Nurses and Patient-Centered Research

By Shawn Kennedy, editor-in-chief

I’m immersed in nursing research and nursing leaders this week, attending (in order and immediately following one another) meetings of the Council for the Advancement of Nursing Science (CANS), the 25th anniversary concluding scientific symposium of the National Institute of Nursing Research (NINR), and finally, the American Academy of Nursing.

Wednesday was CANS and its focus on comparative effectiveness research. After an opening keynote by Carolyn Clancy, director of the Agency for Healthcare Research and Quality (AHRQ), who discussed the need to accelerate progress in improving U.S. health outcomes, a panel of nurses discussed different methodological considerations, from databases to competencies.

Research to help people make informed decisions. Especially interesting was a discussion of the Patient-Centered Outcomes Research Institute (PCORI), the research entity which was mandated by the 2010 Patient Protection and Affordable Care Act. […]

2016-11-21T13:11:45-05:00October 13th, 2011|nursing perspective, nursing research|0 Comments
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Domestic Violence Screening Matters

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

I am a nurse. I am a doctoral candidate and a writer. I am a domestic violence survivor. I lived for years with fear and uncertainty—will this be a good day, a day of laughter and affection? Or a brutal day of fists and humiliation? Like many women experiencing domestic violence, I hid it from my family and friends. In fact, I even hid it from myself. I couldn’t see myself as a battered woman, wouldn’t accept that I was that kind of person. But domestic violence doesn’t happen to a certain kind of woman—it happens to anyone, rich or poor, college educated or high school dropout, urban and rural, of every ethnicity. We—you and I—all are the faces of domestic violence.

Just ask. October is National Domestic Violence Awareness Month. How many of your patients have you asked about domestic violence this month? Or any month? Twenty? Ten? None? Screening matters. One of every four women you see has experienced domestic violence. Research tells us that women will talk about it when asked by a provider that they feel cares and can be trusted. They will leave an abusive situation when they feel supported and resources are available to them. […]

2016-11-21T13:11:46-05:00October 12th, 2011|Nursing|6 Comments
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Killing Traditional Nursing Duties #3 – NPO after Midnight

fasting Buddha/ via Wikipedia Commons

By Shawn Kennedy, editor-in-chief

In early August, on our Facebook page, we asked if there were “old nursing habits” that should be killed off. We received a lot of feedback, which we described in a blog post called “Killing Traditional Nursing Duties #1.” We did another post on the answers to our second question, “When you give IM injections, what site do you most often use—dorsogluteal (upper outer quadrant of buttocks), ventrogluteal (lateral hip), or deltoid (upper arm)?” This also got many comments in response.

Our last question was this: “Does your institution routinely follow ‘NPO after midnight’ for preoperative patients?” Here’s some of the comments we received on the blog:

My institution does follow the NPO after midnight for preop patients. I sometimes disagree d/t the time patients may be going to surgery. If a patient is not scheduled for the OR until the following day at 5 pm, why should they have to be NPO after midnight the night before?

…most of the younger anesthesiologists/CRNA’s allowed BLACK COFFEE to be drunk right up until time  of surgery. No dairy or sugar in it, obviously.

The facility that I work for does routinely follow ‘nothing by mouth’ after midnight guidelines. If the patient  is scheduled for a late surgery I may call the doctor and request that the orders be altered and in most cases the doctor’s are agreeable and will change the orders, […]

2016-11-21T13:11:47-05:00October 11th, 2011|nursing perspective, nursing research|0 Comments
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When Being Good Means Looking Bad: An Ethical Quandary for Nurses

Performance measurement, an increasingly pervasive trend in health care, is credited with significant improvements in the quality of care . . . . Even so, this is little comfort when a nurse faces a situation where an action necessary for meeting a performance measure isn’t what she or he believes is best for a particular patient. For example, falls are often tallied as a performance measure, but frail patients need to be walked; raising the head of the bed to prevent pneumonia is often counted in performance evaluation but may result in less turning of the patient, which may mean more sacral ulcers—which may or may not be tallied as a separate performance measure.

That’s from an article in this month’s AJN by nurse ethicist Doug Olsen. It’s called “When Being Good Means Looking Bad,” and is about potential unintended effects of some well-intentioned performance measures that don’t easily allow for consideration of clinical context. Olsen writes that the nurse may, in certain situations, find herself or himself faced with three highly imperfect options to choose between:

2016-04-18T15:03:34-04:00October 7th, 2011|career, Ethics, nursing perspective|5 Comments
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Blind Spot – At the Intersection of Mother and Nurse

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

Being a nurse has changed my reactions to situations at home. For one thing, I don’t get overexcited about non-life-threatening medical problems. I can hardly stand the thought of going to an emergency room (Steri-Strips and ice are my usual “go-to” treatment plans). I’d like to blame this on working in a trauma center—it makes sense that seeing catastrophic injuries every day tends to make less severe injuries look insignificant—but I’m not sure that completely excuses my recent diagnostic error.

My son, who’s 12, came home from school last week complaining that his hand was sore. He’d hit a wall in gym, he said, but it was a padded wall, and he hadn’t hit it very hard. Still, he was absolutely certain that, at the very least, he’d dislocated something, and that, most likely, he’d broken his hand.

To my defense, he has a history of overdramatizing situations, and I took his self-assessment with a grain of salt. Although the side of his hand was slightly swollen, nothing was bruised, and everything seemed to be moving all right.

We iced it, of course, and although hand pain didn’t seem to interfere with his usual activities, he proceeded to tell anyone who would listen that he’d broken his hand.

“Stop saying that!” I told him. […]

2016-11-21T13:11:48-05:00October 6th, 2011|career, Nursing, nursing perspective|7 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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