evidence-based Archives - Off the Charts

Decreasing the Trauma of IV Sticks – for Patients and Nurses

In my clinical days, I was adept at IV sticks. I had a lot of experience from my days in the ER, but especially from working as a chemotherapy nurse, where I had patients with fragile and damaged veins. I learned every trick to coax a vein to appear and which gauge needle would work the best to avoid puncturing through the vein. I was so “into” IVs at one point, I’d note the veins on people’s arms, judging whether they’d be an easy or hard stick.

Venous access may be difficult to achieve in older adults. Photo © Alto / Alamy Stock Photo.

Little instruction in starting an IV.

But it wasn’t always so. I recall approaching the first time I had to draw blood with much trepidation. There was virtually no training—a more experienced colleague had me watch her and then walked me through it in a few minutes:

“It’s not that hard: see which hand or arm has the better veins; tie the tourniquet around the arm; swab the skin with alcohol; insert the needle, bevel down; pull back and see […]

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Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-07-19T12:02:08-04:00July 19th, 2018|Nursing|0 Comments

Acknowledging Nightingale’s Pervasive Influence on Medicine as We Know It

By Jacob Molyneux, senior editor

Florence Nightingale in Crimean War, from Wikipedia Commons

There’s a very good article about Florence Nightingale in the New York Times right now (“Florence Nightingale’s Wisdom”)—and it’s by a physician.

The author, Victoria Sweet, writes that Nightingale was the last person she wanted to know about or identify with when she was in medical school. Then she gradually began to realize Nightingale’s extraordinary influence on modern medicine as it’s now practiced. As Sweet point out,

So much of what she fought for we take for granted today — our beautiful hospitals, the honored nursing profession, data-driven research.

It’s a good piece, and though you may already know some of what it covers, it’s well worth reading. For those who want to learn more about Nightingale, let me point out a series of short posts we ran back in the summer of 2010 on this blog. In Florence’s Footsteps: Notes from a Journey, written by Susan Hassmiller, senior advisor for nursing at the Robert Wood Johnson Foundation, detailed the stages of a trip she took that summer as she retraced Nightingale’s steps through England and all the way to the Crimea, all the while contemplating her legacy.

Jacob Molyneux, senior editor/blog editor2016-11-21T13:05:17-05:00March 4th, 2014|career, nursing history, nursing perspective|3 Comments

Essential Nursing Resources: A Crucial Tool for Nurses Seeking Information on the Web

This nursing resource will help you find anything you need to know

By Maureen Shawn Kennedy, AJN editor-in-chief

Back in the dark ages, before the Web, when I was in school and researching a topic, I would go to the university library (in Manhattan, this meant a subway ride to the main campus), fill out a form, and hand it to the librarian. After a couple of hours, I’d check back and the librarian would have pulled up to eight “on-reserve” books (no more were allowed until these were returned) from the stacks and have them waiting for me. This cycle would repeat itself several times, and sometimes I’d have to wait for an “ILL”—an interlibrary loan. Of course, if I procrastinated, the material I wanted might already have been taken out by other students and I’d be out of luck, facing a deadline with no source material.

Of course, it’s all different now with the Web. This week, even the venerable Encyclopedia Britannica announced it is ceasing print production after almost 250 years and will only be available in digital format.

Now, researchers and students have virtually every article published available to them via the Internet. For nurses, there’s something called Essential Nursing Resources (pdf), an annotated listing of resources for nursing published by the Interagency Council on Information Resources in Nursing (ICIRN).

Founded in 1960 (here’s a brief history) by […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2016-11-21T13:10:20-05:00April 10th, 2012|digital health, nursing research|0 Comments

Confused About the Charge Nurse Role? You’re Not Alone

Charge nurses—as is often the case, there’s the ideal and the reality. Consider a recent blog post at the nursing blog At Your Cervix, which expresses some honest reservations about acting as a charge nurse—both about the challenges involved, and the lack of compensation for the added duties. Here’s an excerpt:

I’m really not so sure about this charge nurse thing. I was told when I arrived on a recent shift that I was to be in charge. I think I’ve done charge (maybe?) three times. Those times were only because there was no one available who did charge, and I was the most likely choice to do it. I haven’t been trained or oriented to do charge. It was kind of a “toss her in there and do it” situation.

If you read the entire post, you’ll learn that this blogger isn’t so sure she wants to take this role on again anytime soon. As it happens, AJN published a CE article back in September of last year (our clinical editor, Christine Moffa, wrote this post about it at the time) on an initiative which took place at the highly respected New York-Presbyterian Hospital/Weill Cornell Medical Center. Its goal was to figure out this charge nurse thing in a more systematic and sensible way.

Like so many roles in so many professions, there may […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:14:08-05:00February 3rd, 2011|nursing research|1 Comment

When Timely Nurse Removal of Urinary Catheters Reduces UTI Rate

By Christine Moffa, MS, RN, AJN clinical editor

Ever since we started the Cultivating Quality column at AJN, manuscripts featuring evidence-based quality improvement projects have been pouring in. There is a lot of great work being done at the bedside by practicing nurses, and this column provides the opportunity to share their ideas with others.

This month’s Cultivating Quality installment, Reducing Rates of Catheter-Associated Urinary Tract Infection, comes from Joyce Wenger, MS, RN, the infection control performance improvement coordinator at Lancaster General Hospital, Lancaster, PA. According to the CDC, urinary tract infections (UTIs) account for more than 30% of hospital-associated infections, and almost all are “caused by instrumentation of the urinary tract.” Nursing staff were able to reduce catheter-associated urinary tract infection (CAUTI) rates using a three-pronged approach “beginning with education, progressing to tests of new and better products, and ending with the nurse-driven protocol for catheter removal.”

That last part is my favorite. In most facilities a doctor or nurse practitioner has to write an order before a Foley catheter can be removed from a patient. Patients may end up spending several days at increased risk for UTI because of an unnecessary urinary catheter in place. This hospital came up with a plan to give nurses the autonomy to remove them—which makes sense, since they’re the ones checking the patient daily. The team at Lancaster General created the following list of criteria that patients need to meet in order to maintain […]

Jacob Molyneux, senior editor/blog editor2017-02-24T14:36:31-05:00August 19th, 2010|Nursing|1 Comment