An exploratory-descriptive design was used to explore and describe knowledge and perceptions about the organ donation process of persons who had consented for their relatives organs to be donated. A 19 question mailed survey was administered to 110 people who met study criteria. Descriptive methods were used to analyze the data. Less than half of the respondents had discussed organ donation previously or knew if their relative carried a donor card, they indicated that they understood the concept of brain death and its cause. These families were positive about their decision to donate and perceived altruism as the most positive aspect of the process. The most difficult aspect of the donation process emerged as "reality of death." Nurses are a critical link in the organ donation process. Results of this study are useful for nursing assessment, diagnosis, and formulation of care plans for families in the position to donate organs.

Appropriate use of intensive care units is imperative. The purpose of the study was to describe severity of illness and nursing intervention scores of ICU patients at admission, discharge, and readmission, and to investigate whether severity of illness and nursing care needs influenced ICU discharge. Retrospective chart reviews were conducted at a Level I University affiliated medical center. Severity of illness (APACHE II) and nursing care needs (NIS score) were determined for ICU admission and discharge. Of the 123 subjects studied, 11 died; 10 subjects were readmitted. APACHE II and NIS scores decreased significantly between admission and discharge. The ICU survivors demonstrated a wide range of APACHE II and NIS scores. It was concluded that discharge appeared to be based an some recovery rather than recovery to a certain level. Development of objective tools to assess physiologic status and nursing care needs would assist in the appropriate admission and discharge of patients.

Currently 12% of the U.S. population is over the age of 65, and by the year 2030 this number is projected to be 25% (U.S. Senate Special Committee on Aging (SSCA), 1990). It is estimated that 37% of people over age 55 have an alcohol or substance abuse problem (Subcommittee on Health and Long-Term Care (SHLTC), 1992). Failure to recognize the elderly alcoholic results in delayed treatment and as a result, the older drinker suffers adverse effects related to the disease (Metzger & O'Brien, 1990). Extant tools for detecting alcoholism have been developed and used in younger populations, however there is a lack of information about the use of these tools in older populations (Graham, 1986). This study examined differences between two different age groups of known alcoholics using an established instrument, the Alcohol Use Inventory (Horn, Wanberg, & Foster, 1986).

Grounded theory methodology was used to describe the perceptions of five birthmothers relating to the surrender of their children for adoption. Data analysis revealed a process whereby birthmothers create patterning in their lives that encompass the major concepts of Hurting, Healing, and Creating Meaning. The phenomena of 'Creating Meaning' began for each woman with the surrender of their child for adoption. Following the surrender, periods of hurting were experienced by each birthmother. The continuation of life events led each woman to also experience healing interludes. As interactions with important others, themselves, and the environment evolved, an increasing awareness of the overall impact of the surrender emerged for each birthmother. This research represents initial work in an area with limited previous knowledge and delineates a first step in the discovery of the process used by birthmothers in creating meaning in their lives after the surrender of a child for adoption.

Healing is a human experience of primary concern to nurses. Understanding the experience of healing can offer nurses insight and possibly new ways to support healing in others. Healing Touch is an energy based therapeutic modality used to promote healing. With Healing Touch as one path and phenomenology as a guide, the lived experience of healing was explored. After analysis of the data from taped interviews the essential structure of the experience of healing was determined. Many similarities were found with literature and previous studies. Healing is described as a process, requiring active participation and effort through which a person becomes more aware with a higher consciousness, a sense of self worth and a feeling of serenity and joy. From this process and the many suggested paths, a prescription for healing emerged.

Managed care has been proposed as a system for decreasing the cost and improving the quality of care to hospitalized patients. Critical paths, which time and sequence nursing and medical interventions, are an integral part of managed care. The purpose of this study was to describe the relationships between use of the critical paths and selected patient outcomes: length of hospital stay, mobility, pain medication regimen, and bowel regimen. A retrospective record review of hospital care for adults, having total hip replacements (n = 30), and total knee replacements (n = 30) suggested that the critical paths were used more intensively with patients having knee replacements. Although significant relationships between the intensity of use of the critical paths and patient outcomes were not found in this study, some of the findings were in the predicted direction.

Military nurses are often faced with uncertainty in their careers. The potential for deployment raises several concerns: family security, personal safety, and appropriate training to meet the requirements of deployment. Effectively managing these concerns necessitates coping skills and a supportive environment. Using grounded theory, three Air Force nurses were interviewed about their experience of deployment in support of Desert Shield/Storm. From these interviews, a theory emerged of Camaraderie, Patriotism, and Personal Growth as defining the experience. Camaraderie had three dimensions: Physical, Emotional, and Psychological. Despite the stressors encountered throughout the period of time deployed, the experience was described as an overall positive event. This study was an initial attempt to define the experience of deployment. Nurses facing future deployments could use this theory to design supportive processes to ensure a positive experience.

Tepid sponge baths can distress febrile children, and are of unproven value for reducing fever. This study compared the cooling effect of acetaminophen alone, and acetaminophen plus a 15 minute tepid sponge bath. Twenty children (age range: 5 to 68 months) seen at the Urgent Care or Emergency Department with fever of ≥ 38.9°C were randomized to receive (1) no sponge bath, or (2) a 15 minute sponge bath 30 minutes after the acetaminophen. Subjects received a 15 mg/kg dose of acetaminophen. Tympanic temperature was monitored every 30 minutes for two hours, and subjects were monitored for signs of discomfort (crying, shivering, goosebumps). Significance level was set at 0.05. Sponge bathed subjects cooled faster during the first hour; however, there was no significant difference between groups in overall temperature change after two hours. Sponge bathed subjects had significantly higher discomfort scores during the bathing period only (p ≤ 0.009).

The purpose of this research was to describe the relationship between maternal perception of infant health, reliance on others and caregiving in mothers of low birth weight (LBW) (ṉ = 30) infants and mothers of normal birth weight infants (ṉ = 30). A descriptive research design was used for a secondary analysis of data. Significant relationships were found between maternal perception of: infant health and caregiver burden (R² =.29, p̱ ≤ .001); confidence in caregiving and caregiver burden (R² change =.12, p̱ ≤ .01); infant health and confidence in caregiving (R² change =.18, p̱ ≤ .001); and preparation for caregiving and confidence in caregiving (R² change =.10, p̱ ≤ .02). A significant difference was found between mothers of LBW infants and mothers of normal birth weight infants in their perception of infant health (ṯ (58) = -2.02, p̱ ≤ .05) and caregiver burden (ṯ (58) = -3.50, p̱ ≤ .001).

The purpose of this study was to describe the characteristics of falls and risk factors for falls in elderly male veterans residing in a Veterans Affairs nursing home care unit. Risk factors included cognitive status, mobility status, and restraint use. Relationships between risk factors and falls were investigated using a two-phase descriptive correlational design. Nursing and medical records of residents who fell were reviewed retrospectively, and assessment of cognitive status was done using the Mini-mental Status Exam. The convenience sample included 20 male veterans, age 65 and older, who had at least one documented fall from the year of January 1991 through December, 1991. Results were not statistically significant; however, trends in the data were identified. Findings were clinically significant and validated literature on risk factors for falling.