Features

STI guidelines

2021 CDC STI guidelines: A review of changes

Follow current recommendations for prevention, assessment, and treatment.  Takeaways: Sexually transmitted infections are epidemic in the United States with numbers steadily rising and reaching an all-time high for…
Addressing transgender myths

Addressing transgender myths

Know the facts to ensure safe, equitable care.  Photos courtesy of The Gender Spectrum Collection  Takeaways Transgender people deserve to be treated with dignity and respect when accessing…
arrhythmogenic-cardiomyopathy

An overview of arrhythmogenic cardiomyopathy

Understanding conditions that can cause this disorder will help nurses educate and care for patients. Takeaways: Arrhythmogenic cardiomyopathy (ACM) is a description given to various rare conditions that…
ECMO

Answers to the top 10 ECMO questions

ECMO, a form of partial cardio­pulmonary bypass, provides either venoarterial (VA) or venovenous (VV) support. The ECMO circuit pumps venous blood outside of the body to an oxygenator,…

Antibiotic stewardship for staff nurses

Over the past decade, antibiotic resistance has increased and spread dramatically throughout the world. According to the Centers for Disease Control and Prevention (CDC), antibiotic use is the single most important factor leading to antibiotic resistance. The…

APRNs and the Choosing Wisely® campaign

Advanced Practice RNs (APRNs) influence outcomes for patients in a number of ways, including better symptom management, reduced costs, and improved health. Demonstrating the outcomes of APRN care remains a…
opioid

Avoiding iatrogenic opioid dependency and addiction

Assessment, empathy, and nonpharmacologic options are effective strategies. Takeaways: Pain perception is multifactorial and includes somatic and medical, cognitive, emotional, behavioral, social, and motivation factors. Iatrogenic refers to…

Better safe than sepsis

Tips for a hospital sepsis prevention program Takeaways: The Surviving Sepsis Campaign international consensus guidelines summarize best practices based on the medical literature, but they don’t illustrate how…
biosimilars-lower-drug-costs-patients

Biosimilars: An alternative to biologics

Biosimilars may help lower drug costs for patients. Takeaways: Biologics and biosimilars are classes of drugs used to treat many complex conditions, including inflammatory bowel disease, diabetes, and…
cannabis

Cannabinoid hyperemesis syndrome explained

Learn how to identify this frequently misdiagnosed condition. Takeaways: Cannabinoid hyperemesis syndrome is a growing but poorly understood healthcare concern within the rising number of chronic, habitual cannabis…

Carbon monoxide poisoning: The silent killer

In June 2013, a mother and her 11-year-old son drove to the North Carolina mountains for an overnight stay and checked into a nice hotel with an indoor pool. Shortly after their arrival, she went to…
cardiotoxic effects of cancer therapy

Cardiotoxic effects of cancer therapy

Treatment risks and how to manage them Takeaways: Some cancer treatments can have cardiotoxic effects. Cardiotoxic effects include decreased heart function, chest pain, arrhythmias, palpitations, edema, hypertension, vascular…

Caring for patients with lumbar drains

A LUMBAR DRAIN is a small, flexible tube placed in the arachnoid space to drain cerebrospinal fluid (CSF). Indications for lumbar drains include: to drain CSF leakage secondary to a…

Centralized vs decentralized staffing: Two case studies

Strive for balance to achieve improved outcomes. Takeaways:  Nurse staffing is influenced by an organization’s structure and culture.  Centralized staffing manages staffing through a central office. Decentralized staffing…
common-hearing-loss-adults

Common causes of hearing loss in adults

Nurses can help reduce potential loss of quality of life. Takeaways: Approximately 16% of adults age 18 years and older report trouble hearing Symptoms of hearing loss can…
Cranial nerve assessment, healthcare, registered nurse, nursing, nursing journal

Cranial nerve assessment: A practical approach

Use mnemonics to aid remembering and identifying abnormal findings.  Takeaways Many nurses find remembering the cranial nerves and their functions to be challenging. Neurologic assessments occur in all…
critically ill obstetric patients

Critically ill obstetric patients

Be prepared to care for pregnant and postpartum patients in critical care settings. Takeaways: Some critical care nurses have reported that they don’t feel prepared to care for…
DKA

Diabetic ketoacidosis and hyperglycemic hyperosmolar state

Early identification and management are key to good outcomes.  Learning Objectives  Compare onset, diagnosis, and treatment of diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state. Identify special considerations for…
diagnosis treatment prevention cystitis

Diagnosis, treatment, and prevention of cystitis

A case report to guide nurse practitioners. By Myriam Jean Cadet, PhD, APRN, MSN, FNP-C Takeaways Early diagnosis of cystitis is important to manage and prevent renal complications. Antibiotic…
disaster regulation proactive response ant

Disasters, regulation, and proactive response

Is nursing prepared for the next disaster? By David Benton, RGN, PhD, FFNF, FRCN, FAAN With alarming frequency, nurses are confronted with the professional, organizational, and personal consequences…
Discontinuing medically administered nutrition

Discontinuing medically administered nutrition

Support patient’s values, beliefs, and goals.  Takeaways: Medically administered nutrition and hydration (MANH) is indicated for individuals with chronic, complex, or serious illness for whom oral nutrition is…

Effective bag-valve-mask ventilation saves lives

Robert Walker*, your patient in the postanesthesia care unit, is recovering from laparoscopic cholecystectomy. The anesthesia provider tells you that the patient’s history is unremarkable and surgery went well.…

Frailty syndrome: A weakly addressed problem

Fran Covington, age 82, has a history of cardiovascular disease, chronic diastolic heart failure, type 2 diabetes, and chronic obstructive pulmonary disease (COPD). She lives at home with her husband and enjoys gardening and visiting with…

Helping patients who harm themselves

Why would someone deliberately hurt herself? The notion might seem odd—but as a nurse, you may encounter patients with signs of selfinjury (also called cutting, selfinflicted violence, self-harm, or self-mutilation). Cutting the skin is the most…
His Bundle

His bundle pacing

These pacemakers provide an alternative for those who don’t respond to other devices.  Takeaways: His bundle pacing offers a superior alternative to the potential adverse effects of pacing…
design-thinking

How innovation and design thinking can improve care

Empathy and collaboration create opportunities to help vulnerable populations.  Takeaways: Design thinking is a problem-solving tool driven by the needs of the targeted population. The authors used designing…

How to help patients live with liver failure

A life-threatening condition, liver failure results from liver damage. In many cases, the damage is gradual and silent, causing few symptoms until the organ loses all of its functions. Liver failure can be acute…

How to recognize and intervene for pediatric sepsis

A life-threatening, life-altering emergency, sepsis can have catastrophic effects. When the condition progresses undetected, it can lead to multiple organ dysfunction syndrome and death. Mortality ranges from 9% to…

How to recognize delirium in pediatric patients

A syndrome  of acute brain dysfunction, delirium causes observable changes in behavior. A hallmark of delirium is a disturbance of consciousness and cognition, with inattention that develops acutely and fluctuates over time. (See Understanding diagnostic criteria…

How you can avoid laboratory errors

YOU MIGHT be wondering: Since when do nurses make laboratory errors? Actually, we make them fairly often—typically by using improper technique when collecting and handling samples and specimens. Preanalytic errors (those occurring before the sample…
Hypothyroidism and nursing care

Hypothyroidism and nursing care

Learn to recognize the symptoms of this commonly overlooked condition. By Dorothy Moore, DNP, FNP-C, CCRN Sandra Reynolds, a 64-year-old homeless woman, is admitted to your unit for…
Implementing trauma-informed care

Implementing trauma-informed care 

Simple nurse actions can ensure patients feel safe and empowered.  Takeaways: Trauma-informed care is a core component of nursing practice. Nurses must implement universal strategies to prevent retraumatizing…
influenza flight flu

Influenza vaccines and nurses

Find out how to improve influenza vaccination rates among healthcare workers. Takeaways: Barriers to influenza vaccination include inconvenience and cost, previous negative experiences, personal and religious beliefs, and…
initial assessment mgmt burn patients ant

Initial assessment and management of burn patients

Your quick action can help decrease morbidity and mortality, shorten hospital stays, and reduce costs. Takeaways: Large total body surface area burns require immediate and aggressive assessment and…
glucose monitoring

Insights into glucose monitoring for diabetes

Developments in testing provide better outcomes for your patients. Key Takeaways – Self-monitoring of blood glucose allows patients with diabetes to take a more active role in disease…

Interacting with individuals on the autism spectrum

Successful care depends on communication with patients, families, and caregivers. Takeaways: Optimizing health encounters for patients on the autism spectrum (ASD) requires an individualized approach. Understanding similarities among…

Intimate partner violence in pregnancy

Screening, assessment, and intervention. Takeaways  According the Centers for Disease Control and Prevention, 32.4% of women in the United States have experienced physical violence by and intimate partner…
leadless pacemakers cardiac pacing

Leadless pacemakers: A new technology in cardiac pacing

Learn about the nursing implications of these innovative devices. Takeaways: The leadless pacemaker is a right ventricular single chamber pacemaker used to treat symptomatic bradycardia. The leadless pacemaker eliminates…

Lyme disease prevention and treatment

SCENARIO: When you meet your patient Tom for the first time, he reports fever, headaches, a rash on his stomach, and muscle aches. As you perform your assessment, he says, “I’m not sure…
manage mental health emergency ant

Managing mental health emergencies in the ED

Safety and continuity are key to successful care. By Jessica L. Dzubak, RN Takeaways: The most important consideration when caring for this special population is ensuring, first and…

Massive blood transfusion protocols

RACHEL BROWN*, a 74-year-old woman, is admitted to the intensive care unit (ICU) after a non-ST segment elevation myocardial infarction. She’s on a heparin infusion. A cardiac catheterization…

Mitigating melanoma

Early detection and intervention is key for higher survival rates. Takeaways: Late identification and recognition of melanoma lead to worsening health outcomes. Nursing patient education requires that nurses…
Motivate Gen Z nursing students

Motivate Gen Z nursing students

Facilitate—don’t direct—education.    Takeaways: Intrinsic motivators—learning facilitation, passionate presentation, content value revelation, concise information delivery, student and educator engagement, experiential learning, and meaningful feedback—improve Gen Z student learning retention.…
nurse-heroes

Nurse heroes of the Pandemic

Nurses share a common theme: Hope. Be prepared, be strong, and don’t panic Crystal Davis Campbell, BSN, RN Staff nurse, medical ICU, Vidant Medical Center Greenville, North Carolina…

Nurse research and the institutional review board

Learn how the IRB process works to ensure participant safety and quality research. Takeaways: The institutional review board (IRB) process is intended to ensure study participant safety and…
hurricane experience nurse

Nurses share hurricane experiences

AMERICAN NURSE TODAY asked nurses to share their personal and professional experiences related to Hurricanes Harvey and Irma. Here are a few of their responses. (more…)

Nurses’ essential role in supporting professionalism

Key takeaways – Most nurses behave professionally and ethically. – A tiered approach to intervention when unprofessional behavior occurs offers the opportunity for self-directed, nonpunitive change that prevents…

Paternal postpartum depression

Prevent and screen for depression in new fathers. Takeaways: Paternal postpartum depression effects one in ten fathers. Paternal postpartum depression can affect fathers, the likelihood of the mother…
patient violence ant

Patient violence: It’s not all in a day’s work

Strategies for reducing patient violence and creating a safe workplace Takeaways: Nurses alleviate stress when they report incidents of workplace violence. Nurses need to be proactive and expect…
Pediatric Sepsis

Pediatric sepsis: Are you ready?

Implement protocols for early identification and management.  Takeaways: Sepsis has received much attention recently, but the pediatric population is missing from many of these discussions. Increased nursing knowledge…
person-centered-care-dementia

Person-centered care and dementia

Best practices for residents living in long-term care Takeaways: A growing body of evidence supports the idea that personhood and selfhood are not lost even in advanced dementia.…
Postural orthostatic tachycardia syndrome

Postural orthostatic tachycardia syndrome

Mary Watson*, a 32-year-old woman, arrives at her provider’s office with complaints of dizziness, fatigue, and a rapid heart rate when changing from a sitting to a standing…
older citizens climate change

Preparing older citizens for global climate change

Collaborate and advocate to meet patient needs and implement policy change. Takeaways: Older adults have increased vulnerability to the effects of climate change because of greater exposure to the…
Primary Care

Preparing RNs for emerging roles in primary care

Shifts in care delivery require a shift in nurse preparation.   The increase in the aging population, surge of chronic diseases, passage of the Affordable Care Act, and trends…
Nurse,With,Patient.,Routine,Health,Check,And,Putting,Elderly,Patient

Pressure injury prevention in long-term care

Follow the evidence to improve outcomes.  Takeaways: High quality healthcare is established using evidence-based practice in nursing protocols and procedures. To decrease pressure injury (PI) rates in long-term…

Preventing surgical site infection

Stopping infection requires effective discharge teaching. Takeaways: Executing a successful discharge is the ultimate goal for all involved in the perioperative process. An interprofessional approach to discharge education…

Primary hypothyroidism: More common than you think

Be alert to this frequently unrecognized condition. Takeaways: Hypothyroidism develops slowly over time and if left undiagnosed may put patients at risk for serious conditions, including cardiovascular disease,…
DD

Recognizing and treating dissociative disorders

The nurse’s role in supporting patients and their families. Takeaways: Dissociative disorders are a group of psychiatric disorders that result from experiencing or witnessing trauma; affects up to…
recurrent respiratory papillomatosis

Recurrent respiratory papillomatosis in children

Treatment for this rare disorder may require repeat surgeries. Takeaways: Recurrent respiratory papillomatosis (RRP) is disease, but it’s progressive and can effect quality of life and even be…
What are descriptive statistics

Research 101: Descriptive statistics

Use these tools to analyze data vital to practice-improvement projects. By Brian Conner, PhD, RN, CNE and Emily Johnson, PhD Takeaways: Nurses at every level should be able…
Shortages

Retaining nurses to mitigate shortages

Flexibility, creative policies, and new care models are key to retention. Takeaways: 22% of RNs and 20% of nurse leaders may leave their position within the year as…

Right-sided heart failure

Give the right side of the heart the attention it’s due. Takeaways: In right-sided heart failure, ventricular independence (between the right and left ventricles) can lead to systemic…
screening management hepatitis-c

Screening and management of hepatitis C

Use education to dispel the myths about the disease and increase screening and treatment. Takeaways:  Hepatitis C infection is a significant public health issue in the United States. …
secondary hyperparathyroidism chronic kidney disease american nurse journal

Secondary hyperparathyroidism in chronic kidney disease

Through early recognition and prompt treatment, you can help relieve patient pain and discomfort. Key Takeaways – Patients with chronic kidney disease, particularly those who have end-stage renal disease…
Sepsis

Sepsis identification: A race against time

Nursing assessments and recognition of risk factors aid prompt recognition and treatment.  Sepsis is a life-threatening condition that occurs when the body’s response to infection causes organ injury.…
reversible-causes-of-dementia

Seven reversible causes of dementia in older adults

Early identification and accurate diagnosis can improve patient outcomes. Takeaways: Some causes of dementia can be reversed through proper identification, intervention, and treatment. Nurses play an essential role…

Sharps injuries: Where we stand today

Needlesticks and other sharps-related exposures to bloodborne pathogens (including HIV, hepatitis B virus [HBV] and hepatitis C virus) continue to pose a significant occupational risk for healthcare workers. Largely…
smart-pumps-smart-management-safe-patients

Smart pumps, smart management, safe patients

When organizations and clinicians team up, patients are protected.  Takeaways: Medication administration errors continue to occur due to mistakes in smart electronic infusion pump setup, programming, and clinical…

Spontaneous coronary artery dissection

Be aware of this often misdiagnosed and possibly deadly condition. Takeaways:  Nurses should have a high level of suspicion for spontaneous coronary artery dissection (SCAD) when patients, especially…
stop acute upper gi bleed ant

Stopping acute upper-GI bleeds

Risk stratification and quick intervention can save lives. Takeaways: GI bleeding remains a major concern, particularly for the elderly with multiple co-morbidities. Management of acute GI bleeds in…
support-nurse-health-walking-program

Support nurse health with a structured walking program

Identify barriers and create structure to aid participation.  Takeaways: Supporting nurses to embrace a healthy lifestyle can have a positive outcome on their well-being. A structured walking program…
surviving sepsis campaign hour 1 bundle

Surviving Sepsis Campaign hour-1 bundle

This 2018 update to the sepsis bundle focuses on beginning treatment immediately. Takeaways:  Sepsis bundles are designed for bedside application of key elements of the Surviving Sepsis Campaing…
targeting zero cautis

Targeting zero CAUTIs

 Empower nurses and proactively reduce urinary catheter device use  Takeaways: A nurse driven quality improvement project improved catheter utilization rates in one hospital. A urinary catheter insertion decision…
sepsis challenge develop process educate staff lead reduce mortality

The Sepsis challenge

Developing processes and educating staff lead to reduced mortality. Takeaways: Sepsis requires early identification with rapid treatment. Sepsis core measure bundles are a challenge for clinicians. Algorithms and…

Understanding medical management of aortic stenosis

Key takeways Medical management of aortic stenosis can’t cure or delay its progression. Nursing expertise aids in maintaining the often precarious hemodynamic stability of patients with aortic stenosis.…
Female,Doctor,Holding,Up,Oxygen,Mask,As,If,To,Put

Understanding noninvasive ventilation

Knowing the benefits and drawbacks of the options helps drive patient-centered care. Takeaways: Traditionally, oxygen delivery systems are categorized as low, moderate, and high flow. Understanding oxygen delivery…
radiation dermatitis

Understanding radiation dermatitis

According to the National Cancer Institute, an estimated 1.6 million new cases of cancer will have been diagnosed in the United States in 2015. During the course of…

Unplanned Extubation: Eliminating preventable deaths

Know the risk factors and take steps to prevent harm. Takeaways: Unplanned extubations (UEs) can be reduced through the implementation of standardization of best practices, policies and procedures…
adolescents nonsuicidal self injury

Why do adolescents engage in nonsuicidal self-injury?

How nurses can screen, intervene, and provide appropriate referrals. Takeaways: Nonsuicidal self-injury is a commonly hidden behavior among adolescents Screening in primary care and schools provides optimal opportunities…

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