About Diane Szulecki

Associate editor, American Journal of Nursing

Should Adults Experiencing In-Hospital Cardiac Arrest Be Intubated?

Photo by A.J. Heightman / Journal of Emergency Medical Service / PennWell Corp.

Although it’s commonly practiced, results from a large new study call into question the effectiveness of intubating adults who experience in-hospital cardiac arrest.

As we report in a May news article, researchers analyzed data for 108,079 adult patients who experienced cardiac arrest in the hospital between 2000 and 2014—and found that patients who were intubated within the first 15 minutes of arresting were less likely to survive than patients who were not.

Among other findings, intubated patients were less likely to experience a return of spontaneous circulation and had a lower rate of good functional outcome (defined as either mild or no neurological deficit, or only moderate cerebral disability).

The researchers concluded that the study results do not support early intubation for adults who experience cardiac arrest. However, they noted that their analysis was unable to eliminate potential confounders like the skills and experience of health care professionals, the underlying cause of the cardiac arrest, and the quality of chest compressions. Additional clinical trials are needed to yield useful results and to better understand the influence of confounding factors. […]

2017-05-15T09:13:26+00:00 May 15th, 2017|Nursing|2 Comments

AJN in May: Venous Thromboembolism Update, Deep Tissue Pressure Injury Review, Much More

The May issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Original Research: Creating an Evidence-Based Progression for Clinical Advancement Programs

The Institute of Medicine (IOM) and the Quality and Safety Education for Nurses (QSEN) project have identified six nursing competencies and supported their integration into undergraduate and graduate nursing curricula nationwide. But integration of those competencies into clinical practice has been limited, and evidence for the progression of competency proficiency within clinical advancement programs is scant. Building on the competencies identified by the IOM and QSEN, the authors of this study developed eight nursing competency domains and 186 related knowledge, skills, and attitudes for professional nursing practice, then sought to validate them and to determine their developmental progression within a clinical advancement program.

CE Feature: Venous Thromboembolism: Updated Management Guidelines

Each year, as many as 900,000 cases of venous thromboembolism occur in the United States; between 100,000 and 300,000 cases end in death. This article presents an overview of venous thromboembolism—including its pathophysiology, risk factors, symptoms, and key clinical assessments—plus a review of recommendations from an updated American College of Chest Physicians guideline related to treatment options, nursing practice, patient education, diagnostic testing, and more.

2017-04-28T09:09:57+00:00 April 28th, 2017|Nursing|0 Comments

A National Standard to Prevent Health Care Workplace Violence?

National Nurses United joined members of Congress to speak out at a press conference unveiling findings from the Government Accountability Office’s 2016 report on workplace violence prevention in health care. Photo courtesy of National Nurses United.

In 2014, health care and social assistance workers suffered injuries from workplace violence at a rate more than four times higher than that of private sector employees. What can be done to keep health care workers safe on the job?

As we report in an April news article, National Nurses United, AFL–CIO, and other unions have petitioned the Occupational Safety and Health Administration (OSHA) to create a federal standard for preventing health care workplace violence. OSHA issued a request in December for information on the subject, and held a public hearing in January in which health care workers spoke about their experiences of workplace violence and their ideas for improving safety and protection policies. Through early April, the agency collected comments from the public on a federal standard—but uncertainty surrounds its direction under the Trump administration.

Nine states have enacted measures against workplace violence in health care settings. The toughest of these is California’s Workplace Violence Prevention Health Care standard, which was enacted last year. It requires health care facilities to implement a comprehensive program with multiple components for addressing workplace violence.

See more news stories from our April issue, which are free to access through April 21:

2017-04-14T08:49:22+00:00 April 14th, 2017|Nursing|0 Comments

AJN in April: Nurse Perceptions of Risk for Harm, Climate Change and Mental Health, More

The April issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Original Research: Do Nurses or Electronic Assessment Tools Better Predict Risk for Harm?

In many hospitals, nurse-led “safety huddles” are used to relay patient safety information, although whether this effectively identifies patients at risk for harm has not been determined. New electronic risk assessment tools are designed to identify patients at risk for harm during hospitalization, based on specific markers in the electronic health record. The authors of this study compared the results of both methods, finding statistically significant differences in the way nurses and data mining software identify risk of harm. In many instances, factors that the software captured had been anticipated by the nurses or were already addressed in the plan of care.

CE Feature: Overactive Bladder in Women

This article provides an evidence-based review of the screening, assessment, and management of overactive bladder in women, many of whom do not seek help for the condition and try to self-manage its symptoms, which may inadvertently worsen them. Those with overactive bladder often experience related physical and psychological symptoms and report a poorer quality of life than other women. However, many […]

2017-03-27T09:34:06+00:00 March 27th, 2017|Nursing|0 Comments

March News: Kangaroo Care Benefits, APRN Practice Authority Gains, More

Here are some of the news stories you’ll find in our current issue:

A new mother holds her baby in the neonatal intensive care unit of Johns Hopkins All Children’s Hospital. Photo by Scott Keeler / Tampa Bay Times / The Image Works.

Benefits of Kangaroo Care for Premature Babies Continue into Young Adulthood

“Kangaroo care” involves skin-to-skin contact, breastfeeding when possible, and early hospital discharge with close monitoring. A study that followed infants who were no more than 4 lb. at birth found that the benefits of kangaroo care remained 20 years later.

VA Grants Most APRNs Full Practice Authority

A new VA rule allows three […]

2017-03-07T08:57:13+00:00 March 7th, 2017|Nursing|0 Comments