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

Time to Get Serious About ‘Handshake-Free’ Health Care?

By Shawn Kennedy, AJN editor-in-chief

Tombstone handshake, from Mel B, via Flickr. Tombstone handshake, from Mel B, via Flickr.

Last month in JAMA, Mark Sklansky and colleagues wrote a Viewpoint column, “Banning the Handshake From the Health Care Setting.” The article explored the idea and its feasibility, while acknowledging the importance of such rituals as handshakes in human interaction. In the end, the authors argued that it’s an idea we might need to start taking more seriously.

Is this an antisocial idea? That’s debatable, but it would certainly be a good step towards reducing transmission of infections—and one that’s probably long overdue.

It’s well known that pathogens are easily transmissible from health care workers’ hands, even if they practice hand hygiene in between seeing patients. But as the authors remind us, heath care workers are notoriously bad at doing so—they cite research showing that “compliance of health care personnel with hand hygiene programs averages 40%.”

And it’s no better in ambulatory care settings—an original research article we published in March 2013 that measured hand hygiene compliance by health care workers in an ambulatory care clinic found that, even after a campaign to improve adherence, compliance (as measured by direct observation) had only improved to between 32% and […]

Nurses Join Fight Against Counterfeit Medicines

Hidden-in-Fake-Meds-2-1024x1809 Click infographic to enlarge

“Fight the Fakes” is a scary article in the June issue of AJN about counterfeit medicines and the role the International Council of Nurses (ICN) has taken in the Fight the Fakes campaign to inform the public about just how common the problem is and how dangerous it can be. Here’s the opening paragraph:

In February 2012, a cocktail of salt, starch, acetone, and a variety of other chemicals was delivered to 19 U.S. cancer clinics, instead of a vital chemotherapy medication they were expecting. Earlier this year, the Daily Mirror reported on black market abortion tablets that are being sold online to young teenage girls too scared to tell their parents they’re pregnant. The pills can kill if the wrong dose is taken.

The article is by David Benton, chief executive officer of the ICN, and Lindsey Williamson, the organization’s publications director and communications officer. Below is a brief blog post they sent us to give readers an idea of what’s at stake—but we hope you’ll also go ahead and read their article, which raises issues that should concern us all as patients or health care professionals.—JM, senior editor

Fake medicines are a global problem: they are reported in virtually every region of the world. Fake medicines may include products […]

AJN June Issue: Genomic Advances in CF, LGBT Care Disparities, Denying Smokers Jobs, More

AJN0614.Cover.OnlineAJN’s June issue is now available on our Web site. Here’s a selection of what not to miss.

The newborn featured on our cover this month is wrapped in a blanket decorated with a string of letters—better known as genetic code. Today, all newborns in the United States are screened for various inherited and congenital conditions, but the use of genomic sequencing at birth could provide information beyond what current screen­ing already provides—health information to go in their medical records for use in detecting and managing disease.

Cystic fibrosis (CF) is one disorder that has been affected by recent developments in the field of genetics. The discovery of the CF gene in 1989, along with advances in molecular genet­ics, made it possible to screen for CF through DNA testing. Early diagnosis and prompt treat­ment of CF has been shown to improve patients’ overall health and survival. Genetic advances have also led to the development of promising drugs to treat CF. For more on the impact of genomic advances on diagnosis and treatment, and implications for nursing practice, read, Genomic Breakthroughs in the Diagnosis and Treatment of Cystic Fibrosis,” and  earn 2.3 CE credits by taking the test that follows the article.

LGBT health care disparities. The health care disparities that affect people who are lesbian, gay, bisexual, or transgender (LGBT) are closely tied to sexual and […]

Pioneering Spirits, Kept Promises: Critical Care Nurses in Denver

By Shawn Kennedy, AJN editor-in-chief

In Denver for the annual National Teaching Institute of the American Association of Critical-Care Nurses (AACN), I’m once again overwhelmed by the size and breadth of the meeting. It’s not just the attendance, though it drew over 7,000 nurses. Perhaps it’s the Colorado Convention Center, which seems to go on forever. (Fittingly, there’s a mammoth blue bear two stories high peering in one of the glass walls.)

Big Blue Bear, Colorado Convention Center, Denver Big Blue Bear, Colorado Convention Center, Denver

While trying to find my way to a session, I met a nurse who was there with her mother. Mom’s a Boston ER nurse and her daughter is a critical care nurse in New Hampshire. Every year they do a mother-daughter trip to either this meeting or the Emergency Nurses Association meeting. Kudos to them!

Sociologist, inspirational speaker, and comedian Bertice Berry mc’d the opening session, quickly warming up the audience. A highlight was the presentation of AACN’s Pioneering Spirit awards to Loretta Ford (founder, along with physician Henry Silver, of the first NP program in 1965), Carrie Lenburg (pioneer in nontraditional and distance learning), and Lucian Leape (a physician who spearheaded the movement to reduce medical errors).

Some quotes from these feisty folks who had […]

Noise in the ICU: Terminology, Health Effects, Reduction Strategies, and What We Don’t Know

By Jacob Molyneux, AJN senior editor

Noise isolation headphones to use in loud environments via Wikimedia Commons

I woke up this morning, as I do every morning now, to the sound of pile driving at a large construction site a block and half away on the Gowanus Canal. It shakes the earth and reminds me of the forges of evil Sauron in one of the Lord of the Rings movies. I once had a dog lose a good bit of hair when there was a pile driver for several months in the lot behind another apartment in Brooklyn.

The negative physical and emotional effects of excessive noise get an occasional mention lately in health reporting, but in New York City or along the remotest forest lane, the forces of quiet can seem to be in rapid retreat before an army of leaf blowers, all-terrain vehicles, diabolically amped-up motorcycles, huge TV sets, garbage trucks, helicopters, and the like.

Lest I sound like a total crank (I do have useful noise-cancelling headphones plus an Android app that offers such choices as white noise, brown noise, burbling creek, steady rain, crickets, and soothing wave sounds), there’s a reason for the preamble. Florence Nightingale herself called unnecessary noise “the most cruel absence of care which can be inflicted either on sick or well,” as is pointed out by the University of Washington researchers who wrote the latest installment of our column Critical Analysis, Critical Care.

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