Medical-Surgical Clinical Student Error and Near-Miss Event Reporting.

The aim of this study was to identify medical-surgical clinical error near-miss events (ENME) and causative factors as reported by senior-level nursing students. Qualitative and quantitative ENME data were obtained using a survey tool during clinical courses. Students identified cognitive and behavioral/performance issues, human factors, system issues, and communication as contributing factors, with 97 percent of the errors reported as preventable.

An update on the peripheral pseudoaneurysm.

A false aneurysm, or pseudoaneurysm, is a hematoma that occurs after injury of all layers of the arterial wall and that may occur secondary to trauma or to infection or as a complication of arterial bypass reconstruction. The presence of a pulsatile mass is usually the initial finding on physical examination that leads to more definitive testing and diagnosis. Treatment traditionally has been surgical repair.

Limb loss in the elderly peripheral vascular disease patient.

Limb loss in the elderly is a significant problem for a number of reasons. One of the primary problems this patient population experiences is rehabilitation. Regaining independence following amputation is often a slow and painful process.

Jugular venous vasopressin increases during carotid endarterectomy after cerebral reperfusion.

Several recent reports have suggested that pressor hormones may be released during and after carotid endarterectomy and that release of these factors may be associated with postoperative hypertension and other postoperative morbidity. We measured vasopressin, adrenocorticotropic hormone, and cortisol in jugular venous blood during carotid endarterectomy under general anesthesia in 43 patients with routine carotid shunting. Jugular venous vasopressin increased significantly after the second period of carotid occlusion for shunt removal and remained increased at closure.

The nursing shortage and specialty practice.

This paper has reviewed numerous factors contributing to the nursing shortage. These factors include changes in medical practice and the patient population, professional beliefs and objectives, and economic factors. Although many articles reviewed focus on the reasons for and solutions to the shortage, few note specifics regarding how the shortage may or may not impact on the quality of patient care.