Nursing Considerations for Post-Hurricane Hazards

NASA satellite image of Hurricane Irma at peak intensity, Sept. 6, over Virgin Islands

On Sunday, September 10, many of the residents of coastal towns around the state of Florida sought shelter from Hurricane Irma in shelters, and in their homes when shelters reached capacity. Hurricane Harvey relief efforts were still fresh in the minds of the public—and in fact still underway—even as Florida prepared for a projected direct hit of Hurricane Irma and Georgia and South Carolina braced for storm surges and tropical storms.

By Tuesday, the weather system had dissipated and flood waters covered the areas hit by Hurricane Irma, creating environments that present many hazards, some known and others unknown. As other parts of the Southeast feel relief, with restored electricity and Internet and cell phone service restored, some towns that didn’t fare so well are still recovering from the devastation. Recovery may be hampered as we receive news of additional severe storms developing in the Atlantic.

For Florida residents in certain areas, the storm is far from over. Those most vulnerable for health problems in this post-hurricane period include persons with chronic conditions, children, older adults, those living in poverty and those newly impoverished by the hurricane, relief workers and first responders, undocumented immigrants, and the temporary […]

2017-09-18T07:50:13+00:00 September 18th, 2017|Nursing, Public health|0 Comments

Safety vs. Independence: When Is a Person Too Old to Drive?

I’d venture that many of us have had family discussions about whether it’s safe for a grandparent or elderly aunt or uncle to be driving. Driving is often the last vestige of independence and one that is fiercely held onto.

I had an aunt and uncle who worked out a unique and very shaky scheme so they could still get around independently: he couldn’t drive because of severely diminished eyesight, but he would direct his wife, my aunt, who had early Alzheimer’s, as she drove. Between the two of them, they could get to grocery stores, church, medical appointments, and bingo.

And one colleague, to prevent her father from driving after multiple accidents, told him she needed the car to get to work; in reality, she just drove it a few blocks from the house and parked it.

While author Loren Staplin and his colleagues note in ”Can Your Older Patients Drive Safely?” that “decline in driving abilities is related to functional status, not chronological age,” they also observe that the “greater risk associated with driving at age 75 and older is . . . evident in these drivers’ greater level of involvement in fatal motor vehicle accidents relative to their representation in the licensed driver population.” […]

2017-09-13T09:26:54+00:00 September 13th, 2017|Public health|1 Comment

The Health Impacts of Hurricane Harvey—What Nurses Need to Know

Geocolor imagery of Hurricane Harvey on verge of making landfall. Image created by the Cooperative Institute for Research in the Atmosphere.

As Hurricane Harvey, now a tropical storm, continues to affect a large area of southern Texas and other parts of the South, the full impact on human health has yet to be determined. But it’s clear the flooding has caused a historical crisis in Houston and surrounding areas—and that nurses and other health professionals will be in great demand in the coming days, weeks, and months.

Short- and Long-Term Health Concerns

The short- and long-term health consequences people are facing as they escape rising water levels are detailed in the Washington Post. Although drowning is the most immediate and dangerous threat during a flood, those seeking safety are also endangered by sharp objects and even wild animals caught up in floodwaters. Mold and its impact on human health will be a concern in the coming weeks and months, as water-damaged buildings are reoccupied.

In the meantime, health authorities are worried about the spread of infectious diseases. As sewage contaminates the floodwaters and people crowd into shelters, they may be more susceptible to the development of skin, gastrointestinal, and respiratory infections. A prolonged lack of power, and thus air conditioning during the […]

Tuberculosis: Nurses Play Critical Role in Prevention, Diagnosis, Treatment

Mantoux skin test/CDC PHIL

In the U.S., the chances are that tuberculosis isn’t on your mind a lot. Most of us focus on TB only when we have a patient on airborne precautions—or when we’ve been exposed to TB at work.

Globally, TB was one of the top 10 causes of death in 2015. In the U.S., after a spike in cases early in the HIV epidemic, the incidence of TB has fallen to about three cases per 100,000 people. In TB-endemic countries, incidence rates run into hundreds per 100,000. But with TB elimination defined as a rate of less than one case per million people, we are far from eradicating this disease in the U.S. In fact, the number of TB cases in the U.S. rose slightly from 2014 to 2015.

Also, of course, nurses often work with people who are at high risk of acquiring TB—transplant recipients, others who are immunocompromised, people with HIV or certain cancers, those who are refugees or homeless—increasing our own risk for the disease as well. Therefore, the low overall U.S. incidence rate doesn’t reflect the experience (or risk) of most nurses. (And if you are “PPD positive,” click here for some reminders about what that should mean to you as a nurse: “Nurses and Latent TB Infection.”) […]

Antibiotic Stewardship: Inherent to Good Nursing Practice

neutrophil interacting with two pink-colored multidrug-resistant Klebsiella pneumoniae bacteria

Although most nurses are aware of the urgent problem of antibiotic overuse in hospitals, some may be unfamiliar with terms like “antibiotic stewardship.” This is partly because few nurses besides those working as infection control preventionists have had a formal role in stewardship programs, explain authors Rita D. Olans, Richard N. Olans, and David J. Witt in “Good Nursing Is Good Antibiotic Stewardship,” which appears in this month’s issue as a Special Feature. In the article, the authors detail how bedside nurses are vital to the success of these efforts.

What Is Antibiotic Stewardship?

Antibiotic stewardship programs offer a formal approach to addressing the current crisis, in which an increasing number of organisms are developing resistance to antimicrobial medications. In the absence of new drugs, stewardship programs have been established to improve the way currently available antibiotics are used in hospitals. These programs aim to:

  • optimize antibiotic therapy.
  • shorten the duration of use of broad-spectrum antibiotics.
  • reduce the number of adverse events.

According to the authors, “because nurses are not typically prescribers of antibiotics, they often don’t see themselves as participants in antimicrobial stewardship programs.” Yet, even though they may not know it, “staff nurses are already performing many critical antimicrobial stewardship functions.” For example, nursing practices directly relevant to antibiotic stewardship […]

2017-08-02T11:36:27+00:00 August 2nd, 2017|Nursing, Public health|1 Comment