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Biomedical subjects

D Pelletier

Publications and source records attributed to D Pelletier.

At least 37 records · Page 2Linked to original sources
PubMed1996

The impact of the technological care environment on the nursing role.

Proliferation of acute health care technology creates problems and benefits for nurses and patients. In this paper the impact of technology on the nursing work role is reviewed through the international literature. The thrust of the nursing literature has, not surprisingly, matured over time as the use of technology has become well established in the acute care environment, and three themes can be identified. The implications for acute care nurse specialists, including their educational needs, are set in context of the Australian health care system, with particular reference to the cardiac care environments.

Australia↗
PubMed1996

Do clinical nurse specialists and nursing unit managers believe that the provision of quality care is important?

The nursing profession has a long tradition of evaluating the quality of its product in order to ensure that the best possible care can be given. However, in the climate of economic rationalism which prevails worldwide, it is possible that the emphasis on fiscal restraint has distracted nurses from their previous focus on quality. This paper discusses the findings of two research studies designed to determine the competencies expected of nursing unit managers and clinical nurse specialists. Discussion focuses specifically on their roles in the provision of quality care.

Clinical Competence↗
PubMed1995

Diploma-prepared nurses' use of technological equipment in clinical practice.

Increasingly, nurses throughout the western world are receiving their educational preparation for initial registration in a tertiary environment at either the diploma or bachelor degree level. The length of time spent in the clinical setting has been reduced considerably, with the elimination of the apprenticeship system and the role of the student nurse as paid staff member. Concurrently, the amount of technological equipment used in the health care sector is both increasing rapidly and now found in general wards, not just the traditional 'high tech' environments. It is important to evaluate how well the tertiary experience prepares students in terms of their ability to handle common technological equipment such as infusion control devices or suction pumps. In the study reported here 245 diploma-prepared registered nurses completed a questionnaire designed to assess how nurses from tertiary institutions perceived their ability to handle technical equipment in the workplace. The majority of the respondents had been working for 7 to 12 months. No significant relationship was found between the frequency of use of specific items of clinical equipment and whether that item caused the nurse concern in practice. There was also no significant relationship between the frequency of use of an item and whether participants believed that competence should be acquired in relation to that item prior to tertiary graduation. Although moderate levels of comfort in the use of technical equipment were reported upon entry to the workplace, subjects rapidly acquired high levels of comfort in relation to equipment handling. The implications for hospital administrators and tertiary teaching programmes are discussed.

Adult↗
PubMed1995

CNSs' perceptions of role competencies: one Australian perspective.

A survey of 373 CNSs employed in hospitals in New South Wales, Australia, was undertaken to determine the competencies they believed necessary to fulfill that role. This study was designed as a sequel to a similar study of role competencies of first-line nurse managers in the same state. Factor analysis was used to identify a variety of role dimensions. Results indicate that CNSs perceive their role as extremely comprehensive, yet a significant potential to overlap with the role of managers was evident. In addition, some interesting features of the CNS role emerged that may generate both professional approval and concern. The strength of the respondents' acceptance of competencies that link their clinical role to activities that directly influence the quality of care is heartening; however, a number of clinically based competencies, including some of those related to patient care management or quality of care, either loaded weakly or did not load at all on the factor structure. Concern may be felt regarding the claim of these specialized clinicians to competencies traditionally seen as strongly associated with the managerial role. Should specialist clinicians take on too many managerial functions, significant role overload could result, and affect quality care provision.

Attitude of Health Personnel↗
PubMed1995

A profile of the clinical nurse specialist in one Australian state.

The nursing profession in Australia implemented progressively in each state new clinical career structures commencing in 1986. While the structures differ, all states introduced the position of CNS. The role and responsibilities associated with this position also differ. The role of CNS in Australia is different from that described in the North American literature. Findings of a study that established a profile of CNSs in the heavily populated state of New South Wales are described. Data on education, experience, and career plans were obtained from 373 CNSs in 19 hospitals. The results enable some comparison with first-line nurse managers whose role is very similar to the American position of head nurse. As with their managerial counterparts, the Australian CNSs' lack formal educational preparation and were demonstrating a low rate of participation in educational programs at the time of the study. However, 82% of respondents intended to remain in clinical practice. This is significant since this was a major goal in development of a clinical career structure.

Adult↗
PubMed1995

How should enzyme activities be used in fish growth studies?

The activity of glycolytic and oxidative enzymes was monitored in the white muscle of Atlantic cod Gadus morhua experiencing different growth rates. A strong positive relationship between the activity of two glycolytic enzymes and individual growth rate was observed regardless of whether the enzyme activity was expressed as units per gram wet mass, units per gram dry mass or with respect to muscle protein and DNA content. The most sensitive response to growth rate was observed when pyruvate kinase and lactate dehydrogenase activities were expressed as units per microgram DNA, and this may be useful as an indicator of growth rate in wild fish. In contrast, no relationship between the activities of oxidative enzymes and growth rate was observed when cytochrome c oxidase and citrate synthase activities were expressed as units per gram protein. Apparently, the aerobic capacity of white muscle in cod is not specifically increased to match growth rate.

Journal Article↗
PubMed1994

The effects of graduate nurse education on clinical practice and career paths: a pilot study.

The recent proliferation of graduate courses in nursing has increased the need for educational administrators to evaluate the impact of such programmes on clinical practice and the career of participants. 40 registered nurses undertaking graduate studies were surveyed as a pilot for an extensive longitudinal study of their perception of the effects of study on work performance and career opportunities. Overall, positive effects were noted by respondents on their job satisfaction, self-esteem, professional thinking and career moves. Increases in professional behaviours such as mentoring, research and writing for publication were noted. Negative consequences were noted by a minority and were related to alterations to health status and increased levels of stress.

Career Mobility↗
PubMed1994

Role overlap between clinical nurse specialists and nursing unit managers.

Role ambiguity is a serious and costly phenomenon that the healthcare delivery system can ill afford. Classically, it results from a lack of clarity or information concerning the expectations of a role, and it often results in several staff members undertaking the same activities. The resultant inefficiencies are costly to the organization because job satisfaction decreases and the number and quality of applicants for positions decline because people are unsure about the role and its functions. The authors describe an example of role ambiguity that resulted when the new classifications of nursing unit manager and clinical nurse specialist were introduced in New South Wales, Australia, in 1986.

Hospital Units↗
PubMed1993

The focused use of posters for graduate education in the complex technological nursing environment.

Posters are increasingly recognised as both a method of professional communication and a strategy for learning and assessment in nurse education. Rapid technological developments in health care and the nursing practice environment are generating specific educational needs in relation to the use of technology. There is a move to incorporate within the traditional rational technical focus a broader, more comprehensive understanding of technology, technological equipment and procedures. Technological innovations are an ideal subject matter for poster presentations at the graduate level particularly as broader dimensions such as the impetus for introduction, the research base, the evaluation strategy and the cost can be incorporated. Each poster can become a teaching focus for a student presentation to classmates or other professional forums in order to catalyse discussions of these wider dimensions. A description of the use of posters for these purposes with examples and comments by participants is included.

Audiovisual Aids↗
PubMed1993

Hematopoietic progenitor content of fetal cord blood collected using citrate-phosphate-dextrose: influence of holding temperature and delays.

Storage of unseparated fetal cord blood collected into citrate-phosphate-dextrose (CPD) for 48 hours has been studied using progenitor cell assays [plasma clot technique with plasma-conditioned medium, erythropoietin (EPO), erythropoietin + IL-3 as growth factors]; collected fetal blood volume was low [61 +/- 4 ml, mean +/- 95% confidence interval (CI)]. The CFU-GM concentration in total cord blood was 2460 +/- 1476 CFU-GM/ml, comparable to normal bone marrow collected into medium RPMI + heparin (2350 +/- 1258); 2 of 12 samples contained fewer than 10(3) CFU-GM. Storage of unseparated cord blood CFU-GM in CPD was better at 4 degrees C (rapid decrease at day (D) 2 from 15 +/- 9 x 10(4) at D0; 14 +/- 11 x 10(4) at D1 to 6 +/- 4 x 10(4) at (D2) than at 22 degrees C (strong decrease since D1: 5 +/- 4 x 10(4) CFU-GM). The CFU-GEMM content remained steady at 4 degrees C: from 16 +/- 16 x 10(4) at D0 to 18 +/- 16 at D2. Cryopreservation and thawing of unfractionated cord blood at D0 did not affect the CFU-FM cloning rates. Whether mature progenitors are more affected than stem cells by storage in CPD remains to be determined.

Adult↗
PubMed1993

Endogenous lymphokine activated killer cell activity and cytogenetic response in chronic myelogenous leukaemia treated with alpha-interferon.

The capacity of alpha-interferon (alpha-IFN) to induce lymphokine activated killer (LAK) cytotoxicity in the absence of interleukin-2 (IL2) has prompted us to test whether or not its ability to reduce dramatically the number of Ph1+ clones in chronic myelogenous leukaemia (CML) patients is in part mediated through the generation of natural killer (NK) or LAK activity. The latter were tested using NK-sensitive (K562) and NK-resistant (Raji) cell lines in a target-cell colony-growth inhibition assay. Effector cells (E) were patient blood mononuclear cells (MC) without in vitro activation prior to their coculture with targets (T). Out of 16 patients tested so far, three failed to undergo cytogenetic remission under alpha-IFN therapy. No NK nor LAK cells could be detected in the MC from two of them while the other displayed NK activity within upper normal limits. 13 patients underwent complete (eight) or partial (five) cytogenetic remission together with significantly high NK and/or LAK activity as compared to normal controls. These observations could favour the hypothesis of an indirect effect of alpha-IFN on leukaemic cells, mediated by cells involved in immune surveillance.

Adolescent↗
PubMed1993

First-line nurse managers in NSW: perceived role competencies (Part I).

A survey of 412 first-line nurse managers employed in hospitals in New South Wales, Australia was undertaken to determine the competencies they believed an individual should possess to fulfil that managerial role. Factor analyses identified both the significant functions of the role as well as areas of role conflict and confusion. Thirteen factors identified from four major scales indicated that first-line nurse managers perceived their role to be extremely comprehensive in terms of managerial knowledge and skills. The analyses clearly indicate that competencies related to staffing and financial issues are perceived to be essential to role performance. However, the correlation coefficients (factor loadings) indicate that ambiguity exists with competencies concerning patient care, perhaps as the remnants of the charge nurse role are discarded.

Clinical Competence↗
PubMed1993

First-line nurse managers in NSW: perceived role competencies (Part II).

A survey of 412 first-line nurse managers employed in hospitals in New South Wales, Australia was undertaken to determine the competencies they believed an individual should possess to fulfil that managerial role. Factor analyses identified both significant functions of the role as well as areas of role conflict and confusion. 13 factors were identified from 4 major scales indicating that first-line nurse managers perceived their role to be extremely comprehensive in terms of managerial knowledge and skills. The analyses clearly indicate that competencies related to staffing and financial issues are perceived to be essential to role performance. However, the correlation coefficient (factor loadings) indicate that ambiguity exists with competencies concerning patient care, perhaps as the remnants of the charge nurse role are discarded. The findings in this study have been presented in two parts: Part 1 discussed the factors identified in two scales, Functional Management and Patient Care Management; Part II discusses the factors identified in the remaining two scales, Staff Management and Leadership (subdivided into two subscales for analysis).

Clinical Competence↗
PubMed1991

Assessment of children's social problem-solving skills in hypothetical and actual conflict situations.

This study compared the social problem-solving skills of 57 maladjusted and 57 well adjusted first and second graders in a series of hypothetical and actual provocations. All children were asked how they would react to four video-taped provocations involving same-age peers. They were also exposed to three provocations simulated by a peer-confederate; their verbal and nonverbal behaviors were videotaped. Multivariate analyses of variance indicated that, overall, maladjusted subjects displayed less assertiveness and more verbal and nonverbal aggressive responses to the actual provocations. Conversely, hypothetical situations yielded few between-group differences with respect to verbal strategies. The validity of hypothetical situations is questioned; the importance of actual situations for assessment and intervention purposes is stressed.

Aggression↗
PubMed1990

Health promotion as a nursing function: perceptions held by university students of nursing.

Health care in Australia is more often perceived to be illness rather than health focused in nature. The increasing cost of health care has prompted a movement towards health promotion in the community demanding increasing involvement of health care professionals. This three year study was undertaken to determine the attitudes of students towards health promotion on entry and throughout a tertiary nursing programme. This longitudinal study was exploratory in nature and examined the attitudes of two student cohorts over the programme's three years. Entering students cited the health promotion function more frequently than did those nearing programme completion. There is a need to emphasise health promotion as a role if this is seen as desirable behaviour for comprehensively educated nurses. The perceptions of three intakes of students were examined. The function of health promotion was perceived to be important by entry students and was within the three most frequently mentioned functions.

Attitude of Health Personnel↗
PubMed1990

Evidence that downregulation of hexose transport limits intracellular glucose in 3T3-L1 fibroblasts.

Measurements of initial glucose entry rate and intracellular glucose concentration in cultured cells are difficult because of rapid transport relative to intracellular volume and a substantial extracellular space from which glucose cannot be completely removed by quick exchanges of medium. In 3T3-L1 cells, we obtained good estimates of initial entry of [14C]methylglucose and D-[14C]glucose with 1) L-[3H]glucose as an extracellular marker together with the [14C]glucose or [14C]methylglucose in the substrate mixture, 2) sampling times as short as 2 s, 3) ice-cold phloretin-containing medium to stop uptake and rinse away the extracellular label, and 4) nonlinear regression of time courses. Methylglucose equilibrated in two phases--the first with a half-time of 1.7 s and the second with a half-time of 23 s; it eventually equilibrated in an intracellular space of 8 microliters/mg protein. Entry of glucose remained almost linear for 10 s, making its transport kinetics easier to study (Km = 5.7 mM, Vmax = 590 nmol.s-1.ml-1 cell water). Steady-state intracellular glucose concentration was 75-90% of extracellular glucose concentration. Cells grown in a high-glucose medium (24 mM) exhibited a 67% reduction of glucose-transport activity and a 50% reduction of steady-state ratio of intracellular glucose to extracellular glucose.

Animals↗