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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.

Looking Back at 2018
imageA review of a year some labeled ‘toxic.’
Another Ebola Outbreak Provides an Occasion for Reflection
imageNurses can counter fear with a more humane, science-based response.
Nurses and Vaccine-Refusing Families
No abstract available
At-Home Hospital Care
No abstract available
Unsafe Patient Handling
No abstract available
The Top News Stories of 2018: More Extreme Weather Amid Environmental Protection Rollbacks
imageDeregulation continues despite worsening climate outlook.
The Top News Stories of 2018: Health Care Policy Update: Destabilizing Moves Complicate Coverage Gains
The future of public and private plans depends on a confrontation with rising costs.
NewsCAP: FDA expands use of the HPV vaccine to older age groups
No abstract available
The Top News Stories of 2018: Women's Health
imageMaternal mortality rates remain a top concern.
The Top Health Care News Stories of 2018
No abstract available
Proposed Changes to the Public Charge Rule Could Imperil Immigrants’ Health
imageNo abstract available
The Top Nursing News Stories of 2018
imageNo abstract available
Stories to Watch in 2019
imageNo abstract available
2018 Win–Loss Scoreboard
AJN looks back at some of the health care achievements (and disappointments) of 2018.
The Lifelong Reverberations of Toxic Stress
imageChildren are vulnerable to the long-term consequences of adverse childhood experiences.
AJN On the Cover
imageNo abstract available
AJN On the Web
No abstract available
New Antibiotic Approved for Refractory Mycobacterium Avium Complex
Amikacin liposome inhalation suspension (Arikayce) is a newly approved aminoglycoside antibiotic for adults with refractory Mycobacterium avium complex.The product is administered once daily using the Lamira Nebulizer System, which comes with the prescription. Patients need to be taught how to use this system.Amikacin liposome inhalation suspension is associated with a number of respiratory adverse reactions.
HIV Drug May Increase Risk of Neural Tube Birth Defects
The Food and Drug Administration is investigating early reports from an ongoing clinical trial in Botswana that the HIV drug dolutegravir may increase the risk of neural tube birth defects if used from the time of conception through the first trimester of pregnancy.A pregnancy test is now recommended for women of childbearing age prior to starting HIV treatment with dolutegravir.
First Drug Approved for Metastatic or Locally Advanced Cutaneous Squamous Cell Carcinoma
Cemiplimab-rwlc (Libtayo) is the first drug approved to treat metastatic or locally advanced cutaneous squamous cell carcinoma in patients who are not candidates for curative surgery or curative radiation.Immune-mediated adverse effects can be serious and can affect any organ or tissue. Infusion reactions are also possible. Embryo–fetal toxicity can occur if given during pregnancy.
Ojo Caliente
No abstract available
CE: Original Research: Antineoplastic Drug Administration by Pregnant and Nonpregnant Nurses: An Exploration of the Use of Protective Gloves and Gowns
imageBackground: Many antineoplastic (chemotherapeutic) drugs are known or probable human carcinogens, and many have been shown to be reproductive toxicants in cancer patients. Evidence from occupational exposure studies suggests that health care workers who have long-term, low-level occupational exposure to antineoplastic drugs have an increased risk of adverse reproductive outcomes. It's recommended that, at minimum, nurses who handle or administer such drugs should wear double gloves and a nonabsorbent gown to protect themselves. But it's unclear to what extent nurses do. Purpose: This study assessed glove and gown use by female pregnant and nonpregnant nurses who administer antineoplastic drugs in the United States and Canada. Methods: We used data collected from more than 40,000 nurses participating in the Nurses’ Health Study 3. The use of gloves and gowns and administration of antineoplastic drugs within the past month (among nonpregnant nurses) or within the first 20 weeks of pregnancy (among pregnant nurses) were self-reported via questionnaire. Results: Administration of antineoplastic drugs at any time during their career was reported by 36% of nonpregnant nurses, including 27% who reported administering these drugs within the past month. Seven percent of pregnant nurses reported administering antineoplastic drugs during the first 20 weeks of pregnancy. Twelve percent of nonpregnant nurses and 9% of pregnant nurses indicated that they never wore gloves when administering antineoplastic drugs, and 42% of nonpregnant nurses and 38% of pregnant nurses reported never using a gown. The percentage of nonpregnant nurses who reported not wearing gloves varied by type of administration: 32% of those who administered antineoplastic drugs only as crushed pills never wore gloves, compared with 5% of those who administered such drugs only via infusion. Conclusion: Despite longstanding recommendations for the safe handling of antineoplastic and other hazardous drugs, many nurses—including those who are pregnant—reported not wearing protective gloves and gowns, which are considered the minimum protective equipment when administering such drugs. These findings underscore the need for further education and training to ensure that both employers and nurses understand the risks involved and know which precautionary measures will minimize such exposures.
1 CE Test Hour: Original Research: Antineoplastic Drug Administration by Pregnant and Nonpregnant Nurses: An Exploration of the Use of Protective Gloves and Gowns
No abstract available
CE: Addressing Food Insecurity in Vulnerable Populations
imageFood insecurity affects people of all ages, in every area in which nurses work or volunteer. The U.S. Department of Agriculture describes food insecurity as the lack of “consistent, dependable access to adequate food for active, healthy living.” The health effects of food insecurity include, but are not limited to, obesity, diabetes, hypertension, low birth weight, depression, and anxiety. Food insecurity is associated with single parenthood, low socioeconomic status, having three or more children, having low educational attainment, being a member of a racial or ethnic minority, renting a home, living in a city, and having a disabled household member. Veterans and military families; college students; members of the lesbian, gay, bisexual, and transgender community; and immigrants have also been identified as at elevated risk. The American Academy of Pediatrics, Academy of Nutrition and Dietetics, and AARP have called for innovative programs and universal screening tools to identify those who are experiencing or are at risk for food insecurity and connect them to available resources. In addition to screening patients for food insecurity and intervening on their behalf, nurses play a vital role in advocating for food-insecure families and supporting community involvement.
1 CE Test Hour: Addressing Food Insecurity in Vulnerable Populations
No abstract available
Book of the Year Awards 2018
imageThe most valuable texts of 2018, as chosen by AJN's panel of judges.
Helping Students to Be Gritty
No abstract available
Low RN Staffing Levels Linked to Missed Care
According to this study: Low levels of RN staffing in hospitals are associated with reports of missed care.
Low-Dose Aspirin Use Associated with Lower Ovarian Cancer Risk
According to this study: Regular use of low-dose aspirin is associated with a lower risk of ovarian cancer.Long-term, high-quantity use of nonaspirin analgesics may increase ovarian cancer risk.
Increased Seizure Risk After Phototherapy for Jaundice
According to this study: Infants—particularly boys—exposed to phototherapy for jaundice are at increased risk for epilepsy in childhood.
Timing of Second Stage Pushing Doesn't Affect Spontaneous Vaginal Delivery Rate
According to this study: Among nulliparous women receiving neuraxial anesthesia, the spontaneous vaginal delivery rate is similar in those who use immediate and delayed pushing approaches during the second stage of labor.
Early, Nurse-Directed Sepsis Care
imageBackground: Sepsis is one of the leading causes of hospital mortality and readmission. For the past 20 years, sepsis research has focused on best practices for treating patients with the most severe manifestations of sepsis, while the treatment of patients outside of critical care or ED settings, who have early or less severe signs and symptoms of sepsis, have received little attention. Objective: The goal of this quality improvement (QI) initiative was to promote early recognition and treatment of sepsis through the establishment of a multidisciplinary, executive-led sepsis guiding team that leveraged nursing skills and expertise. Methods: To meet this objective, we decided to speed the initiation of sepsis treatment at our medical center, going beyond the Surviving Sepsis Campaign guidelines in place at the time and setting as targets the identification and treatment within one hour of all inpatients and ED patients with suspected sepsis, regardless of their illness severity or care unit. Our early intervention strategy incorporated a nurse-directed ED Code Sepsis, based on the characterization of sepsis as a systemic inflammatory response syndrome—a criterion widely used at the start of this QI initiative—and an inpatient Power Hour, which authorized nurses to initiate order sets independently for lactate levels, blood cultures, and fluid boluses when they suspected sepsis. The order sets both improved bundle adherence and signaled the pharmacy to expedite antibiotic preparation and delivery. To gauge the effects of our initiative, we conducted a retrospective, interrupted time-series cohort evaluation, using the in-hospital sepsis-related mortality rate as the primary outcome, and considered as process metrics the initiation of ED Code Sepsis and the inpatient Power Hour, order set use, bundle adherence, and sepsis-related rapid response team (RRT) calls. Results: Over the course of the seven-year pre- to postintervention evaluation period, ED sepsis bundle adherence increased from 40.5% to 73.7% (P < 0.001), with a mean triage to antibiotic time of 80 minutes. Sepsis-related RRT calls decreased from 2.2% to 0.85% (P < 0.001). And the in-hospital sepsis-related mortality rate dropped from 12.5% to 8.4% (P < 0.001) with an absolute reduction of 4.5 deaths per 100 sepsisrelated discharges. Conclusion: This project demonstrates that using nurse-directed care to promote timely identification and early treatment of sepsis in the ED and in inpatient settings can improve bundle adherence and reduce in-hospital sepsis-related mortality rates.
A Mother and a Nurse
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.
Protecting Patients with Latex Allergies
imageThe Pennsylvania Patient Safety Reporting System is a confidential, statewide Internet reporting system to which all Pennsylvania hospitals, outpatient-surgery facilities, birthing centers, and abortion facilities must file information on incidents and serious events. Safety Monitor is a column from Pennsylvania's Patient Safety Authority, the authority that informs nurses on issues that can affect patient safety and presents strategies they can easily integrate into practice. For more information on the authority, visit www.patientsafety.pa.gov. For the original article discussed in this column or for other articles on patient safety, click on “Advisories and Events” and then “Pennsylvania Patient Safety Advisory” in the top navigation menu.
Ernest Grant Breaks Barriers
imageAJN talks to the first male president of the American Nurses Association.
A Lie by Omission?
imageThe connection between self-disclosure and authenticity in the nurse–patient relationship.

Modern Healthcare
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Latest News from Modern Healthcare -

Providers welcome interstate licensing, while unions oppose it
Health systems are pushing for interstate licensing of nurses, physicians and advanced practice providers to streamline care, but unions claim that it opens the floodgates to substandard care.
Nurse crafts heartbeat mementos for grieving families
A nurse at Intermountain Medical Center is offering families of deceased patients gifts for a lifetime by creating mementos depicting their loved one's heartbeat rhythms.
Massachusetts voters reject mandated nurse-to-patient staffing ratios
Massachusetts voters rejected a ballot measure to institute mandated nurse-to-patient staffing ratios next year. California is the only state to have a similar law.
NLRB: Johns Hopkins tried to deter nurses from unionizing
The National Labor Relations Board has found evidence that Johns Hopkins Hospital tried to impede registered nurses' efforts to form a union.
University of Michigan nurses approve 3-day strike
Nurses at the University of Michigan voted in favor of a three-day work stoppage to protest "ongoing and continuous violations of their workplace rights" after their contracts expired June 30.
Baby boom: 16 nurses pregnant at same Arizona hospital
Banner Desert Medical Center in Mesa, Ariz., is expecting it's own baby boom, with 16 ICU nurses all expecting at once.
Young nurses seek advanced degrees, leaving gaps in direct patient care
More young nurses are opting to get advanced degrees, which could help fill gaps in primary care. But it could also take them away from patients' bedsides, according to a new survey.
Value-based healthcare models require a better-educated, patient-centered workforce
The drive to attain value-based care is reshaping hospital staffing at every level, from hiring to education to teamwork.
Advanced practice and nurse practitioners bring more profit, productivity to medical practices
Physician-owned practices with more non-physicians earned $100,748 more in net income, according to a new report from the Medical Group Management Association.
NYC nurses to get $20.8 million in gender bias settlement
New York City will pay a group of nearly 1,700 nurses $20.8 million to settle a gender discrimination complaint filed by the U.S. attorney for the Eastern District of New York.
Nurses at Vermont's largest medical center go on strike
About 1,800 unionized nurses at Vermont's largest hospital launched a two-day strike Thursday following unsuccessful contract negotiations, but hospital officials say operations continued with little disruption for patients.
More nurse practitioners now pursue residency programs to hone skills
A growing cadre of nurse practitioners—typically, registered nurses who have completed a master's degree in nursing—tack on up to a year of clinical and other training, often in primary care.
Celebrating a life of faith and service at the century mark
In 2013, Sister Mary Maurita Sengelaub was inducted into Modern Healthcare's Health Care Hall of Fame. This year, she'll be celebrating another milestone as a testament to a lifetime of good health; June 28 will mark Sister Mary Maurita's 100th...
Intermountain piloting app to manage the ebb and flow of nurse staffing
Taking a cue from Uber, Airbnb and other on-demand companies, leaders at Intermountain Healthcare think a mobile app for scheduling nurses and other healthcare workers might help solve their staffing challenges.
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

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