ACA Opens Enrollment for 2019: What Patients Need to Know

Open enrollment in the Affordable Care Act (ACA) marketplace opened today, despite shortened deadlines, repeal of the individual mandate, stopping cost-sharing payments, and reduced outreach and marketing for the law. And with all the noise from political talking points adding to an already complicated process, your patients might be in need of a primer on what to do this year. Here are the basics:

Where to enroll

Some states have their own exchange, and some use the federal government’s. Patients can access www.healthcare.gov, www.cuidadodesalud.gov, find their state’s page here, or call (800) 318-2596 for more info.

When to enroll

Enrollment begins November 1 (except for in California, where it began in October). However, deadlines differ in some states. The deadline for most states this year is December 15. A handful (New York, California, Massachusetts, Minnesota, Colorado) have deadlines in January. Those who wait until January to enroll should be aware that their coverage will not start until February.

What about the individual mandate?

Included in the Republican-backed tax plan signed into law last year was a repeal of the individual mandate penalty for individuals who choose not to get insurance. For the coming year, this repeal will be in effect in almost all states (Massachusetts, New Jersey, and the District of Columbia […]

2018-11-01T13:45:23-04:00November 1st, 2018|Patients, Public health|0 Comments
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Nurses Concerned About Removal of Key Children’s Health Advocate at EPA

At the end of September, the Environmental Protection Agency (EPA), with no explanation, placed the director of the Office of Children’s Health Protection (OCHP), Dr. Ruth Etzel, on administrative leave. This sidelining of a vocal children’s health advocate as the office was heading into October, Children’s Environmental Health Month, was concerning for all who work in children’s environmental health.

The OCHP’s essential role.

The OCHP was created under an executive order in 1997 as public consciousness was increasing about the special vulnerabilities of children to environmental hazards. It is housed in the Office of the Administrator so as to be able to provide guidance to EPA leadership and ensure that children’s health protection is prioritized throughout the agency’s activities. This is essential because, as many have observed, children are not simply miniature adults—what they eat, drink, and breathe can profoundly affect their physical and mental development, while their hand-to-mouth and on-the-floor activities put them at greater risk for exposures from environmental hazards.

The office provides essential resources for health professionals and the public on environmental health issues such as environmental triggers of asthma and how parents can reduce exposures, reducing exposures to lead, and air quality in schools. The OCHP-produced report, America’s Children […]

2018-10-31T11:54:23-04:00October 31st, 2018|environmental health, health care policy, nursing perspective, Public health|0 Comments
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Managing Acute Pain in People with Opioid Use Disorder

Photo © IStock.

Have you ever used the Clinical Opiate Withdrawal Scale (COWS) to ascertain whether your patient might be experiencing opioid withdrawal?

Considering the current prevalence of opioid misuse, it’s not unlikely that a patient admitted for a non-drug-related cause could be a person who uses opioids—someone who may or may not have shared that information with you.

The Clinical Opiate Withdrawal Scale is one of many helpful points of assessment and management discussed in this month’s CE article, “Acute Pain Management for People with Opioid Use Disorder.”

Compassionate, informed, nonjudgmental care.

This article, not specifically about unrevealed opioid intake, focuses on the management of acute pain in a person who is known to use opioids because they are currently on medication-assisted treatment (MAT)—that is, someone receiving methadone, buprenorphine, or naltrexone for opioid use disorder who is also experiencing acute pain from (for example) cancer, or after surgery or trauma.

[…]

2018-10-29T08:03:46-04:00October 29th, 2018|Nursing|0 Comments
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November Issue: Patient Handling in Nursing Curricula, Pediatric Pressure Injury Risk, More

“The technical skills and knowledge needed for nursing can be learned. For some nurses, this is enough. They do nursing, but nursing isn’t part of their identity. So how do we change that?” —EIC Maureen (Shawn) Kennedy in her November editorial

The November issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: Patient Handling and Mobility Course Content: A National Survey of Nursing Programs

What do nursing programs teach students about lifting, turning, transferring, repositioning, and mobilizing patients? Despite evidence supporting the use of safe patient handling and mobility practices, the authors’ findings suggest that most curricula need updating in this area.

CE: How to Predict Pediatric Pressure Injury Risk with the Braden QD Scale

This article offers guidance on use of the Braden QD Scale—a pediatric risk assessment instrument that reliably predicts both immobility-related and medical device–related pressure injuries. Readers can test their skills by assigning scores to patients in a variety of scenarios.

Looking Back: Nurses Fight for the Right to Vote

The author shares the stories of four nurse suffragists—Lavinia Lloyd Dock, Mary Bartlett Dixon, Sarah Tarleton Colvin, […]

2018-10-26T08:30:41-04:00October 26th, 2018|Nursing|0 Comments
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Violence Against Health Care Workers: Time for a Zero Tolerance Approach

“Staff should know implicitly that they don’t have to work in an unsafe environment . . . “

The October issue of AJN has two articles that focus on workplace violence. We’ve shared them through social media—and sadly, the response and comments indicate that this information is sorely needed.

One, described in last week’s blog post by clinical editor Betsy Todd, is an article from a health system reporting on how they developed an innovative program to train their employees to deal with violent situations.

‘Staggering numbers.’

The second article (free until Nov. 8) is from nurse and attorney Edie Brous, our contributing editor and coordinator of our legal column, and covers what staff should expect from management in striving for safe workplaces. The numbers of workplace injuries and violent episodes are staggering—the CDC, Bureau of Labor Statistics, and other government agencies dealing with health and safety all show significant increases in the last five to ten years. Brous cites many of these data and notes, “The health care industry experiences almost as many violent injuries as all other industries combined.”

Organizations must be proactive . . . and held accountable.

What responsibility do health care organizations have? Brous writes:

“Organizations must be proactive in protecting their workforce and held accountable […]

2018-10-25T10:18:03-04:00October 25th, 2018|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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