Background: Clinical placements should provide nursing students with a positive environment for learning in which they develop a framework for future practice. The literature articulates that this is not always the ca...Background: Clinical placements should provide nursing students with a positive environment for learning in which they develop a framework for future practice. The literature articulates that this is not always the case. The objective of this research was to develop, implement and evaluate a new education seminar for nursing staff—The Art of Clinical Supervision (ACS), designed for nurses to provide a toolbox of strategies to better support students whilst on clinical placement. The ACS was presented in Western Australia, in both metropolitan and regional health services, in both the public and private health sector. This sample consisted of 199 registered nurses working in areas that actively placed nursing students. A mixed method approach incorporated surveys, online reflections and interviews. This article will outline the qualitative phase of this mixed method research. Analysis of the qualitative data determined that participants perceived the seminar as a helpful strategy for improving nursing practice in relation to student supervision. In particular, the concept of belongingness was viewed as an important component to improving attitudes and placement learning, the focus of this article. The implications of belongingness and how this can be promoted is an important concept that nursing leaders, education providers and clinical supervisors need to consider.展开更多
BACKGROUND Preoperative supplementation with immunonutrients, including arginine and n-3 fatty acids, has been shown in a number of systematic reviews to reduce infectious complications in patients who have undergone ...BACKGROUND Preoperative supplementation with immunonutrients, including arginine and n-3 fatty acids, has been shown in a number of systematic reviews to reduce infectious complications in patients who have undergone gastrointestinal surgery. Limited information, however, is available on the benefits of nutritional supplementation enriched with arginine and n-3 fatty acids in patients undergoing liver resection.AIM To evaluate the effects of preoperative nutritional supplementation enriched with arginine and n-3 fatty acids on inflammatory and immunologic markers and clinical outcome in patients undergoing liver resection.METHODS Thirty-four patients undergoing liver resection were randomized to either five days of preoperative Impact? [1020 kcal/d, immunonutrition(IMN) group], or standard care [no supplementation, standard care(STD) group]. Nutritional status was measured at study entry by subjective global assessment(SGA).Functional assessments(grip strength, fatigue and performance status) were carried out at study entry, on the day prior to surgery, and on postoperative day(POD) 7 and 30. Inflammatory and immune markers were measured at study entry, on the day prior to surgery, and POD 1, 3, 5, 7, 10 and 30. Postoperative complications were recorded prospectively until POD30.RESULTS A total of 32 patients(17 IMN and 15 STD) were analysed. All except four patients were SGA class A. The plasma ratio of(eicosapentaenoic acid plus docosahexaenoic acid) to arachidonic acid was higher in IMN patients on the day prior to surgery and POD 1, 3, 5 and 7(P < 0.05). Plasma interleukin(IL)-6 concentrations were elevated in the IMN group(P = 0.017 for POD7). No treatment effect was detected for functional measures, immune response(white cell count and total lymphocytes) or markers of inflammation(C-reactive protein,tumour necrosis factor-α, IL-8, IL-10). There were 10 patients with infectious complications in the IMN group and 4 in the STD group(P = 0.087). Median hospital stay was 9(range 4–49) d in the IMN group and 8(3-34) d in the STD group(P = 0.476).CONCLUSION In well-nourished patients undergoing elective liver resection, this study failed to show any benefit of preoperative immunonutrition.展开更多
文摘Background: Clinical placements should provide nursing students with a positive environment for learning in which they develop a framework for future practice. The literature articulates that this is not always the case. The objective of this research was to develop, implement and evaluate a new education seminar for nursing staff—The Art of Clinical Supervision (ACS), designed for nurses to provide a toolbox of strategies to better support students whilst on clinical placement. The ACS was presented in Western Australia, in both metropolitan and regional health services, in both the public and private health sector. This sample consisted of 199 registered nurses working in areas that actively placed nursing students. A mixed method approach incorporated surveys, online reflections and interviews. This article will outline the qualitative phase of this mixed method research. Analysis of the qualitative data determined that participants perceived the seminar as a helpful strategy for improving nursing practice in relation to student supervision. In particular, the concept of belongingness was viewed as an important component to improving attitudes and placement learning, the focus of this article. The implications of belongingness and how this can be promoted is an important concept that nursing leaders, education providers and clinical supervisors need to consider.
基金Australasian Society for Parenteral and Enteral Nutrition Research Grant and A+Trust Small Project Grant,No.5576
文摘BACKGROUND Preoperative supplementation with immunonutrients, including arginine and n-3 fatty acids, has been shown in a number of systematic reviews to reduce infectious complications in patients who have undergone gastrointestinal surgery. Limited information, however, is available on the benefits of nutritional supplementation enriched with arginine and n-3 fatty acids in patients undergoing liver resection.AIM To evaluate the effects of preoperative nutritional supplementation enriched with arginine and n-3 fatty acids on inflammatory and immunologic markers and clinical outcome in patients undergoing liver resection.METHODS Thirty-four patients undergoing liver resection were randomized to either five days of preoperative Impact? [1020 kcal/d, immunonutrition(IMN) group], or standard care [no supplementation, standard care(STD) group]. Nutritional status was measured at study entry by subjective global assessment(SGA).Functional assessments(grip strength, fatigue and performance status) were carried out at study entry, on the day prior to surgery, and on postoperative day(POD) 7 and 30. Inflammatory and immune markers were measured at study entry, on the day prior to surgery, and POD 1, 3, 5, 7, 10 and 30. Postoperative complications were recorded prospectively until POD30.RESULTS A total of 32 patients(17 IMN and 15 STD) were analysed. All except four patients were SGA class A. The plasma ratio of(eicosapentaenoic acid plus docosahexaenoic acid) to arachidonic acid was higher in IMN patients on the day prior to surgery and POD 1, 3, 5 and 7(P < 0.05). Plasma interleukin(IL)-6 concentrations were elevated in the IMN group(P = 0.017 for POD7). No treatment effect was detected for functional measures, immune response(white cell count and total lymphocytes) or markers of inflammation(C-reactive protein,tumour necrosis factor-α, IL-8, IL-10). There were 10 patients with infectious complications in the IMN group and 4 in the STD group(P = 0.087). Median hospital stay was 9(range 4–49) d in the IMN group and 8(3-34) d in the STD group(P = 0.476).CONCLUSION In well-nourished patients undergoing elective liver resection, this study failed to show any benefit of preoperative immunonutrition.
