Occurrence, Diagnosis, and Sources of Hospital-Associated Infections. Edited by Fahlberg, Willson J; Groschel, Dieter. Marcel Dekker, Inc, 270 Madison Ave, New York, NY 10016, 1978, 138 pp. $18.50. Hospital-acquiredinfections are of major concern to health care providers, readily apparent by the amount of material available on this complex problem. This book, the first of four volumes on hospital-associatedinfections, is a major contribution to the literature. Written in a clear, succinct, and interesting style, this book contributes greatly to the reader’s understanding and managementof nosocomial infections. The book begins with a brief historical review of the changing role of hospitals in the care of sick and infected patients. The authors then explain the development of contemporary nosocomial infections and describe in detail the steps to diagnose, treat, and contain these complications.Infections are discussed in relation to organ systems and are also categorized into specific medical or surgical problem areas, such as bacteremia, hyperalimentation-related problems, and decubitus ulcers. Other specialty classifications include fetal and neonatal infections, infections of the neurosensory system, wound and soft tissue problems, and infections of the female genital tract. A detailed chapter on principles for laboratory diagnosis contains pertinent information on specimen collection, transportation, and laboratory treatment. Numerous tables list studies required for specific diagnoses, desirable studies, and additional studies that would be helpful in making accurate diagnoses as a basis for therapy. Another chapter presents the underlying
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principles of therapy. It thoroughly explores why specific infections tend to occur, discusses recommended treatment, and gives methods for containing infections to eliminate repeated occurrences. Current concepts and statistics are included, making it easy for the reader to see trends and to identify areas of iatrogenic problems. The final chapter is an excellent discussion of the sources of organisms and methods of transmission within the hospital. Multiple tables list organisms commonly found in body systems and organisms frequently responsible for specific infections. Clinical factors that compromise host defense mechanisms are also identified. This publication is one of the most readable and current books on hospital-associated infections. By becoming familiar with this excellent treatise, medical and nursing personnel can profit considerably in their understanding and management of nosocomial infections. Additional volumes of this series currently in preparation include The Mode of Spread of Hospital-Associated Infections; Problems in the General Hospital Population and Specific Measures of Control; and Hospital-Associated Infections in the Compromised Host. Doris C MacCleliand, R N Del Mar, Calif
Applied .tmmunological Concepts. Blake, Patricia J; Perez, Rosanne C. Appleton-Century-Crofts, 292 Madison Ave, New York, NY 10017, 1978, 159 pp, $7.95 paperback. This is an excellent clinical and physiologic review of the rapidly expanding science of immunology. Reports of advances in research and new clinical applications make this study fascinating, particularly for those with little or
AORN Journal, August 1979, V o l 3 0 , No 2
no formal study in immunophysiology.The authors explain the basic physiologic components of the immunosystem and discuss clinical applications in terms of nursing assessment, diagnosis, and nursing interventions. Of particular interest are the discussions of developmental immunology and conditions related to altered immune responses. The two chapters on humoral and cell-mediated systems and altered immunocompetencies are conclse, but require complete concentration to absorb the detailed information included. Perhaps the most valuable chapters in terms of practical nursing application are those dealing with rationale for immunization against specific conditions in both children and adults and with the bases for various immune responses seen in patients with specific illnesses. This book is not one that every nurse would read cover to cover, but it would be an excellent review for nurses to update knowledge of particular immunoconcepts and practices. It should be available in all medical libraries as a reference source for nurses. Doris C MacClelland, RN Del Mar, Calif The Case for Consultation in NursingDesigns for Professional Practice. Kohnke, Mary F. John Wiley & Sons, 605 Third Ave, New York, NY 10016, 1978, 179 pp, $12.95.
cation and practice, and the role of the clinical nurse consultant. The book defines the consultation process, rationale for the consultant's role, and its components. It also deals with the consultant's relations with others in nursing. The last four chapters are concerned with designs for professional nursing practice in settings such as the hospital, community agencies, and the multidiscipline clinic. Problems for practice in the hospital include the absence of professional practice models, staffing difficulties, resistance to change in roles or shifts in power, and flaws in the medical model of nursing care. The book provides a curriculum design for the master's candidate in nursing and discusses perspectives for the future. An appendix indicates the differences in the knowledge base, responsibility, and roles of the professional nurse and the nursing technician. There is a short summary at the end of each chapter and a bibliography at the end of the book. This well written book deserves a thoughtful reading by all nurses, regardlessof their educational preparation to practice nursing. The sincerity of the author in presenting her views was apparent throughout, whether you agree with her views. Sister Kane, RHSJ, RN, MEd Cornwall. Ontario
The author supports the view that three levels of nursing practice are required. Under this concept, the professional nurse with a BSN degree would plan and evaluate care, offer special support to patients, and guide the work of nursing technicians. The nursing technician with a diploma or associate degree would provide the bulk of nursing. The clinical specialist, prepared at the master's level, would be the consultant to the professional nurse. As a consultant, the clinical specialist would have the knowledge and skills to solve problems and the ability to provide information so that decisions could be based on a wide range of alternatives. The first four chapters deal with what it will take to make nursing a true profession. Discussion includes the development of the clinical nurse specialist, professional nursing edu-
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AORN Journal, August 1979,Vol30, No 2