Hand Washing: What’s It Going to Take to Get the Job Done?

Handwashing Handwashing (Photo credit: kokopinto)

By Shawn Kennedy, AJN editor-in-chief

I took a few days off last week and caught up on some reading. Perhaps the article that struck me most was one from the New York Times on the various methods that many hospitals are using to improve rates of hand washing among nurses, physicians, and other direct care providers. Hospitals are trying everything from buttons that offer gentle reminders to camera monitors to mandating that direct caregivers wear electronic sensors that indicate whether or not they washed their hands.

Perhaps the most disturbing part of the article was the remarks made by Elaine Larson, a nursing professor at Columbia University School of Nursing who had done extensive research on hand washing. She spoke of how some health professionals go out of their way to avoid washing their hands, even ducking under scanners.

A 2009 report from the Centers for Disease Control and Prevention estimated that HAIs (hospital-acquired infections), cost U.S. hospitals between $28.4 to $33.8 billion annually in direct medical costs. Just think about what could be done with that money.

I don’t get it. We all know the importance of hand washing. From Ignaz Semmelweis, who introduced hand washing in obstetrical clinics in 1847 and as a result reduced puerpal fever, to Florence Nightingale, whose insistence on good hygiene and basic cleanliness helped to reduce death rates during the Crimean War, to the extensive body of research conducted by […]

2016-11-21T13:07:04-05:00July 10th, 2013|nursing research|7 Comments
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Does Telephone Follow-up After Myocardial Revascularization Help?

By Sylvia Foley, AJN senior editor

Cellphone macro by Cubosh, via Flickr

Myocardial revascularization, an established treatment for coronary heart disease, is currently done via either percutaneous coronary intervention or coronary artery bypass graft surgery. But recovery and rehabilitation can be hard going, and patients need close monitoring. Investigators Rejane K. Furuya and colleagues wanted to learn more about the use of telephone follow-up with such patients. To that end, they searched the literature, identified relevant studies, and assessed and synthesized the results. In this month’s original research CE, “Telephone Follow-Up for Patients After Myocardial Revascularization: A Systematic Review,” they report on their findings. Here’s a short summary.

The review was conducted in accordance with the Cochrane method. The researchers searched six electronic databases for articles on clinical trials that studied patients after myocardial revascularization using telephone follow-up and were published in English, Spanish, or Portuguese. Of 170 identified studies, seven met the inclusion criteria and were analyzed.

Some findings. Both the purposes and contents of telephone follow-up varied in the analyzed studies. The researchers found that the contents could be grouped into four themes—cardiovascular illness; postoperative complications; self-care, including behavioral and lifestyle changes; and psychosocial evaluation and emotional support. Outcome measures also varied widely, but included health-related quality of life, pain, enrollment in cardiac rehabilitation programs, physical functioning, hospital readmission, mood symptoms, and medication compliance. Telephone follow-up was found to be “an effective intervention for most of the outcomes assessed.”

The […]

2017-07-27T14:51:19-04:00May 3rd, 2013|nursing research|1 Comment
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AJN’s May Issue: Telephone Follow-Up After Myocardial Revascularization, Hemodynamic Monitoring, Staffing Levels, Nurses Week, More

AJN0513.Cover.OnlineAJN’s May issue is now available on our Web site. Here’s a selection of what not to miss.

Coronary heart disease afflicts more than 16 million American adults. Myocardial revascularization has long been considered an effective treatment for this disease. Findings presented in our May original research article, “Telephone Follow-Up for Patients After Myocardial Revascularization: A Systematic Review,” support the use of telephone follow-up intervention after hospital discharge to assess patient knowledge, discuss patient concerns, and encourage behavioral and lifestyle changes. This article can earn you 2.6 continuing education (CE) credits.

Recently, there’s been a shift toward less invasive or noninvasive hemodynamic monitoring methods, and the use of “functional” indicators that more accurately predict fluid responsiveness. “Using Functional Hemodynamic Indicators to Guide Fluid Therapy,” a CE article that can earn you 2.6 credits, reviews the physiologic principles of functional hemodynamic indicators, describes how these indicators are calculated, and discusses when and how nurses can use them to guide fluid resuscitation in critically ill patients.

Celebrating Nurses Week. May’s In Our Community article describes how nurses from one hospital decided to forego traditional gifts during National Nurses Week and instead implemented a “Nurses Give Back” program in their community. How does your hospital celebrate? If you’re reading AJN on your iPad, you can listen to a podcast interview with the authors by clicking on the podcast icon on the first page of the article. The podcast is also available on our […]

2016-11-21T13:07:43-05:00April 26th, 2013|career, nursing research|0 Comments
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Article Types, Topics of Interest, and Other Considerations for Prospective AJN Authors

iPad app exhibit AORNBy Maureen Shawn Kennedy, AJN editor-in-chief

I recently wrote a post that attempted to give readers a clearer sense of what we are looking for in article submissions and what we are not looking for: “My Professor Said to Submit My Paper (We Hope They Also Told You This).”

This post will just provide a quick overview of the types of articles we publish, as well as a plug for why it’s good to be published in AJN.

In terms of impact factor, AJN ranks 29/95 among ranked nursing journals, with an impact factor of 1.119. (Nursing journals with higher impact factors tend to be specialty research journals, whereas AJN publishes a broad range of content in addition to research, and for a variety of audiences.) Through our robust print, digital, iPad, institutional, and social media channels, AJN reaches more nurses than any other nursing journal.

We publish original research, quality improvement (QI), and review articles as primary feature articles and as CE articles. We also publish shorter, focused columns. All submissions must be evidence based and are peer-reviewed.

Clinical features should cover epidemiology, pathology, current research/“what’s new” in knowledge and/or treatment, nursing implications. There is no specific limit for word count, though feature articles are usually in the range of 6,000 to 10,000 words. (We have done two-part and three-part series for larger papers.) For examples of feature articles, see any of the CE articles on our Web site, […]

2016-11-21T13:08:08-05:00March 14th, 2013|nursing research|0 Comments
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Gel and a Poster: A Hand Hygiene Campaign Gets Tested in Two Outpatient Clinics

By Sylvia Foley, AJN senior editor

hand.sochacki.98193355_eb8473c967 Hand by sochacki.info, via Flickr

The trouble with hands is that they get into everything, and rapidly move between mouths, noses, eyes, and other people’s hands.

So says David Owen in his recent New Yorker article “Hands Across America,” which describes the development of the first gel sanitizer—and of course it’s nothing nurses and other clinicians don’t already know, just as they know that the practice of hand hygiene is crucial to reducing health care–associated infection rates. Yet adherence to hand hygiene guidelines among health care workers remains low. Interventions to improve hand hygiene have been tested in hospitals with demonstrated success, but have seldom been evaluated in other settings. In this month’s CE–Original Research feature, authors Kate Stenske KuKanich and colleagues describe their evaluation of a hand hygiene campaign in an outpatient oncology clinic and an outpatient gastrointestinal (GI) clinic.

The intervention. At each clinic, the researchers observed health care workers for the frequency of hand hygiene (attempts versus opportunities). After compiling baseline data, they initiated an intervention, which consisted of introducing an alcohol-based gel sanitizer and an informational poster to each clinic. (The gel sanitizer was provided as an alternative to foam sanitizer and soap and water.) One week later, interventional data were collected for five nonconsecutive days. Afterwards the posters and gel sanitizers were removed, and one month later, follow-up data were collected. Lastly, three months after follow-up observations ended, workers at […]

2017-07-27T14:51:38-04:00March 11th, 2013|nursing research|1 Comment
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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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