About Betsy Todd, MPH, RN

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

Attention to Patients’ Mobility: Low-Tech But Essential

A critical care nurse led a multidisciplinary team to explore the effects of a dedicated ‘mobility team’ on functional and other outcomes in ICU patients.

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

julie kertesz/ via flickr creative common julie kertesz/ via flickr creative common

It’s long been known that immobility leads to deconditioning. Various studies indicate that muscle strength drops by 3% to 11% with each day of bed rest. As most of us have witnessed firsthand in both patients and family members, it can take months to regain pre–bed rest levels of functioning. For some people, the strength and mobility needed for independence never return.

In this month’s issue, a community hospital critical care nurse led a multidisciplinary team to explore the effects of a dedicated “mobility team” on functional and other outcomes in ICU patients. In “Implementation of an Early Mobility Program in an ICU,” Danielle Fraser and colleagues share what they learned.

The mobility team consisted of a physical therapist, a critical care RN, and an ICU rehab aide. Respiratory therapists worked closely with the team. Patients assigned to the early mobility intervention could progress through four successive levels of movement, from passive range-of-motion exercises to full ambulation.

Compared with ICU patients who received routine care, the patients in the intervention group were more functionally independent at discharge. In […]

2016-11-21T13:01:41-05:00December 7th, 2015|Nursing, nursing perspective, nursing research, patient engagement|0 Comments
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Fracking, Health, and the Environment: More Bad News

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

U.S. EPA / via Wikimedia Commons U.S. EPA / via Wikimedia Commons

Last month, Physicians for Social Responsibility and Concerned Health Professionals of New York released the third edition of their Compendium of Scientific, Medical, and Media Findings Demonstrating Risks and Harms of Fracking. This document summarizes more than 500 peer-reviewed studies on hydraulic fracturing (fracking),  along with many government and investigative journalism reports.

Fracking involves drilling into the earth and injecting a mixture of water, sand, and chemicals into the rock at high pressure to release the gas inside. There is extensive evidence to demonstrate health risks, environmental damage, and contributions to climate change caused by this practice.

The compendium is intended for policy makers, researchers, journalists, and the public. Specific fracking-related problems identified in this body of literature include the following:

  • Public health impacts, including respiratory disease and congenital abnormalities
  • Air pollution
  • Water contamination
  • Soil contamination and its effects on agriculture
  • Radioactive releases
  • Inherent engineering problems
  • Occupational health and safety hazards
  • Impacts from fracking-associated infrastructure, including noise, light, and diesel pollution
  • Earthquakes and seismic activity
  • Climate change (primarily from methane leaks)

[…]

2016-11-21T13:01:42-05:00December 2nd, 2015|Nursing, nursing perspective, Public health|3 Comments
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Imagery: A Safe, Simple Practice Available to All Nurses

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

by Ramon Peco/via Flickr by Ramon Peco/via Flickr

“In our quest to keep up with the latest medical advances, we often forget that the healing art of imagery is available to each of us,” writes nurse practitioner Laurie Kubes in this month’s AJN. In “Imagery for Self-Healing and Integrative Nursing Practice,” Kubes explores some of the evidence supporting this technique and illustrates how it can enhance both patient care and our own self-care.

Imagery builds upon the quiet reassurance and support that we routinely provide to patients in our efforts to make them comfortable and relaxed. The more deliberate practice of imagery engages the power of imagination for deeper relaxation and a potentially more healing experience. And all we need in order to do this, as Kubes notes, is an open mind, a basic knowledge of the practice, and time to dedicate to it.
[…]

2016-11-21T13:01:43-05:00November 23rd, 2015|Nursing, nursing perspective, patient engagement, Patients|1 Comment
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Ebola, One Year Later: What We Learned for the Next Big Epidemic

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

Scanning electron micrograph of filamentous Ebola virus particles budding from an infected VERO E6 cell (35,000x magnification). Credit: NIAID Scanning electron micrograph of filamentous Ebola virus particles budding from an infected VERO E6 cell (35,000x magnification). Credit: NIAID

U.S. hospitals have not seen a case of Ebola virus disease since November 11, 2014, when Dr. Craig Spencer was discharged from Bellevue Hospital Center in New York City. While the number of new infections has declined dramatically in the West African countries where the 2014–2015 epidemic began, it is virtually certain that the disease will continue to resurface.

This epidemic was by far the largest and most geographically widespread Ebola epidemic to date, with approximately 28,000 cases (suspected, probable, or confirmed) and more than 11,000 deaths in Liberia, Guinea, and Sierra Leone, the three hardest-hit countries. The seven other countries affected account for a combined total of 34 confirmed (and two probable) cases and 15 deaths.

According to a recent WHO report, these numbers include (through March of this year) 815 confirmed or probable cases among health care workers, more than half of whom were nurses or nurses’ aides. (Doctors and medical students made up about […]

2016-11-21T13:01:48-05:00November 6th, 2015|healthcare social media, infectious diseases, Nursing, nursing perspective|11 Comments
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Do Schools Still Have Nurses?

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

by woodley wonderworks, via Flickr. by woodley wonderworks, via Flickr.

In the December 1903 issue of AJN (reprinted, with an editor’s commentary, in September 2014), Henry Street Settlement nurse Lina L. Rogers described the impact of the first school nurse program in the United States. Ms. Rogers, who worked with Henry Street founder Lillian Wald to establish the program in New York City schools, emphasized that their purpose was not only to improve children’s health but to decrease missed school days.

Wise community leaders have long acknowledged the importance of school nursing in accomplishing these goals. But in recent years, this hasn’t prevented cutbacks that eliminate or severely limit the care that nurses can provide to their school communities.

An  October 10 article in the Philadelphia Inquirer describes an acute shortage of nurses in Philadelphia schools. Detailed here are multi-school coverage by individual RNs, wildly unrealistic caseloads for many of the nurses, and the significant responsibilities for “medical care” now borne by non-nurse teachers and administrators. In the article, Terry Jordan, president of the Philadelphia Federation of Teachers, underscores the complexities of school nurse work, noting, “We have so many families living in deep poverty, and for some of these […]

2016-11-21T13:01:51-05:00October 16th, 2015|Nursing|4 Comments
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