An End to Interruptions: Nurses Preventing Medication Errors

By Christine Moffa, MS, RN, AJN clinical editor

By NathanF/via Flickr (Creative Commons) By NathanF/via Flickr (Creative Commons)

Interruptions are distracting.

I have a hard time focusing when I am repeatedly interrupted. How many times have you walked down the hall to get something, met with an unexpected request or encounter, and then found you couldn’t remember where you were going or why?

A few years ago I was working as float nurse in an outpatient facility. One of the specialties I floated to was the pediatric clinic. There were seven or eight nurses (a mix of RNs and LPNs) working at the same time, with half assigned to administering medication, mostly vaccines, and the others performing telephone triage and monitoring patients in the observation room.  I can now admit that I used to pray to get assigned to the triage section—not because giving injections was a problem, but because the setup of their system terrified me. […]

2019-04-11T14:14:07-04:00November 5th, 2009|nursing perspective, nursing research, patient safety|7 Comments
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Nurses Write, Right?

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

WRITE

As nurses, we have great stories and insight. We see a side of life few other people see. We see people when they’re sick and tired and defeated by illness. We witness the intimacy of people when they’re most vulnerable, when all pretense has been stripped away. We also have a wealth of scientific knowledge about the effects of illness, how to prevent it and manage it, and what it takes to restore individuals to health or at least to the optimum health possible for them.

As an editor, I’m constantly seeking manuscripts. And I mean constantly—I sometimes feel like a beggar, asking people to “please write that as a case study,” or “please submit that (poignant, funny, revealing, uplifting) story,” or “consider doing an update on (name the problem) incorporating new evidence.” Maybe one out of four pieces materializes.

Nurses writing about nursing is vital to the profession. And it’s not just about writing about research. Research advances knowledge but we also need to know how practitioners are applying knowledge. We know “one size does not fit all”—how does practice need to change to meet the needs of diverse groups? What are the problems and issues aound practice? Is the nursing taught in the classroom connected to the nursing we actually do?

We need to document what we do, why we do it, and what are the outcomes. We need to do this not only to share information that can be helpful to colleagues, but also […]

2016-11-21T13:21:21-05:00November 2nd, 2009|nursing perspective, nursing research|4 Comments
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Genomics, Technology, and Nursing: A “Focus on the Whole Person”

UK National DNA Infographic/ by blprnt_van, via Flickr Creative Commons

By Diana J. Mason, PhD, RN, editor-in-chief emeritus. Mason often writes for this blog about policy and research issues.

Last week, I attended the annual conference of CANS, the Council for the Advancement of Nursing Science, the “research-facilitation arm” of the American Academy of Nursing. The title of the conference was “Technology, Genetics and Beyond: Research Methodologies of the Future.” 

‘Genomics’ vs. ‘genetics.’ I’m not a genomics researcher but I found the sessions enlightening in two ways. First, I admit to struggling with the terminology (and jargon) of the field. I was reminded today that the correct term for the field is “genomics,” since “genetics” refers to the study of single genes and thus limits the focus of study mostly to rare diseases.  Genomics looks at associations among genes in the whole person—a shift in perspective that was enabled by the mapping of the human genome.

Targeted interventions. The second enlightenment came from keynote speaker and senior nurse researcher Christine Miaskowski, a dean and a professor of physiological nursing at the University of California at San Francisco School of Nursing. She noted that this shift to a focus on the whole person is what makes nurses and nursing research essential […]

2016-11-21T13:21:36-05:00October 21st, 2009|nursing perspective, nursing research|0 Comments
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TCAB: What’s Your Hospital Doing to Improve Care?

By Diana J. Mason, PhD, RN, AJN Editor-in-Chief Emeritus

November 2009 report cover

What makes a “good hospital”? A patient might have the best surgeon in the world; but as any nurse will tell you, that patient will die unless the surgeon has a top-notch nursing staff to ensure that the patient is well prepared for the surgery and well supported during the recovery period. Too many hospitals have lost their understanding of what’s essential to ensure great clinical and financial outcomes.  In such hospitals, nurses aren’t included in decision making, have little local authority, are penalized for identifying factors that lead to poor care, and can’t claim excellent team relationships.

The American Nurses Credentialing Center’s Magnet Recognition Program has helped to identify the factors that lead to excellence in nursing care, granting Magnet status to hospitals that provide such excellence. Now an initiative known as Transforming Care at the Bedside (TCAB) has provided the framework and tools for empowering bedside nurses to become  agents for change. TCAB nurses work with other health care team members to improve care processes and effectiveness, focusing on four areas:  the safety and reliability of care, teamwork and job satisfaction, patient and family satisfaction, and “value-added care.” (Increasing the amount of time  […]

2016-11-21T13:21:37-05:00October 20th, 2009|nursing perspective, nursing research|0 Comments
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Administering Drugs through a Feeding Tube—Are You Sure You’re Doing It Right?

Drug Administration through an EFT

By Sylvia Foley, AJN senior editor

Research indicates that a “surprising number of nurses”  fail to follow guidelines for preparing and delivering drugs through an enteral feeding tube. (Do you find this surprising? Tell us in the comments!) This can result in medication error and tube obstruction, reduced drug effectiveness, and an increased risk of toxicity.

In this month’s CE feature Drug Administration Through an Enteral Feeding Tube, author Joseph I. Boullata describes the factors to consider before doing so and examines the gap between recommended and common practice. He also explains what the most recent guidelines from the American Society for Parenteral and Enteral Nutrition (ASPEN) recommend and why.

The ASPEN guidelines include:

  • Do not add medication directly to an enteral feeding formula.
  • Administer each medication separately though an appropriate access site.
  • Liquid dosage forms should be used when available and if appropriate; only immediate-release solid dosage forms may be substituted.
  • Dilute the solid or liquid medication as appropriate and administer using a clean oral syringe.
  • Avoid mixing medications intended for administration through an EFT.

For the complete guidelines, check out Table 1 in the article. And for more on this and other aspects of  enteral nutrition, visit ASPEN to read the full 2009 Enteral Nutrition Practice Recommendations. (ASPEN guidelines are free, but site registration is required.)

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2016-11-21T13:21:58-05:00October 5th, 2009|nursing research|2 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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