Patient Input on Obstacles to Sleep Helps Focus One Unit’s Improvement Efforts

Do you know anyone who’s ever had a good night’s sleep in the hospital? As nurses, we hear the complaints; as patients ourselves, or as family members of patients, we’ve been there.

Differing views on the source of a unit’s sleep problem.

After their hospital’s 20-bed telemetry unit received a low HCAHPS survey score on a quiet-at-night question, nurse practitioner Christian Karl Antonio and his colleagues at a northern California community hospital took on the challenge of improving patients’ sleep experience on the unit.

Before designing an intervention, they spoke with patients as well as staff, and were surprised to learn that the two groups see the problem differently.

“Patients perceived being awakened for vital signs, blood draws, and medication administration as the most frequently occurring factors that contributed to noise at night. On the other hand, staff members perceived that noise at night came from staff conversations, equipment with alarms, announcements on the paging system, and delivery carts, among other sources.”

[…]

2020-10-08T10:01:55-04:00October 8th, 2020|family experience, Nursing, nursing research, Patients|0 Comments
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How Do Nurses Feel About Assessing for and Promoting Safe Gun Storage?

My grandfather and uncles were hunters, and they always looked forward to their forays into Michigan’s Upper Peninsula during deer hunting season. But while I was well aware of their activities, they never brought their guns into our house. So I never gave any thought to gun safety issues, even after I became a nurse—not even after caring for one memorable patient, a young man my own age who had been accidentally shot by a companion during a hunting trip.

What can nurses do?

“…a child finds an unlocked loaded gun and accidentally shoots themselves or someone nearby, a despondent teenager makes a rash decision to end their life with the family gun, a homeowner mistakes a family member for an intruder.”

It seems that we read about tragedies like these every day. Can nurses help prevent them? The American Academy of Nursing has recommended that health care professionals “assume a greater role in preventing firearm injuries by health screening.”

In “Nurses’ Knowledge and Comfort with Assessing Inpatients’ Firearm Access and Providing Education on Safe Gun Storage” in the September issue of AJN, Kimberly Smith Sheppard and colleagues report on their original research study, which examined nurses’ knowledge and comfort with assessing patients’ access […]

2020-10-05T10:43:01-04:00October 5th, 2020|Nursing, nursing research, Public health|0 Comments
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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 three […]

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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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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