INR authors speak out: water and dehydration are world health issues

The International Nursing Review invites authors whose work is published in the journal to share informally their insights and experiences as researchers. In this issue, Drs Ruth Davidhizar and April Hart discuss the evolution of their project which resulted in their article entitled A review of the literature on how important water is to the world's elderly population. The article begins on page 159.

Our paper was the result of one small idea that turned out to have worldwide consequences. One of the authors was concerned with identifying personal reasons for thirst. When a comprehensive review of the literature was performed, not only was information obtained on the many explanations for thirst but the extraordinary and serious problem of thirst among the elderly emerged.

We were fascinated and the study was widened to include thirst and dehydration in the elderly as a widespread nursing concern. When we submitted the article to INR, the response to the paper was positive. However, the editors noted that an even broader, and in fact, universal assessment of the implications of water and dehydration related to world health issues should be considered since needs related to water are of international concern.

Thirst and dehydration has turned out to be a timely and critical topic. Much of the world struggles to provide clean water to its inhabitants, especially the elderly. A personal query, ‘Why am I thirsty?’ led to a much larger scope of interest, one all human beings share.

Dr Davidhizar, RN, DNS, ARNP, BC, FAAN is Professor and Dean of Nursing at Bethel College in Mishawaka, Indiana, USA. Her special focus is the alleviation of health care disparities. She is coauthor of Transcultural Nursing: Assessment and Intervention (ed. 4) (2004) which provides a model for assessing individuals in order to design culturally competent care.

Dr Hart, RN, MSN, FNP, BC initiated her nursing career by spending a month in Sierra Leone, caring for various health concerns among the population. She later worked in Critical Care Nursing, particularly Emergency Nursing. She is now an Assistant Professor for Bethel College in Mishawaka, Indiana, USA.

ICN and partners give guidelines for TB control and care

The International Council of Nurses (ICN) is working within a partnership to build health human resource and nursing capacity in tuberculosis (TB) control and care. Today there is a growing recognition of the crucial role played by nurses in TB control and care. However, the lack of well-trained personnel, poor capacity at management level, and the absence of nursing within policy and strategic decision-making are major constraints.

ICN's partners are: the International Union Against Tuberculosis and Lung Diseases (IUATLD), the World Health Organization's (WHO) Nursing and Midwifery Services and Stop TB Department, and Eli Lilly and Company. Lilly provided an unrestricted educational grant for the project. The goal of the partnership is to enhance the quality and quantity of human resources for TB control and care.

‘ICN works with numerous initiatives and partnerships to strengthen directly or indirectly all levels of nursing human resources capacity’, said Tesfamicael Ghebrehiwet, ICN Consultant for Nursing and Health Policy. ‘Nurses working in primary health care settings are often the first to identify and manage suspected TB cases. This is essential to ensure a high level of case detection, a cornerstone of TB control’.

‘In the era of HIV/AIDS, TB is often a coinfection and overall nursing competence in detection, control and care is crucial. Initiatives need to target nurses working in specialist TB services and generalist nurses’, he said.

ICN and IUATLD established a Nursing TB Task Force in 2003. At that time the two organizations agreed to work together to develop nursing guidelines and best practices in TB control and care. ICN and IUATLD member organizations and experts provided input into the best practices.

The guidelines cover three main areas: clinical and nursing/care context, best practices for patient care, and organization to support best practices. A draft version of the guidelines is being field tested in 12 countries with a high burden of TB: Bangladesh, Brazil, Ethiopia, Indonesia, Kenya, Myanmar, Philippines, South Africa, Tanzania, Thailand, Vietnam and Zimbabwe. Following testing, the guidelines will be released in early 2005. A pocket sized version of the guidelines also has been developed. It will be published and disseminated to national nurses associations, schools of nursing and others.

With funding provided by the Swedish Association of Health Professionals, ICN plans to develop a version of the guidelines for Russian speaking nurses.