Killing Traditional Nursing Duties #3 – NPO after Midnight

fasting Buddha/ via Wikipedia Commons

By Shawn Kennedy, editor-in-chief

In early August, on our Facebook page, we asked if there were “old nursing habits” that should be killed off. We received a lot of feedback, which we described in a blog post called “Killing Traditional Nursing Duties #1.” We did another post on the answers to our second question, “When you give IM injections, what site do you most often use—dorsogluteal (upper outer quadrant of buttocks), ventrogluteal (lateral hip), or deltoid (upper arm)?” This also got many comments in response.

Our last question was this: “Does your institution routinely follow ‘NPO after midnight’ for preoperative patients?” Here’s some of the comments we received on the blog:

My institution does follow the NPO after midnight for preop patients. I sometimes disagree d/t the time patients may be going to surgery. If a patient is not scheduled for the OR until the following day at 5 pm, why should they have to be NPO after midnight the night before?

…most of the younger anesthesiologists/CRNA’s allowed BLACK COFFEE to be drunk right up until time  of surgery. No dairy or sugar in it, obviously.

The facility that I work for does routinely follow ‘nothing by mouth’ after midnight guidelines. If the patient  is scheduled for a late surgery I may call the doctor and request that the orders be altered and in most cases the doctor’s are agreeable and will change the orders, […]

2016-11-21T13:11:47-05:00October 11th, 2011|nursing perspective, nursing research|0 Comments
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Killing Traditional Nursing Duties #2

This 2006 image depicted an adolescent female ...

Editor’s note: In early August, on our Facebook page, we asked if there were “old nursing habits” that should be killed off. We received a lot of feedback, which we described in a blog post, “Killing Traditional Nursing Duties #1.” We’re back now with feedback from our second question: “When you give IM injections, what site do you most often use—dorsogluteal (upper outer quadrant of
buttocks), ventrogluteal (lateral hip), or deltoid (upper arm)? Why?”

Hands down, the deltoid injection site was preferred for intramuscular (IM) injections, especially for immunizations and if the patient was an adult. (“People don’t have to drop their drawers” was my favorite reason cited.) A few of those who favored that site noted that, if they didn’t use the deltoid (because of the volume of the injection), they would then go to the ventrogluteal site. One person preferred the vastas lateralis (the outer middle third of the thigh), which wasn’t listed as a choice, but is certainly a site that’s used, especially in infants. And several respondents said they prefer the dorsogluteal site. Reasons given were “more comfort” and “more muscle.”

This is actually contrary to current evidence and teaching, which is that the preferred site is the ventrogluteal site. As noted in an article we did in February 2010, evidence indicates we should avoid the dorsogluteal site because “it poses unnecessary and unacceptable risks of […]

2016-11-21T13:11:59-05:00September 6th, 2011|nursing perspective, nursing research|3 Comments
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Sexual Predators Online: Where Do They Intersect With Adolescents and Young Adults?

Here are some of the results described in “Online Social Networking Patterns Among Adolescents, Young Adults, and Sexual Offenders,” an original research article published in the July issue of AJN:

nearly two-thirds of Internet offenders said they’d initiated the topic of sex in their first chat session; more than half . . . disguised their identity when online; most . . . preferred communicating with teenage girls rather than teenage boys; high school students’ experience with “sexting” . . . differed significantly according to their sex; a small number of students are being threatened and assaulted by people they meet online; avatar sites such as Second Life were used both by students and offenders . .  . .

What’s your own experience? Have a look at the article, and pass along the link if you find it useful, as a parent or nurse. Have you heard any concerns about Internet safety from parents or adolescents you encounter in your own practice or community? What’s your own take on Facebook and privacy, or any other issue raised in this article?—JM, senior editor

2016-11-21T13:12:30-05:00June 30th, 2011|healthcare social media, nursing research|0 Comments
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So What? An Invitation to Nurses To Tell Us How They’re Translating Research into Practice

By Inge B. Corless, PhD, RN, FAAN, professor at the MGH Institute of Health Professions, Boston, and Brian Goodroad, DNP, RN, AACRN, nurse practitioner and associate professor at Metropolitan State University in Minneapolis–St. Paul, Minnesota

by centralasian/via Flickr

Crossing the Quality Chasm, an Institute of Medicine report from 2001, bemoans the chasm between our current research knowledge and the current state of care. Back in 2003, Don Berwick, now the Administrator of the Centers for Medicare and Medicaid Services, provided the following pithy codification of the problem in a JAMA article called “Disseminating Innovations in Health Care” (subscription required; click here for the abstract): “Failing to use available science is costly and harmful; it leads to overuse of unhelpful care, underuse of effective care, and errors in execution.” Berwick pondered the slow pace of innovation adoption and attributed it to three factors:

  • the characteristics of the innovation
  • the characteristics of the potential adopters
  • contextual factors

Berwick also made this observation about innovations that do get adopted: “Health care is rich in evidence-based innovations, yet even when such innovations are implemented successfully in one location, they often disseminate slowly—if at all.”

Given these obstacles, what can be done to facilitate the integration of research findings into practice? What can be done to change this situation, and what would this entail?

One step is […]

2017-05-27T10:28:00-04:00June 17th, 2011|nursing perspective, nursing research|1 Comment
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Tragedy into Policy: A Hepatitis C Outbreak and a Study of Nevada RNs Lead to New Protections for Whistleblowers

By Sylvia Foley, AJN senior editor

In 2008, more than 62,000 people who had undergone procedures at one of two southern Nevada endoscopy clinics were notified that “they might have been exposed to bloodborne pathogens, including hepatitis B virus, hepatitis C virus (HCV), and HIV, as a result of unsafe injection practices.” As author Lisa Black reports in this month’s CE–Original Research feature, a subsequent investigation by federal and state agencies found multiple breaches of infection control protocols. Indeed, 115 patients were found to be “either certainly or presumptively infected” with HCV through the reuse of contaminated medication vials.

Especially distressing was strong anecdotal evidence that because of a general fear of workplace retaliation, staff at the two clinics had often failed to report unsafe patient care conditions. At the request of the Nevada legislature, a study was conducted to examine Nevada RNs’ experiences with workplace attitudes toward patient advocacy activities. Black was the principal investigator. […]

2016-11-21T13:12:47-05:00June 7th, 2011|nursing perspective, nursing research|1 Comment
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