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A dialog by nurses, for nurses
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Ebola: Keeping Perspective

clock October 17, 2014 08:21 by author Lisa Bonsall, MSN, RN, CRNP

Our NursingCenter team has been following the Ebola outbreak closely over the past months, but with recent developments of disease transmission here in the United States, media coverage has increased and protocols and recommendations are being closely examined. As nurses, we play an important role in patient and public education, and it is important that we continue to act with compassion and skill while gathering our knowledge from reputable sources and keeping recent developments in perspective.

Nina and Amber
My thanks and best wishes for a quick recovery go out to Nina Pham and Amber Vinson, two nurses who contracted the Ebola virus while caring for Thomas Eric Duncan, the infected patient who died on Oct. 8, 2014.  I commend your dedication and compassion. I am proud of you.

Nurses and other healthcare providers
To those of you caring for Nina and Amber, those already in or heading to West Africa to help with the outbreak there, and those studying current guidelines and possible systems issues, thank you. I am confident that your hard work will make a difference here and abroad, and that best practices for the safety of patients, healthcare providers, and the public is the priority. 

Stay informed
As a nurse, I will continue to look to professional organizations for the latest information and guidance. The Centers for Disease Control and Prevention has a long list of guidelines and checklists for U.S. health professionals. The Global Alert and Response of the World Health Organization includes up-to-date news and facts, frequently asked questions, and preparedness guidance. The National Institutes of Health also lists facts about the virus as well as the latest developments of research on prevention, treatment, and detection. 

I encourage you all to stay up-to-date and share your knowledge with your patients and the public. Refer to the sites above or to our Ebola page on NursingCenter (which we update daily with information from the above sites). Our colleagues at the American Journal of Nursing have also shared valuable insights from a nurse epidemiologist, who addresses the concerns surrounding personal protective equipment, and a nurse informaticist, who looks at the role of electronic health records in handling the Ebola outbreak.

Moving forward
I had the pleasure of spending the past week at Nursing Management Congress and was in the company of over 800 nurse leaders from around the country as the news of Ebola virus transmission in the U.S. unfolded. Themes from the general sessions included a focus on restoring pride in nursing, believing in team members, and dealing with root causes instead of putting out fires. I think these themes are appropriate as we face this new challenge in healthcare. 



Enterovirus-D68

clock September 8, 2014 08:34 by author Lisa Bonsall, MSN, RN, CRNP

In the Midwest,  an enterovirus, known as EV-D68, is causing concern. While not a new virus, EV-D68 has recently caused severe respiratory symptoms in affected children in Missouri, and several other states have contacted the CDC for assistance with a possible regional outbreak as well. These are Colorado, North Carolina, Georgia, Ohio, Iowa, Illinois, Missouri, Kansas, Oklahoma, and Kentucky. Symptoms of a common cold are typical at the onset of EV-D68, however the development of fever, rash, or dyspnea – particularly in children with asthma – is occurring and necessitating hospitalization, and in some instances, ICU admission. 

While details continue to be released, please remember your role in patient education and infection control. Tell parents and caregivers about these symptoms of EV-D68 and advise them to seek care for their child if fever, rash, or breathing difficulties develop. Also, share these basics of infection control:

  • avoiding close contact with people who have respiratory symptoms, such as coughing or sneezing
  • staying home when sick
  • washing hands often with soap and water for 15 to 20 seconds or using alcohol-based hand cleansers 
  • not touching eyes, nose, or mouth 
  • keeping surfaces and objects (especially tables, counters, doorknobs, and toys) that can be exposed to a virus clean
  • practicing other good health habits, including getting plenty of sleep, staying active, drinking plenty of fluids, and eating healthy foods

As more details are released, we’ll be sure to keep you informed! 

Update 9/16/14 - More states have reported EV-D68 infections. Please visit our page on this topic for more information and resources!

Reference:

Bonsall, L. (2009). Be prepared for H1N1 flu. Nursing Made Incredibly Easy!, 7(6).




The ‘Threat’ of NPs: An NCNP 2014 Wrap-Up

clock May 5, 2014 07:19 by author Lisa Bonsall, MSN, RN, CRNP

It’s been a little over a week since the National Conference for Nurse Practitioners in Chicago, and I am reviewing my notes and reminded of the learning and networking that took place during the conference. On my very first page, from the Welcome and Opening Remarks of Conference Chairperson, Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, SCP, FAAN, DCC, I had written the following: 

I remember this point vividly, as Dr. Fitzgerald had commented that years ago, when our numbers were much smaller, not too many people had an issue with nurse practitioners practicing to the full extent of our education and training. Now however, as there are over 180,000 nurse practitioners, the power of our numbers is threatening to many, even despite recent research demonstrating our value in patient outcomes and satisfaction. This point is incredibly evident in this recent Op Ed piece from The New York Times, Nurses are not Doctors, where the author cites a study from 1999 to support his opinion, which is clearly not the most up-to-date, best available evidence. Have you read it? I encourage you to do so when you are sitting down, because it did bring out a bit of my temper. Rest assured that some leaders in nursing did reply with some Letters to the Editor and you can read them here

And now back to some take-aways from NCNP…

*The states with the least restrictive NP regulations see twice as many patients as those in other states.
Carol L. Thompson, PhD, DNP, ACNP, FNP, FCCM, FAANP
Keynote Address: Awesome Practiced Daily

*Don’t use an ARB and ACE inhibitor concomitantly to treat hypertension.
Joyce L. Ross, MSN, CRNP, CLS, FNLA, FPCNA
JNC-Late: A Focus and Update on the Long-Awaited Hypertension Guidelines

*Not all infected patients are febrile and not all febrile patients are infected.
Lynn A. Kelso, RN, ACNP-BC, FCCM, FAANP
Acute: Fever of Unknown Origin in Adults

*If a patient has an inappropriate tachycardia related to his elevated temperature, consider pulmonary embolism as the cause.
Lynn A. Kelso, RN, ACNP-BC, FCCM, FAANP
Acute: Fever of Unknown Origin in Adults

*Sepsis doesn’t kill patients; multisystem organ failure resulting from sepsis does.
Sophia Chu Rodgers, ACNP, FNP, FAANP, FCCM
Acute: Understanding the Latest Sepsis Guidelines

*If a patient has kidney injury, used unfractionated heparin for DVT prophylaxis.
Sophia Chu Rodgers, ACNP, FNP, FAANP, FCCM
Acute: Understanding the Latest Sepsis Guidelines

*Our patients give us very important information, if we listen!
Christine Kessler, RN, MN, CNS, ANP, BC-ADM
Common Sense Assessment Tips Every NP Should Know

*If a patient has loss of the hair that makes up the outer eyebrows, think hypothyroidism. 
Christine Kessler, RN, MN, CNS, ANP, BC-ADM
Common Sense Assessment Tips Every NP Should Know

*The presence of pulsus paradoxus is a sign of cardiac tamponade, but can also be seen in severe asthma.
Christine Kessler, RN, MN, CNS, ANP, BC-ADM
Common Sense Assessment Tips Every NP Should Know

*To assess judgment in patients with traumatic brain injury, ask “What would you do if there was a fire in your kitchen?”
Tracey Andersen, MSN, CNRN, FNP-BC, ACNP-BC
Neuro Assessment and Diagnostic Work-up for Advanced Practitioners

Thanks for reading this wrap-up! Want to see photos from the event? Here’s our album – enjoy! 



CEConnection for Allied Health Professionals

clock April 18, 2014 04:34 by author Cara Gavin, Digital Editor

Did you know Lippincott has its own CEConnection tailor-made for allied health professionals? This one-stop resource hosts more than 110 continuing education courses design to help allied health workers improve patient outcomes with activities based on evidence-based practice guidelines. 

This platform offers peer-reviewed multimedia and interactive content from Lippincott journals. The platform is also customizable for institutions and individuals. You can track courses using your own My Planner tab, enabling you to add activities to do now or save for later. You are also able to browse courses by categories, including clinical, topic, specialty, and profession. Once you add an education activity, it’s displayed in your planner, as well as your Shopping Cart. 

Allied Health’s CEConnection currently covers courses for 12 professions, including:

Addiction Counselor
Cardiovascular Technologist
Case Manager
Clinical Laboratory Scientist
Dietetic Professional
Healthcare Quality Professional
Pathology Technologist
Pharmacist
Physical Therapist
Respiratory Therapist
Radiologic Technologist
Speech-Language Pathologist

Each month, new courses and additional allied health specialties are added. 

CEConnection for allied health professionals is available for institutional and individual purchase. Healthcare institutions and specialists interested in this platform can get more information by calling 855-695-5070 or sending an email to Sales@LippincottSolutions.com.



Take a look inside our collection of stroke resources

clock March 6, 2014 03:43 by author Lisa Bonsall, MSN, RN, CRNP

Caring for patients with stroke can be challenging; when a stroke is occurring, it is imperative to distinguish the symptoms from other diagnoses. Determining the type and location of stroke is yet another difficulty. Further challenges are met with treatment and rehabilitation. 

To help you manage these complex issues, we’ve created a Focus On: Stroke collection, which is comprised of journal content, as well as the following special features:

Each item in this collection is only $1.99, or you can purchase the entire collection together with the Powerpoint slides, podcasts, and the Take5 for only $19.99 (doesn’t include CE).  

To further your learning and help you meet your continuing education requirements, we've bundled the three CE articles below at a reduced rate. Earn 7 contact hours for only $19.99 – that's a savings of more than $50 if purchased individually!

Aneurysmal subarachnoid hemorrhage: Follow the guidelines
Nursing2013
3 contact hours

Ischemic Stroke: The first 24 hours
The Nurse Practitioner
2 contact hours

Recognizing and Preventing Acute Stroke in Women
Nursing2012
2 contact hours

I hope you’ll take some time to explore this collection! Have a question or comment? Please feel free to connect with me here on the blog by leaving a comment or you can email me at clinicaleditor@nursingcenter.com.  



3 days left!

clock February 25, 2014 05:03 by author Lisa Bonsall, MSN, RN, CRNP

Two of our most popular CE collections will be expiring on Friday, February 28, 2014. If you haven’t already taken advantage of these specially-priced collections, you should check them out ASAP!

Anticoagulant Medications
7.3 contact hours - $19.99
Expiration Date:  2/28/2014
When patients are on anticoagulant medications, significant safety concerns exist, especially the risk of excessive anticoagulation and hemorrhage. It is important to understand these risks yourself, as a healthcare provider, and to educate the patients in your care on how to minimize their risk and be alert for complications. 

NP: Pharmocology Hours
10.4 contact hours/10.4 advanced pharmacology hours - $44.95
Expiration Date:  2/28/2014
Depending on the state where you work as a nurse practitioner or your area of practice, it may be necessary for you to maintain a certain number of advanced pharmacology hours for your license or certification. 

Need more CE? See our complete list of topical CE collections and our special collections on ‘never events.’ Please be aware that the CE tests for each article must be taken before they expire.



AACN Choosing Wisely®

clock February 8, 2014 00:19 by author Lisa Bonsall, MSN, RN, CRNP

The Choosing Wisely® campaign was launched in 2012 by the American Board of Internal Medicine as a way to spark conversations to improve care and minimize unnecessary testing. The goals of the campaign are to ensure that care is supported by evidence; not duplicative of other tests or procedures already received; free from harm; and truly necessary (ABIM Foundation, 2014). Many organizations have released recommendations in support of the campaign – a full list is available here.

Last week, the American Association of Critical-Care Nurses (AACN) became the first nursing organization to get involved in the campaign. Its Choosing Wisely® list includes the following five evidence-based recommendations (American Association of Critical Care Nurses, 2014) :

  • Don't order diagnostic tests at regular intervals (such as every day), but rather in response to specific clinical questions.
  • Don't transfuse red blood cells in hemodynamically stable, non-bleeding critically ill patients with a hemoglobin concentration greater than 7 mg/dL.
  • Don't use parenteral nutrition in adequately nourished critically ill patients within the first seven days of a stay in an intensive care unit.
  • Don't deeply sedate mechanically ventilated patients without a specific indication and without daily attempts to lighten sedation.
  • Don't continue life support for patients at high risk for death or severely impaired functional recovery without offering patients and their families the alternative of care focused entirely on comfort.

As a nursing professional, I am proud to see AACN collaborate on this important initiative. I encourage you all to remain cognizant of these recommendations, share them with your peers, and stay up-to-date on the latest evidence.

For further reading, the articles below are available for free to logged in members of Lippincott’s NursingCenter.com.  Not a member?  Join now!

In the News: Rethinking Routine Blood Work in Patients with MI
American Journal of Nursing
 
Blood Management: Best-Practice Transfusion Strategies
Nursing2013
 
Parenteral Nutrition Risks, Complications, and Management
Journal of Infusion Nursing
 
Sedation Vacation: Worth the Trip
Nursing2013 Critical Care
 
Ethics in Critical Care: Twenty Years Since Cruzan and the Patient Self-Determination Act: Opportunities for Improving Care at the End of Life in Critical Care Settings
AACN Advanced Critical Care
 
Hoping for the Best, Preparing for the Worst: Strategies to Promote Honesty and Prevent Medical Futility at End-of-Life
Dimensions in Critical Care Nursing

References:

ABIM Foundation. (2014). About. Retrieved from Choosing Wisely: http://www.choosingwisely.org/

American Association of Critical Care Nurses. (2014, January 28). News: Critical Care Groups Issue 'Choosing Wisely' List. Retrieved from American Association of Critical Care Nurses: http://www.aacn.org/wd/publishing/content/pressroom/pressreleases/2014/jan/choosing-wisely-aacn-ccsc.pcms?menu=aboutus



World Cancer Day

clock February 4, 2014 02:24 by author Lisa Bonsall, MSN, RN, CRNP

Today is World Cancer Day and it is inspiring to see the large number of tweets with the hashtag #WorldCancerDay on our twitter news feed! To add to your reading and education, listed below are some of the latest articles published in our journals. All are free to read online and are available for CE credit.

Non-small cell lung cancer: Recent advances 
Nursing2014, February 2014 

 Cancer Pain Strategies and Interventions for Brain Metastases
Oncology Times, January 2014

 Supporting Cancer Survivors
Oncology Times, December 2013

You can find more continuing education articles related to oncology on NursingCenter’s CEConnection.



New nursing tip!

clock November 20, 2013 02:55 by author Lisa Bonsall, MSN, RN, CRNP

I just learned this one this morning while reading Puzzling out SIADH in the November/December 2013 issue of Nursing Made Incredibly Easy!

To remember the early signs of syndrome of inappropriate antidiuretic hormone (SIADH), think FLAT:

Fatigue

Lethargy

Anorexia

Thirst

Here are more nursing tips, and some other mnemonics and "memory joggers" that you might find useful.

 

Reference:
Pullen, R. (2013). Puzzling out SIADHNursing Made Incredibly Easy!, 11(6)



Free CE for Perioperative Nurse Week!

clock November 11, 2013 00:34 by author Lisa Bonsall, MSN, RN, CRNP

Happy Perioperative Nurse Week! To celebrate your hard work and commitment to patient safety, the 2 continuing education articles in the November issue of OR Nurse 2013 are availabe at no charge! That's 4.8 contact hours for FREE! 

 Review of processes to reduce colorectal surgery site infections: An OR perspective
2.3 contact hours

 Tetralogy of Fallot: The evolution of congenital heart surgery
2.5 contact hours 

After reading the articles, just click 'Go to CE Details' to take the test and get your free CE. For even more savings, check out our CE collection on Surgical Site Infections.

Have a great week!



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