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 […]

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! […]

Zika Virus Update: Epidemiology, Sexual Transmission, Pregnancy

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

A close view of a repellent product being sprayed on a person's hand in Brasilia, Brazil, 27 January 2016. The Brazilian government announced that repellent products will be given for free to pregnant women registered in the assistance programs to avoid Zika contagion. EPA/FERNANDO BIZERRA JR. Mosquito repellant being sprayed on a person’s hand in Brazil. EPA

Zika virus is now being actively transmitted in 42 countries, primarily in the Americas and on islands in the South Pacific. As of April 13th, there had been 358 travel-associated cases reported in the U.S., including 31 pregnant women.

While there are as yet no locally acquired U.S. cases, local transmission has been established in several U.S. territories (primarily, Puerto Rico). Travel-associated cases are expected to continue in the U.S., almost certainly leading to eventual limited local transmission.

Transmission. Most cases of Zika virus infection have been vector-borne—that is, they resulted from the bite of an infected mosquito. Other […]

‘Do You Consider Yourself Healthy?’ Study Sheds Light on RNs’ Lifestyle Practices

By Sylvia Foley, AJN senior editor

Over the past decade, the lifestyle practices of nurses and their connection to quality of care and patient outcomes have been gaining attention. Indeed, according to the patient-centered, relationship-based care model, one of the main conditions for optimal care is that providers engage in healthy self-care behaviors. Yet there is some evidence suggesting that RNs don’t consistently do so, especially when it comes to exercise and stress reduction—even when they believe they should.

Nurse researchers Karen Thacker and colleagues recently conducted a study to learn more. They report their findings in this month’s CE–Original Research feature, “An Investigation into the Health-Promoting Lifestyle Practices of RNs.” Here’s a brief summary:

Purpose: To gather baseline data on the health-promoting lifestyle practices of RNs working in six major health care and educational institutions in southeastern Pennsylvania.
Methods: The 52-item Health-Promoting Lifestyle Profile II instrument was used to explore participants’ self-reported health-promoting behaviors and measure six dimensions: health responsibility, physical activity, nutrition, interpersonal relations, spiritual growth, and stress management.
Results: Findings revealed that physical activity and stress management scores were low for the entire group of RNs. There were statistically significant differences between nurses 50 years of age and older and those 30 to 39 years of age for the subscales of health responsibility, nutrition, and stress management, suggesting that older nurses are more concerned about their […]

What to Know About Zika Virus

By Shawn Kennedy, AJN editor-in-chief. Accompanying map via PAHO/WHO.

The media is full of headlines and photos about the recent increase in the number of Brazilian children born with microcephaly, thought to be due to maternal exposure to the Zika virus. If you’re like most nurses, you’ve had family members and friends asking you about it, especially if they’re considering a winter escape to the Caribbean or Mexico. Here are some resources and information to help you stay up to date so you can provide your patients (and families and neighbors) with evidence-based information.

2016-cha-autoch-human-cases-zika-virus-ew-3

Zika basics. Zika virus was first discovered in 1947 in monkeys in the Zika forest of Uganda and the first documented case in humans was in 1952. An outbreak on Yap Island in Micronesia in 2007 showed that it had spread beyond Africa. The virus is spread by the Aedes mosquito, the same mosquito that transmits yellow fever, dengue, and chikungunya.

Outbreaks of Zika have been spreading northward from Brazil through the Americas since 2014. (See above PAHO/WHO map of confirmed cases, 2015-2016.) While most transmission is believed to occur via mosquito bites, according to the CDC, “Perinatal, in utero, and possible sexual and transfusion transmission events have also been reported. Zika virus RNA has been identified in asymptomatic blood donors during an ongoing outbreak.”

Symptoms and course are similar to those of other viruses: […]

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