AJN in September: Pain Management in Opioid Use Disorder, STIs in the U.S., Teaching Vs. Unit Needs

AJN0915.Cover.OnlineOn this month’s cover, perianesthesia nurse Carolyn Benigno helps prepare a young patient for surgery at Children’s National Medical Center in Washington, DC. The photo, the first-place winner of AJN’s 2015 Faces of Caring: Nurses at Work photo contest, shows Benigno practicing “Caring through Play.” The art of working at a pediatric hospital, she says, is “learning how to play with children so that part of your nursing care is play.” Such play can both distract a child in the moment and help the child cope with the disorienting experience of hospitalization.

For another piece on how nurses try to make hospitalization less stressful for children, see this month’s Cultivating Quality article, “Improving Pediatric Temperature Measurement in the ED.”

Some other articles of note in the September issue:

CE Feature: “Acute Pain Management for Inpatients with Opioid Use Disorder.” Inpatients diagnosed with opioid use disorder (OUD) commonly experience acute pain during hospitalization and may require opioids for pain management. But misconceptions about opioids and negative attitudes toward patients with OUD may lead to undermedication, unrelieved pain, and unnecessary suffering. This article reviews the current relevant literature and dispels common myths about opioids and OUD. […]

2016-11-21T13:02:02-05:00September 2nd, 2015|career, Ethics, infectious diseases, Nursing, nursing perspective|1 Comment
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As with Ebola Outbreak, Social Determinants of Health Crucial in Recent Rural U.S. HIV Outbreak

Rachel Parrill, PhD, RN, APHN-BC, is an associate professor of nursing at Cedarville University in Ohio

by banditob/flickr creative commons by banditob/flickr creative commons

This past fall, with the world watching, a crisis unfolded in West Africa that challenged our understanding of sociocultural environments, epidemiology, and health. The spread of Ebola and the intercontinental transmission of the disease exposed weaknesses in our epidemiological defense system. It also drew attention to the powerful role that cultural beliefs and practices can have on disease transmission during outbreaks.

In that same time frame, and with similar cultural etiologies, another infectious crisis played out much closer to home. The setting: the rural Midwest, in and around the small town of Austin, Indiana. The disease: HIV. The crisis: an unprecedented outbreak—one with incidence rates (up to 22 new cases a day at the height of the outbreak) estimated to be higher than those in many sub-Saharan African nations and transmission rates through injection drug use higher than in New York City. Contributing to this “perfect storm” were socioeconomic factors characteristic of many rural settings, including poverty, low education levels, limited access to health care, and few recreational or employment opportunities.

In my work as a faculty member in a rural Midwest setting, I introduce undergraduate and graduate nursing students to concepts of public health nursing and try to provide […]

2016-11-21T13:02:06-05:00August 25th, 2015|infectious diseases, Nursing, nursing perspective|0 Comments
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Legionnaires’ Outbreak in New York City: Some Basics for Nurses

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

11148_loresIn the largest U.S. outbreak of Legionella infection since 1976, when there were 221 cases and 34 related deaths in an outbreak at a Philadelphia American Legion convention, more than 113 cases of the disease have been diagnosed in New York City since mid-July. Twelve people have died.

Legionnaires’ disease is neither rare nor exotic; it is a type of community-acquired pneumonia (it can also be hospital acquired). Symptoms include fever, cough, and progressive respiratory distress. Legionella can also cause a milder, flulike illness known as Pontiac fever that generally resolves without treatment. Because many cases of Legionnaires’ disease are never actually diagnosed, mortality rates are difficult to determine, but the rate currently is estimated at 5% to 30%.

The CDC estimates that 8,000 to 18,000 people are hospitalized with Legionnaires’ disease each year in the U.S., yet only about 3,000 cases are diagnosed and reported. Most cases of Legionnaires’ disease are sporadic, unlinked to any outbreak. The infections often are not recognized as Legionnaires’ disease, for several reasons.

2016-11-21T13:02:09-05:00August 12th, 2015|infectious diseases, Nursing|1 Comment
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An Unending Series of Challenges: APIC Highlights the ‘New Normal’ in Infection Control

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Panelists to the Opening Plenary, Mary Lou Manning, Michael Bell, CDC, Russell Olmsted, Trinity Health, Phillip W. Smith, Nebraska Biocontainment Unit discuss various topics pertaining to infection control. APIC panelists (APIC president Mary Lou Manning; Michael Bell, CDC; Russell Olmsted, Trinity Health; Phillip W. Smith, Nebraska Biocontainment Unit) discuss various topics pertaining to infection control.

At the 42nd annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC), held in late June in Nashville, experts from around the world shared information and insights aimed at infection preventionists but of interest to nurses in many practice settings.

APIC president Mary Lou Manning, PhD, CRNP, CIC, FAAN, opened the first plenary with the observation that to be presented with an unending series of challenges is the “new normal” in infection control and prevention. Collaboration is more important than ever in health care, she said, and “there is strength in our combined efforts.”

Cathryn Murphy, […]

2016-11-21T13:02:19-05:00July 6th, 2015|infectious diseases, Nursing, nursing perspective|2 Comments
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MERS: Where Are We Now and What Do Nurses Need to Know?

WHO map of MERS cases by country WHO map of MERS cases by country. Click to enlarge.

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Middle East respiratory syndrome (MERS) first emerged in Saudi Arabia in September 2012. Until last month, most MERS cases have occurred in that country. But on May 20, South Korea reported its first laboratory-confirmed case of MERS, in a 68-year-old man who had recently returned from a business trip to the Middle East.

The diagnosis was made only after the man had visited four health care facilities since his return home. This resulted in nosocomial transmission to other patients, health care workers, and visitors. To date, the Republic of Korea’s Ministry of Health has identified 108 cases of MERS in South Korea. Nine patients (all with serious preexisting health conditions) have died.

The WHO notes that all of these cases are epidemiologically linked to the index case. That is, there is no evidence that a new “reservoir” of MERS virus has suddenly surfaced in South Korea—all cases thus far stem from the Korean traveler who acquired his infection while visiting the Arabian Peninsula.

This is the largest outbreak of MERS so far outside of the Middle East, and therefore a reason for some concern. However, person-to-person transmission of MERS is not new, and there has as yet been no […]

2016-11-21T13:02:22-05:00June 15th, 2015|infectious diseases, Nursing, nursing perspective|0 Comments
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