Tubes Don’t Kill Patients, Errors Do

By Peggy McDaniel, BSN, RN. Peggy is an infusion practice manager and an occasional contributor to this blog.

by Lars Plougmann/via Flickr

The headline for a recent article in the New York Times caught my attention: U.S. Inaction Lets Look-Alike Tubes Kill Patients. For me, this conjured up pictures of giant tubes with teeth, wrapping around weak patients in their hospital beds and squeezing them. Although I knew exactly what the article was going to discuss, it bothered me that the tubes were given the reputation of being “killers.” Can tubes kill? I think not. Can they contribute to errors? Certainly.

The article explains that numerous patients have been harmed and some have died because clinicians have connected tubing that should not have been connected. These errors run the gamut from enteral feedings being given intravenously and blood pressure inflation devices being attached to IV lines, to administration of intravenous medications into epidural lines.

However, it remains the clinician’s responsibility to provide safe care. […]

2018-03-13T10:51:09-04:00September 10th, 2010|nursing perspective|4 Comments
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With Inadequate Staffing, ‘Nonessential’ Care Goes First–Then Patient Safety

A coworker of mine made a medication error a few weeks ago. It was a multifactorial error—the medication had been ordered wrong, labeled wrong, and administered wrong—and was investigated accordingly. That particular nurse was also “tripled,” with two ICU trauma patients and one critically ill medical resident patient. The nurse’s workload wasn’t factored into the documentation or investigation of the error, though, since the nurse manager didn’t consider it relevant. I heard her say, “An extra patient shouldn’t make any difference in the standard procedure for passing medications.”

2016-11-21T13:15:51-05:00September 8th, 2010|Ethics, nursing perspective, nursing research, safe staffing|7 Comments
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An Evidence-Based Look at the ‘Unvoiced Symptom’: Fecal Incontinence

First, a confession: initially the subject of this month’s CE, fecal incontinence, seemed so daunting that we considered lighter titles (“Don’t Pooh-Pooh Fecal Incontinence,” for one). But we decided against going that route, because we didn’t want to minimize the condition’s importance or its life-altering effects. Indeed, fecal incontinence has been called the “unvoiced symptom,” one so embarrassing that sufferers often fail to tell their health care providers about it—and one that many providers never ask about.

Fecal incontinence has been defined as the “involuntary loss of liquid or solid stool that is a social or hygienic problem.” As authors Donna Zimmaro Bliss and Christine Norton report, possible causes include cognitive or physical disability, impaired sensory or motor function, poor coordination of defecation processes, and loose stool consistency; in some cases the cause may be multifactorial or idiopathic. Although studies of nursing home residents have found prevalence rates of more than 40%, the condition is by no means limited to elderly or disabled people.

Quality-of-life issues. Bliss and Norton provide an overview of fecal incontinence and describe what the research thus far has revealed about its impact on patients’ quality of life. […]

2016-11-21T13:15:53-05:00September 7th, 2010|Nursing|0 Comments
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Nightingale, One More Time

By Shawn Kennedy, AJN interim editor-in-chief

I know we’ve written a lot about Florence Nightingale on this blog recently (see Susan Hassmiller’s series of posts, In Florence’s Footsteps: Notes from a Journey) and I don’t want to put off those who aren’t necessarily fans, but I came across an editorial written by Gloria Donnelly, editor-in-chief of Holistic Nursing Practice, that resonated with me.  She writes about how the holistic nature of Nightingale’s approach fits with much that’s going on today in health care reform, citing as one example the trend toward teaching people to take charge of their own health. (The entire Fall issue highlights the work of holistic practitioners—I especially liked Garden Walking for Depression: A Research Report.)

Donnelly writes:

We believe that Ms. Nightingale, an advocate of health, self-healing, and healthy environments, would be proud of the strides that nurses have made to promote holistic health and care around the world. . . . Nightingale believed that ’health nursing‘ and cultivating good health were equally important to ’sick nursing,’ the art and principles of which she developed almost single-handedly. Prevention superceded cure in Nightingale’s schema as she advocated for Health Missioners to work, first in the villages of rural India and then in England, teaching women how to prevent disease and maintain healthy environments.

This, in a nutshell, describes nursing at its core. It’s a shame that of all of Nightingale’s philosophies and improvements that were […]

2016-11-21T13:15:54-05:00September 2nd, 2010|health care policy, nursing perspective|1 Comment
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Back to School: Team Sports and Concussions

By Shawn Kennedy, AJN interim editor-in-chief

Concussions among young athletes are on the rise—are parents and coaches taking them too lightly?

My sons played ice hockey and football in their high school years, what my husband and I referred to as “collision sports.” The unmistakable sound of helmet-hitting-helmet always made me cringe, especially in hockey where a good skater can generate considerable speed (and therefore force) before impact. I’ve witnessed many players being helped off the ice. The coach, who knew I was a nurse, would sometimes signal to me to come to the bench and check out a player. Most of the time, the player was fine; but there were a few times when it was clear that the player was a bit more than just shaken up.

I recall one 12-year-old who had nystagmus and ringing in his ears and kept asking the same question in a slow, sleepy voice. The coach wanted to put him back out on the ice (“He just saw a few stars, right?”), but instead I sent him with his parents to the ED for evaluation. After an overnight stay in the hospital he was released, but was cautioned not to play hockey for two weeks because he’d suffered a concussion. So he waited two weeks and […]

2016-11-21T13:15:56-05:00September 1st, 2010|nursing perspective|0 Comments
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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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