About Betsy Todd, MPH, RN

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

Rise in Anencephaly (Like Microcephaly, a Neural Tube Defect) Cases Noted in One U.S. State

By AJN clinical editor Betsy Todd, MPH, RN, CIC

Maria Rosario Perez was one of the babies in the Washington State anencephaly clus- ter. Born May 25, 2012, she lived only 55 minutes. Photo by Erika Schultz / The Seattle Times. Maria Rosario Perez was one of the babies in the Washington State anencephaly clus-
ter. Born May 25, 2012, she lived only 55 minutes. Photo by Erika Schultz / The Seattle Times.

Microcephaly has been in the news in recent months because of its possible link to Zika virus infection. Here in the U.S., an unusually high incidence of babies with anencephaly in the state of Washington has concerned health authorities for the past four years.

In the spring of 2012, several babies were born with anencephaly in three counties in south central Washington. This unusual cluster of cases, occurring at more than twice the national rate for anencephaly, was first recognized by nurse Sara Barron. She explores the state’s investigation in “Anencephaly: An Ongoing Investigation in Washington State” in the March issue of AJN.

Like microcephaly, anencephaly is a “neural tube defect” that leads to tragic pregnancy outcomes. In […]

2016-11-21T13:01:22-05:00March 21st, 2016|Nursing, nursing perspective|2 Comments
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‘Circadian Assaults’: Daylight Saving Time May Hasten Strokes, MIs in Those At Risk

By AJN clinical editor Betsy Todd, MPH, RN, CIC

“Nurses and other shift workers may be particularly vulnerable to the problems that can result from sleep deprivation.”

Philippe Boulet/flickr creative commons Philippe Boulet/flickr creative commons

I don’t like daylight saving time (DST). Twice a year, when we begin and end this transition, I’m tired and cranky for a week. These sudden leaps forward and backward in time disrupt our bodies’ natural relationship to what should be gradual changes of season.

Not surprisingly, some studies suggest that these assaults on our circadian rhythms may affect our cardiovascular health. Swedish studies (here and here) based on national myocardial infarction (MI) data found small but significant increases in MI rates in the first few days to a week after the change to DST.

A Michigan study of more than 42,000 MI patients treated with angioplasty found a significant increase in MIs on the Monday after the start of DST. Their data, however, indicated that the overall incidence rate of MIs in need of angioplasty did not change, and the researchers suggested that DST may simply “accelerate” the incidence of cardiovascular events in at-risk patients, pulling them forward in time.

Researchers in Finland recently reported an increase in strokes at the start of DST, and like the Michigan researchers, concluded from their data […]

2016-11-21T13:01:24-05:00March 11th, 2016|Nursing, nursing perspective|1 Comment
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Latino Nurses in the United States: Numbers Don’t Reflect Demographic Trends

“Increasing [the] numbers of RNs from minority backgrounds is a prime consideration in reducing the substantial racial and ethnic disparities in health.” – National Advisory Council on Nurse Education and Practice

indexThe U.S. Census Bureau estimates that, by the year 2060, Latinos, currently 17% of the population, will make up almost 29% of the total U.S. population. Will the diversity of the nursing workforce reflect the diversity of the populations we serve? The authors of “Latino Nurses in the United States: An Overview of Three Decades (1980-2010)” provide us with a demographic baseline against which to measure our future diversity progress:

“In 2010 (the latest data available), there were 1186 non-Latino white RNs for every 100,000 non-Latino whites in the U.S., yet only 311 Latino RNs for every 100,000 Latinos in the U.S.”

The authors review historical information on Latino nursing in the U.S., offer a state-by-state profile from the five states with the largest Latino populations (California, Florida, Texas, Illinois, and New York), and recommend modifications to existing nursing school recruitment, admission, and retention strategies. […]

2016-11-21T13:01:26-05:00February 24th, 2016|career, Nursing, nursing perspective|0 Comments
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Nurses and Latent TB Infection

By Betsy Todd, AJN clinical editor, MPH, RN, CIC

Mantoux skin test/CDC PHIL Mantoux skin test/CDC PHIL

Are you “PPD positive”?

In December, a California maternity nurse was diagnosed with active tuberculosis. More than 1,000 people, including 350 infants, may have been exposed. In infants, tuberculosis can be hard to diagnose and is more likely than in newly infected adults to progress to active disease and to disseminate to extrapulmonary sites. Therefore, a course of isoniazid was recommended for each of these exposed infants, as well as for any parents, visitors, or staff who tested positive after the exposure.

Some of the details of this incident weren’t released to the media. In my experience, active infection in a health care worker who has not recently traveled to a TB-endemic area is almost always the result of reactivated latent infection. That was the case in a similar exposure more than 10 years ago, when a New York City maternity nurse exposed more than 1,500 infants and adults to active tuberculosis.

And in three of the largest TB exposure investigations on which I’ve worked, the index cases were nurses in oncology, transplant, and the ED whose latent tuberculosis infection progressed to active infection. In these three cases, neither the RNs nor their own primary care providers connected their persistent febrile respiratory infections with […]

2016-11-21T13:01:33-05:00January 18th, 2016|infectious diseases, Nursing, nursing perspective|0 Comments
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Electronic Health Records: Still-Evolving Tools to Help or Hinder Nurses

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Photo by Marilynn K. Yee/New York Times/Redux Photo by Marilynn K. Yee/New York Times/Redux

One of my earliest memories of electronic health records (EHRs) is the day I had to review a chart at another hospital in the city. As I headed over to medical records, I expected at worst a “big” chart—one of those 15-inch stacks of multiple folders from a long hospitalization. I wasn’t allowed access to their system to view the chart online, so I was escorted into a separate room, in which the printed-out chart was waiting for me.

But their electronic chart wasn’t “printer-friendly,” and the hard copy version now consisted of thousands of pages of documentation spread out over a nine-foot long table. Many […]

2016-11-21T13:01:40-05:00December 14th, 2015|digital health, Nursing, nursing perspective|2 Comments
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