AJN in February: Rapid Response Teams, Complications of CHD Repair, Managing Type 2 Diabetes, More

AJN0215 Cover OnlineAJN’s February issue is now available on our Web site. Here’s a selection of what not to miss.

Rapid response teams (RRTs) are teams of expert providers who can be called on in an emergency to treat patients before their condition deteriorates. The success of an RRT depends on whether it is activated properly, a task that often falls to staff nurses. The original research article, “Hospital System Barriers to Rapid Response Team Activation: A Cognitive Work Analysis,” describes the factors affecting nurses’ decisions to activate RRTs. This CE feature offers 3 CE credits to those who take the test that follows the article.

Further explore this topic by listening to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad app, or on iTunes).

Long-term complications after congenital heart defect (CHD) repair. Nurses often encounter patients with complications that occurred years after CHD repair. “Long-Term Outcomes After Repair of Congenital Heart Disease: Part 2” reviews four common CHDs, their repairs, common long-term outcomes, and implications for nurses in both cardiac and noncardiac settings. This article offers 2.5 CE credits to those who take the test that follows the article.

Making nurses full partners in reforming health care. The Institute of Medicine’s […]

Telehealth as ‘Disruptive Innovation’ in Nursing

A patient uses telehealth equipment to communicate with his nurse. Photo courtesy of Janet Grady. A patient uses telehealth equipment to communicate with his nurse. Photo courtesy of Janet Grady.

“Telehealth: A Case Study in Disruptive Innovation” is a CE article in AJN‘s April issue. The author, Janet Grady, vice president of academic affairs and chair of the Nursing and Health Sciences Division at the University of Pittsburgh in Johnstown, Pennsylvania, describes the concept of disruptive innovations in nursing and delves into the evolving field of telehealth as a current example.

The article considers the following:

  • uses and potential uses of telehealth in chronic and acute care, home care, and rural medicine, and the evidence supporting its use.
  • obstacles to wider use and acceptance of telehealth, which include cultural resistance within nursing, licensure issues across states, reimbursement challenges, and the need to adapt nursing curriculum to these new ways of delivering care.
  • forces that drive or obstruct disruptive innovations like telehealth.

Here’s the article overview:

Technologic advances in health care have often outpaced our ability to integrate the technology efficiently, establish best practices for its use, and develop policies to regulate and evaluate its effectiveness. However, these may be insufficient reasons to put the brakes on innovation—particularly those “disruptive innovations” that challenge […]

The eICU: Big Brother or Team Member?

Virtual Reality Headset Prototype (circa 1968). Photo by Pargon, via Flickr.

By Peggy McDaniel, BSN, RN

There is an intriguing new technology available to hospital ICUs. It’s called an eICU.  At Alegent Health in Omaha, Nebraska, the “software feeds real time data for roughly 100 patients, including vital signs, laboratory tests, cultures, and pharmacy data,” to nurses and a doctor monitoring the eICU from off site. Using the data, the software sets off alerts that are noted by the eICU staff and passed on to the bedside staff. The bedside clinicians have said that the extra help has allowed them to focus on bedside care.

About two years into its use, an interesting side benefit of this remote monitoring system was noted by the hospital’s director of infection control. She realized that the eICU allowed her to monitor and promote compliance to practice bundles as well as to compile data to promote better antimicrobial measures.

The article reports that the staff initially felt a bit concerned about being watched by “big brother.” However, the hospital promoted the idea of the eICU as a “part of the team” instead of an intrusion, an approach that appears to have been successful.

As a nurse who works to improve compliance to best practices that reduce hospital-acquired conditions, particularly bloodstream infections, I feel this presents an amazing opportunity to promote patient safety.  For example, when I perform hospital audits, I see poor compliance to hand washing and the cleansing of IV access ports. These two practices are proven to help decrease the spread of […]

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