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

Nurse Staffing Matters at the Shift Level—Evidence-Based Scenarios Illustrate How to Apply What We Know

We know that staffing matters. Studies have shown that hospitals with lower proportions of RNs have higher rates of death overall, death following compli­cations (that is, failure to rescue), and other adverse events. But how do such data on staffing translate into what the average hospital nurse experiences on a shift?

That’s the question posed by Gordon West and colleagues, the authors of this month’s CE, “Staffing Matters—Every Shift.” To address it, they reviewed findings from the Military Nursing Outcomes Database (MilNOD). MilNOD, a quality improve­ment and research project conducted in four phases between 1996 and 2009, encompassed data from 111,500 shifts on 56 inpatient units in 13 U.S. military hospitals. The project explored “the effects of staffing levels and skill mix on the probability of patient falls, medication errors, and needlestick injuries to nursing staff.”

As the authors explain, the MilNOD data showed that the number, mix, and experience of nurses on a shift—not just on a unit—were associated with adverse events for patients and needlestick injuries to nurses. West and colleagues offer several realistic, descriptive scenarios to illustrate the potential effects of staffing changes and to show how such knowledge can be applied to daily decision making.

To learn more, read the article, which is free online.—Sylvia Foley, AJN senior editor


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2016-11-21T13:08:46-05:00December 10th, 2012|nursing research|3 Comments

Nursing Research: Alive and Well

By Shawn Kennedy, MA, RN, AJN editor-in-chief

Last week I spent two-and-a-half days in Washington, DC, where there are LOTS of campaign collectibles. My favorite: coffee mugs proclaiming “Friends Don’t Let Friends Vote (insert Democratic or Republican).” Also noteworthy: “Hot for Mitt” and “Hot for Barack” hot sauce (see photos). I was there attending the meeting of the Council for the Advancement of Nursing Science (CANS), where close to 1,000 nursing researchers met to share their work. It wasn’t too long ago that one would have been hard-pressed to find that many nurses doing research. The National Institute of Nursing Research (NINR) only celebrated its 25th anniversary in 2010 (see our 2010 article about their many accomplishments).

Creativity and innovation. Kathi Mooney, PhD, RN, FAAN, from the University of Utah College of Nursing, gave the keynote—and it was perfectly suited to this group, many of whose members are immersed in analytical thought and scientific methodology. Mooney talked about the importance of creativity and innovation in moving research forward—yes, applying scientific rigor to […]

Emergency Contraception: Why It Matters and How Nurses Can Improve Access

By Sylvia Foley, AJN senior editor

Unintended pregnancy can, in some circumstances, be detrimental to the health of both the women who become pregnant and the children born as a result. And such pregnancies happen far more often than you might think, accounting for nearly half of all pregnancies in this country, with even higher rates among women ages 18 to 24 and low-income women. Yet we have had the means to safely prevent such pregnancies for decades, through emergency contraception. Why isn’t emergency contraception used more often?

That’s a question author Kit Devine explores in “The Underutilization of Emergency Contraception,” one of April’s CE features. First, Devine describes the four methods currently available: conventional oral contraceptives and the copper intrauterine device (IUD)—both are used for birth control and can also be used to prevent pregnancy after intercourse has occurred—and the agents levonorgestrel and ulipristal acetate, which are FDA-approved for emergency contraception. Effectiveness ranges from 51% to 62% (for conventional oral contraceptives) to as high as 99% (for IUDs).

Known and likely barriers to their use include […]

2016-11-21T13:10:18-05:00April 16th, 2012|Nursing|1 Comment

Critical Care: Where’s the Evidence for Central Venous Pressure Monitoring?

Editor’s note: This post is by Anne Dabrow Woods, MSN, RN, CRNP, who is AJN‘s publisher and chief nurse and publisher of Wolters Kluwer Health Medical Research. It was originally published on the blog of Lippincott’s Evidence-Based Practice Network.

I read with interest the article Central Venous Pressure Monitoring: Where’s the Evidence?” (purchase required for nonsubscribers) in the January issue of AJN. It’s part of a series called Critical Analysis, Critical Care, which will appraise the evidence regarding common critical care practices. So much of what we do in nursing is not based on evidence but on how we have always done things in practice—or on research that was not credible.

This article looks at the evidence supporting the use of central venous pressure (CVP) monitoring alone to guide treatment decisions for patients. According to the article, a 2008 systematic review by Marik and colleagues concluded that CVP is not an accurate indicator of intravascular volume, nor is it an accurate predictor of fluid responsiveness (whether a patient will respond to a fluid bolus with an increase in stroke volume). The authors of the AJN article critically appraised the evidence and determined the following:

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