Off the Charts

NP’s Model Helps Prevent Mental Health Issues from Slipping Through the Cracks

Brenda Reiss-Brennan, PhD, APRN.

When psychiatric NP Brenda Reiss-Brennan started her independent family therapy practice in 1978, she began to get referrals from primary care providers who were unsure how to handle their patients’ mental health needs. Working with one patient at a time limited her ability to reach many people, so in 1984 she developed a model to train other nurses, primary care providers, and clinics in treating patients with mental illness. The model eventually caught the attention of Intermountain Healthcare, a nonprofit health care system located in Salt Lake City, Utah, which piloted a program featuring the model in its primary care settings.

The care model, which became known as Mental Health Integration (MHI), integrates the treatment of mental health conditions such as anxiety, depression, and substance abuse into the primary care system. Instead of handing out a referral to an external provider and losing patients to follow-up, the MHI model ensures that patients’ mental health conditions and general health care needs are treated in the same primary care practice. Patients receive education materials, are screened for suicide, and are provided a safe environment in which to discuss their mental health concerns. “Patients and families are […]

Amy M. Collins, managing editor2016-12-15T16:34:32-05:00December 12th, 2016|Nursing, nursing roles|0 Comments

AJN December Issue News: Prescription Drug Costs, Infant Simulators and Teen Pregnancy, More

AJN’s monthly news section covers timely and important research and policy stories that are relevant to the nursing world. Here are some of the stories you’ll find in our current issue:

Frank Scavo refused to pay exorbitant prices for an EpiPen, and was hospitalized in August following a severe allergic reaction. Photo © Associated Press.

The High Cost of Prescription Drugs in America

In the past year, the prices of some prescription drugs have skyrocketed–the cost of an EpiPen two-pack, for example, jumped from $100 to more than $600. The reasons for the price hikes are complex, but major culprits include market exclusivity and the ability of drug companies to set prices.

New Patient Safety Requirements Toughen Nurse Licensure Compact

The […]

Diane Szulecki, editor2016-12-09T09:11:41-05:00December 9th, 2016|Nursing|0 Comments

Metabolic Syndrome: Lifestyle Factors and Prevention

Metabolic syndrome: one-third of U.S. adults.

Conversations about health—whether between neighbors or between clinicians and patients—often revolve around weight problems, blood pressure, blood sugar, and cholesterol levels. Taken together, these are the cardiovascular risk factors referred to as metabolic syndrome.

In the United States, more than one-third of all adults have metabolic syndrome. This is an astonishing figure, especially because these risk factors can be modified.

What keeps some who are obese or overweight ‘metabolically healthy’?

In recent years, researchers have learned that some people who are overweight or obese do not demonstrate the other risk factors that are part of metabolic syndrome, and therefore these people have a lower-than-expected risk of cardiovascular disease. In a study reported in this month’s AJN (“Examining the Links Between Lifestyle Factors and Metabolic Syndrome“), a group of Taiwanese nurse researchers set out to learn whether there might be lifestyle factors that keep this subgroup of people “metabolically healthy,” protecting them from the other cardiovascular risk factors that usually come with extra weight.

Lifestyle factors associated with prevention.

Dr. Shu-Hung Chang and colleagues performed community-based physical exams on more than 700 people in northern Taiwan and questioned them about lifestyle factors including smoking, drinking, exercise, and the foods they ate. The researchers […]

Betsy Todd, MPH, RN2017-07-27T11:53:43-04:00December 5th, 2016|nursing research, personal health practices|1 Comment

Dialysis Patients’ Very Different Life or Death Choices

This month’s Reflections essay is called “Sitting with Death.” The subtitle provides a little context: A social worker on a dialysis unit bears witness to patients’ life or death choices. Despite the sad stories the author tells, this remembrance doesn’t leave a reader feeling disheartened.

Retired social worker Linda Converse writes that starting work at a dialysis center was at first daunting. How could she talk to patients about such an ultimate choice as whether or not to give up dialysis?

But over time she began to understand that there was usually no right answer. For each person, there was a different personal algorithm that guided the choice, one based on such factors as quality of life, obligations to loved ones, values, and much else. Writes Converse:

I’ll never forget some of the patients who chose to stop dialysis, nor will I forget those who chose to hold on for as long as possible. There was no consistent logic when it came to an individual’s choice. What one person considered an impossible quality of life, another wouldn’t.

[…]

Jacob Molyneux, senior editor/blog editor2016-12-05T08:57:58-05:00December 5th, 2016|patient engagement, patient experience|0 Comments

A Status Update for World AIDS Day

In light of the recent focus on Zika virus and the last few years’ attention to Ebola, there’s been little attention to HIV/AIDS. Today, December 1, World AIDS Day, is a good time to remember that millions still suffer from this disease and thousands contract it annually.

According to the MMWR report released last week by the Centers for Disease Control and Prevention (CDC), the statistics are still sobering:

Globally, over 36 million people have AIDS and 2.1 million were newly infected in 2015; 1.1 million died.
In the United States in 2013, approximately 1.2 million people had an AIDS diagnosis; approximately 44,000 were newly diagnosed in 2014.

There is good news, in that global access to treatment has increased greatly—in 2010, 7.5 million had access to antiretroviral treatment; by June 2016, over 18 million had access to antiretrovirals.

It’s been over 35 years since AIDS was first reported by the CDC—you can read an overview of the CDC’s response here. I recall the AIDS epidemic only too well. As I wrote in an editorial in 2010:

In 1975, while attending graduate school, I worked part time as a chemotherapy nurse for a hematologist in New York City. Because of his expertise, he was increasingly being asked to consult on cases involving seemingly healthy young men, most of them gay, who […]

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Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2016-12-01T10:24:35-05:00November 30th, 2016|infectious diseases, Nursing, Public health|1 Comment