Nurse-Led Evidence-Based Sleep Program Helps Hospitals and New Mothers Keep Babies Safe

Photo © Associated Press. Photo © Associated Press.

I can remember, when I was pregnant, reading everything I could get my hands on about every mother’s fear—sudden infant death syndrome (SIDS). My mother, who followed the norms of her time when I was born, was surprised that my son’s crib was bare—no blankets, pillows, toys, or bumpers. He wore a sleep sack and was placed on his back to sleep until he began to roll over by himself.

To add to what I learned from my preparatory reading, the nurses at the hospital I gave birth in set a standard for how to care for my newborn—explaining the abovementioned safe sleep tips, and much more. After all, nurses are probably a mom’s first stop for this information, helping new mothers navigate the choppy waters of caring for their newborns.

This month’s Cultivating Quality article, “An Evidence-Based Infant Safe Sleep Program to Reduce Sudden Unexplained Infant Deaths,” from the Hospital of the University of Pennsylvania, describes a nurse-led community program begun after two infants were lost to sleep-related deaths following discharge from the hospital’s neonatal ICU (NICU).

To develop the program, an interdisciplinary team made up of nurses, a physician, an […]

November 18th, 2016|Nursing, patient safety, pediatrics|11 Comments

Dosing Cups, Oral Syringes, or Spoons: A Pediatric Medication Safety Recipe for Disaster?

pediatricdosingA recent article I came across in Pediatrics said that researchers found (during laboratory experiments) that four out of five parents made at least one dosing error when using either a dosing cup or an oral syringe to dispense liquid medication meant for children. As a new parent who has grappled with multiple dosing tools, I can’t say I am surprised.

Growing up, I remember syrupy medicines being doled out by my mother on spoons of varying size—a teaspoon or tablespoon—not a very accurate method when you also factor in that most spoons differ in shape and, probably, actual volume.

After my son had his first round of vaccines, the nurse told me that, in case he had a fever that night, the standard dose of Tylenol for his size and age was 80 mg. He didn’t get a fever in the end, and I didn’t think about what she’d told me until he had his first fever from a cold several months later.

When I went to open my box of Tylenol, I saw that the syringe that came with it did not use the dosage the nurse had told me (in milligrams), but rather, milliliters. I looked on the box for instructions but it only listed the dose for age two or older (my […]

November 1st, 2016|patient safety, pediatrics|0 Comments

Quality: The Anonymous Superhero of Nursing

“Clark Kent has his Superman cape, while I have my spreadsheets of data and the ability to set goals and track them.”

This guest post is by Tasha Poslaniec. A registered nurse for 16 years, Tasha has worked in multiple areas, including obstetrics and cardiology. She currently works as a perinatal quality review nurse. She is one of the most viewed nursing writers on Quora, and has had essays published by the Huffington Post.

sm1018-0021In the world of comics, Superman’s alter ego is the incognito Clark Kent. But in fact, that nerdy, data-oriented, and unassuming reporter, whose mission is to “bring truth to the forefront, and fight for the little guy,” could very easily be a quality review nurse.

The comparison between the two might seem a stretch at first, but there are some parallels that are worth pursuing—especially in the context of understanding who and what your quality nurse is, what quality nurses do, and how Clark Kent’s mission isn’t far from quality nurses’ own motivation for what we do.

An anonymous nursing role.

First, let me put into perspective exactly how anonymous most quality nurses are. Do you know who works in your quality department? Do you know where your quality department is? Did you even know that you have a quality department? If you said no to all three of those questions, then I can relate. It was a little over a year ago when I […]

October 11th, 2016|career, Nursing, nursing roles, patient safety|0 Comments

Getting It Right: Putting the ‘QI’ in Quality Improvement Reports

Towards a Safer Health System

Photo of AJN editor-in-chief Shawn KennedyEver since the famous report To Err is Human: Building a Safer Health System was issued by the Institute of Medicine (now the National Academies of Sciences, Engineering, and Medicine) in 1999, health care institutions have been pushed towards reducing errors and increasing safety.

Changes have been spurred by accrediting and government organizations like the Joint Commission and the Centers for Medicare and Medicaid Services, by independent and professional initiatives like the Institute for Healthcare Improvement and the Magnet Recognition Program, and by consumer advocacy groups like the The Leapfrog Group and the National Patient Safety Foundation.

Nursing Education and Quality Improvement

Nursing, as the largest department in hospitals and the one tasked with shepherding patients through the system, is a key player in any system redesign and many nursing departments are playing an active role in improving the safety and quality of care.

Nursing education has also embraced the QI movement, adopting the Quality and Safety in Nursing (QSEN) program in many curriculums and also making it a hallmark of its doctor of nursing practice (DNP) programs. Developing and implementing QI projects is frequently a requirement for completing these programs. […]

Appropriate Use of Opioids in the Management of Chronic Pain

Painted by Martin Edwards as part of the Paint Your Pain program initiated by the Pain Management Center at Overlook Medical Center, Atlantic Health System, Summit, New Jersey. For artwork of other patients in the program, go to http://bit.ly/ 1Ns0PxL.The dangerous misuse of prescription opioids and drugs like heroin has been much in the news, but millions of patients continue to suffer both acute and chronic pain. For many, prescription opioids play a vital role in alleviating that pain. How can health care providers most effectively and safely use opioids in the treatment and management of chronic pain? Some answers can be found in a CE article in the July issue of AJN: “Appropriate Use of Opioids in Managing Chronic Pain.”

Related questions on opioids and chronic pain addressed in the article include:

  • What is the best way to assess chronic pain patients?
  • Which patients—for example the elderly, those with compromised renal or hepatic function, those with a history of substance abuse—may require special considerations when opioids are prescribed?
  • Which opioid medication or medications, if any, should you select for your patient?
  • And what are the legal and practical challenges to prescribing opioids?

[…]

July 22nd, 2016|Nursing, pain management, patient safety|0 Comments