pain, using biochemical markers.Εισαγωγή: Η διερεύνηση αντικειμενικών δεικτών εκτίμησης του πόνου σε άτομα που δεν επικοινωνούν είναι μεγάλου ενδιαφέροντος για την εντατική νοσηλευτική. Η ουσία P (SP) θεωρείται νευροπεπτίδιο πόνου, η έκλυση του οποίου επηρεάζει και την παραγωγή των κυτοκινών. Σκοπός: της μελέτης ήταν η διερεύνηση: α) των επίπεδων SP στο πλάσμα βαρέως πασχόντων νοσηλευόμενων σε μονάδα εντατικής θεραπείας, β) της συσχέτισης των επιπέδων της SP στο πλάσμα ατόμων με οξύ έμφραγμα του μυοκαρδίου με ανάσπαση του ST (STEMI) και του βαθμού του πόνου που βιώνουν, γ) δυνητικών συσχετίσεων μεταξύ των επιπέδων SP, της αντίληψης του πόνου και βιοχημικών δεικτών ιστικής βλάβης και κλινικής βαρύτητας των ασθενών. Μέθοδος: Προοπτική μη πειραματική μελέτη με επαναλαμβανόμενες μετρήσεις και συγχρονικές συγκρίσεις σε δείγμα ευκολίας 40 ασθενών με STEMI, δύο ομάδων βαρέως πασχόντων που νοσηλεύονταν σε μονάδα εντατικής θεραπείας, με και χωρίς εμφανές ιστικό τραύμα (ν=40 και 40 αντίστοιχα), και σε μία ομάδα υγιών εθελοντών (ν=40), στις οποίες εκτιμήθηκαν στο πλάσμα αίματος τα επίπεδα των SP, IL-6, IL-8, Fas και FasL. Τα επίπεδα των παραγόντων ποσοτικοποίηθηκαν με ανοσοενζυμική μέθοδο (ELISA). Η εκτίμηση της έντασης του πόνου έγινε με την αριθμητική αναλογική κλίμακα και τις κλίμακες πόνου Payen και Puntillo, ενώ το στρες μετρήθηκε με αριθμητικές κλίμακες 0-10 και τις κλίμακες ICUESS, HADS, Zung και Hamilton. Η στατιστική επεξεργασία των δεδομένων πραγματοποιήθηκε με το SPSS 19.0. Αποτελέσματα: Τα επίπεδα της SP στο πλάσμα δεν εμφάνισαν στατιστικά σημαντικές διαφορές μεταξύ των επαναλαμβανόμενων μετρήσεων για την κάθε ομάδα της μελέτης, αλλά ούτε και μεταξύ των ομάδων. Αντίθετα, στην ομάδα ασθενών με STEMI παρατηρήθηκε στατιστικά σημαντική διακύμανση της συγκέντρωσης της IL-6 και του FasL στις διαφορετικές χρονικές στιγμές νοσηλείας και μείωση της συγκέντρωσης της IL-8, του Fas και του FasL στο πλάσμα σε σχέση με την ομάδα ελέγχου. Ακόμη βρέθηκαν αυξημένα επίπεδα IL-6 και Fas, μειωμένα επίπεδα FasL και σημαντική διακύμανση των επιπέδων της IL-8 και του FasL στο πλάσμα διασωληνωμένων ασθενών, με εμφανές ιστικό τραύμα, σε σχέση με το πλάσμα υγιών εθελοντών. Η ένταση του πόνου με τις συμπεριφορικές κλίμακες συσχετίστηκε με τη συγκέντρωση της IL-6 και τους δείκτες Fas και FasL, για το σύνολο των ασθενών και για τις ομάδες των διασωληνωμένων ασθενών. Στατιστικά σημαντική συσχέτιση βρέθηκε μεταξύ των Fas και FasL, με τις κλίμακες αξιολόγησης βαρύτητας της νόσου και της SP με την κατάθλιψη. Συμπεράσματα: Η συγκέντρωση της SP δεν αποτέλεσε δείκτη εκτίμησης της έντασης πόνου, ωστόσο τα επίπεδα της IL-6, του Fas και του FasL φαίνεται ότι συσχετίζονται με την αντικειμενική εκτίμηση της έντασης του πόνου. Περαιτέρω μελέτες προς την κατεύθυνση αυτή μπορεί να αναδείξουν σημαντικά ευρήματα για την αντικειμενική μέτρηση του πόνου, μέσω βιοχημικών δεικτών

Streamlining educational provision for cardiovascular nurses: A beginning not an end

Nurses represent the largest sector of the healthcare workforce with about six million of us in the World Health Organization (WHO) European Region alone, but although this workforce is significant, it is not predicted to be sufficient to meet future healthcare needs.1 The profession of nursing faces several important challenges around its workforce which are also relevant to cardiovascular care settings. First, how can we attract new recruits to the nursing profession? Second, how can we streamline the provision of nurse education across our region? Third, how can we provide colleagues with opportunities for continuing professional development (CPD) to support lifelong learning and enable nurses to work to their full potential? Access to graduate level and continuing education has something to offer in all of these scenarios and is the way forward to strengthen the identity of the nursing profession

Evaluation of the medication process in pediatric patients: a meta-analysis

OBJECTIVE: to meta-analyze studies that have assessed the medication errors rate in pediatric patients during prescribing, dispensing, and drug administration. SOURCES: searches were performed in the PubMed, Cochrane Library, and Trip databases, selecting articles published in English from 2001 to 2010. SUMMARY OF THE FINDINGS: a total of 25 original studies that met inclusion criteria were selected, which referred to pediatric inpatients or pediatric patients in emergency departments aged 0-16 years, and assessed the frequency of medication errors in the stages of prescribing, dispensing, and drug administration. CONCLUSIONS: the combined medication error rate for prescribing errors to medication orders was 0.175 (95% Confidence Interval: [CI] 0.108-0.270), the rate of prescribing errors to total medication errors was 0.342 (95% CI: 0.146-0.611), that of dispensing errors to total medication errors was 0.065 (95% CI: 0.026-0.154), and that ofadministration errors to total medication errors was 0.316 (95% CI: 0.148-0.550). Furthermore, the combined medication error rate for administration errors to drug administrations was 0.209 (95% CI: 0.152-0.281). Medication errors constitute a reality in healthcare services. The medication process is significantly prone to errors, especially during prescription and drug administration. Implementation of medication error reduction strategies is required in order to increase the safety and quality of pediatric healthcare