- Email: [email protected]
Working with bereaved people
64 Accident and Emergency Nuning
Finally, in a comparison of the material costs, excluding anaesthesia and syringes, stapling costs A4.55, compared to A2.75 for sutures. This excludes the staple remover which, at present, the department is also providing. This increased cost has led to a restriction of their use to cases where there is a risk of needle-stick injury, either due to confusion, agitation or violence. They are also used at the discretion of staff where much time may be spent suturing an otherwise uncomplicated wound.
results and patient satisfaction. These may justify the use of staples whilst their material costs remain high. Stapling continues to be used in the department alongside suturing, adhesive strips and surgical glue, providing a range of techniques to be used at the practitioners’ discretion. ACKNOWLEDGEMENTS We would like to thank all the Ftafr and patients involved for them patience and participation, and the representatives from 3M and Davis & Geck for their assistance throughout the trial.
REFERENCES
Many factors affect the choice of skin closure technique, and it was not the aim of the trial to outweigh one method for another. We simply wished to assesswhether stapling was an appropriate closure technique for our area. Staff involved were satisfied with, and often surprised by, the cosmetic results, and patients were generally pleased with the outcome. Further considerations in our department include training of staff (medical and nursing), audit of the technique and patient satisfaction. Discussion with the supplier is ongoing, as to the availability of a larger staple gun, holding 15 rather than five staples. The review of the literature highlighted the need for further comparative study in the emergency area into both techniques in relation to infection and complication rates, speed of closure and costing and into cosmetic
Clayer M, Southwood RT 1991 Comparative study of skm closure m hip surgery. Australian & New Zealand Journal of Surgery 61 (5): 363-365 George TK, Snnpson DC 1985 Skin closure with staples in the Accident & Emergency Department. Journal of the Royal College of Surgeons of Edinburgh 30 (1): 54-56 MacGregor FB, McCornbe AW, King PM, MacLeod BAD 1989 Skin stapling of wounds in the acadent department. Injury 20: 347-348 Pickford IR, Brennan SS, Evans M, Pollack AV 1983 T\vo methods of skm closure in abdominal operations; a controlled clmical trial. Briush Journal of Surgery 70: 226-228 Rlchle AJ, Rocke LG 1989 Staples versus sutures in the closure of scalp wound$, a prospective, double-blind, randomised trial. Injury, 20: 217-218 Stillman KM, Marina CA, Seligman SJ 1984 Skin staples in potentially contammated wounds. Archives Surgery 119: 821-822 Wardrope J, Smith JAR 1992 The Management of Wounds and Burns. Oxford University Press, Oxford
Book Review Working
with
bereaved
people
A Faulkner Clwrchil/ Livingtone, 157pp, Ll1.95
1995. ISBN 0 443 05144 5,
The idea of death, and the emotions which ensue, are not foreign to nurses. We will all die one day and most of use have experienced or will experience the death of a family member or friend, or have nursed someone who was dying. The grief which follows a death provides a bond between those who suffer, if it is handled positively and sensitively. Faulkner, in the book Working with bereaved peoplekaptures the reader’s interest in a topic that is di&Iicult to relate to and as a consequence placed in the ‘too hard’ basket. I think that the
issues addressed in this book, in particular the chapters relating to the concept of loss; after death; the immediate future; assessing the bereaved person and the cost of care, provide a clear, easy to read and informative discussion of issues pertinent to nurses working in A & E, because it is here, often, that the grief process begins. These chapters are supported by personal accounts which base the book in reality and facilitate an understanding of the issues raised. Buy this one, it is worth a read. J Hendricks BA, BAA’, Graduate Diploma of Education, Master of Nursing Studies, Doctoral Candidate, Gr@th Univenity Faculty of Nursing, Queenslarzd, Australia
Finally, in a comparison of the material costs, excluding anaesthesia and syringes, stapling costs A4.55, compared to A2.75 for sutures. This excludes the staple remover which, at present, the department is also providing. This increased cost has led to a restriction of their use to cases where there is a risk of needle-stick injury, either due to confusion, agitation or violence. They are also used at the discretion of staff where much time may be spent suturing an otherwise uncomplicated wound.
results and patient satisfaction. These may justify the use of staples whilst their material costs remain high. Stapling continues to be used in the department alongside suturing, adhesive strips and surgical glue, providing a range of techniques to be used at the practitioners’ discretion. ACKNOWLEDGEMENTS We would like to thank all the Ftafr and patients involved for them patience and participation, and the representatives from 3M and Davis & Geck for their assistance throughout the trial.
REFERENCES
Many factors affect the choice of skin closure technique, and it was not the aim of the trial to outweigh one method for another. We simply wished to assesswhether stapling was an appropriate closure technique for our area. Staff involved were satisfied with, and often surprised by, the cosmetic results, and patients were generally pleased with the outcome. Further considerations in our department include training of staff (medical and nursing), audit of the technique and patient satisfaction. Discussion with the supplier is ongoing, as to the availability of a larger staple gun, holding 15 rather than five staples. The review of the literature highlighted the need for further comparative study in the emergency area into both techniques in relation to infection and complication rates, speed of closure and costing and into cosmetic
Clayer M, Southwood RT 1991 Comparative study of skm closure m hip surgery. Australian & New Zealand Journal of Surgery 61 (5): 363-365 George TK, Snnpson DC 1985 Skin closure with staples in the Accident & Emergency Department. Journal of the Royal College of Surgeons of Edinburgh 30 (1): 54-56 MacGregor FB, McCornbe AW, King PM, MacLeod BAD 1989 Skin stapling of wounds in the acadent department. Injury 20: 347-348 Pickford IR, Brennan SS, Evans M, Pollack AV 1983 T\vo methods of skm closure in abdominal operations; a controlled clmical trial. Briush Journal of Surgery 70: 226-228 Rlchle AJ, Rocke LG 1989 Staples versus sutures in the closure of scalp wound$, a prospective, double-blind, randomised trial. Injury, 20: 217-218 Stillman KM, Marina CA, Seligman SJ 1984 Skin staples in potentially contammated wounds. Archives Surgery 119: 821-822 Wardrope J, Smith JAR 1992 The Management of Wounds and Burns. Oxford University Press, Oxford
Book Review Working
with
bereaved
people
A Faulkner Clwrchil/ Livingtone, 157pp, Ll1.95
1995. ISBN 0 443 05144 5,
The idea of death, and the emotions which ensue, are not foreign to nurses. We will all die one day and most of use have experienced or will experience the death of a family member or friend, or have nursed someone who was dying. The grief which follows a death provides a bond between those who suffer, if it is handled positively and sensitively. Faulkner, in the book Working with bereaved peoplekaptures the reader’s interest in a topic that is di&Iicult to relate to and as a consequence placed in the ‘too hard’ basket. I think that the
issues addressed in this book, in particular the chapters relating to the concept of loss; after death; the immediate future; assessing the bereaved person and the cost of care, provide a clear, easy to read and informative discussion of issues pertinent to nurses working in A & E, because it is here, often, that the grief process begins. These chapters are supported by personal accounts which base the book in reality and facilitate an understanding of the issues raised. Buy this one, it is worth a read. J Hendricks BA, BAA’, Graduate Diploma of Education, Master of Nursing Studies, Doctoral Candidate, Gr@th Univenity Faculty of Nursing, Queenslarzd, Australia