Why Don’t We Pay Attention to Oral Care in the ICU?

By Maureen Shawn Kennedy, MA, RN, AJN editor-in-chief

“Although meticulous oral care has been shown to reduce the risk of ventilator-associated pneumonia (VAP), oral care practices among critical care nurses remain inconsistent, with mouth care often perceived as a comfort measure rather than as a critical component of infection control.”

scanning electron micrograph of Pseudomonas aeruginosa bacteria, one several types that can cause VAP/CDC Scanning electron micrograph of Pseudomonas aeruginosa, one of several bacteria types that can cause VAP/ CDC image

So begins one of our CE feature articles in the current issue of AJN. In “Mouth Care to Reduce Ventilator-Associated Pneumonia” (which you can read for free), the authors discuss why mouth care is so important among the interventions to reduce VAP—and why it is often not given a high priority among patient care procedures.

I have to confess that in my clinical days, mouth care was done almost as an afterthought. In our critical care unit, we were always diligent in monitoring vitals signs and IV fluids, suctioning, turning and positioning the patient, but oral care usually was a perfunctory task, completed with a few quick swipes with lemon-glycerine swabs.

Booker and colleagues explain why oral care deserves the careful attention we give to other measures. They also review the research on […]

The 10 Most Popular Articles on AJN Right Now

From boliston, via Flickr From boliston, via Flickr

The 10 current “most viewed” AJN articles are below. Sometimes we’re surprised by the ones that go to the top of this list. At other times, the high interest in the article makes perfect sense. Most of these articles are currently free, either because they are CE articles or because they are shorter opinion pieces or the like. We hope you’ll have a look.—Jacob Molyneux, senior editor

“The Care of Pregnant Women in the Criminal Justice System” 

CE article. Overview: Current practices in the treatment and transfer of pregnant inmates in this country may negatively affect maternal and fetal health or well-being. Some violate federal or state laws; others conflict with standards of obstetric care and are widely considered unethical or inhumane. This article discusses these practices; their legal status; and implications for nursing practice, policy, and research.

“Developing a Vital Sign Alert System”

CE. Overview: This article describes the implementation of a nurse-designed, automated system for enhancing patient monitoring on medical–surgical and step-down nursing units. The system . . . was found to substantially reduce out-of-unit codes without increasing nurses’ workload.

“Mouth Care to Reduce Ventilator-Associated Pneumonia”

CE. Overview: Despite the well-established association between good oral hygiene and the prevention of VAP, the importance […]

Taking Postpartum Mood Disorders Seriously

By Jacob Molyneux, AJN senior editor

Durer, Melancolia/Wikimedia Commons Durer, Melancolia/Wikimedia Commons

Last week, you probably heard that a 34-year-old mother was shot and killed by police after a car chase that ended with her trying to ram her car through White House barriers, her infant child still strapped in a car seat in the back.

Miriam Carey’s mother told reporters that her daughter was suffering from postpartum depression, though a number of commentators have pointed out that the extremity of her apparent delusions and the violence of her behavior suggest the more severe condition called postpartum psychosis (especially if it turns out that her condition was not chronic but instead began after she’d given birth).

Some estimates of the rate of major or minor depression in new mothers are as high as nearly 20%. AJN published a feature article (free until November 8) on this topic several years ago. The article describes postpartum depression and several related conditions (postpartum psychosis, panic attacks, PTSD, etc.) and discusses prevalence, risk factors, symptoms, diagnosis, interventions, and the potential long-term effects on children.

Postpartum depression can be powerful and hard to face, as it comes at a time that often combines social isolation with the expectation that one […]

Congress Could Learn from Global Nursing Unions

By Shawn Kennedy, AJN editor-in-chief

New South Wales Nurses and Midwives' Association rally New South Wales Nurses and Midwives’ Association rally

In this month’s issue of AJN, we report on the formation of a new international organization of nurses and health care workers in June—Global Nurses United (GNU). Under the auspices of the California-based National Nurses United, unions from 14 countries agreed to work together to “stop the harmful effects of austerity measures, privatization, and cuts in health care services.” The organization also is actively involved in advocating for other issues supported by labor unions, such as a tax on certain financial firms (called the Robin Hood tax) that would raise revenues to help provide needed services. Saving jobs and making workplaces safer unite all unions.

On September 17, the group held an international day of action. Member unions in Africa, Asia, Australia, and Europe held marches to protest cuts in health services and advocate for better working conditions for nurses, better staffing ratios and the Robin Hood tax. Unions in some countries had additional agendas—in South Korea, it was to save the Jin Ju Medical Center; in Australia, mandatory minimum nurse–patient ratios was a demand; in Costa Rica, the member union called for nurses’ right to participate in collective bargaining.

Will these marches and […]

Finding the Calm: A Nurse-Led QI Project to Reduce Patient Agitation

By Sylvia Foley, AJN senior editor

Photo by Lanny Nagler, courtesy of Hartford Hospital Photo by Lanny Nagler, courtesy of Hartford Hospital

For many people, “going to hospital is rather like going to an alien planet,” as the British cartoonist and book illustrator Sir Quentin Blake once observed—it’s a very stressful experience taking place in an unfamiliar environment. For some, the experience of hospitalization can trigger or worsen agitation. In the October CE “Decreasing Patient Agitation Using Individualized Therapeutic Activities,” author Christine Waszynski and colleagues report on a nurse-led quality improvement project that demonstrated promising results. Here’s a short summary.

OVERVIEW: Hospitalized patients who are suffering from cognitive impairment, delirium, suicidal ideation, traumatic brain injury, or another behavior-altering condition are often placed under continuous observa­tion by designated “sitters.” These patients may become agitated, which can jeopardize their safety even when a sitter is present. This quality improvement project was based on the hypothesis that agitation can be decreased by engaging these patients in individualized therapeutic activities. The authors created a tool that allowed continuous observers to identify a patient’s abilities and interests, and then offer such activities to the patient. Data were collected using a scale that measured patient agitation before, during, and after these activities. The authors found that during the activities, 73% of patients had decreased levels of agitation compared with baseline, and 64% remained less agitated for at least one hour afterward.

The intervention appeared effective in reducing levels of […]

2017-07-27T14:49:56-04:00October 4th, 2013|Nursing|1 Comment
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