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 […]

2017-08-02T11:36:27-04:00August 2nd, 2017|Nursing, Public health|1 Comment
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Why Do Pregnant Women Smoke?

 “My mother smoked [when she was pregnant] with me and I am fine.”

“I’d rather smoke a cigarette than take a drink of alcohol to relieve stress.”

“So you’re bored, what are you going to do? Sit down and smoke a cigarette.”

“It relaxes me.”

Tobacco use during pregnancy has been associated with many adverse effects, including abruptio placentae, fetal malpresentation, low Apgar scores, stillbirth, and birth defects such as gastroschisis and cleft lip or palate. Most nurses probably see these as no-brainer reasons for women to stop smoking once they become pregnant. Yet a new research study illustrates that the reasons pregnant women might continue to smoke are very individual, and that clinicians are not always skillful in supporting smoking cessation.

In this month’s AJN, researcher Geraldine Rose Britton and colleagues share the results of their qualitative study on the experiences of pregnant smokers and their health care providers. The researchers used a focus group methodology to learn about the smokers’ experiences and to better understand what motivated them to quit or prevented them from doing so.  There were also separate clinician focus groups to explore the approach of the 45 providers (71% RNs, 11% physicians, plus one NP, one nurse manager, four LPNs, and one PA) to pregnant women who smoke.

Not surprisingly, the researchers discovered that the issue is frustrating to both pregnant women and their maternity care providers. Some physicians and […]

2017-06-21T06:42:46-04:00June 21st, 2017|Nursing, personal health practices, Public health|3 Comments
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Chemical Exposure: A Preventable Cause of Harm to Children’s Health

“Children are often exposed to. . . contaminants through their behavior—when they crawl on the floor or explore their environment by touching and tasting objects indiscriminately. In addition, because they are young, there is the potential for environmental exposures to negatively impact their health for a long time.”

Photo © Associated Press

Chemicals are ubiquitous

In “Project TENDR,” an article in this month’s issue of AJN, author Laura Anderko, PhD, RN, a professor at the Georgetown University School of Nursing and Health Studies, discusses why children are particularly susceptible to environmental exposures to chemicals.

Aside from children’s vulnerability to chemical exposures as still developing individuals, Anderko observes that chemicals are also especially hazardous to children simply because they are everywhere: “ . . . in health care supplies and equipment, the food we eat, the water we drink, the air we breathe, and the cosmetics and personal products (such as shampoos, baby bottles, toys, and thousands of other consumer products) we use.”

Developmental harms of children’s exposure to chemicals

Anderko summarizes the concerns raised by a growing body of evidence linking environmental exposures and pediatric health outcomes:

“ . . . widespread exposure to toxic chemicals can increase the risk […]

2017-05-19T11:27:13-04:00May 19th, 2017|environmental health, Nursing, pediatrics, Public health|0 Comments
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Earth Day 2017: An Important Role for Nurses

By Barbara Polivka, PhD, RN, FAAN, professor and Shirley B. Powers Endowed Chair in Nursing Research, University of Louisville, Kentucky

“… the symptoms or the sufferings generally considered to be inevitable and incident to the disease are very often not symptoms of the disease at all, but of something quite different—of the want of fresh air, or of light, or of warmth, or of quiet, or of cleanliness…”  -Florence Nightingale, Notes on Nursing: What it is and What it is Not (1859).

 

crocus shoots, early spring / Wikimedia Commons

As we celebrate the 46th Earth Day, it’s good to look back.

  • Earth Day was founded by U.S. Senator Gaylord Nelson as an environmental teach-in on April 22nd, 1970.
  • The first Earth Day celebration helped spur the creation of the U.S. Environmental Protection Agency and the Clean Air Act.
  • Earth Day became an international celebration in 1971 when the UN Secretary General talked about it at a Peace Bell Ceremony in New York City.

A time to think about how we affect the environment and are affected by the environment.

Health Care Without Harm (https://noharm.org/) is an international organization promoting environmental health and justice. If you aren’t familiar with Health Care Without Harm I urge you to go to their website to see how health care organizations are decreasing their environmental impact. Health care facilities are:

2017-04-21T08:26:16-04:00April 21st, 2017|environmental health, Nursing, Public health|0 Comments
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Identifying and Addressing the Profound Mental Health Effects of Climate Change

Residents amid homes consumed by flood and fire, White Sulphur Springs, WV, June 2016. Photo © AP Photo / Steve Helber.

A new word for an era of increasing environmental instability.

A lot of attention is currently paid to the physical impacts of climate change, including extreme heat events, droughts, extreme storms, and rising sea levels. Far less attention has been paid to the psychological impacts of this change. For example, you may not be familiar with the term “solastalgia.” It’s related to the older word “nostalgia,” but was created to reflect the environmental and often related sociopolitical uncertainty of our current times—that is, of change that’s slow and incremental, and often even denied, and then sometimes rapid and catastrophic and impossible to ignore.

The term is explained in more detail in an April feature article in AJN, “Climate Change and Mental Health,” by Janna Trombley, Stephanie Chalupka, and Laura Anderko:

Solastalgia is a term coined a decade ago by philosopher Glenn Albrecht . . . It refers to the psychological distress resulting from degradation […]

2017-07-27T11:38:15-04:00April 17th, 2017|climate change, Nursing, patient experience, Public health|1 Comment
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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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