About Betsy Todd, MPH, RN

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

Autism Spectrum Disorder: A Critical Role for Nurses in Screening and Interventions

“‘What’s the scoop with our autism screening?’ a concerned mother asked the nurse upon realizing that the autism spectrum disorder screening questionnaire she had completed wasn’t addressed during her daughter’s well-child visit. The nurse brought the mother’s concern to the primary care provider, who replied, ‘Don’t worry, I only look at screenings if I think there’s a problem. I can spot autism during a patient visit.’”

Is this provider’s confident claim a realistic one? Almost certainly not, as will become clear to anyone who reads the CE articles on autism spectrum disorder (ASD) in the October (“From the CDC: Understanding Autism Spectrum Disorder“) and November (“Autism Spectrum Disorder: The Nurse’s Role“) issues of AJN. As a result of such casual attitudes toward screening, many autistic children are almost certainly not receiving the early treatment and monitoring that can make a big difference in their quality of life.

Delayed diagnosis reduces the window for effective interventions.

ASD is the most common developmental disability in the United States, yet according to the November CE article, screening rates across the U.S. range from a low of 17.2% in Mississippi to a high of less than 60% […]

2020-11-12T10:16:12-05:00November 12th, 2020|Nursing|0 Comments

How Research Starts: Choosing a Question That Passes the ‘So What’ Test

As an undergrad at the University of Michigan School of Nursing more than 40 years ago, I was among the few students who loved the required “research” course. I don’t know whether I looked forward to that class because I was an avid reader of Nancy Drew and saw research as detective work, or simply because nursing was so new to me that everything about it seemed exciting.

The main idea behind the course was that all nurses should be able to read and understand research reports. We didn’t get into the nuts and bolts of study design, complex statistics, or modeling, but we were expected to be able to analyze basic nursing research articles and to identify a study’s strengths and weaknesses.

This early experience didn’t lead me to pursue a career in research, but it left me with a respect for the research process and an interest in asking clinical questions.

Research basics explained.

Now, I have a chance to update my understanding of the field through AJN’s new series on research basics, Nursing Research, Step by Step. The first installment, “How Does Research Start?” is in the October issue of AJN. In this introduction to the subject, author Bernadette Capili makes it clear […]

Patient Input on Obstacles to Sleep Helps Focus One Unit’s Improvement Efforts

Do you know anyone who’s ever had a good night’s sleep in the hospital? As nurses, we hear the complaints; as patients ourselves, or as family members of patients, we’ve been there.

Differing views on the source of a unit’s sleep problem.

After their hospital’s 20-bed telemetry unit received a low HCAHPS survey score on a quiet-at-night question, nurse practitioner Christian Karl Antonio and his colleagues at a northern California community hospital took on the challenge of improving patients’ sleep experience on the unit.

Before designing an intervention, they spoke with patients as well as staff, and were surprised to learn that the two groups see the problem differently.

“Patients perceived being awakened for vital signs, blood draws, and medication administration as the most frequently occurring factors that contributed to noise at night. On the other hand, staff members perceived that noise at night came from staff conversations, equipment with alarms, announcements on the paging system, and delivery carts, among other sources.”

[…]

How Do Nurses Feel About Assessing for and Promoting Safe Gun Storage?

My grandfather and uncles were hunters, and they always looked forward to their forays into Michigan’s Upper Peninsula during deer hunting season. But while I was well aware of their activities, they never brought their guns into our house. So I never gave any thought to gun safety issues, even after I became a nurse—not even after caring for one memorable patient, a young man my own age who had been accidentally shot by a companion during a hunting trip.

What can nurses do?

“…a child finds an unlocked loaded gun and accidentally shoots themselves or someone nearby, a despondent teenager makes a rash decision to end their life with the family gun, a homeowner mistakes a family member for an intruder.”

It seems that we read about tragedies like these every day. Can nurses help prevent them? The American Academy of Nursing has recommended that health care professionals “assume a greater role in preventing firearm injuries by health screening.”

In “Nurses’ Knowledge and Comfort with Assessing Inpatients’ Firearm Access and Providing Education on Safe Gun Storage” in the September issue of AJN, Kimberly Smith Sheppard and colleagues report on their original research study, which examined nurses’ knowledge and comfort with assessing patients’ access […]

How Do You Feel When Your Patients Can’t Afford Care?

“Every day in the United States, nurses watch patients forgo beneficial treatment they cannot afford despite nursing’s moral standard to treat patients without regard to financial condition.”

How often have you been left, pretty much on your own, to figure out a way that your uninsured and/or homeless patients have access to something (anything!) that will maintain their health when you aren’t with them? Are there meds they can’t pay for? Do they need prenatal care that they can’t afford? Can they possibly function without home care of some kind?

Moral distress as a call to seek systemic change.

In “Ethical Issues: The Moral Distress of Nurses When Patients Forgo Treatment Because of Cost” in this month’s AJN (free to access until October 7), Douglas Olsen and Linda Keilman discuss the moral distress of nurses when we are unable to meet the needs of patients who don’t have the money to pay for care in our for-profit health care system. […]

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