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Think About It
A forum for discussion of the latest news and ideas in nursing management and healthcare.
Wednesday, April 29, 2015
April showers bring May flowers and our Nurses Week issue of Nursing Management! It has some fantastic topics from our update on Value-Based Purchasing (CE) to the Leadership Q&A question on engaging recent grads.

Specifically for Nurses Week, the theme of which is "Ethical Practice. Quality Care," is the article on writing effective anti-bullying policies. Bullying has received a lot of attention, most recently, a Marie Claire article was published highlighting the unfortunate outcomes of workplace bullying, including:

  • 85% of nurses have been verbally abused by another nurse
  • approximately 1 in 3 nurses (worldwide) quits because of bullying
  • bullying, not pay, appears to be the major cause of the nurse shortage.

    These are harrowing statistics, however, nurse leaders have the power to help fix the problem. With this information in mind, leaders can be more aware of bullying and harassment that may occur in their organizations. Our anti-bullying article outlines behaviors to look for and provides a sample policy as well as a performance improvement plan. It’s up to leaders to help put a stop to this unwanted behavior, and there’s no better time than the present.

    Have you implemented any anti-bullying policies in your organization? Share your story in the comments.

  • Tuesday, April 28, 2015

    An interesting article was recently published about providing acute care at home. This idea isn’t entirely new or radically different than "standard" home healthcare, but it’s garnering attention. The New York Times article references a study from 2005 that examined the safety, efficacy, clinical and functional outcomes, patient and caregiver satisfaction, and costs of providing acute hospital level care in a hospital-at-home instead of admission to an acute care facility.

    Study participants were community-dwelling older adults who required admission for an acute care facility for any of the following:

    ·         community-acquired pneumonia

    ·         exacerbation of chronic heart failure

    ·         exacerbation of chronic obstructive pulmonary disease

    ·         cellulitis

    A total of 455 patients from three Medicare-managed care health systems and a VA medical center were included in the study. At two of the three study sites, 69% of patients chose hospital-at-home care over hospital-based care. At the third site, 29% chose hospital-at-home care. Compared with patients who were hospitalized, those with hospital-at-home care had a shorter “length of stay” (3.2 days versus 4.9 days) , and fewer complications. Additionally, hospital-at-home care was more cost-effective than acute care hospitalization ($5,081 versus $7,480, respectively).

    Fast-forward 10 years to a transformed healthcare system with a focus on quality over quantity and this hospital-at-home model sounds like a potential solution for cutting costs, maintaining quality care, and satisfying patients.

    Do you think we’ll start seeing more hospital-at-home models of care soon?

    Thursday, April 09, 2015

    April 6th-12th is the American Public Health Association’s National Public Health Week. Daily themes include:

    ● Raising the grade by creating a stronger public healthcare system.

    ● Starting from zip—where you live can greatly impact your health. Find out about health disparities where you live and/or work using this tool. 

    ● Building momentum by creating more health-conscious programs such as Michelle Obama’s Let’s Move initiative. Momentum also includes companies like CVS no longer selling tobacco products.

    ● Building broader communities through expanding partnerships outside of the healthcare sector. Collaborate with city planners, educational officials, and so on to help combat issues that affect health such as poverty and limited educational opportunities.

    ● Building on 20 years of success. This year National Public Health Week turns 20, and it’s cause to celebrate its successes. It’s also a time to reflect on what can be improved as we work toward becoming the “Healthiest Nation in One Generation.”

    Here are some of our articles you can read for free that discuss improving public health.

    Leadership competencies to improve health disparities

    Sleep deprivation in children: A growing public health concern

    Innovations in social media: The MappyHealth experience

    Thursday, April 02, 2015

    April is Sexual Assault Awareness and Prevention Month. Healthcare professionals, not just sexual assault nurse examiners (SANE), can make a difference in the lives of survivors by understanding the facts,  the effects this violence can have on mental and physical health,  where to find information for themselves and their patients, and how to properly care for a survivor. Statistics are grim: approximately 1 in 5 women and 1 in 71 men have been sexually assaulted in their lifetime. Add to this that many assailants aren’t prosecuted for numerous reasons including, but not limited to:

    ● a survivor’s fear of reporting the incident

    ● lack of training among law enforcement officials (unsure how to properly investigate a case, victim-blaming, and so on)

    ● rape kit/ DNA testing backlog.

    Healthcare professionals must be aware that survivors may experience a myriad of physical and mental problems beyond the damages of the actual assault, which include diabetes, irritable bowel disorder, alcohol or drug abuse, post-traumatic stress disorder, asthma, and more.

    To help combat the violence, the White House Council on Women and Girls published its report “Rape and sexual assault: A renewed call to action,” which outlined what the Council plans to do to help end sexual assault. One of the steps to take is improving the forensic evidence collection.  So, in 2013, the National Protocol for Sexual Assault Medical Forensic Examinations (SAFE) was updated to provide “information on assisting populations with special needs such as survivors with limited English proficiency; survivors with disabilities; American Indian and Alaska Native victims; military personnel; and lesbian, gay, bisexual, or transgender victims.” Also mentioned is fully utilizing SANE—not only are they trained to properly collect evidence, they also know how to avoid revictimization, and can provide compassionate care  to survivors.

    On top of these efforts, telemedicine technology is being harnessed as a tool to help any and all clinicians caring for survivors of sexual violence. The National Sexual Assault TeleNursing Center at the Massachusetts Department of Public Health, created by The Justice Department and the National Institute of Justice, “will provide 24/7, year-round remote expert consultation by SANEs to clinicians caring for adult and adolescent sexual assault patients.”

    In the past, we've published articles on sexual assault to help bring awareness to our readers. Read these two for free:

    Sexual assault can happen in your institution: Are you prepared?

    The hard truth about human trafficking.

    Here are some additional resources for further education on this topic:

    Tuesday, March 31, 2015

    Our April issue focuses heavily on issues in nursing, including what makes nurses better professionals, their opinions on shared governance, and why they may or may not participate in a clinical ladder program. The CE, written by Editorial Board Member, Joyce Sensmeier, explains the future of nursing knowledge from an informatics standpoint. As always, it’s free to read.

    You’ll also find part 2 of the Measures that Matter series, which explores “developing or selecting measurement tools, planning data collection strategies, and testing and refining the measurement process—including issues that you may face when you actually attempt to apply metrics in a real-world setting.” And, in Leadership Q&A, Editorial Board Member, Kathleen Murray, answers the question: “How do I maximize the contributions of millennials on my team?”

    The issue is now online, so check it out!

    About the Author

    Nursing Management
    “Think About It” is an extension of Nursing Management. Here, you can read and discuss professional information geared toward helping nurses excel as leaders. This blog tackles important topics without the worry of print publication deadlines!