AJN July Issue: Hepatitis Update, Ehlers-Danlos Syndrome, Nursing’s Blind Spots, More
On the cover of AJN‘s July issue is the 2015 logo for World Hepatitis Day, which takes place on July 28. About 400 million people around the globe live with viral hepatitis, a disease that kills 1.4 million people every year—approximately 4,000 a day. While incidences of hepatitis A and B have declined in the United States in recent years, hepatitis C infection, formerly stable or in decline, has risen at an alarming rate. To learn more about hepatitis in the U.S.—and the role nurses can play in prevention and treatment—read our July CE, “Viral Hepatitis: New U.S. Screening Recommendations, Assessment Tools, and Treatments.”
The article reviews the epidemiology and diagnosis of viral hepatitis, new screening recommendations and innovations in assessment and treatment, and an updated action plan from the Department of Health and Human Services, in which nurses can play an important role in the coordination of care.
Some other articles of note in the June issue:
• CE feature: “Nursing Management of Patients with Ehlers–Danlos Syndrome.” An often debilitating condition, Ehlers–Danlos Syndrome (EDS) refers to a group of hereditary connective tissue disorders that has historically been misunderstood and underdiagnosed due to a lack of familiarity with its signs and symptoms. As awareness and recognition of the syndrome improve, nurses are increasingly likely to care for patients with EDS. This article gives an overview of […]
Surveys Aside, One Crucial Precondition for Real Patient Satisfaction
By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.
During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?
1. Never
2. Sometimes
3. Usually
4. Always
5. I never pressed the call button
Everyone is talking about patient satisfaction these days. Purposeful rounding, responsiveness, and customer service are discussed in meetings, on blogs, and in conversations at work. An entire science has been created out of satisfaction, with whole journals devoted to patient experience and paid officers tracking scores and strategies. Since hospital reimbursement is linked to how happy patients are, we’ve suddenly gotten serious about satisfaction.
But behind the sterile questions on the HCAHPS survey, real stories about real people reside. I find myself often forgetting the flesh and blood that’s represented by each checked box, and am learning to realize that, while satisfaction is something to be striven for, dissatisfaction is something to be learned from.
In a series of posts, starting with this one, I’ll share stories of my own missteps—ones that may have caused my patients to answer never instead of always to questions about my care. The events described here helped me realize that, score or no score, responding to call bells actually matters at the human level:
Sarah was a […]
Breastfeeding’s Benefits vs. Fear of Infection Risks from a Mother’s New Tattoo
By Betsy Todd, MPH, RN, CIC, AJN clinical editor
People, it seems, still have strong feelings about tattoos—and about breastfeeding, too. This month, a judge in Sydney, Australia, ordered the newly tattooed mother of an 11-month-old baby to stop breastfeeding. The judge maintained that the mother’s tattooing the previous month presented “an unacceptable risk of harm” to the baby because the mother could have contracted HIV or hepatitis B (HBV) during the procedure.
The woman had tested negative for both HIV and hepatitis B since she received the tattoos. But poor aseptic technique during tattooing can result in the transmission of bloodborne infections, and people infected with HIV or HBV may not immediately test positive for either virus.
However, while HIV can be transmitted in breast milk, studies indicate that breastfeeding by hepatitis B surface antigen-positive women does not pose a significant risk of infection to their infants.
The theoretical risks put forth by the judge in this case were no match for the well-documented benefits of breastfeeding, and the injunction has already been overturned on appeal.
Still, the case raises interesting questions about how risks to a breastfeeding baby are determined. What if the father had been the person with new tattoos, and he still had a sexual relationship with the baby’s mother? It’s unscientific (and discriminatory) to focus […]
Soul-Satisfied, but Heartbroken: The ‘Soft’ Skills of Oncology Nurse Navigators
Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog. The illustration below is part of a series on mountains as barriers that she is working on.
Untitled oil stick & charcoal on paper by Julianna Paradisi
When I introduce myself to nurses as an oncology nurse navigator, they often respond, “Oh, that’s great,” staring blankly. Sometimes, in the midst of patient care, they say, “Yeah, that’s great, but I’m really busy. Come back later.”
Nurses caring for patients are really busy—so busy that this is one of the reasons the relatively new specialty of nurse navigators exists. Another reason is that oncology care is increasingly complex, and mostly occurs in the outpatient setting where vulnerable patients must fend for themselves.
Patient navigation was founded in 1990 by Harold P. Freeman at Harlem Hospital Center to improve outcomes for poverty-stricken African-American women presenting with stage III and IV breast cancer. Freeman declared, “The core function of patient navigation is the elimination of barriers to timely care across all segments of the healthcare continuum.”
In 2010, the Affordable Care Act (ACA) mandated patient navigation for oncology by 2015. No longer aimed […]
