Healthy Eating: Food for Thought

FDA_Nutrition_Facts_Label_2006.pngWhat information do you consider when you read a food label? My bet is that for those who do take the time to read the fine print, it’s typically the calorie count, the fat and sodium content, and perhaps even the recommended daily allowance of vitamins and nutrients that take center stage, especially for people who have an eye toward losing weight or making healthier choices. But what about the ingredient list? The ingredients in particular, including the ones with names that sound like compounds best discussed in a chemistry class, are often ignored. And I’m sure we all know people who don’t give any part of nutrition labels even a passing glance. I’ve actually heard friends admit, “I don’t want to know what’s in my food; I just want to enjoy it.” There’s no doubt there’s a very strong emotional connection to foods that we love…but we owe it to ourselves to take a much closer look at exactly what we put into our bodies.
 
It’s well established that our food choices play a significant role in our overall health and our risk of developing or worsening chronic diseases. Much has changed in relation to the science of healthy eating and disease prevention since many of us studied nutrition in nursing school. Have you kept up with the latest evidence to inform your own food choices or those of your family and patients, or do you place your trust in popular media and advertising claims about diet and nutrition? How do you knowingly separate the healthy food facts from the hype? Unfortunately, the hype comes from advertising dollars that, in a large part, serve to drown out the evidence from legitimate food science research.
 
I’ve always tried to eat “healthy,” but in retrospect, my diet left a lot to be desired. There’s nothing like a health scare to motivate new learning. My sentinel moment occurred the day I discovered that I had developed a major food allergy to carrageenan. To my great surprise, consuming my favorite brands of coffee creamer, yogurt, ice cream, and sorbet started to reliably induce progressively worsening wheezing, facial flushing, and tachycardia. The reaction that captured my full attention came very close to sending me to the emergency department for treatment. Being a stubborn ED nurse, I self-treated with over-the-counter antihistamines and fully committed to figure out exactly what caused me to react. Through the process of elimination, I found that the common denominator in all four foods was carrageenan. Eating even a small amount of it reproduced my symptoms quite predictably. Switching to brands of products that didn't contain the offending ingredient and carefully scrutinizing all food labels made eating much less eventful and far more enjoyable.  
 
When I researched carrageenan, I learned that it’s made from red seaweed and is added to food as a non-nutritive thickening agent. Although it's a natural product found in many "healthy" foods, it’s a potent inflammatory mediator that’s been linked to inflammatory bowel disease and colon cancer.1 Carrageenan is actually used as an inflammatory agent to test the efficacy of anti-inflammatory drugs.1 Knowing the risk it creates, even for people who don’t have an allergy to carrageenan, I had to wonder why it’s even placed in the products we buy and why it’s so pervasive? 
 
Sadly, I learned that there are many other chemical additives commonly found in our food supply that are suspects in causing a myriad of human health issues. Take artificial sweeteners, for example: a prospective study just published from the Framingham Heart Study Offspring Cohort group revealed that individuals with the highest consumption of artificial sweeteners had a statistically significant higher risk of stroke and dementia, even after other possible contributing factors were adjusted.2

So, my personal mission began to learn as much as possible from legitimate, high quality, evidence-based health literature about nutrition and food safety. The information I found inspired me to make a personal commitment to eat “clean”— that is to avoid food with chemical additives — and completely change my diet to consume foods derived primarily from whole, plant-based sources. The fewer the ingredients, the better. I’ve learned that plant-based, nutrient-dense foods are the very best to fuel our bodies and prevent disease.  Yes, these foods can be prepared in very delicious and healthy ways. Eating like this feels different because most of us were not raised on a clean, plant-based diet. We were raised on high sugar diets with artificial colors, preservatives, and chemical additives because that’s what was advertised on television and we came to believe that these “foods” were somehow good for us.
 
Changing the way we eat is a very heavy lift. It clashes with the typical societal food norms, family customs, and available choices on many restaurant menus. It’s especially tough to be discriminating with food choices when eating out. Few people really understand how to feed someone on a plant-based diet. For example, I was served only a plate of plain lettuce at one recent function that I attended by those who knew my plant-based preferences. Keep in mind that all manner of fruits, vegetables, seeds, nuts, legumes, grains, and healthy, plant-based oils are part of the repertoire of possibilities. 

vegetables.pngEating a clean, plant-based diet is a journey. I’ve found that the more I learn, the easier it is to make good choices. A very broad base of scientific evidence exists to support that dietary choices are firmly connected to personal health. As nurses, we need to expand our knowledge base on this subject and incorporate teaching about the impact of food choices on health into our teaching with patients. Simple steps like choosing to bring fruits, vegetables, nuts, and healthy grains into work for snacks in the break room can make a positive difference (as opposed to the usual tempting fare found on most nursing units). For those of you interested in learning more, I’ve included a reading list of resources that were most helpful to me in shaping my own perspectives. One of my favorite websites, https://nutritionfacts.org, provides reviews on the latest high quality, peer reviewed, evidence-based research on food, nutrition, and overall health. The information contained on this website has enabled me to better make healthy lifestyle decisions. 
 
As we celebrate Nurses’ Week and beyond, I encourage you to take stock of your own dietary habits and make informed choices that promote optimal health!
 
Bon appetit!
Linda
 
References:
1.  Borthakur A, Bhattacharyya S, Anbazhagan AN, Kumar A, Dudeja PK, Tobacman JK.
Prolongation of carrageenan-induced inflammation in human colonic epithelial cells by activation of an NFκB-BCL10 loop. Biochem Biophys Acta, 2012;1822:1300-1307. Retrieved at:  http://ac.els-cdn.com/S0925443912001032/1-s2.0-S0925443912001032-main.pdf?_tid=0b956676-2db2-11e7-8d56-00000aacb360&acdnat=1493563018_03f88014c2f300c3ba560bb71255bd30.

2.  Pase MP, Himali JJ, Beiser AS, Aparicio HJ, Satizabal CL, Vasan RS, Seshadri S, Jacques PF.  Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia:  A Prospective Cohort Study. Stroke. 2017;48:1139-1146.  Retrieved April 24, 2017: https://doi.org/10.1161/STROKEAHA.116.016027.
 
Suggested Reading List
  • Campbell, T. C., & Campbell, T. M.  (2006). The China Study:  The Most Comprehensive Study of Nutrition Ever Conducted.  Dallas:  Benbella Books.
  • Fuhrman, J.  (2011). Eat to Live.  New York:  Little, Brown and Company.
  • Greger, M., Stone, G. (2015). How Not to Die.  New York: Flatiron Books.
  • Greger, M. https://nutritionfacts.org  Accessed April 30, 2017.
  • Robinson, J. (2013).  Eating on the Wild Side.  New York:  Little, Brown and Company.
 
 Linda Laskowski-Jones, MS, APRN, ACNS-BC, CEN, FAWM, FAAN
Editor-in-Chief, Nursing2017
Vice President: Emergency & Trauma Services
Christiana Care Health System – Wilmington, Delaware


 
 
Posted: 5/7/2017 11:25:39 AM by Lisa Bonsall, MSN, RN, CRNP | with 4 comments

Categories: Inspiration


Work-Life Balance: The Elusive Golden Ring

year-of-healthy-nurse-badge.jpgIn anticipation of Nurses Week, on May 1st the ANA launched its “Healthy Nurse, Healthy Nation Grand Challenge” initiative, designed “to help nurses improve their overall health and challenge the rest of the country to do the same.” It’s a worthwhile effort – lord knows we can all use healthier habits in our lives.

As nurses, we work long hours. It can be on our feet doing direct care, attending meetings and writing budgets and working on staffing issues, traveling on public transportation or dealing with traffic to visit patients at home, or teaching the next generation of nurses. In my case, it’s spending hours on a computer, conference calls, and frequent travel to meetings. Then, after work, we go home and take care of others and other things – household bills and repairs, managing growing families, or going to school or even to other jobs, exercising, (notice I put exercise last…) – and then fall into bed wired and exhausted. In the morning, there’s coffee or diet cola to get us up and running and we do it all over again.

question.pngAsk yourself:
  • When was the last time you went outside just to experience the sun on your face or take a leisurely walk?
  • When was the last time you did something just for yourself?
  • When was the last time you did something fun with your kids during the week?
  • When was the last time you can say that you had a good night’s sleep and woke up feeling rested?
We have the data that show that we need to pay attention to how we take care of ourselves.  Research published in AJN on health promotion practices of nurses noted that 66% of the nurses reported too many competing priorities; these nurses scored lower on spiritual growth, interpersonal relationships, and stress management.  We also know that most of us are chronically sleep-deprived -- in another article in AJN, The Potential Effects of Sleep Loss on a Nurse’s Health, the author cites studies that reveal that daily sleep time for nurses was less than six hours, and that many nurses work 15 hours or more a day, or more than 60 hours a week. And we know that fatigue translates into a higher risk for making errors.

Work-life balance is an elusive goal, at least it is for me and many people I know. It’s run, run, run most of the week; catch-up on things we didn’t get to on the weekends and squeeze in time for family and friends. We are often our own last priority when it comes to healthy practices. A health scare a few years ago caused me to rethink how I work, and while I still don’t have ideal work-life balance, I’m doing a few things that are simple and easy to work into a schedule.

Here they are in case they are helpful to you: peanut-butter-toast.png
  • Always eat some kind of breakfast, preferably protein and low carb (you’ll avoid that mid-morning slump. My go-tos: hard-boiled egg, peanut butter on a piece of whole wheat bread, a scoop of cottage cheese with some fruit).
  • Walk around the block (or two) at lunch time or, if too busy, before you head home.
  • Park further away than you have to – walking even a little is better than none. Take the dog (or invite your partner or a child) for an evening walk
  • If feeling very stressed, remove yourself (even if only to the bathroom) and take a few minutes to take a few deep breaths, get a drink of water, and clear your head.
  • Listen to music on the way home from work. I find it helps me make that transition and I arrive home more relaxed.
  • Don’t check email or social media or use a computer or tablet before bed (I know – it’s hard). Give yourself at least an hour to wind down before sleep.
  • Try to get 7 hours of sleep each night.
We make appointments and commitments with other people and consider ourselves dependable and responsible when we keep them. We need to feel the same about taking time for ourselves. Make an appointment with yourself to walk, work out, read, see a movie – anything that will give you time for yourself – put it on the calendar, and honor that commitment just as you would others. You owe it to yourself.

Shawn Kennedy, MA, RN, FAAN
Editor-in-Chief, American Journal of Nursing

 
Posted: 5/6/2017 6:59:51 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration


Balancing Mind, Body, and Spirit: Blog Series for Nurses Week 2017

NNW-logo-300-px.jpgHappy National Nurses Week! As we approach this year’s celebration, I’d like to introduce our upcoming blog series related to the theme of balancing mind, body, and spirit. Several nurse experts will share their knowledge and advice around different aspects of self-care for nurses.
I think you’ll enjoy theses daily blog posts, starting
May 6th, 2017. We welcome any and all feedback or personal experiences that you’d like to share!

Work-Life Balance: The Elusive Golden Ring
Shawn Kennedy, MA, RN, FAAN
Editor-in-Chief, American Journal of Nursing
 
Healthy Eating:  Food for Thought
Linda Laskowski-Jones, MS, APRN, ACNS-BC, CEN, FAWM, FAAN
Editor-in-Chief, Nursing2017
Vice President: Emergency & Trauma Services
Christiana Care Health System – Wilmington, Delaware
 
Hit the road…or the mat
Collette Bishop Hendler, RN, MS, CIC, CCRN (Alumnus status)
Senior Clinical Editor
Health Learning, Research & Practice
Wolters Kluwer
 
Stress:  The Elephant in Your Career
Gloria F. Donnelly, Ph.D., RN, FAAN, FCPP
Professor and Dean Emerita
College of Nursing and Health Professions
Drexel University
Editor in Chief, Holistic Nursing Practice
 
Protect yourself so you can continue to protect others
Vicki Cantor, RN, BSN, MA
Clinical Editor
Health Learning, Research & Practice
Wolters Kluwer
 
Are You Soaring Spiritually?
Kathy Schoonover-Shoffner, PhD, RN
National Director, Nurses Christian Fellowship/USA
Editor-in-Chief, Journal of Christian Nursing
 
If only I had said something…
Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN
Chief Nurse
Health Learning, Research & Practice
 
Be sure to check out all of our Nurses Week plans and take advantage of CE collections, free articles, a crossword puzzle, and more!

Also, follow us on social media -- We’ve got some special giveaways that you don’t want to miss!
 
fb.jpg   twitter.jpg   linkedin.jpg   g.jpg   youtube.jpg   Pinterest-badge-50px.png
 
Have a great week, everyone!

 
Posted: 5/4/2017 8:13:42 PM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration


We’re back at the 2017 NSNA Annual Convention

 
NSNA-hawaii-group-shot-(1).pngThis was my second time at the NSNA (National Student Nurses Association) Annual Convention, and it was well-worth the flight! This year the annual convention was held at the Hilton Anatole, in Dallas.

Just like last year, the nursing students were eager and excited to learn about the different Nursing Student Resources NursingCenter carries. At the convention, we unveiled our New Nurse Success page, as well, which hosts content specifically tailored to nurses entering the workforce, including NCLEX Review resources, tips on how to ace that first job interview, job search content, and much more.
 
NSNA-Truck-yard.jpg

The nursing students I spoke to were fresh-faced, professional, and enthusiastic about joining the nursing workforce. A group of students and a teacher from Chaminade University of Honolulu even wanted to take a selfie with me at our booth after giving them a stack of our helpful nursing tip cards. I felt honored! Other giveaways included pens, headphone cord wrappers, eye glass cleaners, tote bags, notebooks, and flyers.

NSNA-group.png



When exhibit halls hours and sessions were over, I had a chance to explore a bit of Dallas. I had never been to Texas before, and as expected, I was greeted with southern hospitality in a charming backdrop. My colleagues and I tasted great barbeque and heard live music in the Lower Greenville neighborhood. We also took a historic tour of Dealey Plaza, where former President John F. Kennedy was assassinated in 1963. Being able to experience the current culture alongside the important history of the city was a great experience.
 
We can’t wait to be back for the 2018 convention in Nashville, Tenn., next year!


 
Posted: 4/28/2017 10:36:46 AM by Cara Deming | with 0 comments

Categories: Continuing Education


Surgeon General, RN

Sylvia_Trent-Adams_Official_Portrait.jpgIt is an exciting time for nursing! On Friday, April 21, 2017, Rear Adm. Sylvia Trent-Adams, became one of the first nurses to serve as Surgeon General of the United States.

Trent-Adams was a nurse officer in the Army and also served as a cancer research nurse at the University of Maryland. In 1992, she joined the Commissioned Corps of the Public Health Service and was the deputy associate administrator for the HIV/AIDS bureau of the Health Resources and Services Administration. In November of 2013, Trent-Adams joined the office of the Surgeon General as   the 10th chief nurse officer of the U.S. Public Health Service (USPHS).

I look forward to seeing Trent-Adams’ impact on public health. Based on what I’m learning from her biography and her quotes in the articles below, I believe her nursing background will positively influence her decisions and actions.

In a 2014 Profile in American Journal of Nursing, Trent-Adams is quoted as stating:

“Nurses bring common sense to solving problems, which has not been recognized enough,” she said. “Nurses spend more time with the patient than any other health care provider.”
 
In 2015, American Journal of Nursing profiled Monrovia Medical Unit (MMU) Team 1, a group who spent 60 days in Liberia operating a 25-bed Ebola unit outside the capital city, with the specific intention to treat health care workers.

Rear Admiral Sylvia Trent-Adams, chief nurse officer of the USPHS, went to Monrovia with the team as commanding officer of the Commissioned Corps Ebola Response. She said the team "did an outstanding job." They provided "high quality care and treatment services, which were often described by our international partners as the best available care in the country," she said. "Each day we strive to 'protect, promote, and advance the health and safety of our nation,' and this mission was no different."
 
I am proud to see a nurse assume this leadership position. It is an exciting time for nursing, indeed!
   
 
Posted: 4/25/2017 3:30:24 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Leadership


Transplant Nurses Day


transplant-nurses-day-logo.jpgApril 19th is Transplant Nurses Day, hosted by the International Transplant Nurses Society (ITNS). Beginning in 2006, this recognition day raises awareness “of the unique contributions transplant nurses make in the lives of the people with whom they work, especially their patients,” and takes place on the third Wednesday in April.

According to the U.S. Department of Health & Human Services, there are over 119,000 people in the U.S., currently on the national transplant waiting list, and there were “30,970 transplants performed in 2015 – the first year [to exceed] more than 30,000 transplants.” Each day, around “80 people receive organ transplants,” and the Organ Procurement and Transplantation Network reports there were 5,367 transplants performed between January and February 2017.

Transplant nurses and transplant nurse coordinators are a vital part of the organ donation and transplantation process. Transplant nurse coordinators work with patients throughout the process, from evaluation for transplant and getting listed to post-transplant care. Transplant nurses prepare living donors and inform them of any risks involved in donating. They also care for patients who receive essential organs from living donors, assist the medical team during surgery, manage patients during post-operative care, and monitor for organ rejection.
 
Without transplant nurses, transplant centers and programs could not function. In celebration, here are some resources related to transplant nursing:
 
•    Organ Donation Collection – worth 7 contact hours!  CE-badge.pngCore Curriculum for Transplant Nurses
•     Primary Care Management of the Liver Transplant Patient CE-badge.png
•    Issues in Organ Procurement, Allocation, and Transplantation CE-badge.png 
•    Core Curriculum for Transplant Nurses
•    Immunosuppression in Solid-Organ Transplantation: Essentials and Practical Tips
•    A Review of Organ Transplantation: Heart, Lung, Kidney, Liver, and Simultaneous Liver-Kidney





Thank you, transplant nurses, for all that you do! 


 
Posted: 4/19/2017 1:05:16 PM by Cara Deming | with 0 comments

Categories: Clinical topics


Nurses – Get on board!

I must admit, when discussions about nurses on boards transpired here in our office, I wasn’t exactly sure what that meant. Nurses provide patient care – it’s what we study, it’s the work we do, and for many, it’s our passion. When I heard the term “nurses on boards,” I immediately thought of managers and administrators. Serving on a board wasn’t something for all nurses to consider, or was it?

Leadership-competencies-for-nurses-300x750.pngA little history
According to the 2014 American Hospital Association governance data, nurses hold only 5% of board seats in health-related organizations and corporations. Shouldn’t we be involved in the decisions that affect our health care system, our organizations, our profession, our patients, and ourselves? One of the key messages of The Future of Nursing: Leading Change, Advancing Health report is “Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.” As a result of our minimal representation on governing boards and the Future of Nursing report recommendations, the Future of Nursing: Campaign for Action set a goal to get an additional 10,000 nurses on governing boards by 2020.
 
Why nurses need to “get on board”
Earlier this month, Susan Reinhard, RN, PhD, FAAN, chief strategist for the Center to Champion Nursing in America and senior vice president and director of AARP’s Public Policy Institute wrote an excellent piece, Getting nurses on board, for Trustee magazine. In her article, Reinhard addresses the gender gap and other barriers to nurses serving on boards. She also shares her path to the boardroom and the real life stories of other nurses serving on boards and how their service made an impact. For example:

“The late Connie Curran, R.N., told the story of listening as her 100-bed community hospital proposed saving money by eliminating weekend hours at its in-house pharmacy. Medication orders could be filled Friday evenings, the thinking went. The other board members, she noted, were not being negligent. But she was the only person whose experience working nights and weekends led to a few unasked questions, such as, ‘What about newly admitted patients?’ The pharmacy stayed open.”

Can you imagine working where the hospital pharmacy is closed on the weekends? This is exactly why nurses are instrumental to serving on committees, commissions, and boards where health care decisions are made. This example illustrates our unique experience and the need for us to be present where decisions are being made at the organizational level and beyond.

Overcoming barriers
As nurses, we know about overcoming barriers. We face obstacles in our day-to-day practice that force us to speak up and advocate for those in our care. In 2009, Prybil identified three barriers to nurses serving on boards:
  1. Gender – 90% of RNs in the U.S. are women and women are underrepresented on boards
  2. Belief that nurses aren’t able to weigh in on safety and quality issues
  3. Potential conflict of interest related to placing an employee in a voting capacity
How can we remove barriers and foster collaboration? Let’s focus on what we know about ourselves and our profession. First, nurses represent the largest segment of the health care workforce; there are 3.6 million of us in the United States. We are a female-dominated profession, and that should not affect our representation among the decision makers. We need to work hard to have our voices heard, and remember that we are skilled communicators and problem-solvers.

We also know the issues, especially when it comes to safety and quality care. We face these issues every day. We use the nursing process repeatedly in the clinical setting to assess, diagnose, plan, implement, and evaluate. This framework can be applied for strategically tackling any hospital-wide, local, national, or global issue. Nurses are knowledgeable and skilled and need to have a “seat at the table.”
Additionally, people trust us – that’s been proven time and again. We are on the frontlines, not only in the hospitals, clinics, and offices, but also in schools, the community, and so many other settings. And remember, we are all leaders, no matter the setting or role of our work.

The Nurses on Boards Coalition (NOBC)
The Nurses on Boards Coalition was developed to help ensure that the goal of at least 10,000 nurses are on boards by 2020 is reached. It’s a national partnership of organizations committed to this endeavor.

nobc-logo-300.png“Our goal is to improve the health of communities and the nation through the service of nurses on boards and other bodies. All boards benefit from the unique perspective of nurses to achieve the goals of improved health and efficient and effective health care systems at the local, state, and national levels.”

Visit the NOBC website to be counted if you already serve on a board, or to learn more about this initiative and board membership.
 
Wolters Kluwer is proud to be a Healthcare Leadership Organization Strategic Partner of the NOBC.
 
Improving health and wellness of U.S. citizens by placing more nurse leaders on boards
Watch this video of Chief Nurse, Dr. Anne Dabrow Woods, to learn about improving care of communities so we can improve care and outcomes for individuals. Nurses must have a voice where health care decisions are made; our unique perspective is essential to achieve optimum wellness for our patients.
This video was created for A Community Thrives (ACT), part of the USA Today Network nationwide program that provides the resources necessary for philanthropic missions in our communities to succeed.
Please consider casting your vote for this submission. You may vote once daily through May 12, 2017.
 
More Information
Nurses on Boards Coalition
Future of Nursing: Campaign for Action
American Nurses Foundation: Nurses and Board Leadership
American Nurses Association: Policy and Advocacy
References
Huston, C. (2008). Preparing nurse leaders for 2020. Journal of Nursing Management, 16(8).
Prybil, L. (2009). Engaging nurses in governing hospitals and health systems. Journal of Nursing Care Quality, 24(1).
 
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Posted: 4/12/2017 10:47:31 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Leadership


Transmission-based isolation precautions for common pathogens

As a follow-up to our previous post on isolation guidelines, here is a list of transmission-based precautions recommended for common pathogens. 
 
Disease-specific-isolation-recommendations-500x750.png

Megan Doble, MSN, RN, CRNP
 
References:
Centers for Disease Control (CDC), 2016. Prevention Strategies for Seasonal Influenza in Healthcare Settings: Guidelines and Recommendations. Available at: https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm#

Siegel, J.D., Rhinehart, E., Jackson, M., Chiarello, L., & the Healthcare Infection Control Practices Advisory Committee, (2007). Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007. Available at: http://www.cdc.gov/ncidod/dhqp/pdf/isolation2007.pdf
 

Add this infographic to your website by copying and pasting the following embed code:

Posted: 4/9/2017 5:43:04 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Diseases & Conditions Patient Safety


Brushing up on isolation guidelines

As the influenza season begins to subside, we can take a step back and reflect on best practices. Isolation guidelines in the health care setting continue to come up year after year as an area that brings some confusion to the clinical realm. According to the CDC, on average, 200,000 persons are hospitalized with influenza-related illnesses on an annual basis. It is imperative, therefore, that we take proper precautions to prevent the spread in the health care setting. 

Influenza is transmitted from person to person through large particle respiratory droplets which can travel up to 6 feet. Transmission may also occur via contact of infectious particles to mucosal surfaces, such as when someone coughs or sneezes in close contact or on a surface.  Thus, patients with confirmed or suspected influenza must, in addition to standard precautions, adhere to droplet precautions. According to the CDC, patients with confirmed or suspected influenza should adhere to droplet precautions for seven days after illness onset or until 24 hours after the resolution of fever and respiratory symptoms in the health care setting. Some health care facilities may have a specific policy requiring a longer duration of adherence to droplet precautions.

Most health care facilities have an infection control nurse or department to contact if there are any questions regarding the level of transmission-based precautions. Furthermore, the CDC offers a comprehensive reference with explicit details on preventing the spread of influenza in the health care setting.

As a review, the CDC guidelines for isolation precautions are presented in the infographics below.
(Please click infographics to view larger sizes.)
 
Isolation-Precautions-300x750.png  Transmission-Based-Precautions-300x750.png


Megan Doble, MSN, RN, CRNP
 
References:
Centers for Disease Control (CDC), 2016. Prevention Strategies for Seasonal Influenza in Healthcare Settings: Guidelines and Recommendations. Available at: https://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm#

Siegel, J.D., Rhinehart, E., Jackson, M., Chiarello, L., & the Healthcare Infection Control Practices Advisory Committee, (2007). Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007. Available at: http://www.cdc.gov/ncidod/dhqp/pdf/isolation2007.pdf

 

More Reading & Resources
Transmission-based isolation precautions for common pathogens
Evaluating Isolation Behaviors by Nurses Using Mobile Computer Workstations at the Bedside
Clinical Challenges in Isolation Care

   
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Posted: 4/6/2017 9:34:16 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Patient Safety


Nursing Orientation: What to know for your job search

orientation.pngGraduating from nursing school and passing your NCLEX boards is a great accomplishment and one to be very proud of, congratulations! Now you face the next step – applying and interviewing for a nursing job. This can be both exciting and stressful at the same time.

Choosing a job that has a good orientation program, however, can help lessen this stress for you. There are a few different types of orientation programs that a health care facility may offer. Understanding the different types can assist you when interviewing. Many of the terms used to describe orientation programs will vary depending on the health care facility. For instance, the health care facility may use the term preceptor program, mentor program, residency program, or nursing orientation. Most times the health care facility will include many of the same components necessary to orient you to your new role in the health care facility. It will be important for you, however, to find out what does the specific term mean to the institution you are applying to. Below, you will find the common meaning behind these terms in a typical acute care hospital setting.  

Nursing Orientation
Most hospital-based nursing orientation programs will include a general orientation in the classroom followed by an orientation on the unit you were hired to work on. The classroom will include education from each department in the hospital, as well as education on the use of the electronic medical record (EMR). The classroom orientation can vary from a few days to a few weeks depending on the health care facility. Once the majority of classroom orientation is complete, you will orient with an assigned preceptor or mentor on the unit you were hired to work on. A preceptor or mentor is a registered nurse, preferably with a BSN degree, who has been working at the institution for at least two years. The unit orientation can vary in length of time depending on the health care institution. You generally will be on orientation following your preceptor/mentor’s schedule for about three to six months. If you were hired to work in a critical care area, your orientation will most likely be longer and even up to one year depending on the facility.

Many facilities are finding it challenging to recruit experienced competent nurses to work in critical care and specialty areas, such as the Emergency Department (ED) and Operating Room (OR). To meet this challenge, many hospitals started residency programs for new nursing graduates. The residency program generally requires the newly hired nurse to attend the general nursing orientation, as well education classes on specific skills you will need to work in your area. For example, if you are hired to work in the ED or the OR, you will need education and skill competency on ECGs and Advanced Cardiac Life Support (ACLS), as well as education on other skills needed for working in that specific area.  Once the classroom training is completed and skill competency is verified you will orient in that area for a year,  possibly longer depending on the facility and your learning needs.

Many new nurses ask what if I do not feel ready to come off orientation? This is a good question; most health care facilities will extend your orientation a month to a few months depending on your learning needs.

6-questions.pngInterview questions
No matter what term the facility uses to describe their nursing orientation program there are some general questions you may want to ask when interviewing for the job. The questions include:
  • What type of nursing orientation program do you offer?
  • What type of education classes will I be taking?
  • How long will I be in orientation?
  • What support is available to me during and after my orientation?
  • Will there be one or many preceptors/mentors assigned to me during my orientation?
  • Can you provide a sample of what the orientation schedule may look like? 
It is important to remember that the health care facility wants to make your orientation a successful one. A successful orientation program helps ensure your competency caring for patients and improves both nurse recruitment and retention at the facility. You are now ready to begin the interview process, and always keep in mind why you were called to the wonderful world of nursing. Blessings :)    
 
Maureen Kroning RN MSN EdD
Nyack College School of Nursing
 
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Posted: 4/3/2017 2:40:54 PM by Lisa Bonsall, MSN, RN, CRNP | with 3 comments

Categories: Education & Career


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