About Diane Szulecki

Editor, American Journal of Nursing

How Long Should Routine Health Screening Continue in Older Adults?

Photo by Johner Images / Alamy Stock Photo

Communicating to older patients that routine screening tests are no longer recommended can prove difficult. Recent research, however, offers guidance on how nurses and other clinicians should approach such conversations.

As we report in a September news article, a study focused on cancer screening found that older adults unlikely to benefit from certain tests were receptive to recommendations to stop screening, with a caveat: they preferred that life expectancy not be a part of the conversation.

The study’s accompanying editorial notes that broaching the topic of life expectancy can turn a discussion about maintaining health into an unexpected discussion about the end of life, which “may be a shock in the primary care setting at a routine visit.” The authors of the study recommend changing the language used in these conversations—for example, saying “This test would not help you live longer” instead of referring to “life expectancy.” […]

2017-09-06T09:21:09+00:00 September 6th, 2017|Nursing, patient engagement|1 Comment

AJN September Issue: Family Caregivers and Alzheimer’s, Older Adults and Driving, C. Diff. Prevention, More

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

CE: Original Research: The Experience of Transitioning to a Caregiving Role for a Family Member with Alzheimer’s Disease or Related Dementia

This qualitative study explores the experiences of people who transitioned to the role of caregiver for a family member with Alzheimer’s disease or a related dementia. Vivid interview excerpts illuminate the inner struggles caregivers may experience as they navigate a radically changed existence as well as the strategies that have helped them find their way.

CE: Can Your Older Patients Drive Safely?

Many older Americans depend on their cars for independence and connection to the outside world. What are the driving risks associated with advanced age? What behaviors and situations put older drivers at greatest risk, and what are the key indicators of an older patient’s ability to drive safely? Nurses are in a position to raise patients’ awareness of these risks and inform them about transportation alternatives.

Six Things You Can Do Today to Prevent Hospital-Onset C. Difficile Tomorrow

What changes can you make in your practice to prevent transmission of this common bacterial infection?

Lessons Learned from Litigation: Legal and Ethical Consequences of […]

2017-08-25T09:03:28+00:00 August 25th, 2017|Nursing|0 Comments

U.S. Life Expectancy Varies Depending on County of Birth

image via Wikimedia Commons / Wapcaplet

A new study that compared life expectancy by county from 1980 to 2014 has shed light on geographic disparities, which have been increasing over the past 35 years. One of the study’s major findings, as we report in an August news article, is that the difference in life expectancy between the U.S. county with the highest life expectancy and the one with the lowest is 20.1 years.

The counties with the lowest life expectancies include several in North Dakota and South Dakota (in particular, those with Native American communities), and counties along the lower half of the Mississippi River and in Kentucky and West Virginia. Meanwhile, counties in central Colorado have the highest life expectancies.

While national life expectancy increased from 73.8 years to 79.1 years during the study period, the researchers noted regional inequalities in this improvement: some counties in the South experienced little to no improvement in life expectancy, while others on both coasts and in Colorado and Alaska saw large increases. They also found that geographic differences in life expectancy decreased for children and adolescents but increased for adults—especially for those ages 65 to 85 years. […]

2017-08-11T09:04:39+00:00 August 11th, 2017|Nursing|0 Comments

August Issue Highlights: TB Screening, The Baby-Friendly Hospital Initiative, Antibiotic Stewardship, More

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

CE Feature: Tuberculosis: A New Screening Recommendation and an Expanded Approach to Elimination in the United States

The U.S. Preventive Services Task Force (USPSTF) recently issued a new recommendation statement on latent tuberculosis infection testing that expands nurses’ opportunities to identify at-risk populations for tuberculosis prevention. This article provides a general overview of tuberculosis transmission, pathogenesis, and epidemiology; presents pre­ventive care recommendations for targeted testing among high-risk groups; and discusses the USPSTF rec­ommendation’s applicability to public health and primary care practice in the United States.

CE Feature: Beyond Maternity Nursing: The Baby-Friendly Hospital Initiative

The Baby-Friendly Hospital Initiative (BFHI) is a program developed by the World Health Organization and the United Nations Children’s Fund to promote breastfeeding in hospitals and birthing facilities worldwide. Since the program was launched in 1991, breastfeeding initiation, duration, and exclusivity have increased globally, a trend largely attributed to changes in hospital policies and practices brought about by the BFHI. This article provides an overview of these practices and policies, the insti­tutional benefits of achieving BFHI certification, and the process through which health care facilities can do so.

Original Research: The Effects of […]

2017-07-28T09:41:48+00:00 July 28th, 2017|Nursing|0 Comments

There from the Start: A Hospice Nurse Looks Back

A painting of Dianne Puzycki, RN, hangs in Connecticut Hospice in New Haven.

At age 82, Dianne Puzycki has yet to retire from nursing—she still works the night shift once a week at Connecticut Hospice in Branford, where she’s been employed since the organization’s inception in the 1970s. Founded by Florence Wald, it was the first hospice in the United States.

Puzycki started her career in 1955 at Memorial Hospital in New York City, caring for patients with cancer at a time when death and dying wasn’t openly discussed. “We weren’t allowed to talk about that. It really haunted me for years,” she told AJN in a July profile. Several years later, she encountered two influential women: Dame Cicely Saunders, who founded the first modern hospice, and Elisabeth Kübler-Ross, who introduced the concept of the five stages of grief in her groundbreaking 1969 book On Death and Dying. Seeing them speak piqued her interest in the hospice movement, and she began volunteering for Connecticut Hospice, which eventually led to a full-time job.

Throughout the decades, says Puzycki, she’s witnessed hospice care constantly change and improve. She recalls that in the past, more patients used to stay up at night, afraid, spending time in a family room near the nurses’ station—but now, “most people sleep […]

2017-07-26T09:35:44+00:00 July 26th, 2017|Nursing, nursing career|1 Comment