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 Whether […]

2017-04-19T10:43:15-04:00April 19th, 2017|Nursing, nursing research, patient safety|1 Comment
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Identifying and Addressing the Profound Mental Health Effects of Climate Change

Residents amid homes consumed by flood and fire, White Sulphur Springs, WV, June 2016. Photo © AP Photo / Steve Helber.

A new word for an era of increasing environmental instability.

A lot of attention is currently paid to the physical impacts of climate change, including extreme heat events, droughts, extreme storms, and rising sea levels. Far less attention has been paid to the psychological impacts of this change. For example, you may not be familiar with the term “solastalgia.” It’s related to the older word “nostalgia,” but was created to reflect the environmental and often related sociopolitical uncertainty of our current times—that is, of change that’s slow and incremental, and often even denied, and then sometimes rapid and catastrophic and impossible to ignore.

The term is explained in more detail in an April feature article in AJN, “Climate Change and Mental Health,” by Janna Trombley, Stephanie Chalupka, and Laura Anderko:

Solastalgia is a term coined a decade ago by philosopher Glenn Albrecht . . . It refers to the psychological distress resulting from degradation of […]

2017-07-27T11:38:15-04:00April 17th, 2017|climate change, Nursing, patient experience, Public health|1 Comment
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A National Standard to Prevent Health Care Workplace Violence?

National Nurses United joined members of Congress to speak out at a press conference unveiling findings from the Government Accountability Office’s 2016 report on workplace violence prevention in health care. Photo courtesy of National Nurses United.

In 2014, health care and social assistance workers suffered injuries from workplace violence at a rate more than four times higher than that of private sector employees. What can be done to keep health care workers safe on the job?

As we report in an April news article, National Nurses United, AFL–CIO, and other unions have petitioned the Occupational Safety and Health Administration (OSHA) to create a federal standard for preventing health care workplace violence. OSHA issued a request in December for information on the subject, and held a public hearing in January in which health care workers spoke about their experiences of workplace violence and their ideas for improving safety and protection policies. Through early April, the agency collected comments from the public on a federal standard—but uncertainty surrounds its direction under the Trump administration.

Nine states have enacted measures against workplace violence in health care settings. The toughest of these is California’s Workplace Violence Prevention Health Care standard, which was enacted last year. It requires health care facilities to implement a comprehensive program with multiple components for addressing workplace violence.

See more news stories from our April issue, which are free to access through April 21:

2017-04-14T08:49:22-04:00April 14th, 2017|Nursing|0 Comments
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The Significant and the Superficial

Libby Kurz, BSN, MFA, RN, works as an OR nurse. Formerly a nurse in the U.S. Air Force, she lives in Virginia with her family. Her work has been published in several literary magazines. To read more of her writing, visit www.libbykurz.com. 

I often wonder why the world is the way it is. Why, above all other possibilities, do we have two eyes to see, a mouth that tastes, a body that needs food and fluid to sustain itself, but a mind that can entertain thoughts far beyond the realm of the physical world? The more I think about it, the stranger life seems.

People are odd, too. I’m always blown away by our quirks. There’s a surgeon I work with who has to eat his cereal every morning in the shower. He had a shelf built into his shower just for his cereal bowl. One of my coworkers has a pet scorpion and two snakes, but she hates spiders. An acquaintance of mine eats mayonnaise and peanut butter sandwiches.

Working as a nurse provides an environment where these ironies and oddities of life seem even more pronounced. I work […]

2017-04-13T12:11:56-04:00April 13th, 2017|Nursing, nursing stories|1 Comment
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CDC Draws Attention to Youth Concussion Risks, Offers Training and Resources

This post was contributed to AJN‘s blog by the Traumatic  Brain Injury Team at the CDC Injury Center.

As an A-student and star soccer player, Sarah was used to hard work. However, after she sustained a concussion while playing a varsity soccer game during her freshman year in high school, she found herself challenged in ways she had never expected.

“Recovering from the concussion was harder than recovering from other injuries I’ve had,” Sarah recalls. “When I got a concussion, I expected to sit out some games, but I never realized that it would actually hurt to think. For nearly two months I needed frequent breaks to make it through the school day. I would have to go to the school clinic and rest when I was overcome by headaches from the lights and noise of the classroom.”

Sarah’s story is not unusual. In fact, children and teens have the highest rate of emergency department visits for traumatic brain injury (TBI), including concussion, of all age groups. Fortunately, Sarah made a full recovery after four months and continues to be successful […]

2017-07-27T11:40:44-04:00April 11th, 2017|Public health, school nurses|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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