Smoking, Orthopedic Surgery, and Bone Healing

When assessing a smoker who is scheduled for surgery, most of us will quickly zero in on their potential for complications from anesthesia. But what if the upcoming procedure is orthopedic?

Smoking is a well-known risk factor for osteoporosis and bone fracture, so it makes sense that it can be an issue in bone surgery healing.

In “The Effects of Smoking on Bone Health and Healing” in this month’s AJN, authors Stephanie Niu and Fidelindo Lim review the effects of smoking on bone health and healing and offer suggestions on how nurses might use this information to help people facing orthopedic surgery to quit.

“In addition to posing surgical and postsurgical risks for orthopedic patients, tobacco, nicotine, and other byproducts contained in traditional and electronic cigarettes (e-cigarettes or vaping products) adversely affect overall bone health and impede bone healing.”

Smoking associated with poor postsurgical outcomes.

Research has shown that smoking is associated with postop infection and poor bone fusion. It significantly increases time to union and risk of nonunion, and is significantly associated with poor clinical outcomes after surgery. […]

2020-07-20T09:16:45-04:00July 20th, 2020|Nursing|0 Comments
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July Issue Highlights: Magnet vs. Non-Magnet Hospitals, Rapid-Response Team Activation Barriers, More

“Health care workers need a break. . . . a respite from trudging from room to room or house to house, donning and doffing gowns and masks and gloves . . .”—editor-in-chief Shawn Kennedy in her July editorial, “In the Aftermath”

The July issue of AJN is now live. Check out the highlights:

Original Research: How Magnet Hospital Status Affects Nurses, Patients, and Organizations: A Systematic Review

The authors analyze the current evidence comparing Magnet and non-Magnet hospitals to determine whether different outcomes exist between them—and provide new information regarding the economic impact of Magnet recognition.

The Effects of Smoking on Bone Health and Healing

A review of the effects of smoking on bone health, the importance of smoking cessation among patients scheduled for or recovering from orthopedic surgery, and the vital role nurses play in supporting patient efforts to quit.

Special Feature: Perceived Barriers to Rapid Response Team Activation Among Nurses

This literature review explores the major barriers many nurses face in calling the rapid response team—and how those barriers might be overcome.

[…]

2020-06-29T10:05:38-04:00June 29th, 2020|Nursing|0 Comments
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Why Do Pregnant Women Smoke?

 “My mother smoked [when she was pregnant] with me and I am fine.”

“I’d rather smoke a cigarette than take a drink of alcohol to relieve stress.”

“So you’re bored, what are you going to do? Sit down and smoke a cigarette.”

“It relaxes me.”

Tobacco use during pregnancy has been associated with many adverse effects, including abruptio placentae, fetal malpresentation, low Apgar scores, stillbirth, and birth defects such as gastroschisis and cleft lip or palate. Most nurses probably see these as no-brainer reasons for women to stop smoking once they become pregnant. Yet a new research study illustrates that the reasons pregnant women might continue to smoke are very individual, and that clinicians are not always skillful in supporting smoking cessation.

In this month’s AJN, researcher Geraldine Rose Britton and colleagues share the results of their qualitative study on the experiences of pregnant smokers and their health care providers. The researchers used a focus group methodology to learn about the smokers’ experiences and to better understand what motivated them to quit or prevented them from doing so.  There were also separate clinician focus groups to explore the approach of the 45 providers (71% RNs, 11% physicians, plus one NP, one nurse manager, four LPNs, and one PA) to pregnant women who smoke.

Not surprisingly, the researchers discovered that the issue is frustrating to both pregnant women and their maternity care providers. Some physicians and […]

2017-06-21T06:42:46-04:00June 21st, 2017|Nursing, personal health practices, Public health|3 Comments
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June Issue Highlights: Understanding Antipsychotics, Talking to Pregnant Smokers, IBS Basics

The June issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Mental Health Matters: Antipsychotic Medications

In recent years, more adults—and teenagers—are taking at least one type of psychotropic medication, the majority of which are prescribed by primary care and family physicians. This first article in a series on commonly used psychotropic medications for the treatment of mental illness reviews the mechanisms of action, adverse effects, and contraindications of first-generation typical and second-generation atypical antipsychotics.

CE Feature: Original Research: The Experiences of Pregnant Smokers and Their Providers

According to the Centers for Disease Control and Prevention, 10.7% of women nationwide reported smoking during their last trimester. The U.S. Department of Health and Human Services’ initiative Healthy People 2020 targets tobacco use, including smoking during pregnancy, as a continuing major health concern in this country. Yet bringing the U.S. Public Health Service’s 2008 clinical practice guideline, Treating Tobacco Use and Dependence, into routine prenatal care remains challenging.  The authors of this study conducted focus groups of pregnant smokers and their providers, most of whom were RNs, to better understand their experiences and to gain insights to help providers best deliver the stop-smoking message.

Clinical Feature: 

2017-05-30T11:44:24-04:00May 30th, 2017|Nursing|0 Comments
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Remembering a Tough NYC Detective on the 41st Great American Smokeout

Photo of AJN editor-in-chief Shawn Kennedy AJN editor-in-chief Shawn Kennedy

My uncle Joe embodied the persona of the old-time tough NYC Irish detective—he was over six feet tall, had piercing blue eyes and white hair, always wore a tan raincoat, and always had a cigarette in his hand. As a child, my siblings and I were always a little bit afraid of him. That image faded, though, and my last image of him was hunched over, with an oxygen cannula, trying to breathe. All those cigarettes added up, and after a lifetime of smoking, he died from chronic lung disease. This was before the landmark report on smoking and health issued by the U.S. surgeon general in 1964. Tiffany, 35, Louisiana; quit smoking at 34; smoke-free since January 2012. (CDC) Tiffany, 35, Louisiana; quit smoking at 34; smoke-free since January 2012. (CDC)

Today is the 41st annual Great American Smokeout—the day created by the American Cancer Society (ACS) to help encourage smokers to quit smoking. According to […]

2016-11-21T13:00:49-05:00November 16th, 2016|Nursing, personal health practices, Public health|0 Comments
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