Pub Date : 2015-01-05DOI: 10.3912/ojin.vol20no01ppt02
Cara Spencer, K. Pennington
Hearing loss affects 36 million people in the United States of America, including 17% of the adult population. This suggests some nurses will have hearing losses that affect their communication skills and their ability to perform auscultation assessments, potentially compromising patient care and safety. In this article, the authors begin by reviewing the hearing process, describing various types of hearing loss, and discussing noise-induced hearing loss and noise levels in hospitals. Next, they consider the role of hearing in nursing practice, review resources for hearing-impaired nurses, identify the many costs associated with untreated hearing loss, and note nurses' responsibility for maintaining their hearing health. The authors conclude that nurses need to be aware of their risk for hearing loss and have their hearing screened every five years.
{"title":"Nurses with Undiagnosed Hearing Loss: Implications for Practice.","authors":"Cara Spencer, K. Pennington","doi":"10.3912/ojin.vol20no01ppt02","DOIUrl":"https://doi.org/10.3912/ojin.vol20no01ppt02","url":null,"abstract":"Hearing loss affects 36 million people in the United States of America, including 17% of the adult population. This suggests some nurses will have hearing losses that affect their communication skills and their ability to perform auscultation assessments, potentially compromising patient care and safety. In this article, the authors begin by reviewing the hearing process, describing various types of hearing loss, and discussing noise-induced hearing loss and noise levels in hospitals. Next, they consider the role of hearing in nursing practice, review resources for hearing-impaired nurses, identify the many costs associated with untreated hearing loss, and note nurses' responsibility for maintaining their hearing health. The authors conclude that nurses need to be aware of their risk for hearing loss and have their hearing screened every five years.","PeriodicalId":35614,"journal":{"name":"Online Journal of Issues in Nursing","volume":"35 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2015-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70292586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01DOI: 10.3912/OJIN.VOL20NO01ETHCOL01
Jeanne Merkle Sorrell
Research has demonstrated that job stress and shiftwork, both of which nurses often experience, are risk factors for obesity. Zhao and Turner (2008) carried out a systematic review of studies focused on shift workers' lifestyle. Findings from the 17 studies reviewed by the authors suggested that shift workers, as compared to non-shiftworkers, were more likely to be overweight, have adverse lifestyle behaviors, and eat less healthfully. In another study, a sample of 194 nurses from six hospitals participated in anthropometric measurements and self-administered surveys (Malik. Blake. & Batt. 2011), Results of the study showed that a majority of nurses were overweight and that their self-reported health, diet, and physical activity ratings were low. As researchers continue to find relationships between obesity and chronic illnesses and also the negative impact of unhealthy eating habits and lack of exercise on health, employers are considering new ways to help ensure a healthy work environment.In 2011, the Surgeon General recommended a focus on Creating Healthy Worksites to make it easier for employees to participate in exercise programs and make nutritious food choices (Corporate Fitness Works. 2011 ). There are increasing numbers of employer-sponsored wellness programs that are designed to contain rising healthcare costs by encouraging healthy behaviors (Lessack. 20131. Behaviors that are targeted most frequently by wellness programs are exercise, smoking, and weight loss (Muitaba &Cavico, 2013). The Patient Protection and Affordable Care Act (ACA) has allowed companies to provide financial incentives to employees for healthy behaviors (Berman. 2013: Madison. VoIpp. & Haloern. 2011). ACA regulations distinguish between participatory and health-contingent wellness programs. Participatory wellness programs do not require employees to satisfy any particular standard, such as joining a gym or participating in a smoking-cessation program, in order to receive a reward. Health-contingent wellness programs require employees to perform specific activities related to a health factor or to achieve a specific health outcome in order to receive a reward (Lessack. 2013J.In theory, the primary ethical justification for employer-sponsored wellness programs is beneficence - the moral obligation to act for the benefit of others (Rothstein & Harrell, 2009). These programs appear to be a win-win situation: employees have opportunities to be healthier and save on healthcare costs, and employers can benefit from a more productive and healthier workforce (Voigt & Schmidt. 2013)In spite of these advantages, however, implementation of these programs has raised some ethical concerns. The model of beneficence that is integrated by employee-sponsored wellness programs tends to be paternalistic, with health plans designed for economic leverage to encourage employees to adopt the type of healthy lifestyle activities selected by the specific health plan (Rothstein & Harrell. 20
{"title":"Ethics: Employer-Sponsored Wellness Programs for Nurses: The Ethics of Carrots and Sticks.","authors":"Jeanne Merkle Sorrell","doi":"10.3912/OJIN.VOL20NO01ETHCOL01","DOIUrl":"https://doi.org/10.3912/OJIN.VOL20NO01ETHCOL01","url":null,"abstract":"Research has demonstrated that job stress and shiftwork, both of which nurses often experience, are risk factors for obesity. Zhao and Turner (2008) carried out a systematic review of studies focused on shift workers' lifestyle. Findings from the 17 studies reviewed by the authors suggested that shift workers, as compared to non-shiftworkers, were more likely to be overweight, have adverse lifestyle behaviors, and eat less healthfully. In another study, a sample of 194 nurses from six hospitals participated in anthropometric measurements and self-administered surveys (Malik. Blake. & Batt. 2011), Results of the study showed that a majority of nurses were overweight and that their self-reported health, diet, and physical activity ratings were low. As researchers continue to find relationships between obesity and chronic illnesses and also the negative impact of unhealthy eating habits and lack of exercise on health, employers are considering new ways to help ensure a healthy work environment.In 2011, the Surgeon General recommended a focus on Creating Healthy Worksites to make it easier for employees to participate in exercise programs and make nutritious food choices (Corporate Fitness Works. 2011 ). There are increasing numbers of employer-sponsored wellness programs that are designed to contain rising healthcare costs by encouraging healthy behaviors (Lessack. 20131. Behaviors that are targeted most frequently by wellness programs are exercise, smoking, and weight loss (Muitaba &Cavico, 2013). The Patient Protection and Affordable Care Act (ACA) has allowed companies to provide financial incentives to employees for healthy behaviors (Berman. 2013: Madison. VoIpp. & Haloern. 2011). ACA regulations distinguish between participatory and health-contingent wellness programs. Participatory wellness programs do not require employees to satisfy any particular standard, such as joining a gym or participating in a smoking-cessation program, in order to receive a reward. Health-contingent wellness programs require employees to perform specific activities related to a health factor or to achieve a specific health outcome in order to receive a reward (Lessack. 2013J.In theory, the primary ethical justification for employer-sponsored wellness programs is beneficence - the moral obligation to act for the benefit of others (Rothstein & Harrell, 2009). These programs appear to be a win-win situation: employees have opportunities to be healthier and save on healthcare costs, and employers can benefit from a more productive and healthier workforce (Voigt & Schmidt. 2013)In spite of these advantages, however, implementation of these programs has raised some ethical concerns. The model of beneficence that is integrated by employee-sponsored wellness programs tends to be paternalistic, with health plans designed for economic leverage to encourage employees to adopt the type of healthy lifestyle activities selected by the specific health plan (Rothstein & Harrell. 20","PeriodicalId":35614,"journal":{"name":"Online Journal of Issues in Nursing","volume":"20 1 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70292996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01DOI: 10.3912/OJIN.Vol20No01ManOS
Deborah Shelton
The challenges associated with mental illness and the care of persons with mental disorders have been traced through time since 400 B.C. as Hippocrates treated mental illness as a disturbance of physiology, parting ways from the belief systems of his contemporaries that attributed these disorders to demonic possession (PBS. 2014). One way to look to the advances in psychiatric nursing practice is to reflect upon where we have been.The mentally ill have suffered maltreatment from the time of Hippocrates into the present day, treated as criminals, delinquents, and defectives; burdened by atrocities of social and personal abuse. Champions mark these dark years, among which our authors march in their good company. Some I am sure are familiar to you: Dorothea Dix (1801-1887) advocate for humane treatment; Clifford Beers (1876-1943), an early founder of the client-advocate movement; and President Truman (1946) who established the National Mental Health Act and the National Institutes for Mental Health which promotes research in the field (PBS. 2014: Dix, n.d.). Along with the discovery of antipsychotic medications in the mid-1950s, the number of hospitalized mentally ill persons peaked, and by 1961, sociologist Erving Goffman identified the effects of institutionalization upon psychotic symptoms (Goffman. 1961). By the mid-1960s de-institutionalization begins, in large part because of psychopharmacological treatments. Trans-institutionalization, another cycle back into prisons begins, as the promise of community resources fails (Lamb & Weinberger. 2005). In 1979, the National Alliance for the Mentally III is formed, and by the early 1980s one-third of the homeless population is considered to have a mental disorder. Although a new generation of anti-psychotics becomes available in the early 1990s, society's tolerance for homeless persons with mental disorders has reached its limit. Over seven percent of jail intakes are persons with serious mental illness, and of those, 25% were held without charges (Lamb & Weinberger. 2005).Advocacy in mental health care has shifted toward policy initiatives since the 1990s. The Mental Health Parity Act, which broke down some of the discrimination against mental health care has been under consideration by congress since the mid-1990s (National Alliance on Mental Illness fNAMU. 2014). The Americans with Disabilities Act, which took effect in 1992, supported parents and consumers in the workplace and with public accommodations (Frank & Glied. 2007). Participation in public disability insurance programs, such as Medicare, Medicaid, Social Security Disability Insurance (SSDI) and its sister program, Supplemental Security Income (SSI), provide a stable, though often minimal, source of income for people disabled by mental illness. More recently, the Affordable Care Act promises improved access to care and parity protection through expanded insurance coverage for mental illness and substance abuse disorders (Beronio. Po. Skoo
{"title":"Overview and Summary: Emotional Health: Strategies for Nurses.","authors":"Deborah Shelton","doi":"10.3912/OJIN.Vol20No01ManOS","DOIUrl":"https://doi.org/10.3912/OJIN.Vol20No01ManOS","url":null,"abstract":"The challenges associated with mental illness and the care of persons with mental disorders have been traced through time since 400 B.C. as Hippocrates treated mental illness as a disturbance of physiology, parting ways from the belief systems of his contemporaries that attributed these disorders to demonic possession (PBS. 2014). One way to look to the advances in psychiatric nursing practice is to reflect upon where we have been.The mentally ill have suffered maltreatment from the time of Hippocrates into the present day, treated as criminals, delinquents, and defectives; burdened by atrocities of social and personal abuse. Champions mark these dark years, among which our authors march in their good company. Some I am sure are familiar to you: Dorothea Dix (1801-1887) advocate for humane treatment; Clifford Beers (1876-1943), an early founder of the client-advocate movement; and President Truman (1946) who established the National Mental Health Act and the National Institutes for Mental Health which promotes research in the field (PBS. 2014: Dix, n.d.). Along with the discovery of antipsychotic medications in the mid-1950s, the number of hospitalized mentally ill persons peaked, and by 1961, sociologist Erving Goffman identified the effects of institutionalization upon psychotic symptoms (Goffman. 1961). By the mid-1960s de-institutionalization begins, in large part because of psychopharmacological treatments. Trans-institutionalization, another cycle back into prisons begins, as the promise of community resources fails (Lamb & Weinberger. 2005). In 1979, the National Alliance for the Mentally III is formed, and by the early 1980s one-third of the homeless population is considered to have a mental disorder. Although a new generation of anti-psychotics becomes available in the early 1990s, society's tolerance for homeless persons with mental disorders has reached its limit. Over seven percent of jail intakes are persons with serious mental illness, and of those, 25% were held without charges (Lamb & Weinberger. 2005).Advocacy in mental health care has shifted toward policy initiatives since the 1990s. The Mental Health Parity Act, which broke down some of the discrimination against mental health care has been under consideration by congress since the mid-1990s (National Alliance on Mental Illness fNAMU. 2014). The Americans with Disabilities Act, which took effect in 1992, supported parents and consumers in the workplace and with public accommodations (Frank & Glied. 2007). Participation in public disability insurance programs, such as Medicare, Medicaid, Social Security Disability Insurance (SSDI) and its sister program, Supplemental Security Income (SSI), provide a stable, though often minimal, source of income for people disabled by mental illness. More recently, the Affordable Care Act promises improved access to care and parity protection through expanded insurance coverage for mental illness and substance abuse disorders (Beronio. Po. Skoo","PeriodicalId":35614,"journal":{"name":"Online Journal of Issues in Nursing","volume":"20 1","pages":"1 p preceding 1"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34597607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01DOI: 10.3912/ojin.vol20no03crbcol03
Alyce S. Ashcraft
{"title":"Cochrane Review Brief: Gloves, Extra Gloves or Special Types of Gloves for Preventing Percutaneous Exposure Injuries in Healthcare Personnel.","authors":"Alyce S. Ashcraft","doi":"10.3912/ojin.vol20no03crbcol03","DOIUrl":"https://doi.org/10.3912/ojin.vol20no03crbcol03","url":null,"abstract":"","PeriodicalId":35614,"journal":{"name":"Online Journal of Issues in Nursing","volume":"20 3 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70293437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-12-18DOI: 10.3912/ojin.vol20no01infocol01
L. Thede, P. Schwirian
This is the fifth column reporting the results of a survey addressing nurses' attitudes and perceptions regarding standardized nursing terminologies, and completed by the authors in the fall of 2011. Prior columns have examined the demographics of our respondents and their familiarity with the American Nurse?.Association (ANA), standard ized nursing.terminologies (Schwirian & Ih.iad.fi> 2Q12); educational preparation for using the.terminologies, (Thede & Schwirian, 2013b): users perception .of confidence in using the..term in.ologi.es (Ihe.de & Schwirian ,.20.13.0 ; and offsets of documenting with sta nda rdized nursing, terminologies (Thede & Schwirian 20.13a*)In this column, we will report users' opinions about the helpfulness of a terminology in actual clinical practice. The findings presented below are from those respondents who answered 'yes' to the following three questions about the terminology: (a) are you familiar with the terminology?, (b) have you used it in some way?, and (c) have you used this particular terminology in actual patient care?Table 1 and Figure 1 illustrate the percentage of clinical users of a terminology who found the terminology helpful in actual clinical practice.; With the exception of the International Classification of Nursing Practice (ICNP) terminology, for which there were only four responses, more than 60% of clinical users of the nursing-specific terminologies found them helpful in clinical patient care. The Clinical Care Classification (CCC) users and the Omaha System users gave the most positive responses as noted in Table 1. Users of the interdisciplinary terminologies, Logical Observation Identifiers Names and Code (LOINC) and Systematized Nomenclature of Medicine Clinical Terminology (SNOMED CT), had the least positive perceptions regarding the helpfulness of the terminology in clinical practice. For the nursing-specific terminologies, North American Nursing Diagnosis Association, International (NANDA-I) and the Nursing Outcomes Classification (NOC) had relatively high percentages of users who did not find the terminology helpful in clinical practice.Tasks for Standardized TerminologiesClinical users of a terminology who answered 'yes' to the question about whether a terminology was helpful in clinical practice were then asked, "In what ways was X (the specific terminology) helpful to you?" A list of possible choices followed (below). Participants could check as many options as they felt were relevant and could also add other options.* Organizing patient care* Planning care* Generating appropriated outcomes* Generating appropriate interventions* Retrieving information on the same term for many patients* Other (please specify) or commentsTable 2 reports the numbers of respondents who selected each task and the percentage of clinical users of that terminology who found it helpful in that area. The bottom line provides the overall average of the helpfulness of the terminologies for each task/option. If one
{"title":"Informatics: The Standardized Nursing Terminologies: A National Survey of Nurses' Experience and Attitudes--SURVEY II: Participants' Perception of the Helpfulness of Standardized Nursing Terminologies in Clinical Care.","authors":"L. Thede, P. Schwirian","doi":"10.3912/ojin.vol20no01infocol01","DOIUrl":"https://doi.org/10.3912/ojin.vol20no01infocol01","url":null,"abstract":"This is the fifth column reporting the results of a survey addressing nurses' attitudes and perceptions regarding standardized nursing terminologies, and completed by the authors in the fall of 2011. Prior columns have examined the demographics of our respondents and their familiarity with the American Nurse?.Association (ANA), standard ized nursing.terminologies (Schwirian & Ih.iad.fi> 2Q12); educational preparation for using the.terminologies, (Thede & Schwirian, 2013b): users perception .of confidence in using the..term in.ologi.es (Ihe.de & Schwirian ,.20.13.0 ; and offsets of documenting with sta nda rdized nursing, terminologies (Thede & Schwirian 20.13a*)In this column, we will report users' opinions about the helpfulness of a terminology in actual clinical practice. The findings presented below are from those respondents who answered 'yes' to the following three questions about the terminology: (a) are you familiar with the terminology?, (b) have you used it in some way?, and (c) have you used this particular terminology in actual patient care?Table 1 and Figure 1 illustrate the percentage of clinical users of a terminology who found the terminology helpful in actual clinical practice.; With the exception of the International Classification of Nursing Practice (ICNP) terminology, for which there were only four responses, more than 60% of clinical users of the nursing-specific terminologies found them helpful in clinical patient care. The Clinical Care Classification (CCC) users and the Omaha System users gave the most positive responses as noted in Table 1. Users of the interdisciplinary terminologies, Logical Observation Identifiers Names and Code (LOINC) and Systematized Nomenclature of Medicine Clinical Terminology (SNOMED CT), had the least positive perceptions regarding the helpfulness of the terminology in clinical practice. For the nursing-specific terminologies, North American Nursing Diagnosis Association, International (NANDA-I) and the Nursing Outcomes Classification (NOC) had relatively high percentages of users who did not find the terminology helpful in clinical practice.Tasks for Standardized TerminologiesClinical users of a terminology who answered 'yes' to the question about whether a terminology was helpful in clinical practice were then asked, \"In what ways was X (the specific terminology) helpful to you?\" A list of possible choices followed (below). Participants could check as many options as they felt were relevant and could also add other options.* Organizing patient care* Planning care* Generating appropriated outcomes* Generating appropriate interventions* Retrieving information on the same term for many patients* Other (please specify) or commentsTable 2 reports the numbers of respondents who selected each task and the percentage of clinical users of that terminology who found it helpful in that area. The bottom line provides the overall average of the helpfulness of the terminologies for each task/option. If one ","PeriodicalId":35614,"journal":{"name":"Online Journal of Issues in Nursing","volume":"20 1 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2014-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70293005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-12-04DOI: 10.3912/OJIN.VOL20NO01PPT01
J. Blando, M. Ridenour, D. Hartley, Carri Casteel
Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings in light of previous studies and experiences and offer suggestions for decreasing WPV in healthcare settings. They conclude that although many of these challenges to effective implementation of workplace violence programs are both within the program itself and relate to broader industry and societal issues, creative innovations can address these issues and improve WPV prevention programs.
{"title":"Barriers to Effective Implementation of Programs for the Prevention of Workplace Violence in Hospitals.","authors":"J. Blando, M. Ridenour, D. Hartley, Carri Casteel","doi":"10.3912/OJIN.VOL20NO01PPT01","DOIUrl":"https://doi.org/10.3912/OJIN.VOL20NO01PPT01","url":null,"abstract":"Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings in light of previous studies and experiences and offer suggestions for decreasing WPV in healthcare settings. They conclude that although many of these challenges to effective implementation of workplace violence programs are both within the program itself and relate to broader industry and societal issues, creative innovations can address these issues and improve WPV prevention programs.","PeriodicalId":35614,"journal":{"name":"Online Journal of Issues in Nursing","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70292953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-11-12DOI: 10.3912/ojin.vol20no02legcol01
K. Rogers, M. Zeni
Autism Spectrum Disorder (ASD) is a neurodevelopmental, chronic illness characterized by abnormal or impaired development in social interaction and communication, and a restricted repertoire of activity and interests (American Psychiatric Association. 20001. The Centers for Disease Control and Prevention (20141 has estimated that 1 in 68 United States (U.S.) children have been diagnosed with ASD by the age of three; schoolaged boys comprise 1 in 42 of the children diagnosed with ASD. ASD is the fastest growing developmental disability (Autism Speaks. 2011: Centers of Disease Control and Prevention. 20141. Children and adolescents living with ASD may need care from both primary healthcare providers and medical specialists, as well as behavioral health, social, educational, and vocational services.Furthermore, children living with ASD are more frequently diagnosed with other developmental, psychiatric, neurologic, or medical co-occurring chronic illnesses than are children without an ASD diagnosis (Levy et al.. 20101. Analyzing Medicaid insurance claims of ASD children in eight states in the US through ICD-9-CM codes for ASD, Peacock, Amendah, Ouyang, and G rosse (20121 reported that 53% of the ASD children were commonly diagnosed with attention deficit/hyperactivity disorder, seizures, or intellectual disabilities and that the financial cost of managing these illnesses in ASD children was six times greater than for children with nonASD diagnosis. Peacock et al. (20121 also noted significant differences in the cost of outpatient services, medication, and inpatient services between children with ASD and children with non-ASD diagnoses.Due to the needs and complexities of children and adolescents living with ASD, care coordination by a primary care provider within a medical home model is strongly encouraged. Previous researchers have documented the benefits of access to a medical home for children and adolescents, especially if a special health need is present (Strickland et al.. 20041. Healthy People 2020 (U.S. Department of Health and Human Services, 20121 (MICH-30 and MICH-31) established a goal to increase access to medical homes for children with special healthcare needs (CSHCN) to ensure that every child's preventative and special healthcare needs are met without any gaps in care. A medical home, or patient-centered healthcare home, provides coordination of care with a primary healthcare provider who is able to offer a seamless transfer of pediatric-specific primary care into adulthood. Yet children and adolescents with ASD more often lack a medical home compared to children with other special needs, especially during their transition into adult, primary healthcare (Golnik. Ireland. & Borowskv, 20091.Resources for transitioning older adolescents and young adults living with ASD into any adult social or health services decrease dramatically after age 22 (Gerhardt. 20091. During this transitional period, gaps in healthcare services are likely to
自闭症谱系障碍(ASD)是一种神经发育的慢性疾病，其特征是社交互动和沟通发育异常或受损，以及活动和兴趣受限(美国精神病学协会，2001)。美国疾病控制和预防中心(2014)估计，68名美国儿童中有1名在3岁之前被诊断患有ASD;在被诊断为自闭症谱系障碍的儿童中，每42名学龄男孩中就有1名。ASD是增长最快的发育性残疾(Autism Speaks. 2011: Centers of Disease Control and Prevention. 20141)。患有ASD的儿童和青少年可能需要初级卫生保健提供者和医学专家的护理，以及行为健康、社会、教育和职业服务。此外，与没有ASD诊断的儿童相比，患有ASD的儿童更容易被诊断出患有其他发育、精神、神经或医学上共存的慢性疾病(Levy等)。20101. Peacock、Amendah、Ouyang和G rosse(20121)通过对美国8个州ASD儿童的ICD-9-CM代码进行分析，发现53%的ASD儿童通常被诊断为注意力缺陷/多动障碍、癫痫发作或智力障碍，并且ASD儿童治疗这些疾病的财务成本是非ASD儿童的6倍。Peacock等人(20121)也注意到自闭症儿童和非自闭症儿童在门诊服务、药物治疗和住院服务方面的成本存在显著差异。由于患有自闭症的儿童和青少年的需求和复杂性，强烈鼓励在医疗家庭模式下由初级保健提供者进行护理协调。以前的研究人员已经记录了儿童和青少年进入医疗之家的好处，特别是如果存在特殊的健康需求(Strickland等人)。20041. 《健康人群2020》(美国卫生与公众服务部，20121 (MICH-30和MICH-31))确立了一项目标，即增加有特殊医疗需求的儿童(CSHCN)获得医疗服务的机会，以确保每个儿童的预防和特殊医疗需求得到满足，而不会出现任何护理缺口。医疗之家，或以患者为中心的医疗之家，提供与初级医疗保健提供者的护理协调，初级医疗保健提供者能够提供儿科特定初级保健到成人的无缝转移。然而，与有其他特殊需要的儿童相比，患有自闭症谱系障碍的儿童和青少年往往缺乏医疗之家，尤其是在他们向成人过渡的初级卫生保健阶段(Golnik)。爱尔兰。& Borowskv, 20091。在22岁之后，将患有自闭症谱系障碍的年长青少年和年轻人转移到任何成人社会或健康服务机构的资源急剧减少(Gerhardt, 20091)。在这一过渡时期，如果没有成人初级医疗之家，就可能出现保健服务方面的差距。需要过渡性医疗之家。不幸的是，在过渡医疗院里，护理工作并不重要。在这一转变过程中缺乏护理存在的原因包括缺乏对自闭症谱系障碍的知识和从青少年到成人医疗保健服务转变的概念(Osterkamp)。使用。Ehrhardt。& Grom lev。20131. 我们推荐以下方法来促进自闭症患者从青少年服务到成人服务的有效过渡:(a)发展高级护理实践角色，以促进医疗保健转型;(b)对所有成人初级医疗保健提供者进行有关自闭症谱系障碍的教育;(c)通过立法宣传，向当选官员宣传自闭症谱系障碍患者的医疗保健问题，以及支持2011年《抗击自闭症再授权法》继续实施的必要性，以便从战略上规划自闭症谱系障碍患者的需求。…
{"title":"Legislative: Transitioning the Older Adolescent Living with Autism Spectrum Disorder to Adult Primary Medical Home: A Call for Nursing Action.","authors":"K. Rogers, M. Zeni","doi":"10.3912/ojin.vol20no02legcol01","DOIUrl":"https://doi.org/10.3912/ojin.vol20no02legcol01","url":null,"abstract":"Autism Spectrum Disorder (ASD) is a neurodevelopmental, chronic illness characterized by abnormal or impaired development in social interaction and communication, and a restricted repertoire of activity and interests (American Psychiatric Association. 20001. The Centers for Disease Control and Prevention (20141 has estimated that 1 in 68 United States (U.S.) children have been diagnosed with ASD by the age of three; schoolaged boys comprise 1 in 42 of the children diagnosed with ASD. ASD is the fastest growing developmental disability (Autism Speaks. 2011: Centers of Disease Control and Prevention. 20141. Children and adolescents living with ASD may need care from both primary healthcare providers and medical specialists, as well as behavioral health, social, educational, and vocational services.Furthermore, children living with ASD are more frequently diagnosed with other developmental, psychiatric, neurologic, or medical co-occurring chronic illnesses than are children without an ASD diagnosis (Levy et al.. 20101. Analyzing Medicaid insurance claims of ASD children in eight states in the US through ICD-9-CM codes for ASD, Peacock, Amendah, Ouyang, and G rosse (20121 reported that 53% of the ASD children were commonly diagnosed with attention deficit/hyperactivity disorder, seizures, or intellectual disabilities and that the financial cost of managing these illnesses in ASD children was six times greater than for children with nonASD diagnosis. Peacock et al. (20121 also noted significant differences in the cost of outpatient services, medication, and inpatient services between children with ASD and children with non-ASD diagnoses.Due to the needs and complexities of children and adolescents living with ASD, care coordination by a primary care provider within a medical home model is strongly encouraged. Previous researchers have documented the benefits of access to a medical home for children and adolescents, especially if a special health need is present (Strickland et al.. 20041. Healthy People 2020 (U.S. Department of Health and Human Services, 20121 (MICH-30 and MICH-31) established a goal to increase access to medical homes for children with special healthcare needs (CSHCN) to ensure that every child's preventative and special healthcare needs are met without any gaps in care. A medical home, or patient-centered healthcare home, provides coordination of care with a primary healthcare provider who is able to offer a seamless transfer of pediatric-specific primary care into adulthood. Yet children and adolescents with ASD more often lack a medical home compared to children with other special needs, especially during their transition into adult, primary healthcare (Golnik. Ireland. & Borowskv, 20091.Resources for transitioning older adolescents and young adults living with ASD into any adult social or health services decrease dramatically after age 22 (Gerhardt. 20091. During this transitional period, gaps in healthcare services are likely to ","PeriodicalId":35614,"journal":{"name":"Online Journal of Issues in Nursing","volume":"20 1 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2014-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70292887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-09-30DOI: 10.3912/ojin.vol19no03man03
C. Blum
Self-care is imperative to personal health, sustenance to continue to care for others, and professional growth. This article briefly reviews stressors common to students and nurses and the importance of practicing self-care to combat stress and promote health in practice. Florida Atlantic University offers a course for all levels of undergraduate nursing students called Caring for Self. The course, supported by principles of Adult Learning Theory, focuses on guiding the nurse to practice and model self-care. The author describes the evolution of this self-care initiative by discussing the needs assessment, course description and strategies, examples of course activities, and an exemplar of student impact. The conclusion offers discussion of challenges and lessons noted by faculty and students.
{"title":"Practicing Self-Care for Nurses: A Nursing Program Initiative.","authors":"C. Blum","doi":"10.3912/ojin.vol19no03man03","DOIUrl":"https://doi.org/10.3912/ojin.vol19no03man03","url":null,"abstract":"Self-care is imperative to personal health, sustenance to continue to care for others, and professional growth. This article briefly reviews stressors common to students and nurses and the importance of practicing self-care to combat stress and promote health in practice. Florida Atlantic University offers a course for all levels of undergraduate nursing students called Caring for Self. The course, supported by principles of Adult Learning Theory, focuses on guiding the nurse to practice and model self-care. The author describes the evolution of this self-care initiative by discussing the needs assessment, course description and strategies, examples of course activities, and an exemplar of student impact. The conclusion offers discussion of challenges and lessons noted by faculty and students.","PeriodicalId":35614,"journal":{"name":"Online Journal of Issues in Nursing","volume":"19 3 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2014-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70292126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-09-30DOI: 10.3912/OJIN.VOL19NO03MAN02
J. Jackson, R. Fraser, P. Ash
Social media use can have a significant impact on the health of nurses, both at the individual level and in the workplace. There are positive and negative consequences of social media use for nurses, including potential health consequences. This article provides a brief overview of social media and then explores nursing health and social media and risks for nurses. Social media use also extends to healthcare organizations; with implications for consumers of healthcare delivery. A variety of emerging best practices can guide social media use for nurses. The authors also discuss suggestions for using social media carefully, and future directions for research.
{"title":"Social Media and Nurses: Insights for Promoting Health for Individual and Professional Use.","authors":"J. Jackson, R. Fraser, P. Ash","doi":"10.3912/OJIN.VOL19NO03MAN02","DOIUrl":"https://doi.org/10.3912/OJIN.VOL19NO03MAN02","url":null,"abstract":"Social media use can have a significant impact on the health of nurses, both at the individual level and in the workplace. There are positive and negative consequences of social media use for nurses, including potential health consequences. This article provides a brief overview of social media and then explores nursing health and social media and risks for nurses. Social media use also extends to healthcare organizations; with implications for consumers of healthcare delivery. A variety of emerging best practices can guide social media use for nurses. The authors also discuss suggestions for using social media carefully, and future directions for research.","PeriodicalId":35614,"journal":{"name":"Online Journal of Issues in Nursing","volume":"19 3 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2014-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70292169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-09-30DOI: 10.3912/OJIN.VOL19NO03MAN05
N. Albert, R. Butler, J. Sorrell
Hospitals often promote healthy lifestyles, but little is known about nurses' actual diet and physical activity. Greater understanding about these lifestyle choices for clinical nurses may improve existing hospital-based programs and/or create desirable services. This article discusses a study that considered diet and physical activity of clinical nurses, using elements of Pender's self-care theory as a conceptual framework. Study methods included a cross-sectional, correlational design and a convenience sample of 278 nurses who worked on units with 24 hours/day and seven days-per-week responsibilities. Participants completed diet and exercise questionnaires about perceptions of attitudes and opinions, barriers, diet benefits/exercise motivators, self-efficacy, and locus of control, and personal and work characteristics. Diet and activity categories were created. Study results demonstrated that over 50% of nurses had moderately healthy diets but were insufficiently active. Healthy diet and physical activity levels were associated with higher self-efficacy, more diet benefits and physical activity motivators, fewer perceived barriers, and confidence in body image. The article discussion and conclusion sections note areas for future research and suggest that focused interventions that address benefits, motivators, and self-efficacy may increase participation in hospital-based programs and enhance healthy lifestyle for hospital-based clinical nurses.
{"title":"Factors Related to Healthy Diet and Physical Activity in Hospital-Based Clinical Nurses.","authors":"N. Albert, R. Butler, J. Sorrell","doi":"10.3912/OJIN.VOL19NO03MAN05","DOIUrl":"https://doi.org/10.3912/OJIN.VOL19NO03MAN05","url":null,"abstract":"Hospitals often promote healthy lifestyles, but little is known about nurses' actual diet and physical activity. Greater understanding about these lifestyle choices for clinical nurses may improve existing hospital-based programs and/or create desirable services. This article discusses a study that considered diet and physical activity of clinical nurses, using elements of Pender's self-care theory as a conceptual framework. Study methods included a cross-sectional, correlational design and a convenience sample of 278 nurses who worked on units with 24 hours/day and seven days-per-week responsibilities. Participants completed diet and exercise questionnaires about perceptions of attitudes and opinions, barriers, diet benefits/exercise motivators, self-efficacy, and locus of control, and personal and work characteristics. Diet and activity categories were created. Study results demonstrated that over 50% of nurses had moderately healthy diets but were insufficiently active. Healthy diet and physical activity levels were associated with higher self-efficacy, more diet benefits and physical activity motivators, fewer perceived barriers, and confidence in body image. The article discussion and conclusion sections note areas for future research and suggest that focused interventions that address benefits, motivators, and self-efficacy may increase participation in hospital-based programs and enhance healthy lifestyle for hospital-based clinical nurses.","PeriodicalId":35614,"journal":{"name":"Online Journal of Issues in Nursing","volume":"19 3 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2014-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70292250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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