Antibiotic Stewardship: Inherent to Good Nursing Practice

neutrophil interacting with two pink-colored multidrug-resistant Klebsiella pneumoniae bacteria

Although most nurses are aware of the urgent problem of antibiotic overuse in hospitals, some may be unfamiliar with terms like “antibiotic stewardship.” This is partly because few nurses besides those working as infection control preventionists have had a formal role in stewardship programs, explain authors Rita D. Olans, Richard N. Olans, and David J. Witt in “Good Nursing Is Good Antibiotic Stewardship,” which appears in this month’s issue as a Special Feature. In the article, the authors detail how bedside nurses are vital to the success of these efforts.

What Is Antibiotic Stewardship?

Antibiotic stewardship programs offer a formal approach to addressing the current crisis, in which an increasing number of organisms are developing resistance to antimicrobial medications. In the absence of new drugs, stewardship programs have been established to improve the way currently available antibiotics are used in hospitals. These programs aim to:

  • optimize antibiotic therapy.
  • shorten the duration of use of broad-spectrum antibiotics.
  • reduce the number of adverse events.

According to the authors, “because nurses are not typically prescribers of antibiotics, they often don’t see themselves as participants in antimicrobial stewardship programs.” Yet, even though they may not know it, “staff nurses are already performing many […]

2017-08-02T11:36:27-04:00August 2nd, 2017|Nursing, Public health|1 Comment
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Nurse-Author Theresa Brown Reflects on Recent Book About Doctor-Patient Communication

Nurse and frequent contributor to the New York Times Theresa Brown writes a column for AJN called What I’m Reading, in which she reflects on a recent book about an aspect of health care. This month she examines What Patients Say, What Doctors Hear (Beacon Press, 2017), by physician Danielle Ofri.

The book is about communication with patients, about real listening and the kinds of listening that often substitute for it, sometimes to the real harm of patients. Brown also considers some differences between the ways physicans and nurses tend to talk to patients. Here’s a brief excerpt, but we recommend that you read the short article, which is currently free:

Can any of us, nurses or physicians, say that we always listen as well as we should, giving each patient’s story our full attention? Like physicians, nurses feel the unrelenting pressure of time constraints. Although I try very hard to listen well, I’m sure there are times when I fail. Ofri’s book reminds us that it is clinically important to listen to what our patients say. Ironically, such listening can save time in the long run. But the main reason for doing so is simple: in order to give patients the best care possible, we need to hear what they’re actually trying to tell us.

Brown’s column is not a book review; while she draws readers’ attention to books that are well worth reading, the column goes beyond this purpose, […]

2017-07-31T09:33:35-04:00July 31st, 2017|Nursing|0 Comments
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August Issue Highlights: TB Screening, The Baby-Friendly Hospital Initiative, Antibiotic Stewardship, More

The August issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Tuberculosis: A New Screening Recommendation and an Expanded Approach to Elimination in the United States

The U.S. Preventive Services Task Force (USPSTF) recently issued a new recommendation statement on latent tuberculosis infection testing that expands nurses’ opportunities to identify at-risk populations for tuberculosis prevention. This article provides a general overview of tuberculosis transmission, pathogenesis, and epidemiology; presents pre­ventive care recommendations for targeted testing among high-risk groups; and discusses the USPSTF rec­ommendation’s applicability to public health and primary care practice in the United States.

CE Feature: Beyond Maternity Nursing: The Baby-Friendly Hospital Initiative

The Baby-Friendly Hospital Initiative (BFHI) is a program developed by the World Health Organization and the United Nations Children’s Fund to promote breastfeeding in hospitals and birthing facilities worldwide. Since the program was launched in 1991, breastfeeding initiation, duration, and exclusivity have increased globally, a trend largely attributed to changes in hospital policies and practices brought about by the BFHI. This article provides an overview of these practices and policies, the insti­tutional benefits of achieving BFHI certification, and the process through which health care facilities can do so.

Original Research:

2017-07-28T09:41:48-04:00July 28th, 2017|Nursing|0 Comments
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There from the Start: A Hospice Nurse Looks Back

A painting of Dianne Puzycki, RN, hangs in Connecticut Hospice in New Haven.

At age 82, Dianne Puzycki has yet to retire from nursing—she still works the night shift once a week at Connecticut Hospice in Branford, where she’s been employed since the organization’s inception in the 1970s. Founded by Florence Wald, it was the first hospice in the United States.

Puzycki started her career in 1955 at Memorial Hospital in New York City, caring for patients with cancer at a time when death and dying wasn’t openly discussed. “We weren’t allowed to talk about that. It really haunted me for years,” she told AJN in a July profile. Several years later, she encountered two influential women: Dame Cicely Saunders, who founded the first modern hospice, and Elisabeth Kübler-Ross, who introduced the concept of the five stages of grief in her groundbreaking 1969 book On Death and Dying. Seeing them speak piqued her interest in the hospice movement, and she began volunteering for Connecticut Hospice, which eventually led to a full-time job.

Throughout the decades, says Puzycki, she’s witnessed hospice care constantly change and improve. She recalls that in the past, more patients used to stay up […]

2017-07-26T09:35:44-04:00July 26th, 2017|Nursing, nursing career|1 Comment
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The Human Microbiome: A Primer for Nurses

Image courtesy of Bard Medical Division.

​The human microbiome is a collection of organisms living on the skin and in our GI and reproductive tracts. Nurses know these “germs” are there, and traditionally we have regarded them as potentially dangerous. We try to eliminate as many as possible when we disinfect skin before injections, surgery, or other procedures. Yet, as noted by the authors of a continuing education (CE) feature in the July issue of AJN, “Health and the Human Microbiome: A Primer for Nurses,” new research increasingly demonstrates that these microbes affect our health in significant and often positive ways.

​” . . . once unequivocally regarded as dangerous invaders, [microbes] often serve us as integral companions, providing critical functions in fundamental human processes.”

​In this article, Katie Gresia McElroy and colleagues share many thought-provoking research findings about the human microbiome that are relevant to nursing. Some examples: […]

2017-07-24T10:33:11-04:00July 24th, 2017|Nursing|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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