About Betsy Todd, MPH, RN

Former clinical editor, American Journal of Nursing (AJN), and nurse epidemiologist

It’s Spring. Time to Think about Lyme Disease

Ticks Ixodes pacificus (shown here in CDC image) and Ixodes scapularis are known vectors of Borrelia burgdorferi (Lyme disease)

National data confirm that diagnoses of Lyme disease begin to rise each year during the month of April, then rapidly reach their peak in June and July. Just in time for “Lyme season,” readers can learn more about the disease in “Lyme Disease: Diagnosis, Treatment, and Prevention” in this month’s AJN.

Lyme disease was first recognized in 1975 in Lyme, Connecticut. From 492 confirmed cases in 1982 (the first year in which Lyme was a reportable disease) to more than 35,000 confirmed and probable cases in 2016, the causative organism, Borrelia burgdorferi, has continued to expand its geographic reach. The CE article notes that these numbers may be undercounts and cites analysis of laboratory and medical claims data from 2008 suggesting that the true number of annual diagnoses may actually be between 240,000 to 444,000.  […]

2018-04-04T09:11:38-04:00April 4th, 2018|climate change, infectious diseases, Nursing, Public health|0 Comments
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Meeting the Nutritional Needs of Older Patients and Family Members

When copies of the print version of this month’s issue arrived in the office, AJN staff found different meanings in the Albert Anker painting (circa. 1895) that graces the cover. Is the man enjoying a cup of tea in peace and quiet, or is he isolated and lonely, perhaps sipping tea to stave off hunger because there isn’t much food in the house?

The artist’s intent may be open to interpretation, but we chose this cover because it suggests one of the many social, cognitive, physical, and economic factors that can affect the nutritional status of older adults: eating alone.

Many older adults are at risk.

In a March CE article, “Malnutrition in Older Adults,” registered dietitian Ann Reed Mangels, PhD, RD, FADA, summarizes the latest information on malnutrition in older adults, including risk factors, assessment tools, and practical ways in which nurses as well as family and friends can help to ensure good nutrition for elders in the community or in long-term care. Writes Mangels:

“Malnutrition diminishes quality of life, is a strong predictor of short-term mortality, and is associated with higher health care costs.”

[…]

2018-03-19T09:05:08-04:00March 19th, 2018|Nursing, Patients|0 Comments
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A Nurse’s Popular Preteen Classes on Puberty….Parents Included

Julie Metzger, MN, RN. Photo by Holly Andres.

The first time I menstruated, I knew exactly what it meant: that I could never go swimming again. I don’t know how I squared this idea with the fact that older girls and women were always in the city pool when I went there. Illogically, I was convinced I was now doomed to living without my favorite summer pastime.

A couple of years earlier my mom and I, along with most of the girls in my class and their moms, had nervously attended the school nurse’s annual lecture to fourth grade girls. Apparently, “no more swimming” was my garbled take-home from that event.

For preteen girls only, and their mothers.

Today, nurse Julie Metzger tackles misunderstandings like this with lively presentations about puberty to preteens and their mothers. She and her work are profiled in “Great Conversations: A Nurse Tackles the Puberty Talk” (free until March 28) in this month’s AJN. Metzger combines humorous props (a maxi pad stuck to her shoulder) and storytelling to talk about body changes, the opposite sex, decision-making, and friendship. […]

2018-03-20T11:56:23-04:00March 14th, 2018|Nursing|2 Comments
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Late in a High Anxiety Season, Some Flu and Vaccine Basics

After what has seemed like constant media scrutiny for months, influenza hasn’t been in the news as often in recent days. Still, CDC data indicate that flu activity remains “widespread” across the country, so it’s still too early to eliminate flu from your list of “differential diagnoses,” at work or at home.

Maybe it’s the general state of our national psyche, but this year the “flu” seems to have caused more than its usual share of anxiety. This is not a pandemic; there are no brand-new strains of flu in circulation to which no one is immune. But the H3N2 strain that has been predominant this year does tend to lead to a harsher-than-usual season. (The 2014-2015 season was also severe, but the public heard relatively little about it because media were focused on the Ebola outbreak.)

Influenza surveillance basics.

How do we know how bad a flu season really is? Since the 1997–1998 flu season, lab data and clinical reporting have facilitated real-time flu surveillance in the U.S. Public health laboratories in every state, in collaboration with National Respiratory and Enteric Virus Surveillance System laboratories, track the types (A or B) and subtypes (H3N2, H1N1, etc.) of flu in circulation.

To complement these data, the U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet) tracks the percentage of […]

2018-02-28T12:20:28-05:00February 28th, 2018|infectious diseases, Nursing, Public health|0 Comments
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Nursing Assistants in Nursing Homes: Partners in Quality Improvement

“NAs know where the quality gaps lie.”

I loved working in a skilled nursing facility—the long-term relationships with residents and their families, the chance to really hone in on nursing basics, the opportunity to learn about life from people who had seen it all.

But what finally drove me away from this work was the mediocre quality of care in two different “homes” where I was on staff. I was angry and frustrated, and even after several years in nursing, still too inexperienced to understand what I could have done to make things better.

Including nursing assistants in QI projects: ‘crucial to success.’

Today, care is slowly changing. Nursing homes are now required to post on the web certain data about their patient outcomes (https://www.medicare.gov/nursinghomecompare/search.html), and to implement quality improvement (QI) initiatives. But have we regarded QI projects as the province of RNs and administrators only? In this month’s AJN, Kathleen Abrahamson and colleagues make the following observation:

“…nearly all changes driven by QI in work processes, schedules, approaches to care, or documentation will either affect or be carried out by nursing assistants. Thus, including NAs in QI efforts is crucial to their success.”

The truth of this statement is so clear, it might be called a “no-brainer.” As the […]

2018-02-21T09:51:50-05:00February 21st, 2018|Nursing, nursing research|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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