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HEADLINES

Nursing2019 covers the latest news in nursing and healthcare. See what's making headlines this month!

Wednesday, December 12, 2018

Nursing2019 is set to introduce its new Behavioral Health department in print and online in 2019! We are actively seeking manuscript submissions ranging from behavioral health promotion to lifetime psychiatric treatment and recovery. 

Behavioral Health articles will explore the latest developments and issues in psychiatric and mental health nursing practice, education, and research, and will present evidence-based information for optimal patient outcomes. We encourage manuscripts and submission inquiries from authors of all professional backgrounds and levels of experience, including first-time authors. All manuscripts will be reviewed by a panel of qualified peer reviewers to ensure that the article is relevant to current nursing practice and complies with academic writing standards. 

How to submit

For first-time authors interested in submitting an article for this column or for other topics, consider checking out earlier articles to familiarize yourself with the writing style and content of our journal. Our website can be found at www.nursing2019.com. Submissions are accepted on a rolling basis via our submission and review system (https://www.editorialmanager.com/lwwesubmissions/default.aspx). 

Questions?

For questions or topic inquiries regarding submitting an article to Nursing2019, feel free to reach out to Andrew Parent at Andrew.Parent@wolterskluwer.com. For questions or problems regarding a submission, contact Andrei Greska at Andrei.Greska@wolterskluwer.com.

Monday, November 5, 2018

The American Heart Association announced on Monday updated guidelines for CPR and Emergency Cardiovascular Care (ECC).

The 2018 AHA Focused Updates on Advanced Cardiovascular Life Support (ACLS) and Pediatric Advanced Life Support (PALS) were published in cooperation with the International Liaison Committee on Resuscitation. They include the following:

• Amiodarone or lidocaine may be considered for ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) that is unresponsive to defibrillation. These drugs may be particularly useful for patients with witnessed arrest, for whom time to drug administration may be shorter.

• Lidocaine has been added to the ACLS Cardiac Arrest Algorithm and the ACLS Cardiac Arrest Circular Algorithm for treatment of shock-refractory VF/pVT.

• The routine use of magnesium for cardiac arrest is not recommended in adult patients. Magnesium may be considered for torsades de pointes (i.e. polymorphic VT associated with long QT interval).

• There is insufficient evidence to support or refute the routine use of a beta blocker early (within the first hour) after return of spontaneous circulation (ROSC).

• There is insufficient evidence to support or refute the routine use of lidocaine early (within the first hour) after ROSC. In the absence of contraindications, the prophylactic use of lidocaine may be considered in specific circumstances (such as during emergency medical services transport) when treatment of recurrent VF/pVT might prove to be challenging.

• While there are no changes to the depiction of sequences and therapies from the 2015 PALS algorithm, some minor edits have been made to the PALS Cardiac Arrest Algorithm in 2018 to be consistent with language in the ACLS Cardiac Arrest Algorithm.

There were no product changes and no new materials required as part of the updates, but the AHA offered the following guidance for training ACLS and PALS providers.

• Instructors may allow students to practice using either amiodarone or lidocaine during CPR in ACLS, ACLS EP, and PALS courses, consistent with the student's local protocol.

• For testing purposes, AHA Instructors will continue to use the ACLS and PALS Skills Testing Checklists and the Skills Testing Critical Skills Descriptors.

The AHA and ILCOR said last year it would begin updating AHA guidelines for CPR and ECC annually. Before 2017, the guidelines had been updated every 5 years.

Click here to view the updated guidelines in full.

Tuesday, July 24, 2018

By Stephanie Williams, RN, former case manager

​My patient shouted and snapped the fingers of her free hand as I performed a fingerstick blood glucose test, but her efforts were fruitless. Her plump tabby cat, Stuffins, had gingerly stepped onto my nursing bag, which was on the floor at my feet. The cat patted it down with his paws, peered directly into my eyes, and peed. Naturally, that was the end of my poor bag.

I knew all about the importance of hand hygiene, but to me, "bag technique" was just the skilled way in which I brought all my groceries from my trunk to the kitchen in one trip. It wasn't until joining my second agency as a home healthcare nurse that orientation videos taught me never to set my bag on the floor. Instead, it should be placed on an elevated surface covered with a water-resistant drape—or, if no suitable surface is available, hung from a door knob.

Putting this new skill into practice right away helped me slow down and greet my patients more personally as I put down a drape and take out my equipment. Our agency also had a policy of cleaning our equipment in front of the patient before use. During this process, patients might start telling me about an issue they've been having, or maybe about the pie their neighbor dropped off the night before.

My favorite part of "bag technique" is the reminder it gives me that, much like hiking and camping etiquette, I'm expected to leave no trace of my visit in my patients' home. That includes unwanted germs from the outside. It also shows my patients that I'm mindful of my commitment to their care and protection.

If not for Stuffins and his discerning bladder, I wouldn't have such a great anecdote to share with colleagues and nurses I train for home visits. Learn from my mistake. Keep your bag high and dry.

Tuesday, August 22, 2017


​Guest editor: Aguida Dasilva, BSN, RN-BC, clinical nurse at Good Samaritan Hospital in Suffern, N.Y.

It's common for RNs to witness family disagreements involving end-of-life decisions. Arguments at these times only add to the stress of losing a loved one. In my experience as a clinical nurse in an acute-care setting, I've encountered many families with similar circumstances.

Ongoing education is needed regarding end-of-life matters to promote the importance of appointing a proxy at early age.1 In addition, educating healthcare personnel on the subject will help them assist their patients and families in discussing these issues before life-limiting illness occurs. Planning advance directives should begin before advanced age is reached. Advance directives should be discussed routinely with patients at the primary care provider's office. Research shows that patients are very receptive when a physician introduces the subject to them.2 Also, advance directive discussions shouldn't be limited to people with a terminal disease or geriatric patients.2

Healthcare has come a long way in recognizing the needs for improvement in this area, but we still have a long way to go to improve relevant education. With appropriate training, we can slowly break the taboo involving discussing advance directives. Planning for the future will help avoid unnecessary disagreement and distress when saying goodbye to a loved one.

REFERENCES

1. Ryan D, Jezewski MA. Knowledge, attitudes, experiences, and confidence of nurses in completing advance directives: a systematic synthesis of three studies. J Nurs Res. 2012;20(2):131-141.

2. Morhaim D, Pollack K. End-of-life care issues: a personal, economic, public policy, and public health crisis. Am J Public Health. 2013;103(6):e8-e10.

3. Abarshi E, Echteld M, Donker G, Van den Block L, Onwuteaka-Philipsen B, Deliens L. Discussing end-of-life issues in the last months of life: a nationwide study among general practitioners. J Palliat Med. 2011;14(3):323-330. ​


Tuesday, July 11, 2017

Guest editor: Tina Keeler, MSN, RN, Western Michigan University, Bronson School of Nursing in Kalamazoo, Mich.

Not so long ago, healthcare was primarily rendered in the home. Mothers and midwives attended the sick, and physicians were only called for emergencies. People came to hospitals with life-threatening illnesses, but the rest was taken care of at the kitchen sink.

As modern medicine advanced, hospitals began to emerge as a place of health and care instead of death and dying. Today, people seek out hospitals for a multitude of reasons: to celebrate a birth, to grieve a death, to replace a joint, to fix a gut, to repair damage done, or to prevent future injury.

Patients will have some sort of an experience when they come to the hospital. The question we need to ask ourselves is: What can we do to ensure their experience is a positive one?

Patient experiences are based on interactions with nurses and other staff that patients encounter while in the hospital. For example, Betty came to the ED with abdominal pain and is now having blood drawn. The nurse gives the scripted greeting, but is mechanical and minimally interactive. Even though the nurse has a professional manner and flawless technique, Betty perceives the experience as negative. Why? Her perception was that the nurse's demeanor was cold and uncaring. In reality, the nurse was focused on trying to follow protocol and not break sterile technique or contaminate the specimen. Although the service rendered was adequate, it didn't exceed the patient's expectations. What could the nurse have done better to create a positive patient experience?

First impressions are key, so smile and make a connection. Try starting a friendly conversation: "Oh, I see your name is Betty. My mother's name is Betty. She was named after her favorite aunt. Does yours have a special meaning?" While preparing to draw the blood specimen, the patient is probably secretly sizing up the nurse, who appears young. "Have you done this before?" the patient nervously asks. The nurse smiles once again and explains that she's done this many times before. She then compliments the patient on her lovely veins. "I wish more of my patients had vessels like yours. That would surely make my job easier," she says. The patient nervously adds, "But I've been told my veins roll and I'm a difficult stick." Once again, the nurse smiles and says, "Oh, then I have a special way to hold your arm to help prevent that from happening." Then she demonstrates the technique. The patient is put at ease and her experience is markedly better.

We, as nurses, need to expand the dialogue on patient experiences beyond rendering excellent clinical care. How can we engage patients and families to build positive healthcare experiences? By focusing on creating connections, starting with a smile!