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‘Patient Activation’: Real Paradigm Shift or Updated Jargon?

By Jacob Molyneux, AJN senior editor

I attended a Health Affairs briefing yesterday in Washington, DC. Based on the February issue of the journal, it was called “A New Era of Patient Engagement.” A lot of research money appears to have been flowing to this area in recent years.

Our January article on “Navigating the PSA Screening Dilemma” includes a discussion of ‘shared decision making’

The basic idea isn’t entirely new to anyone who’s been hearing the term “patient-centered care” for a long time: as Susan Dentzer writes in “Rx for the ‘Blockbuster Drug’ of Patient Engagement,” a useful article summarizing the main ideas raised in the Health Affairs issue: “Wherever engagement takes place, the emerging evidence is that patients who are actively involved in their health and health care achieve better health outcomes, and have lower health costs, than those who aren’t.”

One might add to these projected benefits: better experiences as patients.

Something’s got to change, so why not this? If many nurses feel they’ve heard all this before, the sense of a health care system in necessary flux […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:08:20-05:00February 7th, 2013|nursing perspective, patient engagement, Patients, personal health practices|1 Comment

What’s So Hard to Understand: Patient Safety, Quality Care Linked to Nurse Staffing

The evidence linking nurse staffing and patient safety is strong.

The data linking nurse staffing as well as shift length with patient outcomes and satisfaction with care continue to roll in. The latest report on nurse staffing, published in the January 13 issue of Medical Care by McHugh and MA, links higher nurse–patient ratios and good work environments to reduced 30-day readmission rates. Read the abstract here.

Most nurses seem to support better nurse–patient ratios, but there’s continuing ambivalence about reducing shift length, as seen in the comments we received on a recent blog post asking whether it’s time to retire the 12-hour nursing shift.

In August, researchers reported a link between nurse staffing and hospital-acquired infections. Publishing in the American Journal of Infection Control, the authors noted a “significant association” between nurse–patient staffing ratios and both urinary tract infections and surgical site infections. Further, they noted that reducing nurse burnout was associated with fewer infections. (Read our news report on the study here.)

Health Affairs published a report in November called “The Longer the Shifts for Hospital Nurses, The Higher the Levels of Burnout and Patient Dissatisfaction.” The findings were there, loud and clear—researchers Stimpfel, Sloane, and Aiken found that “extended shifts undermine nurses’ well-being, may result in expensive turnover and can negatively affect patient care.”

And […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-03-13T10:41:13-04:00January 29th, 2013|nursing perspective, nursing research|20 Comments

Some Recent Notable Posts from Nursing Blogs

Some posts of interest from the nursing blogs (those that are currently active; a fair number of familiar bloggers seem to be taking breaks, having kids, starting new jobs):

“Certified Medical Assistants Calling Themselves Nurses” can be found at The Nurse Practitioner’s Place. It’s not just inaccurate to do so, says the author. It’s often illegal.

Photo from otisarchives4, via Flickr.

At My Strong Medicine, a short post about men, women, USPSTF guidelines, becoming an NP, and reaching a certain age, called “Heard While Studying: Everything Falls Apart at Age 40.”

One blogger, among others, who has been pretty quiet for some months (and who used to organize a regular “blog carnival” that helped create a community among nurse bloggers) is Kim McCallister at Emergiblog. She popped back up several weeks ago with a post called “The Voice,” which is about exactly that—how a nurse blogger lost the sense of freedom she started with as a staff nurse jotting down experiences, and instead internalized a “Sister Superego” that cautioned her to be “prim and proper,” rapping her knuckles until she just fell silent instead. Frustration with computerized charting and the general state of health care seems to be part of it as well. We hope the spirit moves her to write more soon.

Lastly, there’s a nice post by Megen Duffy (who often writes AJN‘s iNurse column, and who […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:08:29-05:00January 25th, 2013|healthcare social media, nursing perspective|0 Comments

What Can’t Be Taught in Nursing School

By Jacob Molyneux, senior editor

The January Reflections essay in AJN, “A Special Kind of Knowledge,” is a revised excerpt from a forthcoming book, Crossing the River Sorrow, One Nurse’s Story, by Janet L. Richards. (The book will be published in June by Vantage Press.) In the essay, the author remembers an encounter she had several decades ago as a nursing student caring for a newly paralyzed young woman. Here’s a paragraph from near the start:

I stood by Carrie during those first harrowing hours in the ICU as she awaited surgery, everyone still hoping for the best. As a brand-new student, I was a silent observer, unsure of how to participate. Her young husband also watched, slumped against the heater under the window at his wife’s bedside. His eyes blazed, wild with fear and disbelief as he struggled to make sense of his sudden immersion into the alien world of disability. I could identify. Pressure sores, urinary catheters, bowel programs, and spasms—these were now part of my new and ever-expanding medical vocabulary. A spinal cord severed at C6 meant life as a quadriplegic. Suddenly this book knowledge seemed all too real.

And here’s a few lines from near the end, to give a sense of the crucial insight the author gained as she struggled to bridge the gap between herself, her patient, and the patient’s husband:

Pain can be palpable as it moves across the space between two people, molten, […]

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Jacob Molyneux, senior editor/blog editor2016-11-21T13:08:32-05:00January 17th, 2013|nursing perspective, students|3 Comments

How Bad Is the Flu Right Now, and Should Nurses Get Vaccinated?

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

The news has been full of reports about the influenza outbreak, deaths from complications, and shortages of vaccine and antivirals. Is the flu season as bad as purported, or are we experiencing media hype? Nurses are frequently asked for information by family, friends, and neighbors (and strangers—I was in a restaurant once and a diner at a nearby table, having overheard my conversation with a colleague, leaned over and asked if he could ask me a health question!), so here’s the latest information.

Week ending 1/5/2013; brown indicates states w/ widespread flu activity. CDC

According to the latest Centers for Disease Control and Prevention (CDC) report for the week ending January 5, epidemiologists from all states except three reported (see map) widespread “influenza-like illness” (ILI, meaning fever and cough or sore throat). California and Mississippi reported regional activity and Hawaii reported sporadic activity. The District of Columbia reported local spread. And while officials in some cities and states declared public health emergencies, the CDC notes that “influenza activity remained elevated in the U.S., but may be decreasing in some areas.”

One of the indicators is the proportion of people seeking treatment for ILI. Thus far, that number has risen as high as 6.0%, but has since fallen to 4.3%, as of January 5. In prior years deemed as moderately severe flu seasons, that indicator rose as high as 7.6%.

So in terms of history, we’re […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:08:33-05:00January 14th, 2013|nursing perspective|6 Comments