Nurse Informaticists Address Texas Ebola Case, EHR Design Questions

By Susan McBride, PhD, RN-BC, CPHIMS, professor and program director of the Masters in Nursing Informatics Program, Texas Tech University Health Sciences Center, and Mari Tietze, PhD, RN-BC, FHIMSS, associate professor and director, Interprofessional Health IT Program at Texas Woman’s University (TWU). The views expressed are those of the authors and don’t represent those of Texas Tech or TWU.

Silo_-_height_extension_by_adding_hoops_and_staves EHRs: information ‘siloes’ or interprofessional collaboration?

The recent Ebola case in Dallas—in which a patient was admitted to the hospital three days after he visited the ER exhibiting symptoms associated with Ebola and reporting that he’d recently traveled from West Africa—brought this global public health story close to home for many of us residing in the area. As has been widely reported, the patient died last week after nearly 10 days in the hospital.

An initial focus of media coverage was the suggestion that a failure of nursing communication had contributed to the release of the patient from the hospital on his first visit. Partly reflecting evolving explanations offered by the hospital, the media focus then shifted to a potential flaw in the hospital’s electronic health record (EHR) system, in which information recorded by a nurse about the patient’s travel history might not have been visible to physicians as well. […]

Addressing Nurses’ Urgent Concerns About Ebola and Protective Equipment

By Betsy Todd, MPH, RN, CIC, AJN clinical editor. (See also her earlier post, “Ebola: A Nurse Epidemiologist Puts the Outbreak in Perspective.”)

This is not a time to panic. It is a time to get things right.—John Nichols, blogging for the Nation, 10/12/2014

Scanning electron micrograph of filamentous Ebola virus particles budding from an infected VERO E6 cell (35,000x magnification). Credit: NIAID Scanning electron micrograph of filamentous Ebola virus particles budding from an infected VERO E6 cell (35,000x magnification). Credit: NIAID

For years, nurses have tolerated increasingly cheap, poorly made protective gear—one result of health care’s “race to the bottom” cost-cutting. Now the safety of personal protective equipment (PPE) is being hotly debated as the Ebola epidemic spills over into the U.S.

If all nurses had access to impermeable gowns that extended well below the knee (and could be securely closed in back, had real cuffs, and didn’t tear easily); faceguards that completely shielded; N95 respirator masks that could be properly molded to the face; and disposable leg and shoe covers, we might not be having the same conversation. Yet how much protection can we count on from the garb we now have available, especially considering the minimal donning and doffing training given to most nurses?

While there […]

Ebola: Infection Control Resources Make All the Difference

This post is follow-up to our widely shared post (“Ebola: A Nurse Epidemiologist Puts the Outbreak in Perspective”) by AJN clinical editor Betsy Todd. The author, Amanda Anderson, is a critical care nurse and graduate student in New York City who is currently doing a graduate placement at AJN two days a week. Her last post for this blog is here.

Enterovirus D68: Precautions, Surveillance, Yes; Alarm, No

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

EV68-infographicAs news coverage focuses on the latest clusters of suspected—and, in some instances, confirmed—cases of human enterovirus D68 (EV-D68) as they occur in successive regions of the U.S., here’s a quick primer on what is known about EV-D68.

Is this a new, dangerous virus?
EV-D68, a non-polio enterovirus, is not a “novel” virus—the term used to describe emerging infections such as SARS and MERS. It’s more accurate to describe it as the CDC does: it is an “increasingly recognized” cause of respiratory infections, especially in children.

EV-D68 was first isolated in 1962. While reports of EV-D68 since then have been sporadic, the CDC in 2011 reported on clusters of this viral infection in Georgia, Pennsylvania, and Arizona as well as in Asia and Europe. It’s likely that there are hundreds or even thousands of EV-D68 infections every year in the U.S. But as with many other viral infections, they will range in severity, and an infection that looks like “a cold” isn’t usually brought to the attention of a health care provider.

According to the CDC, most enterovirus infections are actually asymptomatic; this may be the case with EV-D68 as well.

Diagnostic testing for EV-D68 involves RT-PCR and gene sequencing. Most hospital labs therefore are unable to test for it. Some readily available […]

Labor Day Déjà Vu – Nurses’ Views of Work, Then and Now

By Maureen Shawn Kennedy, AJN editor-in-chief

Photo from otisarchives4, via Flickr. Photo from otisarchives4, via Flickr.

If you like nursing history, there’s a new blog called Echoes and Evidence by the Barbara Bates Center for the Study of the History of Nursing at the University of Pennsylvania. (The first post draws on a 2005 AJN article on how nurses over 100 years ago responded to a series of typhoid epidemics in Philadelphia.)

Because AJN is over 100 years old (115 next year), it has a rich archive that I’ve been digging into recently (see my post from last week about an article Virginia Henderson wrote for AJN 50 years ago, and from late June, about nurses and D-Day).

So it seems especially fitting, just after Labor Day, to point to a January 1953 article by Sister Mary Barbara Ann, a former president of the Iowa Nurses Association (INA), which detailed findings from a survey of 223 general duty nurses in Iowa to learn their opinions of the hospitals in which they worked. I won’t present her exact findings here—we’ve made the article free until the end of September: just click through to the PDF. (Subscribers can always access the archives.) But here’s how she summarized what she learned:

“They [general duty nurses] are asking only for reasonable working conditions in which they can feel happy and secure. They are pleading for recognition and appreciation for what they are as persons and […]

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