Archive for July, 2010

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Tech, EBP Buzzwords Among Nurse Researchers

July 19, 2010

By Shawn Kennedy, AJN interim editor-in-chief

As a lover of history, especially nursing history, I’ve been following Sue Hassmiller’s posts retracing the steps of Florence Nightingale with great interest and a bit of envy.

Well I went on a trip, too—to Sigma Theta Tau International’s 21st International Nursing Research Congress in Orlando. I was astounded by the truly international aspect of the meeting—many meetings say they are international if there’s a few hardy travelers from abroad, but there were many presenters, poster presenters and attendees from outside the United States.

What AHRQ does. Carolyn Clancy, director of the Agency for Healthcare Research and Quality (AHRQ), was the good choice for keynote. She shared some interesting data—like the fact that AHRQ is the leading funder of patient safety research in hospital and ambulatory care, or that the U.S leads the world in rates of hysterectomy. (While our rates are comparable with other countries for hysterectomy for endometrial cancer, they are “all over the map” for hysterectomy for noncancer diagnoses.) She also spoke about the agency’s research priorities—patient safety and quality of care, comparative effectiveness research, and reducing disparities in access to care for minorities and women (she acknowledged that “lack of health insurance is the biggest barrier”).

If there was a catchphrase from this conference, it was “evidence-based practice”—how to do it, teach it, evaluate it, and use it to transform practice, education, leadership style, and workplaces.

Using technology—virtual technology, simulation, social media, and Web technology—was another major theme, and presenters focused on how to integrate technology into current practice and educational settings. Sessions focusing on these topics seemed to be the best attended. Read the rest of this entry ?

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From the Crimea to Vietnam: Generations of Veterans Appreciate Florence Nightingale

July 16, 2010

By Sue Hassmiller, PhD, RN, FAAN, Robert Wood Johnson Foundation Senior Adviser for Nursing (this is the latest in a series of posts by Hassmiller, who’s spending her summer vacation retracing crucial steps in Florence Nightingale’s innovative career)

This post is dedicated to Bob Hassmiller.

It is hard to believe that Florence Nightingale is not buried at Westminster Abbey. The offer was made, but turned down by Florence herself. For all the treasures she bestowed upon this earth while here, she was not one for a lot of pomp and circumstance. She simply wanted to do her work nonstop—to ensure that her voice was heard, and her lessons followed—but she did not want much to do with heroes’ welcomes, medals, or an honorary this or that. So in her will, and in the name of furthering medical science, she asked that her body be donated for medical research.  Read the rest of this entry ?

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Nightingale Used Her Network…Are You Using Yours?

July 16, 2010

By Sue Hassmiller, PhD, RN, FAAN (6th in a series of posts by Hassmiller, who’s spending her summer vacation retracing crucial steps in Florence Nightingale’s innovative career)

Sue Hassmiller

Florence Nightingale said, “we don’t as much need to know, but need to do.” She felt that Embley Park was isolating, and her wealth often a distraction, but she also managed to use her privileged position to her advantage. She couldn’t wait for the clock to strike 10 every night so she could privately and without interruption get to her studies—so that, later, she’d be ready “to do.” And her wealth opened up connections that would serve as a worthy network for her entire life. Read the rest of this entry ?

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Embley Park: Where It All Began

July 14, 2010

By Sue Hassmiller, PhD, RN, FAAN (5th in a series of posts by Hassmiller, who’s spending her summer vacation retracing crucial steps in Florence Nightingale’s innovative career) 

Never in my wildest dreams did I think I would ever be at the home of Florence Nightingale. But here I am, not only visiting her family’s estate, Embley Park, but sleeping here for the next four days. Read the rest of this entry ?

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Interventions to Promote Physical Activity in Chronically Ill Adults: What Does the Evidence Tell Us?

July 14, 2010

By Sylvia Foley, AJN senior editor

It sounds like a no-brainer: physical activity can have great health benefits for people who are chronically ill. But which interventions promote physical activity in this population most effectively? Many studies evaluating such interventions have been conducted; but “without the benefit of a statistical analysis across studies it can be difficult to detect patterns and interpret results,” say the authors of this month’s CE feature, Todd M. Rupper and Vicki S. Conn.

In 2008 Conn and colleagues did just that, performing a meta-analysis that summarized the findings of 163 reports on 213 independent tests of interventions used to promote physical activity among more than 22,000 adults with various chronic illnesses. Now, in this article, Rupper and Conn discuss the implications of  the findings from that meta-analysis, describe the strategies and practices most commonly used, and identify which ones have proven most effective. Among the take-aways: Read the rest of this entry ?

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Nightingale as QI Expert and Hospital Designer

July 13, 2010

By Sue Hassmiller, PhD, RN, FAAN (this is the 4th in a series of posts by Hassmiller retracing Florence Nightingale’s influential and innovative career) 

Seeing the famous St. Thomas’ Hospital today, I thought Florence Nightingale would roll over in her grave with disgust! What were they thinking, I asked the tour guide? Well, she said, it was the ‘60s. No excuse, I barked back! Prince Charles doesn’t like it either, if that makes you feel any better, she responded.

Applying best practices. The most visually prominent buildings in the hospital now consist of a couple of plain, brown, nondescript, blocklike structures—not anything like Nightingale, once the most famous hospital designer in the world, would have had it. Or, rather, did have it. Her friend, Queen Victoria, laid the first stone and Florence Nightingale contributed to the design and relocation of the St. Thomas’ Hospital of the mid-1800s, with the intention of applying best practices she had brought back from the Crimean War as well as her own research and statistics. 

Nightingale was much sought after as a master designer of hospitals; architects, physicians, and royalty from around the world asked her advice. And here was supposed to be her masterpiece . . . but her version of St. Thomas’ is just about gone.

Physical, spiritual, mental health needs. Nightingale envisioned the relocated and rebuilt St. Thomas’ as a beautiful series of pavilions where different patients with different ailments lay. Read the rest of this entry ?

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A Weekend With Florence In London

July 12, 2010

Editor’s note: The two entries below, written on Saturday and Sunday in London, are the latest in a series of posts by the Robert Wood Johnson Foundation’s Senior Adviser for Nursing, Susan Hassmiller, who’s spending her summer vacation retracing the footsteps of Florence Nightingale and reflecting on the implications of Nightingale’s work for nurses today.

Saturday: Westminster Abbey (London)

I arrived in London for my vacation today. They tell me it is uncharacteristically hot (nearly 90 degrees), so that gave me full license to have ice cream . . . not once, but twice! And although the “official” Florence Nightingale tour hasn’t started, I didn’t waste time getting a head start on my quest to better understand the contributions of Ms. Nightingale. Read the rest of this entry ?

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The Nightingale Immersion Experience

July 12, 2010

Susan Hassmiller, the Robert Wood Johnson Foundation’s Senior Advisor for Nursing, is traveling through Europe on a tour developed in honor of the centennial of Florence Nightingale’s death. This is the second of two preliminary posts she gave us last week before taking to the skies; click here for the first. Starting later today (so check back this afternoon!) with a first post from London, Hassmiller will report on her trip, what she’s learning, and why Florence Nightingale is as relevant as ever to nurses’ work today. 


I’m still in immersion mode,
learning all I can about Florence Nightingale—the “Lady with the Lamp” (a name Wikipedia succinctly explains)—as I get ready for my trip. What have I learned so far? Well, I’m blown away. Read the rest of this entry ?

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Following in Florence Nightingale’s Footsteps – Literally!

July 9, 2010

On the Road with Sue Hassmiller as she traces the work of the legendary Florence Nightingale . . .

On her upcoming summer vacation, Susan Hassmiller, PhD, RN, FAAN, the Robert Wood Johnson Foundation’s Senior Advisor for Nursing, will be pursuing a dream to learn more about the life and work of the legendary Florence Nightingale. She’ll be traveling through Europe on a special tour developed in honor of the centennial of Nightingale’s death. In this and upcoming blog posts, Hassmiller reports on her trip, what she learns, and what it means to nurses’ work today. (Addendum: click here for the full series of posts.)

Sue Hassmiller, ready to blog

Eighteen years old and “hot to trot.” That’s what I thought I was. Having just been admitted into nursing school, I was set to change the world…one patient at a time. They tried to teach me about Florence Nightingale, but she was someone from the past…not likely to help me learn to start IVs, put in catheters, or run ventilators. If there were iPods back then, I would have used mine to avoid lessons about how Florence Nightingale changed the face of nursing forever. What an exaggeration, I thought! There was nothing to be learned from her…so I tuned out every last bit of it.  Read the rest of this entry ?

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Reflections on the Freedom to Harm Yourself

July 8, 2010

By Marcy Phipps, RN

(Identifying details of the patient and clinician mentioned in this post have been changed to protect their anonymity.)

Last week I took care of a woman who’d shot herself in the abdomen. This was the third suicide attempt she’d survived. She was physically compromised, to say the least, and was looking at a long recovery. Her despondence was palpable. 

A clinical psychologist came to evaluate her and determined that she was experiencing major depression with suicidal ideations. 

Red For Danger/via RichardO, Flickr

Usually, such patients are “Baker Acted.” In accordance with the Florida Mental Health Act, commonly referred to as the Baker Act, individuals who are deemed to be a danger to themselves or to others are held involuntarily and transferred to a treatment facility.

But because this patient stated to the psychologist that she was not only willing to seek mental health treatment, but also planned on checking herself into a facility near her home, she didn’t qualify to be involuntarily hospitalized. She was free to leave at any time.

As the psychologist explained to me, the first criterion of the Baker Act only considers whether or not the person in question is refusing treatment. According to Florida Statute 394.463, as long as said person does not refuse to be examined, the Baker Act does not apply.          

Although the psychologist assured me that he would find a way to provide the patient with a “safety net,” I found it ironic and slightly shocking that the only thing stopping her from leaving the hospital and carrying out her intentions was the physical self-harm that she’d already inflicted. Read the rest of this entry ?

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