A Crucial Public Health Lesson: Let the Women Speak

” . . . people have their own hope and power which they need to discover.”

Illustration by Gingermoth for AJN.

Do some public health projects fail to live up to their ambitions because they were conceived in a conference room rather than in dialogue with those they are trying to help? It seems possible. Terms like client or community “buy-in” are now fashionable, but maybe what’s really meant by such terms is that people are given a chance to state their needs and their concerns ahead of time. And that someone is listening.

In this month’s Reflections essay by nurse practitioner Mark Darby, he remembers a valuable lesson once imparted to him through example by a Dominican priest. “Shut Up and Let the Women Speak” doesn’t flatter the younger version of the author who once visited the Dominican Republic on a medical mission. […]

2017-12-11T08:37:50-05:00December 11th, 2017|Nursing, nursing stories, Public health|0 Comments
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Despite Outreach Cuts, Open Enrollment for the ACA Underway

Open enrollment for insurance through the Affordable Care Act (ACA) starts tomorrow, and ends December 15, allowing people half the time to enroll compared with previous years. There is much confusion and misinformation surrounding the ACA, particularly after recent executive orders by President Donald Trump to stop cost-sharing reduction (CSR) payments.

In addition, budgets for ACA advertising and outreach have been slashed by the Trump administration this year, which will inevitably lead to fewer people getting covered.

Bridging the ACA outreach gap.

To help bridge the gap left by the reduction in outreach, advocacy groups such as Get America Covered are reaching out to inform the public about enrollment. And nursing groups such as the American Nurses Association have stated their commitment to informing patients on how and when they can enroll. Below is some information for patients who might be confused about the law and how it currently stands. […]

2017-10-31T11:36:37-04:00October 31st, 2017|health care policy, Patients, Public health|0 Comments
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High Opioid Overdose Numbers Spur State, City Initiatives

State 2015 overdose death rates compared with national rate. (CDC image)

As we report in an October news article, recent studies have shed light on the growing scale of the opioid crisis in the United States. Among the latest statistics:

  • 33,000 Americans died in 2015 from an opioid overdose, a high percentage from the use of synthetic opioids such as illegally manufactured fentanyl.
  • The diagnosis of “opioid use disorder” climbed 493% from 2010 to 2016 in Blue Cross Blue Shield claims.
  • Around 4.31% of Americans ages 12 or older use prescription pain relievers for nonmedical uses.

Increasing Naloxone availability.

The findings underscore the urgent need to take steps to combat the crisis—a need that has prompted states and cities to attack the issue using various methods. Baltimore’s health commissioner, for example, issued a standing order for naloxone to be available at all of the city’s pharmacies. Brown University and the Rhode Island School of Design collaborated to create NaloxBoxes—emergency naloxone boxes installed at city social service centers that enable any bystander to administer a rescue dose.

Speeding access to addiction treatment.

And, to minimize delays in patients’ receipt of medication-assisted opioid addiction treatments like methadone, New York State has reached agreements with two insurance companies to end their […]

2017-10-23T08:50:26-04:00October 23rd, 2017|Nursing, Public health|1 Comment
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Thinking About Las Vegas

This latest mass shooting, in which 59 people were killed and 500 wounded in Las Vegas, is distressing—and it won’t be the last. Again we find it incredible that this can be allowed to happen.

And again we are reminded of the unique position of the United States compared to most other countries, our astronomically higher numbers of gunshot deaths and the financial and emotional costs they exact. As I wrote in my February 2016 editorial on gun violence, “firearms accounted for 417,583 deaths—253,638 suicides and 163,945 homicides between 2003–2013.”

There’s more information about gun violence and the dismaying number of injuries and deaths among children in our report in the September issue. And a study just published in Health Affairs puts the annual cost of emergency and inpatient care for firearm injuries at $2.8 billion.

The numbers of deaths and injuries we can measure. The sense of helplessness and frustration, and the creeping sense of anxiety we experience as we go into public spaces, are more invidious. […]

2017-10-07T08:35:43-04:00October 6th, 2017|Nursing, Public health|3 Comments
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A Closer Look at Preventing C. Diff Transmission

Clostridium difficile/ CDC

It’s estimated that Clostridium difficile (C. diff) causes about 450,000 infections and 15,000 deaths each year. Recently, on Facebook, AJN’s question of the week asked about isolation precautions for patients with C. diff. Most readers could not provide the correct answer to the multiple choice question.

In this month’s issue, “Six Things You Can Do Today to Prevent Hospital-Onset C. difficile Tomorrow” offers a quick update of the best ways to prevent C. diff infection and transmission in hospitalized patients.

Author and infection prevention nurse Nancy O’Connor explores the finer points of key basics, including the importance of maintaining a high index of suspicion for cases, performing excellent hand hygiene, and cleaning all surfaces in a case patient’s room with a bleach solution. (And did you know that if the patient remains in the same room posttreatment, after symptoms have resolved, the room should be terminally cleaned to avoid reinfection?)

Isolation precautions and C. diff.

So, what about isolation precautions, which need to be started as soon as C. diff is suspected? Most respondents to our Facebook question thought that standard precautions were sufficient until a C. diff diagnosis was confirmed. But if this “rule-out” patient with diarrhea is positive, does s/he begin to shed C. diff only after the infection […]

2017-09-22T11:21:11-04:00September 22nd, 2017|infectious diseases, Nursing|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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