About Diane Szulecki, editor

Editor, American Journal of Nursing

Nursing Protocol for Stroke Increases Survival, Reduces Disability

image via Flickr / Vormingplus Gent-Eeklo vzw

As we report in a July news article, a new study showed that a nursing care plan for stroke, implemented in the first 72 hours after admission, reduced deaths and disability compared with standard stroke care. The protocol—which was implemented on 19 acute stroke care units in New South Wales, Australia—treated fever, hyperglycemia, and dysphagia using the following interventions:

  • Fever: Temperature monitoring every four hours; administration of paracetamol to lower temperature when needed
  • Hyperglycemia management: Blood glucose monitoring and saline or insulin infusion if indicated
  • Dysphagia detection: Nurses were trained by speech pathologists and assessed to test competency in screening for swallowing problems.

The study included 1,076 patients and confirmed the protocol’s positive outcomes four years later. (The same research group had conducted an earlier study showing the benefits after 90 days.) The authors hypothesized that rigorous implementation of the protocol in an organized stroke services setting helped preserve key tissue. […]

2017-07-12T10:20:34-04:00July 12th, 2017|Nursing|0 Comments
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July Issue Highlights: Health and the Microbiome, Poststroke Depression, Need for Diverse Blood Donors, More

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

CE Feature: Health and the Human Microbiome: A Primer for Nurses

The profound impact of the human microbiome on health makes it imperative that nurses understand the basic structures and functions of the various microbial communities. This article provides an overview of the current state of knowledge about the human microbiome—with a focus on the microbiota in the GI tract and the vagina, the two most commonly studied body sites—and discusses implications for nursing practice.

CE Feature: Early Intervention in Patients with Poststroke Depression

Nearly one-third of stroke survivors experience depression. Poststroke depression is associated with longer hospital stays, poor physical and cognitive recovery, poor quality of life, high caregiver distress, increased risk of recurrent stroke, and higher rates of morbidity and mortality. However, it often goes unrecognized and untreated. The authors of this article explain how poststroke depression often manifests, describe associated risk factors, and discuss the screening tools and therapeutic interventions nurses can use to identify and help manage depression in patients following stroke.

Clinical Feature: The Growing Need for Diverse Blood Donors

The chief nurse of the American Red Cross discusses how changing […]

2017-07-27T11:21:04-04:00June 23rd, 2017|Nursing|0 Comments
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New Warnings About Protecting Children from Dangerous Substances in the Home

Photo © Istock.

As we report in a June news article, findings from several recent studies have underscored the importance of educating parents on how to keep younger children as well as older adolescents safe from exposure to dangerous substances they might accidentally ingest or deliberately seek out. Nurses can talk to parents about safe storage, ask questions about the presence of potentially hazardous substances in the home, and provide information about risks and precautions.

MARIJUANA

A study of the National Poison Data System found an increase in the rate of marijuana exposure (including edible products) among children younger than six. The rates were higher in states that had legalized the use of marijuana—an implication to be aware of as more states do the same.

HAND SANITIZERS

Another study, conducted by the Centers for Disease Control and Prevention, identified health risks in young children who had ingested alcohol-based hand sanitizers. The researchers drew attention to dangers associated with inadequate safety precautions when these products are used with young children, as well as the possibility that older children might abuse them. […]

2017-06-12T09:32:38-04:00June 12th, 2017|Nursing, pediatrics|0 Comments
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June Issue Highlights: Understanding Antipsychotics, Talking to Pregnant Smokers, IBS Basics

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

CE Feature: Mental Health Matters: Antipsychotic Medications

In recent years, more adults—and teenagers—are taking at least one type of psychotropic medication, the majority of which are prescribed by primary care and family physicians. This first article in a series on commonly used psychotropic medications for the treatment of mental illness reviews the mechanisms of action, adverse effects, and contraindications of first-generation typical and second-generation atypical antipsychotics.

CE Feature: Original Research: The Experiences of Pregnant Smokers and Their Providers

According to the Centers for Disease Control and Prevention, 10.7% of women nationwide reported smoking during their last trimester. The U.S. Department of Health and Human Services’ initiative Healthy People 2020 targets tobacco use, including smoking during pregnancy, as a continuing major health concern in this country. Yet bringing the U.S. Public Health Service’s 2008 clinical practice guideline, Treating Tobacco Use and Dependence, into routine prenatal care remains challenging.  The authors of this study conducted focus groups of pregnant smokers and their providers, most of whom were RNs, to better understand their experiences and to gain insights to help providers best deliver the stop-smoking message.

Clinical Feature: 

2017-05-30T11:44:24-04:00May 30th, 2017|Nursing|0 Comments
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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. […]

2017-05-15T09:13:26-04:00May 15th, 2017|Nursing|2 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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