AJN in October: Oral Treatments for Breast Cancer, PAD in Older Adults, Research or Not Research, More

The October issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: A Review of Common Oral Treatments for Breast Cancer: Improving Patient Safety in Nononcology Settings

According to the National Cancer Institute, more than 3 million women in the United States are currently living with a breast cancer diagnosis. Many seek care in nononcology settings for treatment, acute symptoms and complaints related to their cancer diagnosis, or unrelated concerns. Yet many nononcology providers are unfamiliar with the various oral agents used to treat breast cancer and their possible adverse effects and drug interactions. This article provides an overview of the most common oral treatments for breast cancer and discusses common adverse effects and management.

CE Feature: “Assessing Pain, Agitation, and Delirium in Hospitalized Older Adults

In the acute care setting, pain, agitation, and delirium (PAD) often occur as interrelated parts of a syndrome rather than as separate entities. Because the three facets of PAD may be similar in presentation, it is often difficult for clinicians to recognize the syndrome and to assess and treat it. The challenge is particularly great in older patients. This article provides an overview of each aspect of PAD, discusses clinical considerations related to the assessment and treatment of the syndrome in older adults receiving acute care, and illustrates the application of published PAD guidelines.

Perspectives on Palliative Nursing:For Advanced Cancer, What Treatment is Next?

This second installment in a series on palliative care developed in collaboration with the Hospice and Palliative Nurses Association, discusses how nurses can best serve patients faced with the choice between aggressive treatments and palliative or hospice care.


October 4th, 2016|Nursing|0 Comments

Injurious Falls in the Hospital Setting

by Maureen Shawn Kennedy, AJN editor-in-chief

PatOriginal.00000446-201609000-00022.FF1ient falls are, unfortunately, a frequent occurrence in hospitals and the consequences can vary from none to serious life-threatening injuries. There has been a lot of attention focused on identifying those at high risk for falls and effective prevention measures, but according to our September CE feature, there’s been little attention focused on falls that cause injuries. In this original research study, Predicting Injurious Falls in the Hospital Setting: Implications for Practice, Amy Hester and colleagues at the University of Arkansas for Medical Sciences conducted a retrospective review of medical records to see if they could pinpoint which patient factors were associated with falls with injuries. Their results may surprise you.

Here’s the abstract:

Background: Despite years of research and increasingly evidence-based practice, falls continue to be the most commonly reported adverse events experienced by hospitalized adults. Yet a majority of the relevant research has focused on predicting and preventing falls in general; there has been little focus on injurious falls.

Purpose: The purpose of this retrospective study was to determine which patient factors are associated with injurious falls in hospitalized adults.

Methods: The study site’s adverse event reporting database was used to identify 1,369 patients who fell between January 1, 2006, and October 31, 2013. Of these, 381 (27.8%) subjects suffered injurious falls. Variables of interest included age, sex, fall history, use of diuretics, use of central nervous system medications, cognitive impairment, primary discharge diagnoses, abnormal laboratory values, impaired mobility, and […]

August 31st, 2016|Nursing, nursing research|0 Comments

‘Do You Consider Yourself Healthy?’ Study Sheds Light on RNs’ Lifestyle Practices

By Sylvia Foley, AJN senior editor

Over the past decade, the lifestyle practices of nurses and their connection to quality of care and patient outcomes have been gaining attention. Indeed, according to the patient-centered, relationship-based care model, one of the main conditions for optimal care is that providers engage in healthy self-care behaviors. Yet there is some evidence suggesting that RNs don’t consistently do so, especially when it comes to exercise and stress reduction—even when they believe they should.

Nurse researchers Karen Thacker and colleagues recently conducted a study to learn more. They report their findings in this month’s CE–Original Research feature, “An Investigation into the Health-Promoting Lifestyle Practices of RNs.” Here’s a brief summary:

Purpose: To gather baseline data on the health-promoting lifestyle practices of RNs working in six major health care and educational institutions in southeastern Pennsylvania.
Methods: The 52-item Health-Promoting Lifestyle Profile II instrument was used to explore participants’ self-reported health-promoting behaviors and measure six dimensions: health responsibility, physical activity, nutrition, interpersonal relations, spiritual growth, and stress management.
Results: Findings revealed that physical activity and stress management scores were low for the entire group of RNs. There were statistically significant differences between nurses 50 years of age and older and those 30 to 39 years of age for the subscales of health responsibility, nutrition, and stress management, suggesting that older nurses are more concerned about their health. Sixty-seven percent of participants reported having too many competing priorities and had significantly lower subscale scores for spiritual growth, interpersonal relations, and stress management, as well as significantly lower total scores.
Conclusion: The findings provided baseline data that will be useful in planning health-promoting lifestyle interventions for participants specific to their institutions, and that may help guide future research and educational initiatives. […]

Have You Fallen Prey to a Predatory Publisher?

Predatory publishers promise prompt, easy publication. The hidden charges come later, as well as the realization that the journal has no real standing or quality control. Not only is this bad for potential authors, it’s bad for knowledge, flooding the market with inferior information made to superficially resemble the information you need.

Imagine this scenario: You receive an email from a seemingly respectable journal inviting you to submit a paper for publication. You’ve wanted to publish on this topic for some time, and this journal promises you a quick review and publication within a few months. As a new author, you are thrilled . . . that is, until you get charged an outrageous processing fee upon turning the article in. You’ve just fallen victim to a predatory publisher.

Unfortunately, this scenario is becoming all too common. These journals are often difficult to spot, with their professional-looking Web sites and names that sound legitimate, if a little vague. In fact, just recently at AJN, we stumbled across a Web site featuring a journal that looked a lot like ours and had a very similar name. (Jeffrey Beall, a librarian at the University of Colorado, has been tracking predatory publishers since 2009 and maintains a list of them on his Web site, Scholarly Open Access.)

shawnkennedyIn our April issue, editor-in-chief Shawn Kennedy tackles this topic in her editorial, “Predatory Publishing Is No Joke.” As Kennedy explains, predatory publishers “take advantage of the relatively new open access model in publishing,” in which authors “pay the publisher a fee in order to make their article freely available or ‘open’ to all.” […]

Noise in the ICU: Terminology, Health Effects, Reduction Strategies, and What We Don’t Know

By Jacob Molyneux, AJN senior editor

Noise isolation headphones to use in loud environments via Wikimedia Commons

I woke up this morning, as I do every morning now, to the sound of pile driving at a large construction site a block and half away on the Gowanus Canal. It shakes the earth and reminds me of the forges of evil Sauron in one of the Lord of the Rings movies. I once had a dog lose a good bit of hair when there was a pile driver for several months in the lot behind another apartment in Brooklyn.

The negative physical and emotional effects of excessive noise get an occasional mention lately in health reporting, but in New York City or along the remotest forest lane, the forces of quiet can seem to be in rapid retreat before an army of leaf blowers, all-terrain vehicles, diabolically amped-up motorcycles, huge TV sets, garbage trucks, helicopters, and the like.

Lest I sound like a total crank (I do have useful noise-cancelling headphones plus an Android app that offers such choices as white noise, brown noise, burbling creek, steady rain, crickets, and soothing wave sounds), there’s a reason for the preamble. Florence Nightingale herself called unnecessary noise “the most cruel absence of care which can be inflicted either on sick or well,” as is pointed out by the University of Washington researchers who wrote the latest installment of our column Critical Analysis, Critical Care.