Nursing Handoffs: Do We Know What Constitutes Best Practice?

By Sylvia Foley, AJN senior editor

A systematic literature review on nursing handoffs, written by nurse researcher Lee Ann Riesenberg and colleagues and featured as a CE article this month, might just shock you. The researchers found that although there is  “abundant evidence that poor communication and variable procedures result in inadequate handoffs,” surprisingly little is known about what makes nursing handoffs effective. Which is kind of incredible, given how crucial handoffs are to providing safe and effective patient care.

Of the 95 English-language articles that met the researchers’ inclusion criteria, just 20 reported on research on nursing handoffs, and only 3 were found to be of reasonably good quality (scoring above 10 on a 16-point scale). The researchers concluded that although “the Joint Commission is calling for structured handoffs . . . we found very little evidence to support the use of any specific structure, protocol, or method.”

Barriers and Strategies
But the researchers were able to identify, categorize, and list numerous barriers to and strategies for handoffs that were mentioned in the literature. […]

2016-11-21T13:18:21-05:00April 7th, 2010|nursing perspective, nursing research|0 Comments
Read More

Taking A Stand Against Terminal Illness — Self-Delusion, or the ‘Good Fight’?

By Shawn Kennedy, MA, RN, AJN interim editor-in-chief

This week, The New York Times published an article about a young palliative care specialist who, when advised her cancer had progressed to the point where she should consider palliative care, rejected the notion and proceeded to pursue all available options. She was only 40 years old and said she was not ready to die. While the aggressive treatments (which she had plenty of money to pursue) gave her about another year, the article explains that her final days were spent heavily medicated for pain from the tumors throughout her body—even as she continued to request brutally painful procedures with little chance of prolonging her life.

That was her choice, and she knew what she was choosing. But that doesn’t always happen; too often, people really don’t know what it may cost them to take a stand against the inevitable. (For an engaging and comprehensive look at the issue and its implications for nurses, see Life Support Interventions at the End of Life: Unintended Consequences in the January issue of AJN.)

This month, AJN’s Reflections essay describes a scenario when full disclosure of the likely results of pursuing treatment wasn’t forthcoming from health providers. It tells of one nurse’s dilemma in balancing her role as family member and as a nurse during the last days of her […]

2016-11-21T13:18:23-05:00April 6th, 2010|Nursing|3 Comments
Read More

“The Next Time She Needs a Pap Smear at 3 AM . . . “

Sunset, Turks and Caicos Islands


By Christine Moffa, MS, RN-BC, AJN clinical editor

Vacations are an important part of keeping balanced in life and a good way to prevent career burnout. However, I’m sure that, like me, many of you have had to step out of relaxation mode to come to the aid of some unfortunate vacationer who either injured herself or himself trying a new activity, had a near drowning at the beach, or suffered some other tragedy.

I’ve just returned from a trip with six friends to Turks and Caicos. There was beach, sun, a lot of activities like snorkeling and the flying trapeze, and unlimited food and alcohol; in other words, it was the perfect set-up for a trip to the infirmary. (I once had a three-week nursing gig at a resort, so I know the usual ailments: overindulgence in food, alcohol, and sun; twisted ankles from people playing sports they haven’t attempted in the last 10 years; and the occasional serious accident or heart attack.)

Two days into the trip, one of my co-travelers fell ill with food poisoning, which resulted in a day’s worth of vomiting. At 2 a.m. my phone rang. It was this friend telling me that not only was she sick, but she’d just hit […]

2016-11-21T13:18:24-05:00April 2nd, 2010|career, nursing perspective|3 Comments
Read More

In Long-Term Care, What’s Favoritism?

By Sheena Jones, an LPN who is in training to be an RN at Dutchess Community College, Poughkeepsie, NY

Is it really fair when we get the favoritism speech from our superiors when we supply residents who have no family or friends with hygiene supplies? When there are two roommates and one has family and friends who visit daily and bring her all that she could need or want and the other has nothing and no one? Am I wrong for getting a couple of supplies from the dollar store for her? We all know that the hygiene supplies in many facilities are watered down and cheap. Am I wrong for buying someone some socks when they have none? We can’t share supplies or clothing between patients, so do I let someone walk around with nothing? If these people were my family or friends I would want someone to make them comfortable. They can’t leave the facility to go shopping with family or friends, and many of them have lost most of their mental capacity and have no one to help them—but that does not mean that they should walk around less put together than someone with a family? Do we just let these residents go without?

Bookmark and Share

2016-11-21T13:18:26-05:00March 31st, 2010|nursing perspective, students|3 Comments
Read More

What Nurses Need to Know About Continuous Glucose Monitoring

Case 1. A 27-year-old man has had type 1 diabetes for 19 years. His hemoglobin AIc level prior to starting RT-CGM [real-time continuous glucose monitoring] was 9.4%. . . . Over the 15 months of RT-CGM use, he was able to decrease his hemoglobin AIc level to 7.7% and maintain it at that level for several months. After he stopped using RT-CGM because his insurance didn’t cover sensors, his hemoglobin AIc level rose to 8.5%. When he got a new job and was able to resume use of RT-CGM, after three months his hemoglobin AIc level had once again decreased, this time to 7.9%.

Case 2. A 10-year-old girl has had type 1 diabetes for almost three years. Her hemoglobin AIc level before starting RT-CGM was 9.8%. By five months after starting RT-CGM her hemoglobin AIc level had decreased to 7.2%. After discontinuing sensor use because of the high cost of RT-CGM supplies and a lack of insurance coverage, her hemoglobin AIc level rose to 8.2%.

The above are composite cases of patients with type 1 diabetes who used real-time continuous glucose monitoring devices as a tool to improve their blood sugar control. They’re from an article in the April issue of AJN that gives a balanced overview of this technology, including how it works, its current uses (as a diagnostic tool, a warning system for hypo- and hyperglycemia, and a way to improve long-term glycemic control), its coverage and costs—and its advantages and disadvantages, […]

2016-11-21T13:18:31-05:00March 30th, 2010|Nursing|0 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top