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Research Highlights
Renal Insufficiency Can Predict Cardiovascular Disease
Taken from the Veterans Health Administration Highlights dated May 5, 2003
People with end-stage renal disease have a cardiovascular mortality rate that is 10 to 20 times greater than those in the general population. VA researchers analyzed data from the Cardiovascular Health Study – a prospective population-based study of nearly 6,000 people older than 65, who had a serum creatinine measured at baseline and were then followed for a median of 7.3 years. Researchers also examined the association between elevated creatinine levels and all-cause mortality and incident cardiovascular mortality and morbidity among subjects with a history of the disease at baseline. Incident cardiovascular events included myocardial infarction, agina, congestive, congestive heart failure (CHF), peripheral vascular disease, stroke, and transient ischemic attack.
Key findings were that elevated creatinine levels were associated with increased all-cause mortality and the development of cardiovascular disease and CHF, even after adjusting for cardiovascular disease risk factors and sub-clinical disease; mildly elevated creatinine levels were predictive of cardiovascular disease morbidity and mortality, and the risk grew steadily with increased creatinine levels; those with elevated creatinine had a higher rate of both clinical and sub-clinical cardiovascular disease at baseline; those with elevated creatinine levels were older, more likely to smoke, and had higher levels of inflammatory and prothrombotic markers.
The article, titled, "Renal Insufficiency as a Predictor of Cardiovascular Outcomes and Mortality in Elderly Individuals," was recently published in the Journal of the American College of Cardiology, April 2003.
Taken from the Veterans Health Administration Highlights dated March 24, 2003
Nurses' Working Conditions and the Nursing Shortage
Employees at the Tampa VA Medical Center, concerned about working conditions for nurses and nursing shortages, sent the following response to the editor of the Journal of the American Medical Association on April 2, 2003. The increased risk of musculoskeletal injuries is a significant reason for people not wanting to enter the profession, for nurses not wanting to work in nursing homes and hospitals, and for injured nurses leaving the profession. One solution is to increase the number of assistive staff to help perform some of the more strenuous physical demands of the job. However, lifting even a small patient far exceeds the 51-pound weight load for ideal conditions recommended by the National Institute for Occupational Safety and Health.
The research and experience shows that introducing the right type and amount of patient care technology into clinical settings is far superior to increasing the numbers of staff to perform lifting. Lifting equipment can significantly decrease job-related stress, lost work, and light duty days due to musculoskeletal injuries, and direct costs associated with injuries, as well as decrease injury rates, self-reported musculoskeletal pain, and the frequency of unsafe patient-handling. Safer work environments for nurses translate into greater job satisfaction and improved retention rates. As the United Kingdom has found, no-lift policies with patient-handling technology are the critical answers to the heavy physical demands of bedside nursing.
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