About Betsy Todd, MPH, RN

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

How’s Your N95 Supply These Days?

Since the pandemic began to wreak havoc in the U.S., my first question to bedside nurses has been, “Do you have enough PPE?” To my amazement, even as hospital admissions surged, many nurses told me that yes, they had a good supply of N95s. I quickly learned to be more specific: “How often do you receive a new N95?” Sometimes, the answer was “every shift.” More often, nurses told me “every week,” sometimes adding, “but I cover it with a new surgical mask every day.”

Redefining the PPE norm.

And so, barely a month into the pandemic, nurses had quickly adapted to a new normal. These days, it seems that N95 supplies are “good” when we have any at all. Certainly, nurses continue to protest our lack of PPE. But how did we arrive at this place where we are glad to have any protection at all?

“The lack of essential personal protective equipment (PPE) has been a defining characteristic of the coronavirus pandemic. From the beginning, respiratory protection guidance was driven by shortages of N95 respirators and surgical masks rather than by the well-established standards of infection prevention and control.”

In this month’s AJN Reports, we look at why PPE supplies are still suboptimal and likely […]

2020-06-19T15:07:18-04:00June 19th, 2020|Nursing|1 Comment
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Are You on Top of Your Patient’s Lab Values?

“Alterations in potassium, chloride, BUN, and creatinine provide important information about patients’ renal function, volume status, and acid-base balance… [and] demonstrate the importance of the nurse’s ability to integrate laboratory results with patient history, hospital course, physical examination findings, and underlying physiological mechanisms.”

Years ago, I monitored my patients’ labs by checking to see which results had been flagged by the lab as abnormal and making sure the physician was aware of these. I was on top of glucose and PTT’s, and knew well the steps we had to take in order to correct abnormal glucose or coagulation levels.

But I was fuzzy on the significance of many other changes in blood chemistry or hematology, and rarely connected any lab values with the larger picture of the patient’s overall health trajectory—nor, for that matter, was I expected to, back in the 1980s.

Today, nurses are more intimately involved in monitoring and managing lab abnormalities. […]

2020-06-09T06:35:53-04:00June 9th, 2020|Nursing|0 Comments
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Environmentally Sustainable Nursing Practices: Small Changes Make a Big Difference

“The decisions nurses make about waste and efficiency on the front lines of clinical care matter, and the potential impact on health and the environment should not be underestimated.”

These days, most nurses have little time for anything that isn’t COVID related. Either we’re inundated with patients, changing work flow and physical spaces to accommodate long-term social distancing, or trying to home-school our kids or plan the next trip to the grocery store. Inevitably, though, our attention will return to other urgent issues in health care. The impact of our everyday work practices on the health of the planet is one of these issues.

How often do you toss unused linen into a laundry hamper after a patient is discharged, or discard leftover but unopened supplies that have been in a patient’s room, or hurriedly throw away soiled “chux” in a “red-bagged waste” container because that’s the nearest receptacle? In “Reducing Waste in the Clinical Setting” in this month’s issue, Sara Wohlford and colleagues at Carilion Roanoke Memorial Hospital in Roanoke, Virginia, share how increased attention to wasteful practices and modest changes in workflow can impact the environment and save money.

Small changes in three areas can make a big difference.

The authors looked at three […]

2020-06-04T10:11:36-04:00June 4th, 2020|environmental health, Nursing, nursing research|0 Comments
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How Can We Improve the Hospital Experience of Visually Impaired Patients?

VIP Care Toolbox used in QI project

“Hello, I’m your nurse, Jane. Are you able to see me clearly?”

I have trouble functioning without a pair of eyeglasses within reach. If I were in the hospital without my glasses, I’d be at a loss—unable to read for pleasure, let alone read menus or instructions or consent forms. How much harder is it for people with moderate vision loss, or those who are totally blind?

Christine Carlson and her colleagues at St. David’s North Austin Medical Center in Austin, Texas, set out to answer this question. They met with visually impaired people in the community, reviewed the literature, and surveyed their own staff in order to learn the best ways to accommodate the unique needs of visually impaired patients, or ‘VIPs.’

In “Caring for Visually Impaired Patients in the Hospital: A Multidisciplinary Quality Improvement Project” in the May issue of AJN, the authors highlight how frightening and frustrating a hospitalization can be for those with limited or no sight, and share simple, practical interventions that can make an enormous difference in the safety and quality of a VIP’s hospital experience.

“I’m always afraid to go to the hospital. They don’t know […]

2020-05-21T09:52:23-04:00May 21st, 2020|patient experience, Patients|0 Comments
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The U.S. Still Can’t Manage COVID-19 Testing: Why Is This Such a Big Deal?

By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor. Published April 20.

How is it that we in the U.S. make up 4% of the world’s population but account for more than 31% of global COVID-19 cases? Because at the start of the pandemic we weren’t prepared to test quickly and widely—and incredibly, after three months’ time, we still aren’t.

Coincidentally, both the U.S. and South Korea saw their first cases of COVID-19 on January 20. Two weeks later, South Korean scientists had perfected a diagnostic test for the virus, and infected people began to be identified and isolated.

Meanwhile, in the U.S. a series of problems and poor decisions held back test development. In early March, as the number of cases of COVID-19 exploded in parts of the country, Health and Human Services Secretary Alex Azar promised that by March 14, labs would be running four million tests per week. As of April 20, the total number of SARS-CoV-2 tests performed in the U.S. since the pandemic began was only 3.8 million, according to covidtracker.com. Our testing capacity is frighteningly low. Estimates of an adequate […]

2020-04-20T12:32:03-04:00April 20th, 2020|infectious diseases, Nursing, Public health|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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