Measles Outbreaks, and an Unexpected Vulnerability

The second-greatest number of cases since ‘elimination.’

3D graphical representation of spherical-shaped, measles virus particle studded with glycoprotein tubercles. CDC/ Allison M. Maiuri, MPH, CHES

Last month, a state of emergency—which has now been halted by state court—was declared in nearby Rockland County, New York, barring children who hadn’t been vaccinated against measles from public places. The unprecedented step made worldwide news and highlights the public health measures being taken to stem the six currently ongoing measles outbreaks in the United States.

Measles was eliminated in the United States in 2000, but outbreaks have occurred since, increasingly so in recent years. The CDC reported this week that almost 400 cases of measles have been confirmed in 15 states during the first three months of this year alone. This is the second-greatest number of reported cases since eradication of the disease. The most—667 cases—occurred in 2014.

Public health authorities are clear about the cause of these outbreaks: people contract measles abroad and bring it back to the United States, where groups of people who are unvaccinated are particularly susceptible to developing and spreading this highly contagious disease. Up to 90% of unvaccinated […]

2019-04-08T07:55:37-04:00April 8th, 2019|infectious diseases, Nursing, Public health|3 Comments
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Violence Against Health Care Workers: Time for a Zero Tolerance Approach

“Staff should know implicitly that they don’t have to work in an unsafe environment . . . “

The October issue of AJN has two articles that focus on workplace violence. We’ve shared them through social media—and sadly, the response and comments indicate that this information is sorely needed.

One, described in last week’s blog post by clinical editor Betsy Todd, is an article from a health system reporting on how they developed an innovative program to train their employees to deal with violent situations.

‘Staggering numbers.’

The second article (free until Nov. 8) is from nurse and attorney Edie Brous, our contributing editor and coordinator of our legal column, and covers what staff should expect from management in striving for safe workplaces. The numbers of workplace injuries and violent episodes are staggering—the CDC, Bureau of Labor Statistics, and other government agencies dealing with health and safety all show significant increases in the last five to ten years. Brous cites many of these data and notes, “The health care industry experiences almost as many violent injuries as all other industries combined.”

Organizations must be proactive . . . and held accountable.

What responsibility do health care organizations have? Brous writes:

“Organizations must be proactive in protecting their workforce and held accountable for […]

2018-10-25T10:18:03-04:00October 25th, 2018|Nursing|0 Comments
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Hitting the Nursing Conference Trail: Many Miles, But Much to Inspire

“Nurses are doing such interesting and important work.”

A big part of what we do at AJN is seek out the latest information and compelling stories to bring to readers each month. That often means a lot of traveling. While sometimes it does get a bit much (conferences are mostly clustered in the spring and the fall), I’ve come to enjoy traveling—nurses are doing such interesting and important work!

Here’s a recap of some recent travels:

Nursing Research

2016-11-21T13:00:52-05:00November 2nd, 2016|Nursing|0 Comments
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CDC Opioid-Prescribing Guideline for Chronic Pain: Concerns and Contexts

by frankieleon/ via flickr by frankieleon/ via flickr

By Jacob Molyneux, senior editor

The CDC’s new Guideline for Prescribing Opioids for Chronic Pain was released this week. The context for this comprehensive new guideline is widespread concern about opioid-related overdose deaths and substance abuse in the U.S.

The guidelines make 12 main recommendations, among them the following:

  • nonpharmacologic or nonopioid pharmacologic treatments should be considered “preferable” first-line therapy for those with chronic pain.
  • a daily opioid dosage limit of morphine milligram equivalents should be imposed.
  • immediate-release opioids should be prescribed before moving to extended-release formulations.
  • urine testing should precede new opioid prescriptions for chronic pain and treatment goals should be set.
  • clinicians should prescribe the lowest possible number of days’ worth of medication for acute pain (often three days or less).
  • prescription drug monitoring program (PDMP) databases should be consulted to determine patients’ past histories of opioid prescriptions.

Some of the recommendations would seem to be no-brainers, such as consulting PDMPs when writing new prescriptions. Others, such as a “one-size-fits-all” daily dosage limit and restrictions on the use of extended release formulations, have raised alarms among pain management experts. See, for example, “I’m Worried About People in Pain,” a recent AJN Viewpoint essay by Carol Curtiss, a nurse and pain management expert, who notes the increased stigmatization experienced by pain patients and the chilling effects of new […]

2016-11-21T13:01:23-05:00March 17th, 2016|Ethics, Nursing, nursing perspective, pain management, patient engagement|4 Comments
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Practical Steps for Nurses to Reduce Prescription Opioid Diversion

By Shawn Kennedy, AJN editor-in-chief

“Opioids diverted from friends and family members who have legitimate prescriptions are a major source of abused prescription opioids.”

More than 800 lbs. of drugs have been collected in Lycoming County, PA, since drug collection boxes were placed in law enforcement agencies over a year ago, allowing residents to safely dispose of unwanted drugs. Here the drugs are separated from their containers before incineration. Photo courtesy of Karen Vibert-Kennedy / Williamsport Sun-Gazette. More than 800 lbs. of drugs have been collected in Lycoming County, PA, since collection boxes were placed in law enforcement agencies over a year ago, allowing residents to safely dispose of unwanted drugs. Here the drugs are separated from their containers before incineration. Photo courtesy of Karen Vibert-Kennedy / Williamsport Sun-Gazette.

Amid recent reports from the CDC drawing attention to a prescription painkiller and heroin overdose epidemic, last week President Obama announced an initiative to address both prescription drug and heroin abuse in the United States. In addition to a […]

2016-11-21T13:01:50-05:00October 28th, 2015|Nursing, pain management, Patients|0 Comments
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