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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The Fraught Journeys of Those Fleeing Hurricanes

AJN received this guest post last week, when the effects of Hurricane Irma were still in the headlines, from Kathryn Jackman-Murphy, EdD, MSN, RN, professor of nursing at Naugatuck Valley Community College in Connecticut. The challenges she describes here are not specific to Hurricane Irma—they are faced again and again by those forced from their homes and communities by storms and other natural disasters, and they often happen out of sight of the media.

by patchy patch, via flickr

Right after Hurricane Irma began to hit Florida, I checked in with one of my son’s adult friends. He was searching for a safe landing site for himself and his elderly parents, as his initial plans to stay had been compromised by the hurricane. He was now in Tennessee, with no idea of where they would be able to stay until it was safe to return home. The dad is a Vietnam-era veteran with PTSD, hypertension, and diabetes. The mom also has diabetes and some limitations with mobility related to arthritis and walks with a cane.

How can nurses help?

Watching the devastation in Florida and Texas, I was searching for something to do to help. That’s what nurses do—we help. Being so far away in the Northeast, I felt not only helpless but acutely aware that […]

2017-09-20T13:33:35-04:00September 20th, 2017|climate change, environmental health, Nursing, Public health|0 Comments
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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 […]

2017-09-18T07:50:13-04:00September 18th, 2017|Nursing, Public health|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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