Decreasing ED-Acquired Pressure Injuries

Perfect candidates for developing pressure injuries.

The photos of EDs crowded with patients waiting for admission at the height of the COVID-19 surges brought back many memories of clinical days in Bellevue’s ED. But even on our worst evenings, it was never like what I saw in those photos in the news media. And in some places, the ED hallways still have lines of stretchers with patients waiting to be sent to units.

In busy hospitals, patients can wait hours, sometimes a full day, on stretchers in the ED, waiting to be sent to a patient care unit. And we know that if they are being admitted for inpatient care, they usually have complex medical needs—many of these patients may be unable to ask for help, be incontinent, or unable to move themselves. These patients are perfect candidates for developing pressure injuries (PIs).

PIs can develop in a matter of hours.

As an article in the February issue of AJN notes, pressure injuries can develop in a relatively short time (the authors cite studies that found hospital-acquired PIs can “occur in as little as two hours of unrelieved pressure”).

The article, “Pressure Injury Prevention in Patients with Prolonged ED Stays Prior to Admission,” details how a nurse-led evidence-based practice (EBP) team sought to decrease hospital-acquired pressure […]

2021-02-16T14:23:23-05:00February 16th, 2021|Nursing|0 Comments
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June Issue: Sickle Cell Complications, Stoma Skin Care, Promoting Nurse Retention, More

“I am as grateful to the nurses who work in hospitals serving the sickest and most vulnerable patients as I am to the nurses who have chosen a path focused on policy and public service.”—Virginia Reising, author of the June Viewpoint column, “What Is a Nurse?“

The June issue of AJN is now live. Here are some highlights.

CE: Understanding the Complications of Sickle Cell Disease

In this evidence-based review, the authors examine the genetic, hematologic,
and clinical features of sickle cell disease and describe its major
health complications—as well as the nursing implications of each.

CE: Stoma and Peristomal Skin Care: A Clinical Review

Written for nurses who are not ostomy specialists, this article provides information about the care of stomas, including the normal stoma, with a focus on early and late complications of the stoma and peristomal skin.

Original Research: Exploring Working Relationships Between National and Expatriate RNs on Humanitarian Aid Missions: The Perspectives of Liberian Nurses

The authors of this qualitative study explored the perceptions and concerns of Liberian RNs who work for international nongovernmental organizations in Liberia, yielding insights on how to improve collaboration between national and expatriate nursing staff.

EBP 2.0: Implementing and Sustaining Change: Promoting Nurse Retention Through Career Development Planning

This second article in a new series on […]

2019-05-28T09:42:37-04:00May 28th, 2019|Nursing|0 Comments
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Revisiting Evidence-Based Practice, and ‘Making Change Stick’

Do you ever wonder why nurses engage in practices that aren’t supported by evidence, while not implementing practices substantiated by a lot of evidence? In the past, nurses changed hospitalized patients’ IV dressings daily, even though no solid evidence supported this practice. When clinical trials finally explored how often to change IV dressings, results indicated that daily changes led to higher rates of phlebitis than did less frequent changes.

That’s the beginning of the first article in our first “step by step” series, Evidence-Based Practice, Step by Step, launched in November 2009. It won the Nursing Print Media Award for Nursing Excellence from Sigma Theta Tau International; the 12 articles in the series continue to be among the most highly viewed of any AJN articles online.

Nurses know about EBP, but changing practice is another thing.

The continued popularity of the articles made us wonder if the tenets of EBP were still not adequately known by nurses. So we asked the experts, and the result is our new series, EBP 2.0: Implementing and Sustaining Change.

Sharon Tucker, PhD, RN, FAAN, and Lynn Gallagher-Ford, PhD, RN, NE-BC, DPFNAP, FAAN, both  at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College of […]

2019-04-17T08:43:00-04:00April 17th, 2019|Nursing, nursing research|1 Comment
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April Issue: IV Patient-Controlled Analgesia Errors, Implementing EBP, Nurses and Climate Action, More

“Think about your own workplace: do you take pride in what you do, feel that you and your work are valued, and enjoy the team you work with? Do the good days outweigh the bad days?”—AJN editor-in-chief Shawn Kennedy in her April editorial

The April issue of AJN is now live. Here are some highlights.

CE: Original Research: Errors in Postoperative Administration of Intravenous Patient-Controlled Analgesia: A Retrospective Study

The authors describe and analyze the errors associated with the use of IV patient-controlled analgesia at a large medical center in South Korea.

CE: A Historical Review of Nurse–Physician Bedside Rounding

How has the nurse’s role in bedside rounding evolved since the 19th century? This article discusses the challenges of nurse participation in bedside rounding from 1873 to 1973.

Sustaining Nursing Grand Rounds Through Interdisciplinary Teamwork and Interorganizational Partnership

The authors present the implementation of a grand rounds program at their naval hospital, and demonstrate how nursing grand rounds can support professional growth and strengthen partnerships.

New Series: EBP 2.0: Implementing and Sustaining Change: From Strategy to Implementation

Our follow-up to the popular Evidence-Based Practice, Step by Step series (which appeared in AJN from 2009 to 2011) is focused on the most challenging of the seven EBP steps—implementation.

Environments and […]

2019-03-25T09:53:59-04:00March 25th, 2019|Nursing, nursing history|0 Comments
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How Should We Measure Temperature in Young Children?

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Photo courtesy of Exergen Corporation. Photo courtesy of Exergen Corporation.

Do you dread taking rectal temperatures in pediatric patients, knowing that your action will leave you with a screaming, distrustful child as well as a distressed parent? Rectal temperature measurements have long been considered the “gold standard” for accuracy. But are they essential in very young children, especially when infection is not suspected?

“Improving Pediatric Temperature Measurement in the ED” in our September issue relates how a group of ED nurses explored possible alternatives to routine rectal temperature measurements during triage. Their ED protocol had been to use this method in all children under the age of five. However, this practice extended the time needed for triage, was often upsetting to parents, and seemed potentially unnecessary when the reason for the ED visit did not suggest infection (where there would be a need for more careful fever assessment).

An existing emergency services committee made up of ED staff nurses from the hospital’s two campuses set out to explore their options. The committee’s first move was to clearly define the practice problem:

Using PICOT format (Patient population, Intervention of interest, Comparison intervention, Outcome, Time frame), the committee initially formulated the following clinical question: For pediatric patients younger than five years of age (P) who require temperature […]

2016-11-21T13:02:01-05:00September 10th, 2015|Nursing, Patients|0 Comments
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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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