Orlando: Another Reminder of Public Health Measures Not Taken

Mary_Magdalene_Crying_StatueOnce again, we’re reading about a mass shooting—this one the deadliest so far, with 50 dead in a nightclub in Orlando, Florida. We’ve learned that the alleged shooter, born in the United States to immigrant parents, appears to have been volatile and prone to angry outbursts.

He’d made threats about killings months earlier, according to news reports of interviews with coworkers and family members. Reports also indicate that he professed a hatred of gays and, during the attack, pledged allegiance to the radical Islamic terrorist group ISIS. He had been investigated by the FBI at earlier dates in conjunction with suspected terrorist activities.

And also once again, we learn that the guns, including an assault-style semiautomatic rifle*, were purchased legally. Assault rifles like the one used in Orlando are often used by mass shooters. Assault weapons had once been banned—but when the ban expired in 2004, it was not renewed by Congress, nor does it seem likely to be. […]

2016-11-21T13:01:08-05:00June 13th, 2016|nursing perspective, Public health|3 Comments
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Intimate Partner Violence: ‘Troubling Knowledge and Practice Gaps’ among Rural Providers

By Sylvia Foley, AJN senior editor

Table 8. Perceived self-efficacy on a 1-to-5 scale (mean score above 2.5 indicates greater sense of self-efficacy). Table 8. Perceived self-efficacy on a 1-to-5 scale (higher score indicates greater self-efficacy).

Intimate partner violence (IPV) remains a widespread health and social problem in the United States, affecting an estimated one in three women during her lifetime.

Health care providers can make a critical difference in the lives of these women, yet a lack of IPV-related knowledge, negative attitudes and beliefs, and low rates of screening are common. And women in rural areas face particular challenges.

To learn more about rural providers with regard to IPV, nurse researchers Karen Roush and Ann Kurth conducted a study. They report their findings in this month’s CE–Original Research feature, “Intimate Partner Violence: The Knowledge, Attitudes, Beliefs, and Behaviors of Rural Health Care Providers.” Here’s an overview:

Methods: Health care providers working in a large rural health network were asked to complete electronic surveys that examined their IPV-related knowledge, attitudes, beliefs, and behaviors. Descriptive and correlational statistical analyses of the data were conducted.
Results: A total of 93 providers returned completed surveys. In general, the respondents demonstrated good overall knowledge, judicious attitudes, and beliefs congruent with […]

2016-11-21T13:01:08-05:00June 10th, 2016|health care policy, Nursing, nursing research, Public health|0 Comments
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The Real and Evolving Threat of Superbugs: A Primer

pillsinspaceJust how super is the latest superbug? The good news is that the infected U.S. patient has recovered. The bad news:  mcr-1, the resistance gene identified in this strain of E. coli, has brought us another frightening step closer to a “post-antibiotic” era.

In recent years, antimicrobial resistance among Gram-negative bacteria (E. coli, Klebsiella, Pseudomonas, Acinetobacter, Salmonella, and others) has been a growing public health concern. Most of the increase in resistance has been the result of mobile genetic elements that can easily transfer resistance from one bacterium to another, allowing bacteria to “catch” antibiotic resistance from one another.

To make matters worse, resistance enzymes are often packaged together. One genetic “cassette” can carry multiple resistance determinants, thereby spreading resistance to more than one class of antibiotics at the same time.

Early on, we relied on the carbapenem class of antibiotics to treat infections caused by multidrug-resistant (MDR) organisms such as the “ESBLs” (extended-spectrum beta-lactamase-producing organisms). But carbapenemase-producing organisms soon developed, and resistance to carbapenems spread quickly.

In 2009, the emergence of a “super” kind of carbapenem resistance gene, ndm-1 (New Delhi metallo-beta-lactamase) was found to be highly resistant to many antibiotic classes, including:

  • the carbapenems and other beta-lactams (penicillin derivatives and cephalosporins)
  • the fluoroquinolones (ciprofloxacin, levofloxacin, et al)
  • the aminoglycosides (gentamicin, amikacin, et al).

These antibiotic classes include the main drugs used to […]

2016-11-21T13:01:11-05:00June 6th, 2016|infectious diseases, Nursing, Public health|1 Comment
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Recent Decline in U.S. Opioid Prescriptions: Good News But Some Concerns

by frankieleon/ via flickr by frankieleon/ via flickr

It was widely reported in the past week that there have been steady declines in the number of opioid prescriptions in the U.S. for the past three years, with the declines the steepest in some of the states considered to have the worst opioid misuse crises.

This is good news, suggesting that efforts to address some problem areas like renegade pain clinics prescribing for profit, patients who go from doctor to doctor seeking opioid prescriptions, and the diversion of legitimate opioid prescriptions may be starting to bear fruit.

A balanced overview of the situation can be found in this New York Times article. The authors also acknowledge that patients in pain are now facing new hurdles to pain relief, quoting the director of one prominent medical school’s program on pain research education and policy: “The climate has definitely shifted. . . . It is now one of reluctance, fear of consequences and encumbrance with administrative hurdles. A lot of patients who are appropriate candidates for opioids have been caught up in that response.”

Much of the reporting on the opioid epidemic lumps all people who take opioids into one big statistical brew. While startling and alarming numbers about overdoses from legal and illegal opioids steal the headlines, little media and scholarly analysis focuses on the lower […]

2016-11-21T13:01:12-05:00May 26th, 2016|health care policy, Nursing, nursing perspective, pain management, patient experience, patient safety, Patients|1 Comment
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Nurses, Exercise, Time: Hitting a Nerve

Flickr creative commons/ Richard Masoner Flickr creative commons/ Richard Masoner

Hitting a Nerve. I received several recent emails about an editorial I wrote in the April issue of AJN, in which I discussed nurses’ health practices, including exercise, in conjunction with one of our feature articles, “Original Research: An Investigation into the Health-Promoting Lifestyle Practices of RNs.”

The authors found that, for study participants,

“physical activity and stress management scores were low for the entire group of RNs.”

Drawing a connection between these findings and recent research by Letvak and colleagues suggesting an association between nurses’ health and job performance, I wrote, “If the nurse caring for you or your loved one is suffering from fatigue and stress, she or he may be more apt to make an error or to sustain a workplace injury.”

Judging from the emails I received, I hit a chord. The writers stressed the difficulty of working full time and, in many cases, caring for a family as well. Often, they said, they had little energy left over for themselves. One writer, though, did say that my editorial was the ‘kick’ she needed to get back to walking! […]

2017-06-28T14:34:26-04:00April 28th, 2016|Nursing, nursing perspective, personal health practices|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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