January Issue: Best Practices for PIVC Management, CAUTI Prevention, More

“Growing, evolving, and progressing are part of the natural order of things. In my almost 40 years as an RN, I have seen enormous evolution and elevation of nurses in the delivery of health care.”—AJN editor-in-chief Carl Kirton in this month’s editorial, “Evolution in a New Year”

The January issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

The Year in Review: 2022

The top health care, clinical, and policy news stories of the year, plus stories to watch in 2023.

Original Research: Practice Variations in Documenting Neurologic Examinations in Non-Neuroscience ICUs

This study explored existing practices for documenting neurologic examinations by RNs and providers in medical, surgical, and cardiovascular ICUs, which don’t routinely admit patients with a primary neurologic injury.

CE: Evidence-Based Practice for Peripheral Intravenous Catheter Management

The authors discuss the evidence for the appropriate use of short PIVCs in hospitalized patients, assess the ongoing need for PIVCs, provide recommendations for alternative options, and argue for promptly removing a PIVC that is no longer in use.

[…]

2022-12-27T10:14:58-05:00December 27th, 2022|Nursing|0 Comments
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The 12-Hour Nursing Shift: Preferred by Staff, but Good for Patients?

A new study finds reduced communication skills after consecutive shifts but no clinical deficits.

Twelve-hour shifts have been a mainstay of nursing schedules since they began as a staffing strategy in the 1970s, but debate continues about their effect on nurses’ health and ability to safely care for patients.

Studies have examined both aspects of the issue. Regarding staffing, researchers have found that a majority of nurses and hospital administrators prefer 12-hour shifts as a means to achieve continuity of care, ease of scheduling, and for nurses, work–life balance. Regarding patient care quality, research has shown an association between longer consecutive shifts and more clinical errors.

The latest findings. 

A recent study from Washington State University aimed to test the latter. The research team recruited 94 RNs working consecutive 12-hour shifts to examine the cumulative effect of shift work–related changes on sustained attention, cognitive effectiveness, and subjective sleepiness. Participants were evaluated in two 20-minute simulated care situations by other RNs trained to assess performance. Nurses working day and night shifts were randomized across fatigued and rested conditions, defined respectively as having worked three consecutive 12-hour shifts or having three consecutive days off.

[…]

2022-07-15T10:14:05-04:00July 14th, 2022|Nursing|0 Comments
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Looking Back to Look Forward: Top Health, Nursing, Policy, and Clinical Practice News of 2019

Photo via Flickr / Luis Marina

Each January, AJN takes a close look at the most noteworthy health care–related news of the past year, from general health stories and policy to specific nursing and clinical issues. Which stories stood out in 2019? Here’s a rundown:

Health care news

  • Negative trends intensify for key measures of population health and access to care. As life expectancy declines again in the United States, signaling a three-year trend, the Affordable Care Act remains under threat from GOP-sponsored litigation; children have been losing coverage; new work requirements and paperwork barriers are undercutting Medicaid coverage gains; and rising drug costs are in the spotlight.
  • Cyberattacks and hospital data security. Health care organizations’ cybersecurity spending lags behind that of other industries.
  • A changing climate. As environmental protections are weakened or rolled back, new research details the significant and long-lasting health consequences of climate change.
  • Women’s reproductive health. The U.S. maternal mortality rate continues to rise, and several states have passed legislation to curtail abortion access.
  • Society in distress. In 2019, Americans experienced the public health consequences of political discord, poverty, and unaddressed social needs, as magnified by the crisis at the border and rising rates of gun violence and homelessness.

2020-01-14T09:16:17-05:00January 14th, 2020|health care policy, Nursing|0 Comments
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In Colorado EDs, ‘Alternative to Opioids’ Pilot Project Exceeds Goals

Ashley Copeland talks to her mother in the Swedish Medical Center ED. Copeland was treated for a severe headache with a nerve-blocking anesthetic, but no opioids. (John Daley/CPR News)

Last year, in an effort to address the state’s acute opioid abuse problem, several Colorado health care organizations—including the Colorado Emergency Nurses Association—worked together on an intervention to target patients admitted to the ED with pain. The plan? Implement a pain management program to promote alternative strategies, with a goal of decreasing opioid usage by 15% in the participating EDs.

As discussed in a June news article, the program, which was piloted in 10 hospitals and involved heavy involvement from nurses, surpassed its goal: opioid usage during the intervention period (as measured in morphine equivalent units) was 36% less than in the previous year.

The pilot […]

2018-06-14T09:29:35-04:00June 14th, 2018|Nursing, patient experience|1 Comment
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High Opioid Overdose Numbers Spur State, City Initiatives

State 2015 overdose death rates compared with national rate. (CDC image)

As we report in an October news article, recent studies have shed light on the growing scale of the opioid crisis in the United States. Among the latest statistics:

  • 33,000 Americans died in 2015 from an opioid overdose, a high percentage from the use of synthetic opioids such as illegally manufactured fentanyl.
  • The diagnosis of “opioid use disorder” climbed 493% from 2010 to 2016 in Blue Cross Blue Shield claims.
  • Around 4.31% of Americans ages 12 or older use prescription pain relievers for nonmedical uses.

Increasing Naloxone availability.

The findings underscore the urgent need to take steps to combat the crisis—a need that has prompted states and cities to attack the issue using various methods. Baltimore’s health commissioner, for example, issued a standing order for naloxone to be available at all of the city’s pharmacies. Brown University and the Rhode Island School of Design collaborated to create NaloxBoxes—emergency naloxone boxes installed at city social service centers that enable any bystander to administer a rescue dose.

Speeding access to addiction treatment.

And, to minimize delays in patients’ receipt of medication-assisted opioid addiction treatments like methadone, New York State has reached agreements with two insurance companies to end their […]

2017-10-23T08:50:26-04:00October 23rd, 2017|Nursing, Public health|1 Comment
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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.
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