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ANA Chart Compares Key Nursing Provisions in House and Senate Bills

By Judith Leavitt, MEd, RN, FAAN

There’s a tremendous amount of information available about the different congressional proposals on health reform. But it’s difficult to know how the proposed legislation might affect nurses and the profession. The American Nurses Association has just released an excellent chart offering side-by-side comparison of key provisions related to nursing in the two current bills, the House bill (H.R. 3962) and the Senate bill (H.R. 3590). These provisions include:

  • increased financial support for nursing recruitment and advanced education
  • increased funding for graduate education for nursing faculty
  • increased funding for education for students who will practice in underserved areas
  • establishment of a Public Health Workforce Corps
  • increased Medicare reimbursement rates for advanced practice nurses, including nurse–midwives
  • pilot programs to provide reimbursement under Medicare for nurse practitioners to create or lead “medical homes”
  • increased reimbursement to school-based health clinics under Medicaid

There’s much more to be gleaned here, and the chart format makes scanning for particular points of interest easy. Have a look!

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2016-11-21T13:20:44-05:00December 4th, 2009|career, health care policy, nursing perspective, students|1 Comment
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An End to Interruptions: Nurses Preventing Medication Errors

By Christine Moffa, MS, RN, AJN clinical editor

By NathanF/via Flickr (Creative Commons) By NathanF/via Flickr (Creative Commons)

Interruptions are distracting.

I have a hard time focusing when I am repeatedly interrupted. How many times have you walked down the hall to get something, met with an unexpected request or encounter, and then found you couldn’t remember where you were going or why?

A few years ago I was working as float nurse in an outpatient facility. One of the specialties I floated to was the pediatric clinic. There were seven or eight nurses (a mix of RNs and LPNs) working at the same time, with half assigned to administering medication, mostly vaccines, and the others performing telephone triage and monitoring patients in the observation room.  I can now admit that I used to pray to get assigned to the triage section—not because giving injections was a problem, but because the setup of their system terrified me. […]

2019-04-11T14:14:07-04:00November 5th, 2009|nursing perspective, nursing research, patient safety|7 Comments
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Trauma in Pregnancy: An Expert’s Calm Look at What Nurses Need to Know

PregnantTrauma.

By Sylvia Foley, AJN senior editor

In this month’s CE feature on Trauma in Pregnancy, author Laura M. Criddle takes a calm look at a distressing subject. After outlining possible mechanisms of injury, Criddle reminds readers that “trauma care priorities don’t change when the patient is pregnant.” Initial interventions will still focus on the “ABCs”—airway, breathing, and circulation. She also points out that the fetus’s best chance for survival is “vigorous resuscitation of the mother,” since most fetuses will not survive maternal death.

However, the normal changes of pregnancy can affect both the nature of injury and the body’s responses; this has important implications for nursing care. Among Criddle’s key points:

  • Compression and displacement of various organs occur as pregnancy advances. This makes some injuries more likely, others harder to detect.
  • The normal changes of pregnancy can mask the signs of decompensation.
  • Pregnancy and its changes can also make complications after injury more likely.

Criddle provides several examples for each point. She also offers strategies for assessment and interventions for both mother and fetus.

Have you cared for pregnant trauma patients? What was the experience like? Please tell us in the comments.

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2016-11-21T13:21:20-05:00November 3rd, 2009|nursing perspective|2 Comments
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October Poem: An Emergency Nurse’s “Purgatory”—and Sanctuary

Purgatory_screenshot.partial4In  “Purgatory,” poet and ED nurse Stacy R. Nigliazzo writes about the sick and the stranded as they wait their turns at a hospital Emergency entrance—and the “nurse behind the bulletproof glass” who summons each in turn, her raw voice “calling sanctuary.” Read the poem here; listen to the poet’s reading here.

If this piques your curiosity, take a look at previous issues (Art of Nursing is always free; you might need to access page 2 or 3 of an issue’s table of contents to find it). To hear more poems read by their authors, click here. Interested in submitting your own work to Art of Nursing? Read this blog post for details. Guidelines can be found here; and if you still have questions, feel free to write to the Art of Nursing coordinator (me) at sylvia.foley@wolterskluwer.com.

Sylvia Foley, AJN senior editor

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2016-11-21T13:21:45-05:00October 14th, 2009|nursing perspective|0 Comments
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Administering Drugs through a Feeding Tube—Are You Sure You’re Doing It Right?

Drug Administration through an EFT

By Sylvia Foley, AJN senior editor

Research indicates that a “surprising number of nurses”  fail to follow guidelines for preparing and delivering drugs through an enteral feeding tube. (Do you find this surprising? Tell us in the comments!) This can result in medication error and tube obstruction, reduced drug effectiveness, and an increased risk of toxicity.

In this month’s CE feature Drug Administration Through an Enteral Feeding Tube, author Joseph I. Boullata describes the factors to consider before doing so and examines the gap between recommended and common practice. He also explains what the most recent guidelines from the American Society for Parenteral and Enteral Nutrition (ASPEN) recommend and why.

The ASPEN guidelines include:

  • Do not add medication directly to an enteral feeding formula.
  • Administer each medication separately though an appropriate access site.
  • Liquid dosage forms should be used when available and if appropriate; only immediate-release solid dosage forms may be substituted.
  • Dilute the solid or liquid medication as appropriate and administer using a clean oral syringe.
  • Avoid mixing medications intended for administration through an EFT.

For the complete guidelines, check out Table 1 in the article. And for more on this and other aspects of  enteral nutrition, visit ASPEN to read the full 2009 Enteral Nutrition Practice Recommendations. (ASPEN guidelines are free, but site registration is required.)

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2016-11-21T13:21:58-05:00October 5th, 2009|nursing research|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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