Implementation Science: Systematic, Sustainable, Evidence-Based Change

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Reading the article by Russell-Babin and colleagues in the December 2023 issue of AJN made me grateful for all the work that went into developing the nursing implementation science (IS) program at Inova. As a nurse working at this health care system, I’d like to share how I benefited from being in the first cohort of nurses trained and engaged in IS over the last three years.

For the past eight years, I’ve been a clinical coordinator of two different disease-specific programs—first stroke and now sepsis. In these roles, I’ve been engaged in many different quality improvement (QI) projects and have become familiar with the tools and processes used to improve patient care and outcomes.

Towards more comprehensive and systematic evidence-based change.

However, as I was invited to step into the world of IS, I began to realize that a strict QI approach cannot alone bring about all the changes we desire within the complex systems of health care. The fact is […]

2024-01-11T10:06:42-05:00January 11th, 2024|Nursing, nursing roles, Quality improvement|1 Comment
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Invisible Battles: Military Toxic Exposures and Health Provider Roles

Photo courtesy of U.S. Dept. of Veterans Affairs

The intersection of military service and environmental exposures has become an increasingly critical area of concern. Environmental factors affect the health and well-being of military personnel in complex and multifaceted ways, and ill and injured military veterans may find their high aspirations undermined by mental and physical ailments that significantly affect their quality of life.

This is the case for several of my family and friends, including my uncle, a veteran from the era of Desert Shield/Desert Storm, who has suffered for years because of the effects of environmental and other exposures while in the military.

A direct strike against health and wellness.

Many veterans say that they had a picture-perfect bill of health before exposure to environmental hazards during military service. Here is a glance at some of the exposures that service members faced in recent decades while in a garrison or on deployments to conflict zones.

Exposures and health impacts on service members:

2024-01-08T10:35:25-05:00January 8th, 2024|environmental health, Nursing|0 Comments
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Reducing Addiction Stigma: Recommended Reading in AJN’s January Issue

The January issue of AJN is now live.

What are the consequences of addiction stigma, and what steps can nurses take to reduce biases related to substance use? Learn more in this month’s CE, “Reducing Bias Against People with Substance Use Disorders.”

Get your 2024 reading list started: here are the winners of our annual Book of the Year Awards.

“Original Research: Predictors of COVID-19 Vaccine Hesitancy Among Asian Indians in the United States: A Cross-Sectional Descriptive Study” examines the relationships between select demographic variables and COVID-19 vaccine hesitancy among this population.

In “Improving Discharge Teaching for Adult Patients with an Ileostomy,” the authors discuss a QI project they conducted to decrease patient-initiated postdischarge inquiries by using a FAQ handout at discharge.

See also the extensive health care news sections, the Journal Watch and Drug Watch sections, a Viewpoint column on solving the nursing shortage, an AJN Reports on the U.S. maternal health crisis, and more.

A note on the cover:

This month’s cover honors Barbara J. Braden, PhD, RN, FAAN, who pioneered risk assessment and risk-based prevention of pressure injuries. Braden passed away in June 2023; read a tribute written by her […]

2023-12-26T11:05:07-05:00December 26th, 2023|Nursing|0 Comments
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PrEP, HIV, and Continuing Barriers to Access

As a gay man navigating the complex landscape of health care, I never expected to encounter judgment, stigma, and discrimination in my pursuit of preventative measures against HIV. In a world that’s constantly evolving, it’s disheartening to see how outdated attitudes still hinder access to essential services like pre-exposure prophylaxis (PrEP). My personal experience may shed light on the urgent need for an update on PrEP for HIV prevention.

The human cost of judgment and stigma.

Like many in the LGBTQIA+ community, I faced the harsh reality of being told not to have sex, to pursue monogamy and marriage as the only path to a healthy life. These societal expectations, fueled by ignorance and prejudice, led me to suppress my desires, inadvertently putting my health at risk. Denial of access to prevention services like PrEP left me feeling isolated, vulnerable, and frustrated.

My wake-up call came through a close friend who, unfortunately, lived out the consequences of societal judgment. Despite being vulnerable and at risk, he was denied access to PrEP because of the same archaic beliefs that I had encountered. The result was a diagnosis of HIV that forever altered his life and left me grappling with the reality that I could […]

2023-12-18T09:33:20-05:00December 18th, 2023|equity, infectious diseases, Nursing|0 Comments
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A Nurse-Led QI Project to Reduce ED to ICU Transition Time

Countless studies conclude that the longer an admitted patient boards in an emergency department (ED) the greater the risk for negative outcomes such as falls and hospital-acquired conditions. ED patients waiting for admission to the intensive care unit (ICU) may be at the greatest risk, as they are categorized as critical.

Transporting critical patients from the ED to the ICU requires coordination of multiple clinicians from both units, which can lead to delays. Leading and managing these coordination efforts is a challenge. However we are optimistic as small tests of change have led us to advancements in the timeliness of ICU admissions and improvements in quality and safety.

-Jonathan Nover, MBA RN, senior director of nursing, Mount Sinai Queens

The Project

Geneline Barayuga, MSN RN

The ED and ICU teams at Mount Sinai Queens, a 165-bed hospital with 70,000 annual ED visits in Queens, New York, performed a quality improvement (QI) project by developing a collaborative approach between the ICU and ED charge nurses to reduce the median […]

2023-12-11T10:17:23-05:00December 11th, 2023|Nursing, Quality improvement|0 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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