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
Read More

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:

2016-11-21T13:10:59-05:00January 13th, 2012|nursing perspective, nursing research|0 Comments
Read More

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 […]

2016-11-21T13:11:21-05:00November 29th, 2011|nursing research|0 Comments
Read More

On Protocols, Shortcuts, and the Unforgettable Smell of Ether

By Linda Johanson, EdD, RN, associate professor of nursing at Appalachian State University, Boone, NC

In nursing school my professors warned us of the dangers of taking shortcuts when performing procedures. They cautioned that deviations from protocols could lead to serious error. I had to learn this lesson the hard way, and although it’s been about 30 years since I made this mistake, I still remember the occasion like it happened yesterday.

The patient was in ICU bed #10, a glassed-in isolation room across from the nursing station. He was in his mid-60s, but he was mentally handicapped, so he appeared and acted younger. He was in the unit recovering from a respiratory arrest, and on the day I was caring for him he was still intubated, but breathing spontaneously.

I was completing an assessment on him when the charge nurse called to me from the nursing station, and I stuck my head out the door to see what she wanted. She told me there was a new order to remove the patient’s indwelling urinary catheter. I checked my pockets for a 10 mL syringe to perform the procedure but didn’t find one.

When I complained about having to go all the way to the supply room to collect one, the charge nurse queried, “Well, […]

2016-11-29T13:29:41-05:00November 9th, 2011|nursing perspective|9 Comments
Read More

One Take on the Top 10 Issues Facing Nursing

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

So I’ve been in Dallas at the Sigma Theta Tau International (STTI) biennial meeting. The venue is the Gaylord Texan, a large, climate-controlled resort under a glass dome—as you leave your building and walk “outside,” you’re really not. Don’t believe the flowing stream or flowers or gardens (all real) along the walkways, or the Longhorn steer (fake) behind a fence that stands outside my building—you’re still inside. And to make it even more surreal, there are Christmas holiday decorations everywhere, including a gingerbread house the size of a small hotel room. It will be strange to step back in time to Halloween when I get back home.

A daunting list. There are a few thousand people here for the meeting, way too many sessions to choose from (20 different topics for each concurrent session period), plus rows of posters and exhibit booths. And of course, great networking. One lively session I attended was standing room only—and that’s after any floor space had been occupied by people sitting cross-legged. It was a discussion of the top 10 issues facing nursing, led by STTI’s publications director Renee Wilmeth (she’s not a nurse, which probably makes her less biased). The issues were compiled from responses provided by 30 nursing leaders, and were presented in question form:

  1. Is evidence-based practice (EBP) helpful or harmful? (Amazing how many interpretations there were of EBP, some of them—as I know from our […]
2016-11-21T13:11:34-05:00October 31st, 2011|students|10 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top