Nurses spend more time with patients than most other types of providers and have unique insight into patient care and the the healthcare system.

Today’s Notes from the Nursosphere

Image of Japanese Attack - Pearl Harbor, Hawai...

As noted today by Joni Watson at Nursetopia, it’s Pearl Harbor Day, and nurses were (surprise) key players in that day’s awful events. Here’s how the post begins:

My heart was racing, the telephone was ringing, the chief nurse, Gertrude Arnest, was saying, “Girls, get into your uniforms at once, This is the real thing!”

Speaking of safety, “Top 10 Health Technology Hazards for 2011” (pdf), from the ECRI Institute, gives us a list of hospital patient safety risks that, according to the authors, “reflects our judgment about which risks should receive priority now, a judgment that is based on our review of recent recalls and other actions . . . , our analysis of information found in the literature and in the medical device reporting databases of ECRI Institute and other organizations, and our experience in investigating and consulting on device-related incidents.” These include “radiation overdose and other dose errors during radiation therapy,” “alarm hazards,” and eight others.

And now to electronic charting vs. doing it the old-fashioned way: we have a comment thread going on at AJN‘s Facebook page about whether or not EHRs save nurses time or not. Go there to comment, or leave a comment here.

Also noted: Stephen Ferrara at A Nurse Practitioner’s View wonders whether the preceptorship model is still adequate for training NPs. Or is it time for a residency model instead?

2016-11-21T13:14:44-05:00December 7th, 2010|nursing perspective|0 Comments
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‘Problems Worthy of Attack’: Takeaways from IOM Summit on Nursing’s Future

By Shawn Kennedy, AJN interim editor-in-chief

Last week, I spent two days at the summit convened by the Robert Wood Johnson Foundation to launch the Campaign for Action—the strategic plan to implement the recommendations of the Institute of Medicine’s (IOM) report on the future of nursing.

The days were packed with presentations from key players in health care, who offered their perspectives for implementing the recommendations (plus lots of networking, hallway “sidebars,” animated dinner conversation, and commitments from individuals and organizations to continue the momentum). Here are some quotes and snippets of conversation that stick with me as I work on a more comprehensive report:

IOM president Harvey Fineberg, in his opening remarks: “It’s our turn to act to advance nursing and health.”

Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, opening the event: “We will remember that we were here on November 30 at the beginning of a new future for nursing.” And cautioning: “scope of practice is the hot button that could blow all this apart.” (A thought echoed by Jack Rowe, an IOM committee member, professor at Columbia University Mailman School of Public Health, and former CEO of Aetna, who used the term “combustible.”) […]

2016-11-21T13:14:45-05:00December 6th, 2010|career, health care policy, nursing perspective|0 Comments
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To Err is Human . . . To Improve Elusive?

Peggy McDaniel, BSN, RN, is an infusion practice manager and occasional blogger

As a nurse working in the quality improvement and patient safety arena, I’m not surprised that the title of a recent article at Fierce Healthcare got my attention: “Hospitals Are Bad for Your Health.” The article highlights a recently released report from the Department of Health and Human Services Office of Inspector General based on a study of Medicare patients discharged in 2008. Among other things, it revealed that “44% of adverse or temporary harm events were clearly or likely preventable.” The usual culprits were to blame:

  • infections
  • medication errors
  • surgery-related errors
  • patient care issues

Most of these have been previously labeled as “never events” by the Centers for Medicaid and Medicare Services (CMS), and currently hospitals are not being reimbursed for the costs incurred if one or more of these happen to a patient while in the hospital. CMS was the first to implement such a pay-for-performance model—and major insurance companies have followed their lead.

In recently published NEJM study, 63% of the adverse events reported in the hospitals studied were deemed preventable. This study was disheartening because we recently passed the 10-year anniversary of the release of the

2016-11-21T13:14:47-05:00December 1st, 2010|nursing perspective|3 Comments
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Turkey, Sweet Potatoes, and Living Wills

By Christine Moffa, MS, RN, AJN clinical editor

When I was growing up, my family spent Thanksgiving dinner at my grandmother’s house. She was a star in the kitchen, with cooking and baking skills beyond compare. However, while she made a chocolate cream pie to kill for, her knack for turning every conversation into a newsfeed of various neighbors’ illnesses, symptoms, and near-death experiences, if not actual deaths, stood out more. She did this so much that my brother began referring to her as Grandma Kevorkian.

It turns out that death-and-dying discussions on Thanksgiving might not be such a bad thing, according to Engage with Grace, a nonprofit organization that promotes end-of-life discussions. In 2008 they launched a blog rally timed with Thanksgiving weekend, for bloggers to get the word out about end-of-life discussions. The idea is to have the conversation when most of the family members are together, and the Thanksgiving holiday is a perfect fit. There’s a five-question tool available on the site that can be used as a conversation starter, as well as other resources.

While talking about these topics could potentially clear a room, it’s a lot worse to be sitting at a family member’s bedside in the ICU and not knowing what to choose for them because they didn’t let you know in advance.

For additional information on end-of-life discussions and options, see the AJN articles “Life-Support Interventions at the End of Life: Unintended Consequences,” by […]

2016-11-21T13:14:50-05:00November 24th, 2010|nursing perspective, patient engagement, Public health|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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