Nurses vs. Computers: Predicting Risk of Patient Harm

Not All Signs of Potential Harm Are Quantifiable

From chego101, via Flickr

Hospital nurses have many, many responsibilities and tasks, but one of the most important is to ensure patient safety by assessing patients for changes that can signal worsening of a condition or a new potential harm. Creating special units like ICUs, recovery rooms, and step-down units; flags on charts; various alarmed monitors; and safety huddles are a few of the ways hospitals have tried to identify potential problems. Now we have computerized tools to do this—or do we?

The complaint I have heard most from nurses about the electronic health record (EHR) is its inability to capture all the nuances of patient care or various patient problems, especially those that don’t involve easily quantifiable measures like heart rate or lab values. (For more detail, read our November 2016 report on nurses’ concerns with EHRs.)

One cannot accurately use a check mark to convey certain patient behavioral parameters or the “can’t put my finger on it but something’s going on with this patient” assessment that experienced nurses often make. In the April issue of AJN, we published an important study that investigates just this issue: “Identifying Hospitalized Patients at Risk for Harm: A Comparison of Nurse Perceptions vs. Electronic Risk Assessment Tool Scores

Deciding Whether to Implement an Electronic Risk Tool

Researchers […]

Nurses Try Out Plant-Based Diet, Report Health Benefits

            If you don’t take care of your body, where will you live?

Photo from Shutterstock.

This adage, sometimes attributed to Chinese philosopher Lao Tzu, reminds us that the personal choices we make are important. Drugs and procedures are unlikely to ensure continuing good health, especially if we don’t first attend to the basics. And when it comes to personal choices, nothing is quite as personal as food.

Maybe this is why some nurses and physicians are so quick to dismiss decades of promising research on the effects of meatless diets. “People will never change the way they eat; it’s not worth talking about.” But as Michael Greger, a general practitioner specializing in nutrition and an advocate for plant-based diets if you want to know more about an awesome diet check out one guy’s review to get more info, once said in a lecture I attended, “That attitude may be one of the true leading causes of death and disability.”

In “A Plant-Based Nutrition Program” in this month’s AJN, Joanne Evans and colleagues describe the results of a “personal experiment” in which nurses at three faculty-led community health clinics […]

2017-06-16T18:54:08+00:00 March 22nd, 2017|Nursing, nursing research|11 Comments

How to Create a Poster that Attracts an Audience: New Research Yields Clues

Have you ever designed a poster to present at a nursing conference?

If so, how did you know what to do?

Today, digital design and printing capabilities present many options for professional-looking posters. But how can you increase the chances that nurses at a conference will actually read what you’ve gone to so much trouble to share?

In this month’s AJN, Sandra Siedlecki, PhD, RN, CNS, senior nurse scientist at the Cleveland Clinic, discusses the attributes of a good poster in an original research article: “How to Create a Poster That Attracts an Audience.”

Past articles in the nursing literature have described how to create a “winning poster,” but Siedlecki could find no actual evidence-based recommendations about poster design. So she set out to learn what attracts nurses to specific posters by surveying attendees at a nursing conference.

What captures the attention of conference attendees?

In addition to asking nurses to rate the importance of various poster design elements on a scale of zero to 10, Siedlecki also asked attendees these open-ended questions:

  • When walking through a poster session, how do you select the posters you will take a closer look at? What is most important to you?
  • How do you select the posters to read completely? What is […]
2017-03-13T10:13:59+00:00 March 10th, 2017|Nursing, nursing research|0 Comments

Nurses and Patient Safety: Parallel Histories

Photo from AJN archives.

I’m especially pleased that one of the CE articles in the February issue focuses on nursing’s role in creating a safe environment for patients: “Nursing’s Evolving Role in Patient Safety.” And in full disclosure, I was excited to see that the authors used the AJN archives to chronicle how nursing addressed (or didn’t address) safety issues around patient care.

From the earliest days of nursing through to the current complex systems in which we practice, nurses have been the health professionals responsible for ensuring safe passage of patients through the health care system. From Nightingale’s criteria for creating a healing environment to the “5 rights of medication administration,” patients rely on nurses to act as sentinels.

The authors reviewed 1,086 AJN articles from 1900 to 2015 and conducted a content analysis to identify patient safety themes. Aside from uncovering many fascinating (and sometimes alarming!) details of former health care practices, the authors drew this general conclusion:

“Emphasis on patient safety increased as patient care became more complex. As nurses developed a professional identity, they often put a spotlight on safety concerns and solutions.”

Here’s a quote from a nurse who wrote in 1908 about nurses’ duties: […]

Metabolic Syndrome: Lifestyle Factors and Prevention

Metabolic syndrome: one-third of U.S. adults.

Cycling Mother and Daughter, Netherlands/via Wikimedia CommonsConversations about health—whether between neighbors or between clinicians and patients—often revolve around weight problems, blood pressure, blood sugar, and cholesterol levels. Taken together, these are the cardiovascular risk factors referred to as metabolic syndrome.

In the United States, more than one-third of all adults have metabolic syndrome. This is an astonishing figure, especially because these risk factors can be modified.

What keeps some who are obese or overweight ‘metabolically healthy’?

In recent years, researchers have learned that some people who are overweight or obese do not demonstrate the other risk factors that are part of metabolic syndrome, and therefore these people have a lower-than-expected risk of cardiovascular disease. In a study reported in this month’s AJN (“Examining the Links Between Lifestyle Factors and Metabolic Syndrome“), a group of Taiwanese nurse researchers set out to learn whether there might be lifestyle factors that keep this subgroup of people “metabolically healthy,” protecting them from the other cardiovascular risk factors that usually come with extra weight.

Lifestyle factors associated with prevention.

Dr. Shu-Hung Chang and colleagues performed community-based physical exams on more than 700 people in northern Taiwan and questioned them about lifestyle factors including smoking, drinking, exercise, and the foods they ate. The researchers found that overweight and obese people who quit smoking, exercised, […]