American Journal of Nursing最新文献

From the United States to Denmark, an oncology nurse's path to leadership.

Neurodivergent nurses bring unique strengths that can enhance patient care.

Abstract: The youth mental health crisis in the United States was exacerbated by the COVID-19 pandemic, as well as in part by widespread, frequent use of the internet and social media. Schools provide an opportune setting for delivering prompt preventative interventions to actively mitigate this crisis. The purpose of this project was to identify policy recommendations for improving school-based mental health services and reducing inequities in care, as well as to produce guidelines on how to advocate for better policies for school mental health services. School policies were analyzed in 3 states at 3 different levels: the state level, district level, and school level. To augment the policy reviews, unstructured interviews were conducted with 5 school nurses from the 3 states. Recommendations for just and sustainable policies for school-based mental health care and strategies on how to advocate for such policies are outlined. This project exemplifies the need for strong policies to support school mental health, with a focus on the role of the school nurse.

Abstract: This is the fifth article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making (EBDM). It builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step and EBP 2.0: Implementing and Sustaining Change (to access both series, go to https://links.lww.com/AJN/A133). This follow-up series on EBDM will address how to teach and facilitate learning about the evidence-based practice (EBP) and quality improvement (QI) processes and how they impact health care quality. This series is relevant for all nurses interested in EBP and QI, especially DNP faculty and students. The brief case scenario included in each article describes one DNP student's journey. To access previous articles in this EBDM series, go to https://links.lww.com/AJN/A256.

Elevated risk can last for several years after infection.

Background: Insulin pens are the mainstay of insulin delivery in the pediatric population, especially among patients unable to use an insulin pump. Safety pen needle (SPN) devices have been embraced by both nurses and patients because they limit the risks of needlestick injury and exposure to blood-borne pathogens. With the commonly used traditional passive SPN device, however, it can be difficult to observe that the dose has been accurately or fully administered.

Purpose: The purpose of this study was to determine nurses' perceptions about the feasibility of using an active SPN device (specifically the Unifine SafeControl insulin pen needle), compared with the currently used passive SPN device, in pediatric patients ages 21 years or younger who require subcutaneous insulin injections.

Methods: This feasibility study was conducted on a pediatric inpatient unit at 1 pediatric hospital in the southeastern United States. A total of 49 RNs completed both a pre-device change survey regarding the currently used passive SPN device and a post-device change survey regarding the active SPN device. The RNs also completed daily evaluations assessing the ease of teaching patients and their caregivers how to use the active SPN device. Participation consent was also obtained for 132 pediatric patients with diabetes who were admitted to the unit.

Results: The majority of the RNs (87.8%) reported overall satisfaction with the active SPN device, compared to about half (52.7%) who reported overall satisfaction with the passive SPN device. Almost all the RNs (98.6%) reported that the active SPN device was easy or very easy to use. Nearly all the nurses (93.9%) reported feeling completely or very confident that the active SPN device allowed them to deliver the full intended dose; and nearly all reported that it was easy or very easy to teach patients (98.2%) and their caregivers (96.4%) how to use the active device.

Conclusions: As frontline workers in patient care, nurses can lead the innovation and development of new treatment approaches, protocols, and equipment. This nurse-led study explored the nurses' perceptions about the feasibility of a new active SPN device versus the passive SPN device in terms of safety, ease of use, ease of and confidence in dose administration, and ease of teaching device use to pediatric patients and their caregivers. The RNs' clear preference for the active over the passive SPN device suggests that the newer, active devices warrant more widespread use in hospital settings, with further research also recommended.

Nurses safeguard patients with proven practices.

AJN enters its 125th year as the leading voice in nursing.