Late in a High Anxiety Season, Some Flu and Vaccine Basics

After what has seemed like constant media scrutiny for months, influenza hasn’t been in the news as often in recent days. Still, CDC data indicate that flu activity remains “widespread” across the country, so it’s still too early to eliminate flu from your list of “differential diagnoses,” at work or at home.

Maybe it’s the general state of our national psyche, but this year the “flu” seems to have caused more than its usual share of anxiety. This is not a pandemic; there are no brand-new strains of flu in circulation to which no one is immune. But the H3N2 strain that has been predominant this year does tend to lead to a harsher-than-usual season. (The 2014-2015 season was also severe, but the public heard relatively little about it because media were focused on the Ebola outbreak.)

Influenza surveillance basics.

How do we know how bad a flu season really is? Since the 1997–1998 flu season, lab data and clinical reporting have facilitated real-time flu surveillance in the U.S. Public health laboratories in every state, in collaboration with National Respiratory and Enteric Virus Surveillance System laboratories, track the types (A or B) and subtypes (H3N2, H1N1, etc.) of flu in circulation.

To complement these data, the U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet) tracks the percentage of […]

2018-02-28T12:20:28-05:00February 28th, 2018|infectious diseases, Nursing, Public health|0 Comments
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Aid-in-Dying: A Daughter’s Challenging New Nursing Role

A father’s request.

The March Reflections essay in AJN is by a nurse whose terminally ill 92-year-old father asked her to help him legally end his own life under the requirements of Oregon’s Death with Dignity Act. The short essay is intimate, informative, and honest. Here’s a brief excerpt from near the end:

Although I miss my father terribly, I have no regrets. Mostly, I am thankful for his strength and courage, his clear-mindedness, and his willingness to work with me to repair our relationship. I am also thankful that nursing prepared me for the role of nurse advocate and taught me how to ‘be with’ a person at the end of life, even when that person was my father.

By Barbara Hranilovich for AJN.

Death With Dignity laws.

It can’t be easy for a nurse, whose job usually focuses on restoring patients’ health and preserving their lives, to help a family member die in this way. Nor is the process without challenges: the requirements of Death with Dignity laws are rigorous, layered with checks and double-checks to guard against potential abuses. […]

2018-02-26T10:41:13-05:00February 26th, 2018|Nursing, nursing stories|1 Comment
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March Issue: Oral Intake During Labor, Malnutrition in Older Adults, RN-Performed Lumbar Puncture, More

The March 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: An Investigation into the Safety of Oral Intake During Labor

In this study, the authors compared the maternal and neonatal outcomes among laboring women permitted ad lib oral intake with those permitted nothing by mouth except for ice chips. The findings support relaxing the restrictions on oral intake in cases of uncomplicated labor.

CE: Malnutrition in Older Adults

A review of the many cognitive, psychological, social, and economic factors that can affect the nutritional status of older adults, and how nurses can intervene to prevent and address malnutrition in these patients.

Cultivating Quality: Expanding RN Scope of Practice to Include Lumbar Puncture

A quality improvement initiative enhanced access to neurology services in an ambulatory clinic by teaching nurses to perform lumbar puncture.

Supporting Family Caregivers: No Longer Home Alone: Teaching Wound Care to Family Caregivers

Methods to promote wound healing that nurses can use to teach family caregivers, including a tear sheet of key points and links to instructional videos. This article is one in a series published in collaboration with the AARP Public Policy Institute.
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2018-02-23T09:00:42-05:00February 23rd, 2018|Nursing|0 Comments
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Nursing Assistants in Nursing Homes: Partners in Quality Improvement

“NAs know where the quality gaps lie.”

I loved working in a skilled nursing facility—the long-term relationships with residents and their families, the chance to really hone in on nursing basics, the opportunity to learn about life from people who had seen it all.

But what finally drove me away from this work was the mediocre quality of care in two different “homes” where I was on staff. I was angry and frustrated, and even after several years in nursing, still too inexperienced to understand what I could have done to make things better.

Including nursing assistants in QI projects: ‘crucial to success.’

Today, care is slowly changing. Nursing homes are now required to post on the web certain data about their patient outcomes (https://www.medicare.gov/nursinghomecompare/search.html), and to implement quality improvement (QI) initiatives. But have we regarded QI projects as the province of RNs and administrators only? In this month’s AJN, Kathleen Abrahamson and colleagues make the following observation:

“…nearly all changes driven by QI in work processes, schedules, approaches to care, or documentation will either affect or be carried out by nursing assistants. Thus, including NAs in QI efforts is crucial to their success.”

The truth of this statement is so clear, it might be called a “no-brainer.” As the authors […]

2018-02-21T09:51:50-05:00February 21st, 2018|Nursing, nursing research|0 Comments
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Avoiding the Chaos of Unit Transfers

Photo by Photographer’s Mate 2nd Class Johansen Laurel, U.S. Navy.

Patient transfers between units can be less than orderly, resulting in miscommunication and frustration. Most ICU nurses have a war story (or two) that quickly comes to mind if asked about a memorable admission to their unit from the OR or recovery unit. I recall one instance, when I was a clinical nurse specialist covering critical care, in which I received a frantic call at 11:30 am from the ICU nurse manager.

Apparently, the ICU had been told they would receive a patient from recovery at about 2 pm. With this in mind, the ICU had arranged to transfer a patient out to a med-surg unit just after noon. The ICU manager had worked out the transfer time with the med-surg nurse manager to allow the med-surg RN to return from lunch before the transfer, and also to give the ICU nurse a chance to have lunch and prepare the equipment in the ICU slot for the new patient after it was cleaned by housekeeping.

But as it happened, the recovery nurse manager called the ICU at 11:30 am to say her unit needed the bed and the new patient would […]

2018-02-20T10:06:37-05:00February 20th, 2018|Nursing, nursing research|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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