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AJN The American Journal of Nursing - Current Issue
AJN The American Journal of Nursing - Current Issue
AJN is the oldest and largest circulating nursing journal in the world. The Journal's mission is to promote excellence in nursing and health care through the dissemination of evidence-based, peer-reviewed clinical information and original research, discussion of relevant and controversial professional issues, adherence to the standards of journalistic integrity and excellence, and promotion of nursing perspectives to the health care community and the public.

Nurses Wanted—Almost Everywhere
imageIt seems the nursing shortage has arrived.
Not So Smart: Cell Phone Use Hurts Our Patients and Profession
imageThe clinical setting is no place for divided attention.
Nutrition and Wound Healing
No abstract available
Ostomy Care
No abstract available
Simulation Training
No abstract available
Recognizing Delirium
No abstract available
Relaxing Food Restrictions on Women in Labor
No abstract available
Colorado ‘Alternative to Opioids’ Pilot Project Exceeds Goals
imageThe ED pain management program reduced opioid use in populations at high risk for misuse or abuse.
How Media Influences Perceptions of Suicide
imageA panel separates myths from facts.
NewsCAP: Only 50% of teens with depression are diagnosed before they reach adulthood
No abstract available
The Safety and Quality of Abortions in the United States
A review documents few complications, but location matters.
NewsCAP: All schools need a full-time nurse, preferably with a baccalaureate, says the AAN
No abstract available
NewsCAP: E-Cigarettes pose more harm than good as a tool to reduce smoking
No abstract available
Unsafe Firearm Storage in Homes with Children
imageOnly about one-third follow AAP safety guidelines.
NewsCAP: Study finds increased infant mortality from unintentional suffocation
No abstract available
NewsCAP: APHA unlocks free public access to articles on firearm issues and research
No abstract available
Making Hospitals Less Threatening to Patients with Dementia
imageMeasures have been proposed, but how realistic are they?
Trump Administration Opens Division of Conscience and Religious Freedom
In controversial move, federal health department signals shift in civil rights focus.
AJN On the Cover
imageNo abstract available
AJN On the Web
No abstract available
Cardiotocography vs. Intermittent Auscultation in Assessing Fetal Well-Being
Editor's note: This is a summary of a nursing care–related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.
Antibiotic May Increase CV Risk in those with Heart Disease
The Food and Drug Administration is urging providers to use caution when prescribing clarithromycin to patients with heart disease because the drug may increase their risk of cardiovascular morbidity or death.This risk can extend for several years after use of the antibiotic.
FDA to Minimize Abuse Potential of OTC Antidiarrheal
The Food and Drug Administration remains concerned about potential abuse of the over-the-counter antidiarrheal loperamide. The agency is working with manufacturers to create packaging that more clearly shows the dose for consumers and to limit the number of doses in one package.Intentional abuse or unintentional overdose of loperamide can lead to serious cardiac complications and possibly death.
FDA Approves First Treatment for Nonmetastatic, Castration-Resistant Prostate Cancer
Erleada (apalutamide) is the first treatment approved for nonmetastatic, castration-resistant prostate cancer.If patients prescribed apalutamide are also taking other drugs metabolized by the same cytochrome P-450 isoenzyme systems, the circulating levels of apalutamide may be altered.
Bladder Cancer Drug Approved to Treat Stage III Non–Small Cell Lung Cancer
Imfinzi (durvalumab), a drug previously approved to treat locally advanced or metastatic bladder cancer, is now also approved to treat stage III non–small cell lung cancer with tumors that are unresectable and have not progressed after chemoradiation.New warnings for durvalumab include risk of infusion reactions and embryo–fetal toxicity.
Cavitation
No abstract available
CE: Original Research Understanding the Hospital Experience of Older Adults with Hearing Impairment
imageBackground: Older hospitalized adults with hearing impairment are vulnerable to adverse outcomes. These patients are at risk for being labeled confused, experiencing a loss of control, experiencing heightened fear and anxiety, and misunderstanding the plan of care. Objective: This qualitative study sought to assess the hospital experience of older adults with hearing impairment in order to formulate suggestions for improving nursing care. Methods: Open-ended interviews were conducted with eight participants, ages 70 to 95 years, who were identified as having a hearing impairment and were admitted as inpatients to a midwestern medical center. Results: Through data analysis, three common themes emerged: health care communication difficulties, passivity and vulnerability, and frustration with family. Conclusions: Nurses will benefit from having a deeper understanding of the hospital experience of this vulnerable population. Efforts to address their needs can be accomplished through the following nursing actions: assess, accommodate, educate, empower, and advocate.
1 CE Test Hour: Original Research Understanding the Hospital Experience of Older Adults with Hearing Impairment
imageNo abstract available
CE: Understanding the Nurse's Role in Managing Gaucher Disease
imageLysosomal storage disorders (LSDs) are a group of inherited metabolic conditions, the overall incidence of which is estimated to range from one in 5,000 to one in 7,000 live births. Gaucher disease, the most common LSD, is of autosomal recessive inheritance. It results from a deficiency of acid β-glucocerebrosidase and can affect the spleen, liver, bone, bone marrow, and central nervous system. Gaucher disease is clinically classified into one of three phenotypes, depending on the absence or presence of neurodegenerative disease and the rate of disease progression. Although there is no cure for Gaucher disease, it may be treated with enzyme replacement and substrate reduction therapy. With the development of enzyme testing through dried blood spots, Gaucher disease may now be detected at birth through newborn screening. The purpose of this article is to review the epidemiology and pathophysiology of Gaucher disease, update nurses on advances in newborn screening, diagnosis, and management of this genetic disorder, and highlight the role of nurses in the diagnosis and care of patients with Gaucher disease.
1.5 CE Test Hours: Understanding the Nurse's Role in Managing Gaucher Disease
imageNo abstract available
The Benefits of Implementing an Early Mobility Protocol in Postoperative Neurosurgical Spine Patients
imageBackground: Despite the known benefits of early postsurgical mobility, there are no clear recommendations on early mobility among uncomplicated postoperative neurosurgical spine patients. Purpose: The purpose of this quality improvement initiative was to establish an NP-led early mobility protocol to reduce uncomplicated postsurgical spine patients' length of stay (LOS) in the hospital and eliminate the variability of postsurgical care. A secondary objective was to educate and empower nursing staff to initiate the early mobility protocol independently and incorporate it in their practice to improve patient care. Methods: Two neurosurgery NPs led an interprofessional team to develop the early mobility protocol. Team members provided preadmission preoperative education to communicate the necessity for early mobility and provide information about the protocol. New nursing guidelines called for patient mobility on the day of surgery, within six hours of arrival on the medical–surgical unit. Nurses were empowered to get patients out of bed independently, without a physical therapy consultation; they also removed urinary catheters and discontinued IV opioids when patients' status permitted. Results: Over a one-year period, implementation of the protocol resulted in a nine-hour reduction in LOS per hospitalization in neurosurgical spine patients who underwent lumbar laminectomies. The protocol also allowed nurses more autonomy in patient care and was a catalyst for patient involvement in their postoperative mobility. Given the success of the protocol, it is being replicated by other surgical services throughout the organization. Conclusions: This low-cost, high-reward initiative aligns with the strategic plan of the organization and ensures that high-quality, patient-centered care remains the priority. NPs in other institutions can modify this protocol to promote postoperative mobility in their organizations.
The Hard of Hearing Patient
Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses’ work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times. This February 1944 article is by Louise Neuschutz, who wrote extensively in AJN and elsewhere about the hard of hearing, deafness, and lipreading. Here she discusses the ways in which nurses can help “war-deafened men… returning steadily from the various fronts.” Her guidance is critically relevant more than 70 years later, and we would do well today to follow her practical tips for communicating with the hearing impaired. A hearing deficit can magnify the stresses of hospitalization and even affect patient outcomes. In this issue, Amy Funk and colleagues explore the potential hearing-related problems of hospitalized patients in their qualitative study, “Understanding the Hospital Experience of Older Adults with Hearing Impairment.” Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
Getting and Giving Report
imageThis column is designed to help new nurses in their first year at the bedside—a time of insecurity, growth, and constant challenges—and to offer advice as they learn what it means to be a nurse. This article offers strategies new nurses can use and specific steps they can take to help them succeed in both giving and receiving report.
When Disaster Strikes
Apps, websites, and volunteer organizations can provide assistance.
Caring with Intention: Hospice Care and the Human Family
Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely—and often more personal—perspectives on professional, policy, and clinical issues. Best of the Blog will be a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.
Legal Issues in Dismissing Unvaccinated Patients
imageEven small proportions of parents refusing vaccines have important consequences.
An Unflinching Exploration of Trauma and Obesity
imageRoxane Gay's Hunger and why it matters for nurses.
Aromatherapy Relieves Nausea in ED Patients
According to this study: In patients presenting to the ED with nausea or vomiting who don't require immediate intravenous access, nasally inhaled isopropyl alcohol with or without oral ondansetron can provide greater relief than ondansetron alone.
Effect of Body Positioning in Critically Ill Patients
According to this study: The level of backrest elevation among patients receiving mechanical ventilation is not associated with changes in tissue integrity.
Determining Differences Between Physician And Nursing Care
According to this article: Quantitative evidence supports the hypothesis that physicians and nurses focus on different aspects of patient care.
Patient Coaching Saves Lives And Money
According to this study: By closing treatment gaps, a standardized coaching program can reduce both mortality and health care costs.
Probiotics in the Clinical Management of Lower GI Symptoms
According to this study: Specific probiotics can relieve lower gastrointestinal symptoms in patients with irritable bowel syndrome.
The Thin Flat Line Between Life and Death
imageIn nursing, there's often a delicate balance between worlds.

Modern Healthcare
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Nurses want to delete Zuckerberg name from San Francisco General Hospital
SEIU nurses in San Francisco want to delete the Zuckerberg name from Zuckerberg San Francisco General Hospital
Too much nurse overtime can hinder collaboration
Overtime among nurses is relatively common, but the practice can lead to decreased collaboration with other nurses or physicians even if it's just an hour over the nurse's shift, according to new research.
Week Ahead: Hospital execs swoop into D.C.
Hospital execs and lobbyists will flood the Washington Hilton for the American Hospital Association's annual membership meeting. HHS Secretary Alexa Azar, CMS Administrator Seema Verma, and Sen. Susan Collins (R-Maine) are among the D.C. dignitaries...
Arizona nurse stuns running world at Boston Marathon
A nurse from Banner-University Medical Center in Tucson, Ariz., captured second place at the Boston Marathon, only her second marathon.
Bill would give Virginia nurse practitioners more autonomy
A measure passed by Virginia's General Assembly would allow most types of nurse practitioners with five years of full-time clinical experience to earn approval to practice without maintaining a contract with a physician who oversees them.
Workplace violence prevention plans now required at California hospitals
Starting this week, healthcare facilities in California must have comprehensive plans in place to protect clinicians from workplace violence.
Detroit Medical Center charity care levels questioned by union nurses
Union nurses at a Detroit Medical Center hospital charge that Tenet Healthcare Corp. has violated the terms of its 2013 purchase of DMC. They say charity care has dropped 98% since 2013 at four DMC hospitals.
Hundreds of Quebec doctors say they don't want pay raise
When offered a raise, hundreds of physicians in Quebec just said no. Or at least they've signed a petition protesting the recently negotiated pay hikes.
CMS urged to scrap policy letting nurses evaluate lab tests
Hospital lab personnel are asking the CMS to roll back a 2016 policy that allows nurses to analyze lab tests. The request comes as such tests become more complex and widely used.
Nursing shortage will continue to pinch hospital margins
The nursing shortage is expected to persist through 2025, which will increase hospitals' expenses related to recruiting and retaining qualified employees.
Longtime California Nurses Association leader DeMoro retires
RoseAnn DeMoro, the executive director of National Nurses United and the California Nurses Association, retired Sunday after 32 years at the head of the labor union that has 150,000 members across the country.
Q&A with ANA President Pamela Cipriano: Nurses are vulnerable to rising workplace violence
Nearly three years ago, the American Nurses Association drew a firm line in the sand when it comes to workplace violence. The organization declared that it was taking a zero tolerance stance against violence and bullying and called on other parts of...
Advanced practitioners oppose AMA effort to limit their practice authority
Advanced practice nurses are urging the American Medical Association to rescind a recent decision to launch a campaign focused on limiting independent practice of non-physician practitioners across state lines.
The Hokeypokey Queen rules at St. John's Hospital
There's a lot of partying in one patient's room at St. John's Hospital in Springfield, Ill. And it's all about the hokeypokey.
What do nurses want?
Nurses ask hospitals to hire more, restrict mandatory overtime; hospitals cite nursing shortage.

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