Diane Szulecki, editor, Author at Off the Charts

August Issue: Pain in Nonverbal Children, Sepsis Update, Particulate Matter Exposure, More

“I didn’t really know what to do . . . . This happened to other people’s families, not mine. I was supposed to be reading the monitors and titrating the drips. I was supposed to be taking care of the patient. I was supposed to be comforting the family. I was the nurse.” —Tonja Padgett, author of this month’s Reflections essay, “The Crazy Aunt or the Nurse“

The August issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: Pain in Nonverbal Children with Medical Complexity: A Two-Year Retrospective Study

Children with medically complex conditions often experience pain, but in the absence of self-report, assessing pain can be challenging. The authors of this article sought to describe the signs and symptoms parents of such children find worrisome, the sources of pain in these children, and how to best assess their pain.

CE: A Review of the Revised Sepsis Care Bundles

An update on recent revisions to the sepsis care guidelines, including development of the new one-hour bundle, plus screening and assessment tools to identify sepsis in the ICU, in the ED, on the medical–surgical unit, and outside the hospital.

Environments and Health: Nursing Practice and Particulate Matter Exposure

Both indoor and outdoor particulate matter […]

Diane Szulecki, editor2018-07-27T09:18:49-04:00July 27th, 2018|Nursing|0 Comments

July Issue: Ketamine Analgesia During Burn Care, Breast Cancer Screening Update, Difficult IV Access, More

“How powerful would it be if every nurse took one action today to improve her or his community’s health?” —Barry Ross, MPH, MBA, BSN, RN, author of this month’s Viewpoint

The July issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: The Efficacy and Safety of an RN-Driven Ketamine Protocol for Adjunctive Analgesia During Burn Wound Care

Because of its unique mechanism of action and lack of association with respiratory depression, ketamine may be an ideal agent for adjunctive analgesia in burn patients. The authors of this study evaluated the efficacy and safety of a practice protocol allowing critical care RNs to independently administer IV ketamine for burn wound care.

CE: Breast Cancer Screening: A Review of Current Guidelines

In light of recent changes to national breast cancer screening guidelines, this article reviews the guidelines of the American Cancer Society, the U.S. Preventive Services Task Force, and the National Comprehensive Cancer Network and provides guidance to nurses as they support and educate patients.

Special Feature: Ethics Champion Programs

The authors, all of whom lead ethics champion programs at their respective […]

Diane Szulecki, editor2018-06-29T08:14:55-04:00June 29th, 2018|Nursing|0 Comments

In Colorado EDs, ‘Alternative to Opioids’ Pilot Project Exceeds Goals

Ashley Copeland talks to her mother in the Swedish Medical Center ED. Copeland was treated for a severe headache with a nerve-blocking anesthetic, but no opioids. (John Daley/CPR News)

Last year, in an effort to address the state’s acute opioid abuse problem, several Colorado health care organizations—including the Colorado Emergency Nurses Association—worked together on an intervention to target patients admitted to the ED with pain. The plan? Implement a pain management program to promote alternative strategies, with a goal of decreasing opioid usage by 15% in the participating EDs.

As discussed in a June news article, the program, which was piloted in 10 hospitals and involved heavy involvement from nurses, surpassed its goal: opioid usage during the intervention period (as measured in morphine equivalent units) was 36% less than in the previous year.

The pilot project […]

Diane Szulecki, editor2018-06-14T09:29:35-04:00June 14th, 2018|Nursing, patient experience|1 Comment

June Issue: Hearing-Impairment and Hospitalization, Gaucher Disease, an Early Mobility Protocol, Giving and Getting Report, More

“The problem is the insidious way personal smartphones divert and fracture our attention. If you don’t take work home with you, why is it okay to bring home to work?” —Kathleen Bartholomew, MN, RN, author of this month’s Viewpoint

The June issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: Understanding the Hospital Experience of Older Adults with Hearing Impairment

Older hospitalized adults with hearing impairment may be labeled confused, experience heightened fear and anxiety, or misunderstand the plan of care. This qualitative study assessed the hospital experience of hearing-impaired patients in order to formulate suggestions for improving nursing care.

CE: Understanding the Nurse’s Role in Managing Gaucher Disease

The author discusses the epidemiology and pathophysiology of Gaucher disease—a lysosomal storage disorder that can affect the spleen, liver, bones, bone marrow, and central nervous system—as well as recent advances in screening, diagnosis, and management.

Cultivating Quality: The Benefits of Implementing an Early Mobility Protocol in Postoperative Neurosurgical Spine Patients

The authors present their quality improvement initiative to establish an NP-led early mobility protocol aimed at reducing uncomplicated postsurgical spine patients’ length of hospital stay and eliminating the […]

Diane Szulecki, editor2018-05-25T08:48:44-04:00May 25th, 2018|Nursing|0 Comments

From Staff Nurse to CEO

Regina Cunningham, PhD, RN, NEA-BC, FAAN, and Kevin Sowers, MSN, RN, FAAN, both started their nursing careers as staff oncology nurses. Today, Cunningham is chief executive officer of the Hospital of the University of Pennsylvania in Philadelphia; Sowers is president of the Johns Hopkins Health System and executive vice president of Johns Hopkins Medicine in Baltimore, Maryland.

As they told AJN in our May Profiles article, neither necessarily envisioned themselves as high-level leaders. So how did they get to where they are today, and what can fellow nurses learn from their experiences?

TAKING CHANCES

After getting a master’s degree in nursing administration, and while earning a doctorate, Cunningham (photo at right) worked her way into progressively larger leadership roles within oncology nursing. Her experiences as a nurse manager and a nursing director led her to become the chief nursing officer at a New Jersey cancer center. Then, after serving as senior director for cancer nursing at Mount Sinai Medical Center in New York City, she worked in nursing leadership at the Hospital of the University of Pennsylvania.