October Issue: Hypertensive Emergency, Proning, Preventing Medjacking, More

“One expects nurses to be better informed than the general public when it comes to science and health matters.”—editor-in-chief Shawn Kennedy in her October editorial, “Getting on Board with Vaccinations”

The October issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

CE: Hypertensive Emergencies: A Review

An overview of the pathophysiology, clinical manifestations, and management of hypertensive emergency, plus nursing considerations for acute and preventive care.

CE: A Prone Positioning Protocol for Awake, Nonintubated Patients with COVID-19

How an interdisciplinary team at one Boston hospital developed and
implemented a protocol for proning awake, hypoxemic patients with
suspected or confirmed COVID-19 on medical–surgical units.

Special Feature: Preventing Medjacking

This article discusses medical device cybersecurity, the risks and consequences of compromised medical and personal data, and what nurses can do to guard against security threats and educate patients. […]

2021-09-24T09:19:42-04:00September 24th, 2021|Nursing|0 Comments

Are Fall Prevention Precautions Missing the Mark?

Happy first day of autumn! Let’s have some fall talk.

If you spend any time in the acute care setting, you’ll be inundated with signs of fall precautions: yellow alert armbands, yellow nonslip socks, yellow signs on patient room doors, and of course the constant ringing of bed alarms.

It appears that hospitals put a lot of effort into fall prevention, and understandably so—falls cost hospitals money. These costs include tests and procedures that aren’t covered by insurance, increased length of stay while the patient recovers, and lawsuits from injured patients or from their families.

Checking boxes vs. individual patient needs.

However, the current approach of applying all precautions to all patients at risk for falling isn’t supported by research, and may decrease patient satisfaction. Sometimes it seems more focus is put on checking boxes about having prevention strategies in place than on the actual patient’s preferences or needs. For example, a former patient told me about a time she was in the bathroom of her hospital room and felt lightheaded. Rather than risk falling, she eased herself to the floor and hit the call bell for assistance to get back to bed. Upon finding her on the floor, the staff were so focused on filling out an incident report and assessing her for injury that they ignored her attempts to explain what actually happened.

The ‘next era’ in fall reduction.

2021-09-22T09:47:00-04:00September 22nd, 2021|Nursing, patient safety, Patients|0 Comments

Mental Illness and Public Tragedy: Recognizing Critical Warning Signs

In 2020, I was asked to review a submission for AJN’s Viewpoint column. Reviewers are not told who the author of a work is, nor are authors informed who is reviewing their submission. But I hadn’t gone very far when I knew exactly who the author was and what she was writing about.

Photo © Shutterstock

In my career I have read and been moved by many articles and first-person accounts, but this time was different. Each word took me closer into what I realized was a very personal viewpoint on an unimaginable national tragedy.

The author of the article was Arlene Holmes, a nurse and mother who was writing about her son James, who on July 20, 2012, opened fire on movie theater patrons in Aurora, Colorado, killing 12 and wounding 70. (Her article, “Why a Nurse (and Mother) Didn’t Know,” was eventually accepted and published in AJN‘s June 2020 issue.)

Asking the same questions over and over.

After completing the review of this article, the questions I asked myself were the same ones I ask each time we hear of such tragic events happening at the hands of someone who has a mental illness:

What could have been done to change the outcome and prevent […]

2021-09-16T10:05:00-04:00September 16th, 2021|Nursing|0 Comments

Delta, Mu, and Others: What to Know About Covid Variants

Daily Trends in COVID-19 Cases in the U.S. Reported to CDC (9-21-21): red line shows 7-day moving average. Click image to enlarge.

According to the CDC, the delta variant now makes up more than 99% of COVID-19 cases across the U.S. Recently, though, the media has been drawing attention to the mu variant. Should we worry?

How serious are variants?

Viruses constantly change. Mutations might make a virus easier to spread or more virulent, change its clinical presentation, or alter its response to tests, vaccines, or treatment. Or there may be no observable change in its characteristics at all. Some variants simply fade away; others stick around, but can’t compete with more dominant variants and never really get a “foothold” in a particular population. At this time—and this is a pretty big caveat—the COVID-19 mu variant seems stuck in this last category, at least in the U.S.

What about mu?

Although the mu variant has been identified in more than 39 countries, including the U.S., there have been only about 2,000 cases here, mostly in California, Florida, Texas, and New York. The World Health Organization (WHO) calls mu a “variant of interest” […]

2021-09-14T14:36:42-04:00September 14th, 2021|COVID-19, infectious diseases, Nursing|1 Comment

Acute Care Nurses: An Endangered Species?

Our acute care settings are in crisis—staff are physically and emotionally exhausted. And many have decided they can’t take it anymore.

“At the virtual conference of the American Organization for Nursing Leadership (AONL) in July, researcher Peter Buerhaus reported preliminary findings of his study on the impact of the pandemic on the nursing workforce. He reported that a phone survey of over 800 AONL members conducted in May revealed that more than 50% of hospital chief nurse officers were seeing “increased retirements, sick leave, and early exits, including among younger nurses.”— AJN Editorial, September 2021

It’s been no secret that the hospital work environment has been problematic for nurses and patients alike—we know stressed and worn-out clinicians make more errors, and patient care suffers. In 2004, the Institute of Medicine released Keeping Patients Safe: Transforming the Work Environment of Nurses, which discussed workplace staffing and processes as intrinsic to ensuring patient safety. More recently, the National Academy of Medicine published Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being (2019), which noted, “The job demands placed on clinicians are often greater than the job resources available to them; this imbalance can lead to burnout.”

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