Nursing Archives - Page 127 of 408

In Colorado EDs, ‘Alternative to Opioids’ Pilot Project Exceeds Goals

Ashley Copeland talks to her mother in the Swedish Medical Center ED. Copeland was treated for a severe headache with a nerve-blocking anesthetic, but no opioids. (John Daley/CPR News)

Last year, in an effort to address the state’s acute opioid abuse problem, several Colorado health care organizations—including the Colorado Emergency Nurses Association—worked together on an intervention to target patients admitted to the ED with pain. The plan? Implement a pain management program to promote alternative strategies, with a goal of decreasing opioid usage by 15% in the participating EDs.

As discussed in a June news article, the program, which was piloted in 10 hospitals and involved heavy involvement from nurses, surpassed its goal: opioid usage during the intervention period (as measured in morphine equivalent units) was 36% less than in the previous year.

The pilot […]

Diane Szulecki, editor2018-06-14T09:29:35-04:00June 14th, 2018|Nursing, patient experience|1 Comment

Who’s Listening to Hospitalized Patients with Hearing Impairment?

In my early years in nursing, attention to patients’ hearing deficits was a big deal. It was assumed that we couldn’t properly care for someone if that person couldn’t hear us. Every admission assessment included an appraisal of the patient’s hearing: “Hears ticking watch eight inches from each ear,” or “hears quiet conversation at three feet without difficulty,” or “patient states deaf in right ear,” or some other specific description.

When hearing difficulties were evident, a sign was prominently posted over the head of the bed, a note in red ink was written in the Kardex (those quick-reference summaries of key points on all patients that were updated daily), and a special label was affixed to the front of the (paper) chart.

A communication impediment, often ignored.

Why don’t we do these things anymore? I see little indication that the needs of a hearing-impaired patient are a clinical priority. The deficit is not noted on the whiteboards that seem to be standard issue in patients’ rooms today. As a hospital visitor, I watch with dismay as staff fail to acknowledge acutely obvious hearing impairments.

A family member has tumor-induced hearing loss in one ear, and I explain on every admission that people need to speak up when addressing him. I ask them to make use of his intact hearing […]

Betsy Todd, MPH, RN2018-06-12T12:53:06-04:00June 12th, 2018|Nursing, nursing research, patient experience|1 Comment

Critical Mass at the Critical Care Nursing Conference

Boston + 9,000 nurses = NTI2018

The American Association of Critical-Care Nurses (AACN) is well-known for its annual National Teaching Institute (NTI), but this year, in terms of sheer scope, it surpassed all other meetings I know of. With over 9,000 attendees, registration had to be closed for the first time ever. Imagine—there were almost too many people at the Boston Convention Center, one of the largest venues in the country.

The exhibits, as always, were never-ending, with sections for industry, education, organizations, recruiters, and publishers. And as always, the “newbies” could be identified by the bags of giveaways they carted off . . . as opposed to the NTI veterans, who merely scan badges and have info sent to them.

Obstacles as opportunities for change.

Monday’s opening address by AACN president Christine Schulman was heartfelt. Reflecting on her soon-to-end year as the president and its chosen theme, “Guided by Why,” she encouraged us to explore the possibilities of making real changes when we face obstacles. And she announced that AACN was planning to take on the fundamental issue of nurse staffing:

“Inappropriate staffing has gone on for far too long. It involves many factors . . . and needs a major shift in how we think about delivering patient care.”

Body language creates and projects confidence.

The next day’s keynote address by social psychologist Amy Cuddy (see her popular TED Talk, “Your Body Language May Shape Who You Are“) gave attendees some insight […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-06-06T12:38:27-04:00June 6th, 2018|career, Conference reports, Nursing|0 Comments

As a Long-Predicted Nursing Shortage Gets Real, Staffing and Retention Issues Get Urgent

Is the nursing shortage finally here?

In her June issue editorial, AJN editor-in-chief Shawn Kennedy notes that in her recent visit to the annual National Student Nurses’ Association (NSNA) conference, many of the senior students she spoke with already had jobs lined up.

She surveys some recent indicators pointing to the possible arrival at last of a long-predicted nursing shortage, and some of the possible implications this is having or may have in the coming years for patient care and the health of organizations. For example:

“A survey of 233 chief nursing officers conducted last July conducted last July by national staffing company AMN Healthcare found that 72% said their shortages were moderate to severe, and most expected shortages to worsen over the next five years. They also acknowledged that the shortage was having a negative effect on patient care, patient satisfaction, and staff morale.”

Bonuses for new hires.

She notes that, with hospitals in some regions paying signing bonuses to new nurses, the question of staff retention and development remains the elephant in the room.

The class of 2018, it seems, is entering a job seeker’s market. . . . Organizations that can invest in new nurses with programs that provide support and training will have a leg up in recruitment. But retaining […]

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Jacob Molyneux, senior editor/blog editor2018-06-04T12:21:33-04:00June 4th, 2018|Nursing|2 Comments

The Risks and Benefits of Transfusion Therapy

Potential complications of transfusions.

If your patient develops mild jaundice or thrombocytopenia two weeks after a blood transfusion, would you consider their transfusion history an important part of your assessment?

When I think of monitoring a patient who is receiving a blood transfusion, I think primarily about watching for a hemolytic transfusion reaction or circulatory overload. To me, that means keeping a close watch during the transfusion and for about 24 hours afterwards. Yet “classic” hemolytic reactions and volume overload are not the only potential complications of blood therapy. Delayed reactions can occur days or even weeks after you’ve run through your saline flush and disposed of the blood bag.

Update of current transfusion practices.

In this month’s AJN, Margaret Carman and colleagues provide readers with an update of current practices in transfusion therapy. In “A Review of Current Practice in Transfusion Therapy,” the authors survey the benefits and risks of fresh whole blood (used today primarily in military or disaster settings) and blood components—red blood cells, plasma, cryoprecipitate, and platelets. […]

Betsy Todd, MPH, RN2018-05-29T11:19:05-04:00May 29th, 2018|Nursing, patient safety, Patients|0 Comments