About Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)

Editor-in-chief, (emerita), AJN

Health information Technology, EHRs, Meaningful Use, and Nursing

By Maureen Shawn Kennedy, MA, RN, AJN editor-in-chief

If you’re like most nurses working in a health care organization, you’ve been involved in a migration to electronic health records, computerized physician order entry (CPOE), or bar code medication administration.

If you’re lucky, nursing input was considered during the planning stages of all this health information technology (HIT). We’ve heard from many nurses (and have had a few submissions from nurses about their experiences—see for example the Reflections essay “Paper Chart Nurse”) who have had “issues” with the systems or who wonder, why the big push?

In the August issue of AJN, which is available online and on the iPad (download the app here), Susan McBride and colleagues John Delaney and Mari Tietze debut their three-part series on HIT. The first article, “Health Information Technology and Nursing,” examines the federal policies behind efforts to expand the use of this technology, the importance of meaningful use, and the implications for nurses. Subsequent articles upcoming in the fall will take a closer look at the use of HIT to improve patient safety and quality of care, and the important role nurses are playing—and could play—in this system-wide initiative.

It’s crucial for nurses to understand HIT. As the authors note,

“If HIT systems are going to truly improve care, nurses need a voice in their planning and development to ensure patient safety and system usability. The success of this technology depends on nurses informing the […]

About Those Death Panels

By Shawn Kennedy, AJN editor-in-chief

Diana Mason, former editor-in-chief of AJN, wrote a post on July 9 on the JAMA Forum blog that’s well worth reading. In it, she talks about the resurgence of “death panels” rhetoric to stir opposition to the Affordable Care Act (ACA), specifically in relation to the Independent Payment Advisory Boards, which are to issue binding recommendations for controlling costs if Medicare grows too rapidly.

In a nutshell, these boards will determine where to reduce costs. If Congress opposes the plan, it will have to come up with same-size cost cuts if it doesn’t want to institute what the board recommends. The message that opponents of the ACA want the public to hear is that their fates will be determined not by them but by an arbitrary committee.

But IPABs are about reducing costs of programs, not passing judgment on individuals.  (As Mason notes, the death panel rhetoric was “declared the “2009 Lie of the Year” by PolitiFact, a project of the Tampa Bay Times and partner news organizations.”)

People should have conversations about how they wish to be treated in their last moments, but these should occur with loved ones and direct care providers and be supported by the legal system. People shouldn’t have to worry that they will be rushed along to death if they’re not ready—in fact, this seems […]

Nurse Staffing: Are the Brits on the Right Track?

By Maureen Shawn Kennedy, AJN editor-in-chief

hazard/jasleen kaur, via Flickr

According to an article at Nursing Times, hospitals in England may be required to publish “nurse-to-bed” ratios as part of an overall “dashboard” of indicators to measure  performance. While some say this is a step forward, UNISON, the public service union that represents nurses, argues that the better ratio to measure is nurse-to-patient and that variables in patient acuity should also be considered.

Nurse staffing has become an issue in National Health Service hospitals and in April UNISON released results of a survey of over 1,500 nurses and other health care workers about their shifts during the 24-hour period of March 6. The vast majority of respondents (73%) felt they did not have “enough time to spend with patients to deliver dignified, safe, compassionate care.” The Royal College of Nursing also supports mandatory safe-staffing ratios that take into account the skill mix of RNs to “health care support workers” or nursing assistants. 

Here in the United States, California is the only state to achieve any legislation for mandatory hospital staffing and it is a “minimum” nurse-to-patient ratio. While similar legislation has been introduced in a few other states and nationally, it hasn’t advanced.

The ANA does not support mandatory minimum ratios per se, noting in its Principles for Nurse Staffing (2nd edition), released earlier this […]

If You Like Nursing History…

Pediatric NP, circa 1965

By Maureen Shawn Kennedy, AJN editor-in-chief

If you enjoy reading about nursing in the days of yore like I do, then there are a few resources I want to point out to you.

The first is Nursing History & Health Care, a Web site of the University of Pennsylvania School of Nursing. The site was funded through several government and foundation grants and all the information is freely accessible, so this is a valuable resource. (In the interest of transparency: some years ago, Lippincott Williams and Wilkins, AJN’s publisher, donated many of AJN’s historical holdings to this institution.)

Last month, we published “Key Ideas in Nursing’s First Century,” by Ellen Davison Baer, professor emerita at the University of Pennsylvania School of Nursing, Philadelphia, and cofounder and former associate director of the university’s Barbara Bates Center for the Study of the History of Nursing. It’s a concise review of the early days of American nursing’s development and organization. You can also listen to the author and me discussing the article and nursing history in general in a podcast.

And I would be remiss not to mention AJN’s own archives, which go back to the very first issue in October 1900. Access to these archives does require a subscription, but if you ask me (and I freely admit I’m biased), it’s worth it to have access to the classic articles that have shaped the profession. As an example, […]

Critical Care 2012: An Educational Extravaganza

By Maureen Shawn Kennedy, AJN editor-in-chief

So, for the 12th or 13th time (I’ve lost count), I attended the National Teaching Institute of the American Association of Critical-Care Nurses (the “other” AACN organization, not to be confused with the American Association of Colleges of Nursing) in Orlando last week. And as usual it was impressive—approximately 6,000 attendees, and rows and rows of exhibitors. There were two helicopters, a bus, and an ambulance in the exhibit hall, as well as two-story booths and classrooms. While there were some recruiters looking for staff, they were overshadowed by monitoring companies, bed and equipment manufacturers, and pharmaceutical companies.

Some highlights:

Left to right: Outgoing AACN president Mary Stahl and incoming president for 2013, Kathryn Roberts.

Kudos to the AACN for its creativity in making general sessions lively and interesting. This year, the organization held open auditions for a member to assist as “MC” for the general sessions (or “super sessions”). It was a tie, and attendees were treated to two of their own in action, hamming it up and enjoying the spotlight.

The TED-talk presentation style used by both AACN president  Mary Stahl and president-elect Kathryn Roberts was refreshing—and unique for nursing meetings.

I interviewed both presidents—click the link to listen to the podcast (it may take a minute to load). The 2013 president, Kathryn Roberts, MSN, RN, CNS, CCRN, […]

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