Off the Charts

Staying Current with Sepsis Tools, Definitions, and Practices

Whatever happened to SIRS? Why don’t we use the term “severe sepsis” anymore? And what’s a qSOFA score?

Changing knowledge, changing practices.

Since the Society of Critical Care Medicine and the European Society of Intensive Care Medicine launched the Surviving Sepsis Campaign (SSC) in 2002, there has been an ongoing search for best practices.

Education campaigns have focused on early diagnosis and aggressive treatment. Best practices continue to evolve rapidly. As our understanding of sepsis pathophysiology has increased, definitions have changed and “sepsis bundle” interventions have been updated. […]

Betsy Todd, MPH, RN2018-02-09T09:57:19-05:00February 9th, 2018|guidelines, Nursing|0 Comments

Low Physical Activity Among Chinese American Immigrants with Prediabetes and Type 2 Diabetes

“…compared with the general population, people who have or are at risk for type 2 diabetes are significantly less likely to engage in regular physical activity.”

On this month’s cover, group practices tai chi during snowfall in Shenyang, China. ©Photo Reuters/Stringer.

We all know that physical activity is important for maintaining health—for everyone. It’s especially important to prevent or manage prediabetes and type 2 diabetes.

AJN’s February research feature, “Physical Activity Among Chinese American Immigrants with Prediabetes or Type 2 Diabetes,” takes a special look at the issue among Chinese American immigrants. Diabetes is the fifth leading cause of death among Asian Americans, so researchers wanted to investigate what this population’s knowledge of and barriers to physical activity might be.

Recruiting from a community health center in New York City, researchers conducted interviews with 100 foreign-born Chinese American adults having a diagnosis of prediabetes or type 2 diabete

According to the study authors:

“Chinese American immigrants with prediabetes or type 2 diabetes tend to be sedentary and are less likely to perform moderate or vigorous physical activity than the general population . . . .The findings also highlight some of the barriers to such activity and suggest a need for greater involvement […]

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Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-02-07T10:30:12-05:00February 7th, 2018|exercise, Nursing, nursing research, patient engagement, personal health practices|0 Comments

The School Nurse

by rosmary/via Flickr

They march into my heart like little soldiers. There are lads and lassies, rich and poor, sporting bling and brawn. Sometimes they leave the bus and walk into my office as soon as they get in the front door. The litany continues daily.

“I don’t feel good.”

“My stomach hurts.”

My responses follow the pattern.

“Did you tell your parents you didn’t feel good?”

“Did you eat breakfast?”

“Were you up late last night?”

The thermometer comes out. Triage begins. Some came in under the power of suggestion.

“My mother said if I didn’t feel good to come to the nurse’s office.”

Children always think that’s a free ticket to get out of the remaining school day. The sick ones are directed to cots in the back part of the office. Some will rest awhile. Some will have crackers or granola bars to offset the empty stomach they came to school with. Charts come out. The search begins. Some phone numbers are accurate, and parents can be reached. Some, sadly, can’t be contacted. The phone messages become trite.

“The person at this number is not taking calls now.”

“This number is no longer in use.”

I have to put my Sherlock hat on. I search all sources to see if there is a parent or relative who can come and pick up their child per protocol because […]

Guest Author2018-02-01T08:23:45-05:00February 1st, 2018|Nursing|5 Comments

Experienced Bedside Nurses: An Endangered Species?

“The trend toward our hospitals being primarily populated with nurses with less than two years’ experience is worrisome.”

At least three colleagues who’ve recently been patients in hospitals or had family members who were have remarked on the youthful nurses they encountered—and on their lack of experience. In two of the conversations, my colleagues cited instances in which this lack of experience was detrimental to care, one of them dangerous. That “sixth sense,” that level of awareness that comes with lived experience and becomes part of expert clinical knowledge, is important for safe, quality patient care.

In the February editorial, I report on the answers I received when I queried our editorial board members about new nurses’ inclination to work in acute care for only two years to gain experience and then leave to pursue NP careers. Many of the board members have seen a similar trend, one reflected by research on nurse retention, some of it published in AJN (most recently, see Christine Kovner’s February 2014 study on the work patterns of newly licensed RNs, free until February 6). […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-01-29T09:54:37-05:00January 29th, 2018|career, Nursing, nursing roles, patient safety, Patients|28 Comments

February Issue: Updated Sepsis Guidelines, Chinese American Immigrants and Diabetes, Improving OR–ICU Handovers, More

The February 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: Physical Activity Among Chinese American Immigrants with Prediabetes or Type 2 Diabetes

The benefits of exercise for patients with type 2 diabetes have been studied extensively, but not among Chinese American immigrants diagnosed with prediabetes or type 2 diabetes. The authors of this mixed-methods study analyzed this population’s levels of exercise intensity, examining the types of activity performed, as well as the barriers to such activity.

CE: Managing Sepsis and Septic Shock: Current Guidelines and Definitions

This article discusses recent updates to the Surviving Sepsis Campaign’s sepsis treatment guidelines, changes in the sepsis bundle interventions, and the new definitions and predictive tools introduced in the Third International Consensus Definitions for Sepsis and Septic Shock.

Moving Closer to the 2020 BSN-Prepared Workforce Goal

The authors report findings from the four-year Academic Progression in Nursing initiative to identify and develop the most promising strategies for creating a more highly educated nursing workforce.

Cultivating Quality: A Multidisciplinary QI Initiative to Improve OR–ICU Handovers

This QI study examines […]

Diane Szulecki, editor2018-01-26T09:32:47-05:00January 26th, 2018|Nursing|0 Comments