AJN’s June Issue: Fracking, Assessing Sleep in Teens, Preventing CAUTI, More

AJN0613.Cover.3rd.inddAJN’s June issue is now available on our Web site. Here’s a selection of what not to miss.

Fracking hazards. Though we’re moving into summer, our cover does not depict a jar of fresh, local honey. It is a photograph of Washington County, Pennsylvania, resident Jenny Smitzer, holding a jar of contaminated tap water that turned that color af­ter natural gas drilling began in 2005 above her farm. Even the best water filter jug can’t purify this. Eleven U.S. states currently engage in natural gas hydrofracking (“fracking”), and eight more are either considering or preparing for this method of gas drilling.

For an in-depth look at the potential health hazards caused by fracking, such as air pollution, working hazards, and water pollution, see our Environments and Health article, “Fracking, the Environment, and Health.” If you’re reading AJN on your iPad, you can listen to a podcast interview with the authors by clicking on the podcast icon on the first page of the article. The podcast is also available on our Web site.

Most teens get far less than the nine hours of sleep a night they require, which could affect their mental and physical health. An understanding of sleep physiology is essential to helping nurses better assess and manage sleep deprivation in teens. “Assessing Sleep in Adolescents Through a Better Understanding of Sleep Physiology” provides an overview of sleep physiology, describes sleep changes […]

2016-12-17T14:39:29-05:00May 24th, 2013|Nursing|0 Comments

From the Blogs: Negotiating Medicare, Nurses Doing Research, Reader Comments

[youtube=http://www.youtube.com/watch?v=oOClkw1TNks&feature=player_embedded]
Medicare is confusing for providers who aren’t yet familiar with it. Here’s a Nursetopia post that draws attention to its complexity and notes the useful video above (it’s one of a series of videos on different aspects of Medicare). Those of you who know all about it already: Drop by her thoughtful (and consistently updated!) blog and let her know your own tips on handling the ins and outs of Medicare and Medicaid.

EBP matters. Terri Schmitt at Nurse Story has a frank and engaging post on evidence-based practice (EBP): “Translation of EBP: Why Creating Nurse Scientists is the Way to Improve Patient Outcomes.” Here’s what she promises to cover in it:

  • Research is sometimes far removed from bedside nurses
  • Research is COOL!
  • Research is about PATIENTS and not fame/fortune of researcher
  • Research is critical to practice and there are big gaps that nurses need to fill
  • Bedside nurses may be the most crucial link in research ideas, translation, and practice.

(Shameless plug for related AJN content: See our recent, amazingly useful step-by-step CE series on how nurses can get involved in evidence-based practice.)

Plus a brief note on reader comments: we’ve been getting a lot of great comments lately on this blog, and we’re grateful for that. So thank you. A fair number of the comments were on posts from previous months, such as this post comparing U.S. and Australian health care systems. Is somebody by chance teaching a nursing course that requires students to leave thoughtful, respectful, engaged comments in the blogosphere? If […]

When Timely Nurse Removal of Urinary Catheters Reduces UTI Rate

By Christine Moffa, MS, RN, AJN clinical editor

Ever since we started the Cultivating Quality column at AJN, manuscripts featuring evidence-based quality improvement projects have been pouring in. There is a lot of great work being done at the bedside by practicing nurses, and this column provides the opportunity to share their ideas with others.

This month’s Cultivating Quality installment, Reducing Rates of Catheter-Associated Urinary Tract Infection, comes from Joyce Wenger, MS, RN, the infection control performance improvement coordinator at Lancaster General Hospital, Lancaster, PA. According to the CDC, urinary tract infections (UTIs) account for more than 30% of hospital-associated infections, and almost all are “caused by instrumentation of the urinary tract.” Nursing staff were able to reduce catheter-associated urinary tract infection (CAUTI) rates using a three-pronged approach “beginning with education, progressing to tests of new and better products, and ending with the nurse-driven protocol for catheter removal.”

That last part is my favorite. In most facilities a doctor or nurse practitioner has to write an order before a Foley catheter can be removed from a patient. Patients may end up spending several days at increased risk for UTI because of an unnecessary urinary catheter in place. This hospital came up with a plan to give nurses the autonomy to remove them—which makes sense, since they’re the ones checking the patient daily. The team at Lancaster General created the following list of criteria that patients need to meet in order to maintain […]

Searching for the Evidence? AJN Series Demystifies EBP

By Shawn Kennedy, AJN interim editor-in-chief

Trying to get evidence-based practice (EBP) implemented in your hospital or nursing home? Running into problems or just not quite sure how to proceed? Well, AJN has the answer.


EBP should be the basis for any clinical practice. Since last November, AJN has published a series of articles by the faculty at Arizona State University College of Nursing and Health Innovation’s Center for the Advancement of Evidence-Based Practice. Articles are published every other month and are designed to take the reader, step-by-step, towards implementing EBP. The current article describes the beginning steps to appraising the evidence; or go here to read the first article and follow in sequence.

Listen to a podcast with series leaders Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FNAP, FAAN, and Ellen Fineout-Overholt, PhD, RN, FNAP, FAAN, the authors of Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. And we’ll have a second “Ask the Authors” call in November (check our home page for details after November 1).

If you’ve had problems or hit snags on your journey to EBP, e-mail me (shawn.kennedy@wolterskluwer.com) so we can address these issues on our next call.

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If You Think ‘Evidence-Based Practice’ Is Just Another Buzzword, Think Again

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. In many hospital EDs across the country, children with asthma are treated with albuterol delivered with a nebulizer, even though substantial evidence shows that when albuterol is delivered with a metered-dose inhaler plus a spacer, children spend less time in the ED and have fewer adverse effects. Nurses even disrupt patients’ sleep, which is important for restorative healing, to document blood pressure and pulse rate because it’s hospital policy to take vital signs every two or four hours, even though no evidence supports that doing so improves the identification of potential complications.

That’s from the start of an article in the November issue of AJN, the first in a new series we are running to highlight the way’s evidence-based practice (EBP) changes what nurses do at the bedside—and saves lives. The authors point out that every day nurses perform dozens of actions and procedures without ever really asking whether the way they are doing them is the best way, or whether or not they are even helping patients by performing these actions.

While […]

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