AUGUST 2002, VOL 76, NO 2

studies are needed to determine the optimum length of time that supplemental oxygen should be continued postoperatively.

Considering the substantial costs associated with SSIs and the finding that there is only minor, if any, additional cost required to use 80% oxygen, supplemental oxygen administered during sur- gery and a short recovery period using a nonrebreathing mask can be implemented easily by periop- erative personnel. Implementing such a process cames with it the potential for significantly reducing the incidence of SSIs and posi- tively affecting the documented weighty cost of SSIs.

GEORGE ALLEN RN, PHD, CNOR CIC

NURSING RESEARCH COMMITTEE

PHYSICAL ACTIVITY AND CORO- NARY HEART DISEASE IN WOMEN: IS "NO PAIN, NO GA1N" PAS&? I-Min Lee et a1 JAMA Vbl285 (March 21,2001) 1447-1 454

n the past, women were not considered at high risk for coro- I nary heart disease; however, it

now is known that coronary heart disease is the leading cause of death for women in the United States. Studies have focused on the relationship between coronary heart disease and physical activity in women. Evidence clearly indi- cates that women who are active have lower coronary heart disease rates than those who are inactive. It is unclear, however, whether this association differs by intensity of activity. This study examined the relationship between physical activity, specifically walking, and coronary heart disease in women.

Methodology. The Women's

Health Study, which is a longitu- dinal, randomized, double-blind, placebo-controlled trial using low- dosage aspirin and vitamin E for primary prevention of cardiovas- cular disease and cancer, was the source of participants for this study. The Women's Health Study has been in progress since September 1992. Data were col- lected by self-report from 39,372 women participating in the study.

Researchers assessed the amount of time and energy partici- pants spent on various physical activities and recorded the kilo- calories burned per week. They also assessed additional variables, including age; weight; height; cig- arette smoking status; diet; history of hypertension, elevated choles- terol level, and diabetes mellitus; menopausal status; use of post- menopausal hormones; and parental history of coronary heart disease. Participants periodically reported a diagnosis of myocardial infarction, undergoing coronary artery bypass graft procedures, or undergoing percutaneous translu- minal coronary angioplasty proce- dures. Researchers used medical records and other relevant material to confirm self-reports. Statistical analysis was conducted to deter- mine the relationship between the amount of time spent performing various physical activities, particu- larly walking, and coronary heart disease risk.

Results. The study showed that more active women had a lower mean body mass index, were less likely to smoke ciga- rettes, had a healthier diet, ate more fruits and vegetables, and consumed less saturated fat than less active women. Women who walked at least one hour per week or whose usual pace was at least three miles per hour experienced

about half the coronary heart dis- ease risk of women who did not walk regularly. Researchers meas- ured time spent walking and pace and found that time, but not pace, independently predicted lower risk.

Discussion. This study indi- cates that vigorous activity is not necessary to reduce the risk of coronary heart disease, nor is fast- paced walking. The benefit appears to come fiom the amount of time spent walking; however, few studies exist to c o n f i i this finding. Perhaps the parameter of total energy expenditure is the rel- evant variable that needs to be confiied.

The large sample size is a strength of this study. The limita- tions are self-report of physical activity and the possibility that the sample may not be representative of the general population. In spite of these limitations, the results are encouraging to women who are not inclined to participate in vig- orous activity to achieve per- ceived health benefits. This study supports walking one hour per week to reduce the risk of coro- nary heart disease. Additional studies are needed to confirm the results of this study.

MARY LYNNE WEEMERING RN, MSN, CNOR

NURSINO RESEARCH COMMITTEE

BOOK REVIEWS

FIRE AND LIFE SAFETY IN HEALTH CARE FACILITIES By Mawin J; Fischer et al 2000, 713pp $124.75 hardback

romoting life safety for patients and personnel in P health facilities is an impor-

tant aspect of health care. This

331 AORN JOURNAL

AUGUST 2002, VOL 76, NO 2

book is a compilation of valuable information on building, fire, and electrical codes and key measures taken by all types of health care institutions to maintain safety, The information is intended to guide new construction; remodeling and routine maintenance of buildings; development of electrical, fire protection, gas, and vacuum sys- tems; and communication between departments in health care facilities. The book refer- ences major regulating agencies and code-making groups, as well as standards. The authors have many years of experience in fire and life safety, all having served on and/or chaired committees for the National Fire Protection Association, a nonprofit organiza- tion dedicated to protecting lives and property from fire hazards.

The book's intended audience is health care facility designers, engineers, architects, safety 06- cers, maintenance personnel, and administrators. Managers fiom all areas of health care, however, will find this book a usehl reference during a redesign project or regu- latory review preparation, as well as when educating staff members about establishing and maintain- ing safety.

Each chapter discusses an aspect of building design and information related to codes and standards, installation, testing, maintenance, and inspection. The authors state this book is not intended as a design handbook.

for perioperative managers and educators conducting safety reviews. For example, it address- es training staff members about patient piped gas systems. This section stresses the significance of educating perioperative staff members about the sounds of the alarms activated when the pres- sure in a piping system changes. Staff members should know where shutoff valves are located,

This book is a helpful resource

how and when to use them, and what to do when outlets and inlets look damaged. Simply shutting off a valve may cause higher pressure and create anoth- er dangerous or life threatening situation. Staff members operat- ing this equipment must be taught its operation, and they must know the intended use of the systems they use on a daily basis.

This book is available from National Fire Protection Associ- ation, Inc, One Batterymarch Park, Quincy, MA 02269; http://www.nfpacatalog.org.

ANN BARTON RN, BS, CNOR

CENTEGRA HEALTH SYSTEM MCHENRY, WOODSTOCK, ILL

SURGICAL SERVICES CLINICIAN

BASIC PHARMACOLOGY FOR NURSES, 12th ed By Bruce D. Clqton, Itonne N. Stock 2001, 640pp $39.95 paperback

his basic text provides any- thing you want to know about T pharmacology. The authors,

professors in pharmacy practice and nursing, collaboratively pro- vide detailed medication informa- tion and emphasize nursing aspects of patient care. This edi- tion is revised and updated to include the most current informa- tion and documentation methods, such as new medications, herbal medications, and patient education and monitoring forms.

The book is comprehensive and allows easy access to desired information. The first part offers introductory information about medication nomenclature, legal requirements, principles of med- ication actions and interactions, the nursing process, and domains of learning (in reference to patient teaching). It also illustrates med- ication administration techmques and reviews arithmetic and mathe-

matical formulas used in prepar- ing accurate doses. One chapter describes the documentation process of medication administra- tion and teaching.

The second part of the book contains the bulk of the text and is divided into units and chapters. Each chapter covers medications that affect or treat disorders of dif- ferent body systems. They follow a consistent format, including content, objectives, and key words, and discuss anatomy, physiology, and medication thera- py for that condition or body sys- tem. The steps of the nursing process are incorporated to high- light nursing responsibilities in preparing, administering, and monitoring medications in patient care. The authors integrate princi- ples of patient teaching through- out the text, emphasizing the adaptations of the nursing process to the health teaching process.

Compared with other medica- tion books, this book's incorpora- tion of the nursing process greatly augments the material. It brings together the technical facts of medication actions and issues of patient compliance. Discussions about fostering health mainte- nance by addressing desired responses and anticipated side effects and offering concrete sug- gestions about how to alleviate side effects or when to notify the physician all contribute to mini- mize patient upset or anxiety and increase adherence to treatment.

The authors focus on patients' choices by discussing alternatives and personal values and beliefs, which all are part of culturally sensitive care. Moreover, they emphasize the importance of veri- fying comprehension and docu- menting nursing actions and teaching. The suggested attention to emotional (eg, anxiety) and physical (eg, oxygen, pain relief) needs before teaching is practical advice. Special considerations for

332 AORN JOURNAL