Blood Culture Bottle Shortage: Reducing ED Utilization in One Health System

Jonathan Nover, MBA, RN
Vice President of Nursing | Emergency Services
Mount Sinai Health System, New York City

The problem.

In early July 2024, a nationwide blood culture bottle shortage was announced. At the Mount Sinai Health System, specifically for our eight emergency departments (ED), naturally high utilizers, it was critical to devise contingency plans to reduce utilization and preserve supplies. Since it was evident early on that ED nursing would play a critical role in reducing utilization and waste, it was crucial to understand our current burn rates, utilization rates, contamination rates, and fill volume rates. We would need to recalibrate our blood culture stewardship and check in with our teams to understand workflows and their knowledge baseline about the nationwide shortage.

Discovering a gap in knowledge.

Through varying methods including huddles; “walking the GEMBA” with nursing leaders, epidemiologists, and infection preventionists; and eliciting transparent feedback we learned very quickly that our ED teams were not all aware of the top reasons for blood culture waste.

A nursing practice alert.

We created a nursing practice alert to highlight several key elements we’d learned . The areas of focus,

2024-09-12T10:31:16-04:00September 3rd, 2024|Nursing|0 Comments
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How Nurses Use Humor at Work: And Other Recommended Reading from AJN’s September Issue

On this month’s cover is ephemeral snow, a painting by Pennsylvania medical–surgical nurse Ren Hernandez. See our “On the Cover” column to learn more about his work.

The September issue of AJN is now live.

“Through both happy and tragic moments, humor can change one’s perceptions of a situation, making it easier to face workplace challenges and demands,” write Edessa Cadiz and colleagues in this month’s Original Research article, “Exploring Nurses’ Use of Humor in the Workplace: A Thematic Analysis.” Their study findings clarify how humor serves as a coping strategy.

The September CE article, “Strengthening Nurses’
Influence in Health Policy,” introduces the Patton Zalon Ludwick Policy Assessment Framework that nurses across settings and roles can use to examine their knowledge and actions for expanding policy activities.

What does it mean to take an intersectionality-informed stance in nursing practice? Read editor-in-chief Carl A. Kirton’s Focus on DEI column to find out.

In “Professional Licensure: Protecting Your Nursing Livelihood, Part 1,” nurse and attorney Edie A. Brous explains why nurses are […]

2024-08-26T12:27:51-04:00August 26th, 2024|Nursing|0 Comments
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How to Get Started as a Nurse Advocate Around Key Issues Like Scope of Practice

Have you ever been frustrated by a professional issue and wondered if new legislation could fix it? This happened to me as a nurse practitioner after moving to a new state.

I was young and newly married, wanting to be closer to family. I didn’t realize how drastically different each states’ Nurse Practice Act could be in terms of advanced practice registered nurse (APRN) scope of practice. My work as a psychiatric NP had been focused on child and adolescent psychiatry, but moving to Florida in 2013 hindered my ability to continue this practice. State laws did not allow advanced practice nurses to prescribe controlled substances, and the majority of attention-deficit/hyperactivity disorder medications are considered Schedule II.

Getting started as an advocate.

Ultimately, this legal restriction led to two things: my transition to adult-only practice, and learning how to be a nurse advocate. This overview was developed as an introduction to the process of impacting legislative change as an advocate for your patients and your profession.

2024-08-23T15:25:02-04:00August 19th, 2024|career, Nursing, nursing roles|0 Comments
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Beyond ‘Leaning In’: Pull Up a Chair for Others

A commitment to ‘always be at the table.’

Many years after reading Sheryl Sandburg’s 2013 book, Lean In: Women, Work, and the Will to Lead, and watching her Ted Talk, “Why We Have Too Few Women Leaders,” the phrase “sit at the table” sticks with me.

At the time I read the book I was working for a hospital system, overseeing a large research team. I often sat in interdisciplinary meetings where the doctors would occupy the seats at the table and the support team members, often early career professionals and nurses, would sit on the periphery of the room. These seats were not assigned—it was just how people sat themselves. In her book, Sandberg observed that those who sit at the sidelines of decisions are more often seen as spectators instead of as active participants or decision-makers.

After finishing the book, I made a commitment that I would always be at the table because I refused to believe that my experience, knowledge, or opinions were any less valuable than those of anyone else in the room.

Bring a chair for someone else.

I now work in a nursing academic setting that seeks to offer an environment of belonging and inclusivity for faculty, students, […]

2024-08-12T13:36:16-04:00August 12th, 2024|equity, Nursing, nursing perspective|1 Comment
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The Epidemic of Gun Violence: A ‘Problem to Be Solved, Not a Battle to Be Won’

The alarming surge in child gun deaths

For decades, gun violence in America has been framed “as a battle to be won rather than a problem to be solved,” in the words of a poignant New York Times op-ed by Nicholas Kristof, who argues that we should acknowledge the blunt reality that guns aren’t going away. Therefore, he writes, it’s time to “bypass the culture wars and try a harm-reduction model familiar from public health efforts to reduce deaths from other dangerous products such as cars and cigarettes.”

The current combative public debate has been accompanied by devastating increases in gun violence, particularly for the youngest members of our society. According to an October 2023 study published in Pediatrics, between 2011 and 2021, gun deaths among Americans under the age of 18 surged by 87%, making gun violence the leading cause of death for American children. In stark contrast, there has been an overall steady decline of child deaths from motor vehicle fatalities, with a 51% reduction from 1999 through 2020, showcasing the potential for effective interventions when society’s most confounding issues are treated through a public health lens.

The stark reality of gun violence

The reality of gun violence in America is stark and sobering. […]

2024-08-08T09:48:27-04:00August 8th, 2024|gun violence, Nursing, pediatrics, Public health, school nurses|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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