Revising Protocols in the Midst of Disaster Response

Refining an unsuccessful triage process.

Health care moves at such a rapid pace these days that quality improvement (QI) seems to be never-ending. We know these projects can help us to better our care, but it sure does become tiring when yet another new protocol or data responsibility falls on our shoulders. What if you were tasked with an urgent QI project in the midst of responding to a disaster?

Considering our own repeated scrambles to squeeze QI into ordinary workdays, imagine what it would be like to manage QI in a setting of extremely limited resources, where many people were desperate for emergency services—and you had to “get it right,” ASAP.

In “Implementing a Fast-Track Team Triage Approach in Response to Hurricane Maria” (free until November 15), Brittany Parak and colleagues describe their efforts to improve emergency services after their mobile military hospital was deployed to Puerto Rico, just 16 days after Hurricane Maria devastated the island.

“We soon discovered it would be necessary to refine our triage process, as our initial strategy resulted in limited access to care, prolonged wait times, many people leaving without being seen, and patients with acute problems not being cared for in a timely […]

2019-10-24T10:04:30-04:00October 24th, 2019|Nursing, Public health|0 Comments
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What Can We Do About Vaccine Misinformation?

“ . . . schools reported immunization rates ranging from 19% to 100%, with an average of 91%. . . . Alarmingly, one school reported that none of its students had been vaccinated.”

This year’s measles and mumps outbreaks are a reminder that many of us still think of vaccination as only a personal health practice. We forget that it is also something we do as a member of a community. When a vaccine-preventable disease starts to circulate, every vaccinated or otherwise immune person is a transmission dead end. It’s as though the virus skids to a stop in front of us, unable to pass through the closed door of our immunity to continue to replicate and spread disease.

In “Countering Vaccine Misinformation” in this month’s AJN, Lindsey Danielson and colleagues discuss vaccines, health literacy, and the ease with which misinformation can proliferate on social media. They emphasize the importance of understanding different kinds of opposition to vaccination:

“Vaccine hesitant describes a person who is hesitant about vaccines but still receptive to scientific evidence, while vaccine denier refers to a person who is against vaccination, denies scientific evidence, and uses rhetorical arguments to give the false appearance of legitimate debate.”

[…]

2019-10-21T07:57:26-04:00October 21st, 2019|infectious diseases, Nursing, nursing roles, Public health|1 Comment
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During Domestic Violence Awareness Month, Two Articles Examine Actions Nurses Can Take

Two articles in this month’s issue will increase nurses’ awareness of the realities of domestic violence and point to ways they can respond.

A school nurse and women’s advocate.

“Every year, I have mothers of students who are experiencing domestic violence. I see parents and children who are affected by this issue. It’s our job as nurses to see problems and to try to identify causes, trends, and possible solutions.”

The above quote is from Dawn Wilcox, BSN, RN, who was speaking in her capacity as an elementary school nurse, noting that violence against women is a preventable public health issue, one she regularly encounters in her nursing practice.

Wilcox, who I interviewed for this month’s Profile, is also the creator of the United States Femicide Database, accessible on the website of her organization, Women Count USA. It’s the only such catalog of vital details about the women and girls killed by men and boys each year in the United States.

In the article, Wilcox provides practical tips for nurses who are unsure of how to address discrimination, harassment, and violence toward women and girls. For additional information, listen to our discussion on AJN’s Behind the Article podcast.

Asking questions.

In “When ‘Love’ = Death,” which […]

2019-10-16T11:43:24-04:00October 16th, 2019|Nursing, Public health|0 Comments
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Precision Medicine as a Nursing Competency

Precision medicine, genomic-driven treatment, phenotyping—it all sounded like too much dense material to cover in one article. But I’m happy to say that the authors of the October CE feature, “Knowledge of Precision Medicine and Health Care: An Essential Nursing Competency,” take this complex content and present it in a clear, straightforward, and interesting way.

‘Omics’ sciences.

We’re delighted to be able to bring you this timely and important content. As the authors explain, advances in the study of genes have given rise to the ‘omics’ sciences—the study of how genes function and how treatments can be tailored to an individual’s genetic makeup, i.e., precision medicine. While we’ve long found ways to tailor care to specific characteristics determined all or in part by genetic differences—–for example, prescription lenses to correct vision, blood typing—the completion of the Human Genome Project has given impetus to using genomics in many areas of care.

The completion of the Human Genome Project . . . provided insight into both mutations (genetic variations that occur in less than 1% of the population) and polymorphisms (genetic variations that are sufficiently common to be considered normal). Genetic variations confer not only such unique individual characteristics as eye color and blood group, but also susceptibility to such diseases as sickle cell and Tay–Sachs as well […]

2019-10-15T11:56:26-04:00October 15th, 2019|Nursing|0 Comments
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National Pregnancy and Infant Loss Remembrance Day: Stories That Stay With You

by dave shafer/via flickr

October 15 is National Pregnancy and Infant Loss Remembrance Day, a day of remembrance for those who have suffered a miscarriage, stillbirth, or infant loss. Ronald Reagan proclaimed October a month for recognizing this kind of loss in 1998, and a resolution to declare October 15 a day of remembrance was passed by the United States House of Representatives on September 28, 2006, following an initiative by three mothers who had suffered losses.

The day serves to promote greater awareness, remembrance, and support of the estimated one in four individuals and families whose lives are altered by the death of their children during pregnancy, at birth, and in infancy.

‘A lonely grief.’

In a way, I wish I didn’t know this. I myself suffered an unexpected, second-trimester loss two years ago. The grief, excruciating in the days and months that followed, has subsided, but never fully disappears. It is a “lonely” grief. I found that miscarriage and infant loss is a topic a lot of people tend to shy away from—they don’t always know what to say or sometimes say something unintentionally hurtful (it was God’s will, you can go on to have more children).

This can be very isolating. Only through talking about […]

2019-10-11T09:57:32-04:00October 11th, 2019|Nursing|1 Comment
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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.
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