Researchers Ask: How Do Nurses Perceive Their Use of Clinical Practice Guidelines?

By Sylvia Foley, AJN senior editor

You’ve probably heard about the “knowledge translation” gap that exists between the care that patients often receive and the evidence for best practice. Clinical practice guidelines, which can help clinicians close that gap, are often underused, and most of the existing research on guideline use has focused on physicians. Nurse researcher Kathleen A. Abrahamson and colleagues wanted to learn more about how nurses perceived their use of guidelines. Their findings are reported in this month’s original research CE, “Facilitators and Barriers to Clinical Practice Guideline Use Among Nurses.”

Abrahamson and colleagues examined free-text responses to two open-ended survey questions provided by 575 RNs at 134 Veterans Affairs medical centers: “What are the facilitators to CPG use?” and “What are the barriers to CPG use?” Conventional content analysis of the data allowed several thematic categories and subcategories of responses to emerge.

Among the findings were the following. […]

Transitional Care: How the Affordable Care Act Would Have Helped My Father

By Susan B. Hassmiller, PhD, RN, FAAN, senior adviser for nursing at the Robert Wood Johnson Foundation. This post is also being published at the Robert Wood Johnson Foundation Human Capital blog.

When I heard that the Supreme Court had upheld the Affordable Care Act, I immediately thought of my father. He suffered mightily at the end of his life. Plagued with multiple chronic illnesses, he spent his last year in and out of hospitals. He received good hospital care, but his health deteriorated every time he left the hospital.

He simply couldn’t keep track of a growing list of prescriptions, tests, and doctor visits. He accidentally skipped antibiotics, which led to infections, which landed him back in the hospital. He accidentally skipped blood tests, which landed him back in the hospital. It seemed that every time he came home, he’d land back in the hospital. I lived thousands of miles away and couldn’t be the advocate that he needed.

What he needed was transitional care—he needed a nurse to meet with him during a hospitalization to devise a plan for managing chronic illnesses and then follow him into his home setting. He needed a nurse to identify reasons for his instability, design a care plan that addressed them, and coordinate various care providers and services. He needed a nurse to check up on […]

Web Stuff: Meds and Heat, Noise Epidemic, Nurses and Smartphones at Work

 

Flickr/National Archives and Records Administration

Medicines and summer heat. Anyone with one or more prescription medicines might occasionally wonder whether there’s a better place to store them than a kitchen cabinet. This is especially true for meds mailed to you in three-month supplies rather than the one-month supply we used to get.

Here’s a brief article at the NPR Shots blog that notes a few meds that you particularly should be concerned about, emphasizes that areas of extreme heat or humidity are the worst location (so-called “medicine cabinets” in humid and hot bathrooms are not so great, nor are cabinets over stoves, in direct sun, or the like). While most medicines can tolerate a certain amount of abuse, the ideal environment for most of them (except those that need refrigeration) is room temperature, which doesn’t mean Fahrenheit temperatures reaching into the 80s or 90s. I’ve sometimes wondered why someone doesn’t just invent a type of medicine storage container that can be locked if need be, limits humidity, etc. Steal my idea—please! Are there any strategies you find effective for safely storing medications?

Smartphones at work: OK, in case you didn’t know it, most nurses are using smartphones at work:

In 2010, the U.S. Bureau of Labor Statistics estimated that 72 percent of physicians use smartphones. Nurses aren’t […]

The Affordable Care Act Survives, At Least for Now

Shawn Kennedy, AJN editor-in-chief

Senate roll call, Affordable Care Act/by Kurykh, via Wikimedia Commons

It’s been a couple of weeks now since the Supreme Court upheld the constitutionality of the Affordable Care Act (ACA), and there have been too many articles and analyses to count. The bottom line is that its fate won’t be settled until after the November elections. If the Republicans win the election, the ACA will become the first battleground, as its repeal has been promised by candidate Mitt Romney.

What is concerning is that a great many people pay attention to the rhetoric rather than finding out the facts (remember “death panels”?). This point was well made by political cartoonist Stuart Carlson in this cartoon. It’s hard not to be in favor of many of the provisions—like extending coverage under a parent’s plan for children up to 26 years of age, or barring insurance companies from denying coverage for preexisting conditions.

As nurses, we need to know the facts and go beyond the political rhetoric. We need to be informed for ourselves (anything that has an impact on health care delivery and funding will affect nursing) and for our patients, who will have questions. Get the facts—read the law at the link above, a summary of the law, or the articles we published summarizing how it will affect nursing (our original article, and a 2011 update, both open access until […]

Women’s Health: Paying Attention to an Invisible Group

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

My sister Ellen is getting married in two weeks, so last Sunday I threw a surprise bridal shower. We had all the traditional trappings—flowers and favors and (much to another sister’s chagrin) a shower game and prizes. The only thing not traditional: at this shower there were two brides, my sister and her fiancée, Pat.

After years of standing by invisible while sisters and brothers married, danced with their partners at each other’s weddings, celebrated births and graduations, now it’s their turn. No longer on the periphery, no longer the ‘other,’ at least for this day, these few weeks, they are finally able to celebrate their love and commitment to each other just like the rest of us.

Why am I writing about this in a nursing blog? Because this invisibility, this sidelining of lesbians like my sister and her fiancée, doesn’t only affect their family life—it extends into their health care as well. Neither Ellen nor Pat ever got routine women’s health care—no Pap smears, no clinical breast exams or mammograms, no routine assessment for osteoporosis risk. They were never hooked into the health care system by reproductive health needs, contraception, chlamydia testing or pregnancy […]

2018-03-28T10:36:45-04:00July 5th, 2012|nursing perspective|1 Comment
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