AJN’s December Issue: Staffing Issues, Wandering in Dementia, Type 2 Diabetes Meds, More

AJN’s December issue is now available on our Web site. Here’s a selection of what not to miss, including two continuing education (CE) articles, which you can access for free.

Data from the Military Nursing Outcomes Database project demonstrate that inadequately staffed shifts can increase the likelihood of adverse events. But what does this mean for the average nurse on a shift? In “Staffing Matters—Every Shift,” the authors present common dilemmas hospitals face in nurse staffing, illustrating the potential hazards for patients and nurses alike. This CE article is open access and can earn you 2.1 CE credits.

People with dementia are at risk for both missing incidents and wandering. In “Missing Incidents in Community-Dwelling People with Dementia,” the authors differentiate between these two risks, describe personal characteristics that may influence the outcomes in missing incidents, and suggest strategies for preventing and responding to missing incidents. This CE article is open access and can earn you 2.1 CE credits. For more information, listen to a podcast with the authors.

There is a growing consensus that primary care providers can better address patients’ needs by using different models of care, such as the patient-centered medical home. “The Patient-Centered Medical Home” discusses the guiding principles of this model, nurse care coordination, reimbursement and implementation, cost-effectiveness and quality improvement, and the need for greater nurse advocacy.

Being unaware of the realities of licensure can damage a nurse’s career, even […]

2016-11-21T13:08:50-05:00November 30th, 2012|Nursing|0 Comments

Individualized A1c Targets for Type 2 Diabetes

By Jane Seley, DNP, MPH, MSN, BC-ADM, CDE, diabetes nurse practitioner at New York Presbyterian/Weill Cornell Hospital, New York City

On April 19th, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) released a joint position statement online that represented a giant step forward in the care of people with type 2 diabetes. “Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach” is a comprehensive yet easy to read primer in the most up-to-date therapies, one that also emphasizes individualizing care as the key to success.

An example of the patient-centered approach of this position statement is a refinement of the customary across-the-board hemoglobin A1c test target recommendation of less than 7% for most people with type 2 diabetes, with pre-meal blood glucose (BG) targets of less than 130 mg/dL and post-meal targets of less than 180 mg/dL. The position statement suggests “more stringent” targets of 6%–6.5% for “selected” patients who are younger and in good health, but safer targets of 7.5%–8% for older patients who have comorbidities or are prone to hypoglycemia.

When discussing therapeutic options, each medication is ranked according to its potential for lowering A1c, risk of hypoglycemia, effect on weight, adverse effects, and cost. In addition, the clinician is encouraged to individualize the treatment regimen by considering age, weight goal, and comorbidities such as heart disease and kidney function. For example, if losing weight is an important consideration for the […]

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