Sickle Cell Disease in Children and Adolescents: Aligning Practice with Guidelines

CDC report points to areas for improvement.

The Morbidity and Mortality Weekly Report (MMWR) released by the Centers for Disease Control and Prevention on September 20, 2022, highlights an important opportunity for nurses to provide evidence-based care to children with sickle cell disease (SCD). The report highlights poor compliance with guidelines recommending that children ages 2 to 16 with sickle cell anemia (SCA)—the most common and often most clinically severe form of the disease—should receive transcranial Doppler (TCD) ultrasound screening and that hydroxyurea (HU) should be offered for all children with SCA ages 9 months and older.

In the past, children with SCD usually did not survive past age 20 because of infections/sepsis and stroke. Children with SCD now can live much longer, into their 40s, 50s, and 60s, as a result of the use of penicillin to prevent sepsis and screening for children at high risk for stroke. According to current guidelines for children and adolescents with SCA, when children are screened for stroke by TCD, those at high risk can be identified and referred for monthly transfusions, a practice that has been found to prevent stroke. In addition, there is much evidence supporting the use of HU, including prevention of severe pain episodes, acute chest syndrome, and hospitalization.

2022-09-29T10:59:11-04:00September 29th, 2022|Nursing|0 Comments
Read More

Assessing the Post-Pandemic Future of Virtual Care

The following is a condensed version of an upcoming news article by Joan Zolot scheduled for AJN’s May edition.

Studies of safety and quality will determine the optimum use of this option.

Photo by Anna Shvets from Pexels

The use of telemedicine surged during the COVID-19 pandemic. Phone and videoconferencing limited patients’ exposure to the virus while maintaining their access to care. One estimate found that virtual care peaked at 42% of all ambulatory visits covered by commercial insurers in April 2020. The February 2 JAMA published several articles* addressing the safety, effectiveness, and quality of virtual consults and their future in health care.

Some obvious and potential benefits.

Because of its efficiency, virtual care has been shown to be particularly suitable for mental health consults, prescription refills, and straightforward evaluations. It can reduce patient inconveniences such as travel to appointments and lost work time. It can also enable patients to receive needed care sooner, especially those with limited mobility, caregiving responsibilities, or who live in remote areas. It may also have the potential to improve care coordination by enabling primary care clinicians and specialists to confer jointly with patients.

Risks, concerns, ongoing questions.

Because virtual medicine does not allow for physical examination, it’s inadequate for common clinical situations […]

2021-04-07T14:15:14-04:00April 7th, 2021|digital health, patient engagement, Patients, Public health, Technology|0 Comments
Read More

Hepatitis A, B, and C: The Latest on Screening, Epidemiology, Prevention, Treatments

One of several posters created by the Centers for Disease Control and Prevention to raise awareness that millions of Americans of all ages, races, and ethnicities have hepatitis C—and many don’t know it. Posters are available to order or download for printing at www.cdc.gov/knowmorehepatitis/media/posters.htm. Poster © Centers for Disease Control and Prevention. One of several CDC posters intended to raise awareness that millions of Americans of all ages, races, and ethnicities have hepatitis C—and many don’t know it. Posters are available to order or download for printing at www.cdc.gov/knowmorehepatitis/media/posters.htm. Poster © Centers for Disease Control and Prevention.

It’s crucial that nurses in all health care settings stay informed about the changing landscape of viral hepatitis in the United States. Hepatitis affects the lives of millions, too many of whom are unaware that they have been infected.

Right now, there’s good news and bad news about hepatitis in the U.S. While the incidences of hepatitis A and B in the United States have declined significantly in the past 15 years, the incidence of hepatitis C virus […]

2016-11-21T13:02:17-05:00July 16th, 2015|Nursing|1 Comment
Read More

Ebola: A Role for Nurses in Sharing the Facts

By Shawn Kennedy, AJN editor-in-chief

Screen Shot 2014-10-29 at 12.27.27 PMThe current Ebola crisis has everyone concerned over transmission, and rightly so. The public has been in a quandary as to who and what to believe. I can’t say I blame them. We should have been better prepared and anticipated that, given the situation in West Africa, we would eventually see a patient with Ebola present to a U.S. hospital ED (or clinic or urgent care center). What’s surprising is that it didn’t happen sooner.

I’d thought fears about widespread transmission of Ebola had abated after no more new cases arose from that of Thomas Eric Duncan in Dallas: his family, who were in the apartment with him during the time he was sick, did not contract Ebola and have since been released from quarantine; the two nurses who became ill treating Duncan have now been declared Ebola free and none of their contacts have become ill; no other nurses who provided care for him have fallen ill.

But with the onset of confirmed Ebola in a New York physician who had recently returned from caring for Ebola victims in West Africa, fears of widespread contagion resurfaced. Craig Spencer had been self-monitoring his symptoms while he went about his life; when he began to feel ill and developed a low-grade fever, he initiated a controlled transport in […]

2016-11-21T13:03:37-05:00October 29th, 2014|career, infectious diseases, Nursing, nursing perspective|2 Comments
Read More

As Sepsis Awareness Increases and Guidelines Change, Timing Remains Crucial

By Amanda Anderson, a critical care nurse and graduate student in New York City who is currently doing a graduate placement at AJN two days a week.

stopwatch/wikimedia commons stopwatch/wikimedia commons

September was Sepsis Awareness Month, but the urgency of the issue didn’t disappear when the month ended. I still remember my first day in the medical intensive care unit (MICU) I’d soon call home. I was shadowing the charge nurse, and an admission had just come in from the ED.

“Here, we need a CVP setup.” A crinkly bag of normal saline and a matching package containing something evidently important were shoved into my hands—a medical football passed to the only open player.

Very quickly, I would learn what a CVP, or central venous pressure, was and to monitor it. I would learn all about sepsis, and septic shock, and the treatment of its devastating process. Multiple organ dysfunction syndrome (MODS) was a primer for my care in this unit, and on my first day off of orientation, I was entrusted with one of its full-blown victims: Septic shock from pneumonia, causing respiratory, renal, and heart failure. Learning to spike a bag of saline for a CVP transducer was just my first step into the vast and complicated land of sepsis management.

This was 2007. Sometimes, as in all hospitals, care was delayed and septic patients sat without timely treatment for hours. Back then, we tubed people, snowed people, and flooded people. […]

2016-11-21T13:03:47-05:00October 6th, 2014|Nursing, nursing perspective|0 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
Go to Top