Smoking, Orthopedic Surgery, and Bone Healing

When assessing a smoker who is scheduled for surgery, most of us will quickly zero in on their potential for complications from anesthesia. But what if the upcoming procedure is orthopedic?

Smoking is a well-known risk factor for osteoporosis and bone fracture, so it makes sense that it can be an issue in bone surgery healing.

In “The Effects of Smoking on Bone Health and Healing” in this month’s AJN, authors Stephanie Niu and Fidelindo Lim review the effects of smoking on bone health and healing and offer suggestions on how nurses might use this information to help people facing orthopedic surgery to quit.

“In addition to posing surgical and postsurgical risks for orthopedic patients, tobacco, nicotine, and other byproducts contained in traditional and electronic cigarettes (e-cigarettes or vaping products) adversely affect overall bone health and impede bone healing.”

Smoking associated with poor postsurgical outcomes.

Research has shown that smoking is associated with postop infection and poor bone fusion. It significantly increases time to union and risk of nonunion, and is significantly associated with poor clinical outcomes after surgery. […]

2020-07-20T09:16:45-04:00July 20th, 2020|Nursing|0 Comments
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Magnet Status Is Generally Better for Nurses and Patients

Discussed in this post: “Original Research: How Magnet Hospital Status Affects Nurses, Patients, and Organizations: A Systematic Review” (July, AJN)

Is the work it takes to become a Magnet hospital worth it?

The Magnet award recognizing excellence in nursing has been around for decades. It’s not an easy process, nor an inexpensive one—hospitals that apply invest a lot of time, effort, and money. There’s a considerable fee plus the expenses for the site visit appraisers, and many institutions designate or hire a Magnet coordinator whose job it is to ensure policies throughout the organization comply with Magnet requirements. It’s a huge undertaking. And while administrators may groan over the prospect of going through it, many hospitals do pursue it—there are over 500 Magnet-designated hospitals worldwide.

No institution is perfect, but Magnet does mean improved visibility for nursing.

I’ve had experiences, with friends or family, in both Magnet and non-Magnet hospitals. While I felt that overall patient care and responsiveness to patients and families was better at the Magnet facilities, there were also instances where things didn’t go quite the way they should. But in the harried hospital setting, I don’t expect 100% smooth sailing with every encounter with every nurse. What I have heard from several nurses who participated in their hospitals’ Magnet journey is […]

2020-07-13T12:40:55-04:00July 13th, 2020|Nursing|1 Comment
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Falls in Behavioral Health: Different Population, Different Risk Factors

“I need help in 230A! Mr. Johnson is on the floor!”

(click image to enlarge)

Does your heart still sink when you hear a patient has fallen? We’ve gotten better at preventing falls, but we haven’t eliminated them. They remain one of the most common “incident” reports in hospitals. And did you know that adult behavioral health inpatients have more falls and fall-related injuries than patients on medical-surgical units?

In this month’s Cultivating Quality article, “Preventing Falls Among Behavioral Health Patients,” free until July 20, Stephanie Ocker and colleagues discuss their very successful falls-related interventions on an inpatient behavioral health unit. As they proceeded with their root cause analyses of recent falls, an unusual risk factor stood out:

“Patients frequently walked in the unit’s common area with bath blankets hanging around them and often trailing under their feet. When nurses would ask patients not to walk around with blankets to reduce the risk of tripping, patients would say they were cold.”

[…]

2020-07-06T10:53:28-04:00July 6th, 2020|Nursing|1 Comment
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July Issue Highlights: Magnet vs. Non-Magnet Hospitals, Rapid-Response Team Activation Barriers, More

“Health care workers need a break. . . . a respite from trudging from room to room or house to house, donning and doffing gowns and masks and gloves . . .”—editor-in-chief Shawn Kennedy in her July editorial, “In the Aftermath”

The July issue of AJN is now live. Check out the highlights:

Original Research: How Magnet Hospital Status Affects Nurses, Patients, and Organizations: A Systematic Review

The authors analyze the current evidence comparing Magnet and non-Magnet hospitals to determine whether different outcomes exist between them—and provide new information regarding the economic impact of Magnet recognition.

The Effects of Smoking on Bone Health and Healing

A review of the effects of smoking on bone health, the importance of smoking cessation among patients scheduled for or recovering from orthopedic surgery, and the vital role nurses play in supporting patient efforts to quit.

Special Feature: Perceived Barriers to Rapid Response Team Activation Among Nurses

This literature review explores the major barriers many nurses face in calling the rapid response team—and how those barriers might be overcome.

[…]

2020-06-29T10:05:38-04:00June 29th, 2020|Nursing|0 Comments
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Reframing the Question: A Millennial’s Take On Preparing Nurse Educators of Tomorrow

A millennial novice nurse educator navigates the transition from the clinical arena to the world of nursing academia.

It was happening. I was enthusiastic and ready to start. Obtaining a position at a well-known public university as a lecturer had not only been my dream since my undergraduate years, but was a personal victory.

So many self-defeating thoughts went through my head in the weeks leading up to the notification by the university that I was hired. A member of the millennial generation nearing the end of my twenties, I knew that the outcome of hiring decisions could either boost me up or set me back. I was afraid that more established academic professionals from a senior generation would view me as “not a good fit for the position” or “lacking experience and knowledge.”

It is taboo to discuss, but age and generational bias is a concern for many professionals of the millennial generation. I had experienced this in the past while in the clinical setting.

Time to get to work.

Once I was past the hiring phase, I was faced with a new challenge that left no room to focus on self-doubt. I found myself accepted into academia with open arms from a team of well-rounded, skilled, nurse educators. They never seemed biased […]

2020-06-23T14:31:19-04:00June 23rd, 2020|Nursing, nursing career|2 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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