Injurious Falls in the Hospital Setting

by Maureen Shawn Kennedy, AJN editor-in-chief

PatOriginal.00000446-201609000-00022.FF1ient falls are, unfortunately, a frequent occurrence in hospitals and the consequences can vary from none to serious life-threatening injuries. There has been a lot of attention focused on identifying those at high risk for falls and effective prevention measures, but according to our September CE feature, there’s been little attention focused on falls that cause injuries. In this original research study, Predicting Injurious Falls in the Hospital Setting: Implications for Practice, Amy Hester and colleagues at the University of Arkansas for Medical Sciences conducted a retrospective review of medical records to see if they could pinpoint which patient factors were associated with falls with injuries. Their results may surprise you.

Here’s the abstract:

Background: Despite years of research and increasingly evidence-based practice, falls continue to be the most commonly reported adverse events experienced by hospitalized adults. Yet a majority of the relevant research has focused on predicting and preventing falls in general; there has been little focus on injurious falls.

Purpose: The purpose of this retrospective study was to determine which patient factors are associated with injurious falls in hospitalized adults.

Methods: The study site’s adverse event reporting database was used to identify 1,369 patients who fell between January 1, 2006, and October 31, 2013. Of these, 381 (27.8%) subjects suffered injurious falls. Variables of interest included age, sex, fall history, use of diuretics, use of central nervous system medications, cognitive impairment, primary discharge diagnoses, abnormal laboratory values, impaired mobility, and […]

2016-11-21T13:00:58-05:00August 31st, 2016|Nursing, nursing research|0 Comments
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AJN in July: Opioids and Chronic Pain, Moral Distress, Prediabetes, More

CE Feature: “Appropriate Use of Opioids in Managing Chronic Pain.”

Unintentional death related to prescription opioids has been identified as a public health crisis, owing in part to such factors as insufficient professional training and medication overprescription, misuse, and diversion. The authors discuss current best practices for prescribing opioids for chronic pain, emphasizing patient assessment and essential patient teaching points regarding safe medication use, storage, and disposal, and after you find a more permanent solution people could totally quit opioids by using a detox methods that goes from medicine to even a detox tea like leptinteatox. There are some medicines or supplements that are more easy to use, depending on the problem, like the peruvian brew, that helps with erectile dysfunction and is pretty safe. After that you only need to be careful with stds diseases you can go and test at https://www.stdaware.com/chlamydia-test.

CE Feature: “Moral Distress: A Catalyst in Building Moral Resilience.”

Moral distress is a pervasive problem in nursing: an inability to act in alignment with one’s moral values is detrimental not only to the nurse’s well-being but also to patient care and clinical practice as […]

2017-05-26T00:08:51-04:00June 24th, 2016|career, health care policy, Nursing, nursing research, pain management, Patients|0 Comments
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Intimate Partner Violence: ‘Troubling Knowledge and Practice Gaps’ among Rural Providers

By Sylvia Foley, AJN senior editor

Table 8. Perceived self-efficacy on a 1-to-5 scale (mean score above 2.5 indicates greater sense of self-efficacy). Table 8. Perceived self-efficacy on a 1-to-5 scale (higher score indicates greater self-efficacy).

Intimate partner violence (IPV) remains a widespread health and social problem in the United States, affecting an estimated one in three women during her lifetime.

Health care providers can make a critical difference in the lives of these women, yet a lack of IPV-related knowledge, negative attitudes and beliefs, and low rates of screening are common. And women in rural areas face particular challenges.

To learn more about rural providers with regard to IPV, nurse researchers Karen Roush and Ann Kurth conducted a study. They report their findings in this month’s CE–Original Research feature, “Intimate Partner Violence: The Knowledge, Attitudes, Beliefs, and Behaviors of Rural Health Care Providers.” Here’s an overview:

Methods: Health care providers working in a large rural health network were asked to complete electronic surveys that examined their IPV-related knowledge, attitudes, beliefs, and behaviors. Descriptive and correlational statistical analyses of the data were conducted.
Results: A total of 93 providers returned completed surveys. In general, the respondents demonstrated good overall knowledge, judicious attitudes, and beliefs congruent with […]

2016-11-21T13:01:08-05:00June 10th, 2016|health care policy, Nursing, nursing research, Public health|0 Comments
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Napping on the Night Shift: What a Pilot Study Revealed

By Sylvia Foley, AJN senior editor

Table 1. Guidelines for Hospital Nurses on Implementing Naps on the Night Shift (click to enlarge)Nurses who work the night shift often struggle with high levels of sleepiness. But while onsite napping is effectively used to counter worker fatigue in other safety-sensitive industries, the practice has yet to win wide acceptance in nursing.

Curious about why this is so, nurse researchers Jeanne Geiger-Brown and colleagues recently conducted a pilot study. They report their findings in this month’s CE–Original Research feature, “Napping on the Night Shift: A Two-Hospital Implementation Project” (for some night shift napping ground rules, see, at right, Table 1: Guidelines for Hospital Nurses on Implementing Naps on the Night Shift—click table to enlarge).

Here’s an overview:

Purpose: To assess the barriers to successful implementation of night-shift naps and to describe the nap experiences of night-shift nurses who took naps.

Methods: In this two-hospital pilot implementation project, napping on the night shift was offered to six nursing units. Unit nurse managers’ approval was sought, and further explanation was given to a unit’s staff nurses. A nap experience form, which included the Karolinska Sleepiness Scale, was used to assess pre-nap sleepiness level, nap duration and perceived sleep experience, post-nap sleep inertia, and the perceived helpfulness of the nap. Nurse managers and staff nurses were also interviewed at the end of the three-month study period.

Results: Successful implementation occurred on only one of the six units, with partial success seen on […]

2016-11-21T13:01:12-05:00May 16th, 2016|Nursing, nursing perspective, nursing research, patient safety|3 Comments
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AJN in May: Night-Shift Naps, Intrathecal Cancer Pain Relief, Teaching Nurses to Write, More

On this month’s cover is A Maid Asleep (1656–57) by the Dutch master Johannes Vermeer. We chose this painting to call attention to the issue of sleepiness in nurses who work the night shift, which is explored in this month’s Original Research article.

On-the-job sleepiness among nurses can increase the risk of patient care errors, job-related injuries, and long-term health problems.

For night-shift nurses, one potential solution is being allowed to take brief naps during a shift, which the American Nurses Association recommends as an evidence-based countermeasure to fatigue. But nurses may face barriers to doing so, including a lack of formal breaks on the unit and concerns about impeding the quality of nursing care. To learn about a project that explored those barriers and attempted to implement night-shift naps, read “Napping on the Night Shift: A Two-Hospital Implementation Project.”

Some other articles of note in the May issue:

CE Feature: “Intrathecal Pumps for Managing Cancer Pain.” Among patients with cancer, moderate to severe pain is prevalent and can be refractory even with the use of systemic opioids, which may cause adverse effects that are difficult to manage at the doses required to control pain. When delivered intrathecally, however, opioids and adjuvant analgesics may provide greater pain relief at dramatically lower doses and with fewer adverse effects. This article provides an overview of intrathecal pump therapy, including its benefits and potential risks and complications; the medications that can be delivered intrathecally; and the nursing care […]

2016-11-21T13:01:16-05:00April 29th, 2016|Nursing, nursing perspective, nursing research|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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