Simple Intervention Decreases Oral Mucositis from Head and Neck Cancer Treatment

A painful effect of cancer treatment.

Nurse Cindy Dawson provides patient education on oral care kit used in a nurse-led intervention to reduce oral mucositis severity in adults treated for head and neck cancer. Photo courtesy of Kay Klein.

Years ago, when I worked with patients being treated for head and neck cancer who had been admitted for one reason or another, I felt helpless in the face of their extremely uncomfortable oral mucositis. None of our topical concoctions seemed to bring much relief to these patients, who had often endured disfiguring surgery as well.

While there is as yet no perfect solution to this uncomfortable side effect from the radiation or chemotherapy used to treat head and neck cancers, a group of oncology staff nurses and their colleagues have demonstrated that a consistent, standardized approach to oral care for these patients may significantly alleviate the pain of this almost universal treatment effect.

Consistent, standardized oral care.

After reviewing the literature on oral care, Cullen and colleagues enhanced their usual patient teaching […]

2018-01-12T09:13:13-05:00January 12th, 2018|Nursing, nursing research, patient experience|1 Comment
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‘Micro’ and ‘Macro’ Strategies for Nursing to Thrive as a Profession

At last month’s annual convention of the Academy of Medical-Surgical Nurses (AMSN), nurse and health care economist Peter Buerhaus received the Anthony J. Jannetti Award “for extraordinary contributions to health care.” Buerhaus, a professor of nursing at Montana State University College of Nursing, is widely known across health care disciplines for his research on health care costs and value, especially in regard to nurses and nursing. In his keynote talk, Buerhaus shared some of his recent research findings and offered some “micro” and “macro” nursing strategies for thriving amid today’s health care challenges.

Nurses maintain status as highly trusted professionals.

Click to expand. Most trusted professions, Gallup 2017 poll.

He began by reminding the group of some of the reasons that nurses are respected and trusted in America. People believe that nurses ensure quality of care, protect patients and maintain safety standards, and provide advice on personal health issues.

Studies show that we maintain this trusted status even when the media reports on the mistakes of individual nurses. And after good media attention, as when Alex Wubbels protected her patient or when nurses play key roles in disaster relief efforts, our approval ratings soar.

Accomplishments of NPs have reinforced good reputation of nurses.

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2017-11-17T10:20:27-05:00November 15th, 2017|Nursing, nursing research|0 Comments
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Are There Veterans Among Your Patients?

When vets get non-VHA health care, some issues may be missed.

Most U.S. veterans—and in 2014, there were approximately 19.3 million—do not get their health care from the Veterans Health Administration (VHA). Overburdened facilities with long waiting times and the fact that many veterans live considerable distance from a VHA facility mean that many get their health care from local and private organizations.

And while this may mean more convenient and timely care, it also might mean that health issues related to their military service might be missed by providers who do not have experience providing care to service members and veterans.

This Saturday, November 11, marks another Veterans Day. It’s been our tradition to include content related to health care for veterans or active duty military in November. This year, we have an original research CE article, “Primary Care Providers and Screening for Military Service and PTSD.”

Few providers screen for military service.

The authors of this article sought to examine whether non-VHA primary care providers were screening patients for military service and PTSD. Based on their survey of providers in western Pennsylvania, they found that most did not ask patients about a history of military service—and of those providers who did, few screened patients for PTSD. […]

2017-11-10T10:21:53-05:00November 10th, 2017|Nursing, nursing research|0 Comments
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Becoming a Family Caregiver

Photo by Judith E. Bell, via Flickr.

For me, the saga began six years ago, when I offered to help a family member with some spring cleaning. I knew his place was a mess, but attributed this, stereotypically, to a single man’s lack of interest in housekeeping.

When I dove into the work, I was first puzzled and then fearful at what I found: hundreds of pieces of unopened mail, years old, randomly stacked around the apartment; threatening letters from the Internal Revenue Service; correspondence from the city about a tax lien on his condominium. This, in the home of a man who, as an actor and writer, memorized scripts in two languages, had served on the national board of his union, and could solve complicated math problems without using a calculator. Clearly, something was wrong well beyond the state of his apartment.

In AJN’s September original research article, “The Experience of Transitioning to a Caregiving Role for a Family Member with Alzheimer’s Disease or Related Dementia,” Kathleen Czekanski notes that “caregivers often assume the role of caregiving before they quite realize they are doing so.” In this qualitative study, Czekanski set out to gain […]

2017-09-01T08:54:00-04:00September 1st, 2017|nursing research|0 Comments
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Nurses vs. Computers: Predicting Risk of Patient Harm

Not All Signs of Potential Harm Are Quantifiable

From chego101, via Flickr

Hospital nurses have many, many responsibilities and tasks, but one of the most important is to ensure patient safety by assessing patients for changes that can signal worsening of a condition or a new potential harm. Creating special units like ICUs, recovery rooms, and step-down units; flags on charts; various alarmed monitors; and safety huddles are a few of the ways hospitals have tried to identify potential problems. Now we have computerized tools to do this—or do we?

The complaint I have heard most from nurses about the electronic health record (EHR) is its inability to capture all the nuances of patient care or various patient problems, especially those that don’t involve easily quantifiable measures like heart rate or lab values. (For more detail, read our November 2016 report on nurses’ concerns with EHRs.)

One cannot accurately use a check mark to convey certain patient behavioral parameters or the “can’t put my finger on it but something’s going on with this patient” assessment that experienced nurses often make. In the April issue of AJN, we published an important study that investigates just this issue: “Identifying Hospitalized Patients at Risk for Harm: A Comparison of Nurse Perceptions vs. Electronic Risk Assessment Tool Scores”

Deciding […]

2017-04-19T10:43:15-04:00April 19th, 2017|Nursing, nursing research, patient safety|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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