Off the Charts

COVID-19: What a New Study Says and Doesn’t Say About the Possibility of Airborne Transmission

By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor. Published: March 20.

As we have become a little more comfortable with the concept of social distancing as a way to mitigate the spread of this new coronavirus, a new worry seemed to dominate conversations this week: the idea that the virus can linger in the air. The takeaway for many people, at least in the conversations I’ve been having, is that you can become infected by simply walking down the street. There is no evidence that this is true (unless, of course, someone sneezes in your face!).

Results of recent experiment deepen our understanding.

A March 17 research letter published in the New England Journal of Medicine reported on experiments in which SARS-CoV-2, the virus that causes COVID-19, was artificially aerosolized. (For comparisons, SARS-CoV-1, which causes SARS, was also aerosolized.) A nebulizer was used to aerosolize the virus, and the aerosol was fed into a rotating drum. The drum apparatus helps to keep the suspended aerosols from settling out of the air, so that their dynamics can be more closely studied.

Under these controlled conditions, the researchers were able to demonstrate that artificially aerosolized virus remained viable and infectious for three hours, and that therefore it’s “plausible” that, if something causes the virus to aerosolize outside of the lab, this could be another mode of […]

Betsy Todd, MPH, RN2020-03-20T14:14:49-04:00March 20th, 2020|infection control, infectious diseases, Nursing, Public health|4 Comments

1918 Redux: Supportive Nursing Care for the Coronavirus Pandemic Is Courageous Care

Litter carriers at Red Cross Emergency Ambulance Station in Washington, D.C., during influenza pandemic of 1918.

The lessons of the past.

As we struggle to make sense of unfolding data, announcements, and public health directives about the current coronavirus pandemic, appreciating the lessons from past pandemics can help us understand the effectiveness and challenges related to quarantines and social isolation, as well as the need for reliable and timely communications.

In times of public health uncertainty, nurses and nursing care have played a critical role in saving lives and relieving suffering. We now know a great deal about the role of nursing during the 1918 influenza pandemic. Some lessons need heeding now.

Historian Nancy Bristow’s American Pandemic (New York: Oxford University Press, 2012) presents the historical facts clearly. For example, public health officials’ 1918 prohibitions on public gatherings, the sharing of such (then) new personal items as toothbrushes, and school attendance and religious services met acceptance as well as resistance. […]

Guest Author2021-01-21T11:05:06-05:00March 18th, 2020|infectious diseases, Nursing, nursing history, Public health|1 Comment

Permission to Grieve: A Poet Addresses the Unmapped Territory of Pregnancy Loss

You were so new, still more dream than person.

A poetry submission hits a personal chord.

photo by Susanne Nilsson/flickr

As the column coordinator for AJN’s Art of Nursing, which publishes poetry, flash fiction, and visual art related to health and health care, many poems cross my desk. I always appreciate the creativity and emotion in these poems, even when they aren’t quite a fit for our journal. And then there are the ones that not only fit, but that strike a personal chord and stay with me.

“Carrying,” by Katie Manning, PhD, MA, is one such poem. (Click on the PDF for the best version.) It immediately touched me because of the powerful way it described a sensitive topic: pregnancy loss. As a mother who lost a pregnancy in my second trimester, I found myself nodding with tears in my eyes at her elegant descriptions of grief and loss.

The poem received universal praise from our peer reviewers, and when I wrote to Manning to tell her we’d accepted it, I added a personal note about my own experience (something I had never done as an editor). We exchanged words of comfort and spoke about how the topic is not nearly discussed enough.

An […]
Share this:
Facebook
X
X
LinkedIn
Reddit
Pinterest
Email
Print
More
WhatsApp
Tumblr
Pocket
Like this:
Like Loading...

Amy M. Collins, managing editor2020-03-16T12:16:01-04:00March 16th, 2020|patient experience, women's health|2 Comments

Making Sense of Interim CDC Guidance on N95 vs. Surgical Masks for COVID-19

Surprising new CDC guidance.

By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor. Published: March 13, 2020. New posts will appear on this blog about aspects of the pandemic as the situation and our knowledge about the virus continue to evolve.

For nurses, the biggest news this week wasn’t the declaration of the COVID-19 epidemic as an official pandemic. It was the CDC’s release on March 10 of new interim infection prevention and control recommendations for COVID-19.

Many of us were taken aback to read the new document, which recommends the use of regular surgical face masks instead of N95s and the routine placement of patients suspected or confirmed of having COVID-19 infection in private rooms with the door closed instead of housing them in a negative pressure isolation room (which are always in short supply).

Unfortunately, without first acknowledging the concerns such a change from longstanding infection control practice might occasion among nurses and others, the CDC presented it as necessary due to an N95 shortage, stating, “When the supply chain is restored, facilities . . . should return to use of respirators for patients with known or suspected COVID-19.”

While it’s clear the CDC could have crafted this message more carefully, are caregivers being thrown […]

Betsy Todd, MPH, RN2020-03-16T10:25:22-04:00March 13th, 2020|infection control, Public health|2 Comments

Is Your Facility’s Computer System a Patient Safety Risk?

Discussed in this post: “How Often Do EHRs Result in Patient Harm?” (AJN, News, March).

When we first had computers in the hospital—that is, while we still charted on paper but had quick online access to lab, radiology, and pathology results and could easily look up a patient’s prior admission history—it was wonderful. No more little lab slips floating all over the nurses’ station. No more unit-to-unit searches trying to figure out who last had custody of the patient’s X-ray films. (How could objects so large be so easily lost?)

A rocky transition to EHRs.

The transition to almost fully digital charting, on the other hand, has been pretty much a nightmare from the beginning. Nursing was rarely included in initial needs assessments. Many rollouts were chaotic, without additional staffing for the inevitable glitches that are bound to occur. Training of frontline clinical staff has been routinely minimal; we seem to be expected to pick up the many fine points of new software by some kind of digital osmosis.

That elusive clinician friendly EHR.

It’s very clear at this point that electronic health records (EHRs) were designed primarily for data collection and billing purposes. I have yet to see a system that could in any way be […]

Betsy Todd, MPH, RN2020-03-12T08:02:22-04:00March 12th, 2020|digital health, Nursing, Technology|2 Comments