Environmentally Sustainable Nursing Practices: Small Changes Make a Big Difference

“The decisions nurses make about waste and efficiency on the front lines of clinical care matter, and the potential impact on health and the environment should not be underestimated.”

These days, most nurses have little time for anything that isn’t COVID related. Either we’re inundated with patients, changing work flow and physical spaces to accommodate long-term social distancing, or trying to home-school our kids or plan the next trip to the grocery store. Inevitably, though, our attention will return to other urgent issues in health care. The impact of our everyday work practices on the health of the planet is one of these issues.

How often do you toss unused linen into a laundry hamper after a patient is discharged, or discard leftover but unopened supplies that have been in a patient’s room, or hurriedly throw away soiled “chux” in a “red-bagged waste” container because that’s the nearest receptacle? In “Reducing Waste in the Clinical Setting” in this month’s issue, Sara Wohlford and colleagues at Carilion Roanoke Memorial Hospital in Roanoke, Virginia, share how increased attention to wasteful practices and modest changes in workflow can impact the environment and save money.

Small changes in three areas can make a big difference.

The authors looked at […]

2020-06-04T10:11:36-04:00June 4th, 2020|environmental health, Nursing, nursing research|0 Comments
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Why the Recruitment Experience of Foreign-Educated Nurses Matters for Us All

There’s been talk of a coming nursing shortage for a number of years. A recent report from the US Department of Health and Human Services National Center for Health Workforce Analysis found that of the 3.9 million RNs, the average age is 50, meaning many will retire in the next decade as they reach 65. And this is coming at the same time the number of Americans over 85 years of age is expected to double, from 6.3 million in 2015 to 13 million by 2035.

These data indicate that there may be fewer nurses, particularly in some regions of the country and in some areas of care, at a time when the need for nursing care is increasing. As with other nursing shortages, when schools are unable to graduate enough nurses to fill the gap (the shortage of qualified faculty continues to force schools to turn away qualified students), some hospitals will turn to recruiting foreign-educated nurses (FEN), many of whom are experienced and and have at least a bachelor’s degree in nursing. […]

2020-02-12T11:02:50-05:00February 12th, 2020|Nursing, nursing research|1 Comment
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Milk and Molasses Enemas – A Tradition to Keep

By Maureen Shawn Kennedy, AJN editor-in-chief

I recall giving an “M&M” enema when I worked as a nurse’s aide in high school. The small community hospital medication room had a jar of molasses in the cabinet, and I watched the nurse mix ½ a cup of the thick syrup with ½ cup of milk and put it in an enema bag. She then handed it to me and said, “C’mon, it’s easy, I’ll show you how.” And it was, and it worked pretty quickly. Older nurses and physicians swore by it.

By the time I was out of nursing school and working in clinical practice, commercial preparations seemed to be the standard. But as the song goes, “everything that’s old is new again.” This month in AJN, Jackline Wangui-Verry and colleagues’ paper, “Are Milk and Molasses Enemas Safe for Hospitalized Adults? A Retrospective Electronic Health Record Review,” describes their investigation of this long-time and oft-used intervention for constipation.

Examining the safety of a long-established, ‘last resort’ practice.

The authors “wanted to learn whether this approach is actually safe and effective or more of a ‘sacred cow’ . . . .”

This study focused on safety and a follow-up study will include efficacy. They evaluated the hospital records of 196 hospitalized adults who received an M&M enema after laxatives or stool softeners failed to produce a bowel movement. No serious complications—“allergic reactions, bacteremia, […]

2019-09-11T10:41:01-04:00September 11th, 2019|Nursing, nursing research|3 Comments
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Revisiting Evidence-Based Practice, and ‘Making Change Stick’

Do you ever wonder why nurses engage in practices that aren’t supported by evidence, while not implementing practices substantiated by a lot of evidence? In the past, nurses changed hospitalized patients’ IV dressings daily, even though no solid evidence supported this practice. When clinical trials finally explored how often to change IV dressings, results indicated that daily changes led to higher rates of phlebitis than did less frequent changes.

That’s the beginning of the first article in our first “step by step” series, Evidence-Based Practice, Step by Step, launched in November 2009. It won the Nursing Print Media Award for Nursing Excellence from Sigma Theta Tau International; the 12 articles in the series continue to be among the most highly viewed of any AJN articles online.

Nurses know about EBP, but changing practice is another thing.

The continued popularity of the articles made us wonder if the tenets of EBP were still not adequately known by nurses. So we asked the experts, and the result is our new series, EBP 2.0: Implementing and Sustaining Change.

Sharon Tucker, PhD, RN, FAAN, and Lynn Gallagher-Ford, PhD, RN, NE-BC, DPFNAP, FAAN, both  at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College […]

2019-04-17T08:43:00-04:00April 17th, 2019|Nursing, nursing research|1 Comment
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Are Your PCA Pumps Accurate, and Working?

Device malfunction happens.

After orthopedic surgery several years ago, I awoke in the PACU to find nurses working frantically on one side of my stretcher. Simultaneously, I realized that my leg hurt. A lot. And with another moment’s awareness—awake enough now for my nurse’s brain to begin to kick in—I understood that all of the activity concerned my PCA pump.

neeta lind/flickr creative commons

One of the nurses noticed that I was stirring. “Your pump has malfunctioned. We can’t get the replacement to work. A third pump is on the way. I’m so sorry!”

The scramble for a replacement, and then another, probably lasted less than five minutes, but it was a pretty wild ride. My deep breathing in an attempt to control the pain gave me something to focus on, but it was a pretty weak effort up against bone pain in the immediate post-op period. I’m grateful that my nurses—there were at least three involved at that point—regarded the pump failure as an emergency.

But operator errors are more common.

Needless to say, then, I was particularly interested in a new study that appears in this month’s AJN. In “Errors in Postoperative Administration of Intravenous Patient-Controlled Analgesia: A Retrospective Study,” Yoonyoung Lee and colleagues […]

2019-04-10T09:29:43-04:00April 10th, 2019|Nursing, nursing research, patient experience, Patients|0 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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