UW Medical Center 1st in U.S. to Earn Nursing Distinction

UW Medical Center 1st in U.S. to Earn Nursing Distinction

The University of Washington Medical Center-Montlake in Seattle has become the first hospital in the U.S. to earn seven consecutive “Magnet” designations for gold-standard nursing excellence, as defined by the American Nurses Credentialing Center (ANCC).

UW Medical Center also was the hospital chosen to inaugurate the Magnet designation program in 1994.

“I am so proud and honored to work with such a distinguished team,” said Cindy Sayre, Chief Nursing Officer at the Montlake campus. “Every nurse in the hospital was instrumental to this achievement, which recognizes the excellent care we provide to our patients every day.”

Sayre received notice on Nov. 16 of the unanimous-vote designation from Jeanette Ives Erickson, chair of the ANCC’s Commission on Magnet Recognition. The hospital, Ives Erickson said, has delivered exemplary care, in particular during the emergence of the COVID-19 epidemic.

“The good work that you did, not only within your own organization, but the rest of us benefited from … your sharing of policies and procedures, keeping nurses across the country informed. On behalf of a grateful nation, we want to thank all of you for paving the way through three of the most difficult years we have had in healthcare,” Ives Erickson told Sayre via Zoom.

Hospitals achieve Magnet recognition by having an outstanding clinical practice that results in better patient care, Sayre said, and for having protocols that empower nurses to be autonomous, to initiate change to policy and clinical care, and to advance into roles with greater responsibility. Magnet recognition is in effect for four years.

The designation serves as a recruiting tool, as well, Sayre added. “Nurses looking for employment can be assured that they’re going to be supported to practice at the highest scope of their license. It validates that we have supportive policies that help nurses.”

Study Finds LED Lighting Cuts Risk of Falls 43 Percent

Study Finds LED Lighting Cuts Risk of Falls 43 Percent

Falls in two long-term care facilities dropped by 43% after installing a dynamic LED lighting program tuned to natural sleep and wake rhythms, according to a study by researchers from Brigham and Women’s Hospital and Midwest Lighting Institute.

Investigators assessed the impact of solid-state (LED) lighting on visual acuity, alertness, and sleep and its potential influence on falls across two pairs of facilities.

Two experimental facilities received a solid-state lighting installation that changed intensity and spectrum by increasing short-wavelength (blue light) exposure during the day and decreasing it overnight. Two control facilities kept their standard static lighting, with no change in intensity or spectrum during the day.

Researchers tracked falls using medical records over approximately 24 months. Following the lighting upgrade, falls decreased by 43% at the experimental sites compared to the control sites.

Before the lighting upgrades, the falls rates were similar between the experimental and control facilities.

LED Lighting: Inexpensive Falls Intervention

Fall prevention programs tend to have modest results and are resource and time-intensive, notes Shadab Rahman, Ph.D. MPH, Investigator in the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital, and Assistant Professor of Medicine at Harvard Medical School.

But he says upgrading to solid-state lighting — which also offers superior energy efficiency — is a safe, effective, low-cost, low-burden preventative strategy to reduce fall risk in long-term care settings. And one that has tremendous potential to save lives and improve patients’ health and well-being.

The findings were published in JAMDA.

Documentary Honors Nurses on the Front-Lines Throughout the Pandemic

Documentary Honors Nurses on the Front-Lines Throughout the Pandemic

Lehigh Valley Health Network’s (LVHN) first-of-its-kind documentary honors its nurses by sharing stories about their heroic work throughout the COVID-19 pandemic. The documentary features four nurses who, throughout the pandemic, found the bravery, courage, and resilience to continue working through some of the most challenging career experiences.

The documentary, called “The Strength to Heal,” is a testament to nurses worldwide who learned how to persevere in the worst of times. The featured LVHN nurses share how the bonds forged with their patients and learning to care for themselves outside of work allowed them to keep going, even when the going was getting tough.

“I believe that the foundation of great medical care is nursing, and LVHN’s nurses are among the best you will find. During the challenging initial years of the pandemic, the community turned to LVHN and its nurses not just for stability and care, but for compassion and emotional support,” says Brian A. Nester, DO, MBA, President and Chief Executive Officer of LVHN. “The strength, resiliency, and commitment to patients in the face of uncertainty demonstrated by our nurses are nothing short of heroic. We’re thrilled to showcase that dedication and strength of character in this documentary.”

The documentary highlights nurses’ commitment to their patients and the critical role they are still playing in the community’s fight against COVID-19. 

 

Each of the LVHN nurses featured in the documentary exemplifies dedication to providing high-quality patient care that drives improved patient outcomes and leaves an indelible mark on those in their care. From brightening birthdays spent in the hospital with COVID to bringing loved ones together when difficult goodbyes were made – many virtually – these nurses provided compassionate and personalized support. 

This commitment shone through even as they faced challenges, such as isolating themselves from friends and family so they could continue reporting to the front lines to care for others or facing fears of bringing COVID home to their children. Their strength and resiliency are characteristic of LVHN’s approach to patient care.

The detailed stories featured in the documentary provide a complete view into the lives of nurses during those challenging times. Like those of their colleagues in the nursing community, their stories reflect the difficulties that nurses faced across the nation – providing a complete, detailed look into their lives inside and outside of their work during the height of the pandemic. 

One story, in particular, comes from nurse Nichole Persing, Director of Patient Care Services, Intensive Care Unit (ICU), Lehigh Valley Hospital–Hecktown Oaks, who likened navigating the challenging time to the athletic endurance training she completed to compete in multiple Ironman competitions. 

She shares in this documentary how her passion for training for Ironman races allowed her to apply the endurance mindset to her nursing work, helping her persevere in the most daunting situations as she led an ICU unit through the pandemic and provided care firsthand to affected community members.

“The nursing profession has been irrevocably altered by the pandemic,” Nester says. “This documentary provides an opportunity to pause and reflect on our shared experiences and find meaning in what we will carry forward.”

Monkeypox: What Nurses Need to Know

Monkeypox: What Nurses Need to Know

Cases of monkeypox have greatly diminished in the U.S., but that doesn’t mean it’s gone for good or won’t come back in another form.

Daily Nurse spoke with Jennifer Meyer, Assistant Professor at the University of Alaska Anchorage, Division of Population Health Services, about monkeypox and what nurses should be aware of treating patients. (The interview has been edited for length and clarity).

Q: I know that monkeypox is a virus, but is it similar to COVID?

Although both are viruses, and we have vaccines and antivirals that can significantly prevent infection and reduce serious outcomes like prolonged hospitalization/death, several critical differences exist. Since May, about 20,000 Monkeypox cases have been reported.

First, monkeypox is not a novel virus like SARS-CoV-2, the virus that causes COVID-19. Monkeypox was identified in the 1950s, while SARS-CoV-2 was identified in 2019. Follow current U.S. case data here and Global data here.

The second key difference relates to transmission. Early versions of SARS-CoV-2 appeared to predominantly be transmitted by droplets in the air from one person to another.  Current versions appear to be far more efficiently transmitted in aerosols. How does this happen? Consider the three D’s.

If a virus is changing and finding ways to infect more people, it usually means you need less of a dose or exposure to the virus to cause an infection or less duration of exposure to the virus to cause an infection and/or changes in the distance the virus travels or survives while moving from one host to another.

These days current SARS-CoV-2 variants (like Omicron) can easily transmit through the air in tiny aerosolized particles that can travel greater distances. This has been one of the lessons learned regarding our primitive descriptive terminology for infectious disease transmission.

Traditional terminology would indicate that monkeypox is predominantly transmitted via direct close contact with an infected person with symptoms (rash, sores, feeling ill) or soiled/contaminated surface/linens, etc. However, there is some evidence that Monkeypox can be transmitted via respiratory secretions. Scientists are still investigating how often that occurs along with how infectious someone might be just before the onset of symptoms.

Q: What are the symptoms? How do healthcare professionals know to test for monkeypox?

Symptoms include any combination of the following: rash that can go through several stages, from blisters to scabs, and may include fever, chills, swollen lymph nodes, aches, exhaustion, headaches, muscle aches, congestion, sore throat, etc.

The incubation period for monkeypox is quite long, up to three weeks. Once symptomatic, the person usually gets a rash 1-4 days later. The person is most contagious from when symptoms start to when blisters and scabs have healed, which takes 2-4 weeks. Review clinical guidance here.

Clinicians should be on the lookout for any unexplained rash and, of course, if a patient has been exposed or is suspected to be exposed to someone who has tested positive. Get more guidance here.

In general, viruses don’t live very long when outside the body. Monkeypox, however, can survive a long time–up to 15 days. For comparison, SARS-CoV-2 can survive a maximum of 5 days and HIV a few hours. These experiments are done in controlled lab settings, but you can see a clear difference.

Q: What precautions should nurses take to protect their patients?

Correctly don and doff PPE, wash hands, and disinfect equipment.

Q: What are the myths about monkeypox?

That the infections only occur among gay and bisexual men. While this population is disproportionately affected by monkeypox at this time, anyone can contract it.

Q: Is there a potential for it to have variants?

Certainly, however, pox viruses are not known for changing quickly, while coronaviruses are known for rapid changes.

Q: Is there anything important for our readers to know?

Nurses play a critical role in educating their patients and community. I encourage nurses to stay up-to-date on monkeypox information from high-quality resources. Help patients and community members understand how to protect themselves and each other, especially from health misinformation. Reach out to underserved and historically oppressed members of our community to ensure they have the information and resources they need to stay healthy. Consider inclusive communication strategies, read more here.

Learn more about the new Vaccine Equity Project and if your employer can apply to participate here.

COVID-19 Heightens Risk for Pressure Injuries

COVID-19 Heightens Risk for Pressure Injuries

Patients critically ill with COVID-19 are at exceptionally high risk for developing healthcare-associated pressure injuries (HAPrIs). Therefore, nurses and other clinicians should be extra vigilant with assessments and protective interventions, according to a study published in AACN Advanced Critical Care.

Pressure Injury Risk Assessment and Prevention in Patients With COVID-19 in the Intensive Care Unit” retrospectively examined pressure injury risk in a sample of 1,920 adult patients admitted to one of two intensive care units (ICUs) at a Utah teaching hospital between April 2020 and April 2021.

The study is part of the research team’s ongoing work to develop ways to determine pressure injury risk among ICU patients more accurately. The researchers compared the Braden Scale for Predicting Pressure Sore Risk for patients with COVID-19 with patients who were negative for the disease and identified additional risk factors for device-related HAPrIs in critically ill patients with COVID-19.

“This study and others provide further evidence that patients with severe COVID-19 are at even greater risk for pressure injuries than the general ICU patient population,” says co-author Jenny Alderden, Ph.D., APRN, CCRN, CCNS, associate professor at Boise State University School of Nursing.

Accurately Determining Risk for Pressure Injuries

She says prevention begins with accurately determining risk, and clinicians must consider additional factors beyond those assessed with common classification tools.

Since its development in 1987, the Braden Scale has become the most widely used tool in the United States to determine pressure injury risk across all care settings. Still, a growing body of literature shows that it lacks predictive validity in the ICU population, finding that nearly all ICU patients are at high risk.

The study sample included 1,920 patients, and 407 patients were diagnosed with COVID-19. In the entire sample, at least one HAPrI developed in 354 patients (18%), with a third of those considered device-related. Among the 407 patients with COVID-19, at least one HAPrI developed in each of 120 patients (29%), with nearly half (46%) considered device-related.

The research team looked at data related to demographics, diagnoses, comorbidities, hospital length of stay, treatment interventions, laboratory tests, nutrition, and the results of skin assessments conducted by nurses.

Statistical analysis revealed two variables as potential risk factors for device-related HAPrIs: fragile skin and prone positioning during mechanical ventilation.

The researchers also point to the potential for machine learning methods and explainable artificial intelligence to improve the accuracy of HAPrI risk assessments to provide additional information for clinicians to incorporate into their patient care decisions

Volunteering with Mercy Ships

Volunteering with Mercy Ships

Prior to finding out about Mercy Ships, Christel A. Echu, RN, admits that if you asked her if she wanted to volunteer for any organization and not get paid, she would have said, “No.”

But when a friend who was an authority in the church she attended in Cameroon, Africa, she changed her mind. “I decided to volunteer with Mercy Ships because I was interested in being a part of the great work they were doing for the people of my country, and I wanted to help in any way that I could,” Echu says.

Mercy Ships Bring Hope and Healing

Mercy Ships is a non-profit Christian organization, she says, that sails across West and Central Africa with the mission and vision to provide hope and healing to patients who are poor and/or forgotten in countries there.

When Echu began volunteering with Mercy Ships, she had just graduated from nursing school. First, she worked as a volunteer translator when the ship, the Africa Mercy, was docked in the port of Cameron. She volunteered as a translator for 10 months.

Mercy Ships bring hope and healing

Mercy Ships bring hope and healing

By then, Echo says, she was hooked. She ended up continuing to volunteer for another two years. “I transitioned from that [working as a translator] to working as a volunteer screening nurse until the end of my commitment,” she says. “Screening nurses, we see all the patients before they are seen by the rest of the hospital. We screen, assess, and ensure patients are healthy enough for surgery.”

She says that they pre-screened more than 6,000 patients in a day when they were in Guinea Conakry. “That was the longest shift I have ever had,” she says.

One of the aspects that Echu loved about Mercy Ships is that she got to work with nurses from all over the world: including the Netherlands, Canada, Australia, the United States, and others.

“I loved working with patients and with my team. We also worked alongside our wonderful translators, which was a blessing because they helped to facilitate communication between the patients and nurses,” she recalls. “I think I enjoyed the fact that we could learn from each other to provide the best care to the patients we served. I enjoyed seeing the joy the patients felt whenever we announced to them that they were getting surgery. “The dance of joy” was a thing in the screening tent and I enjoyed seeing the patients come back to show us their “new self” without the tumor or the deformity. Moments like that, reminded me why I decided to volunteer in the first place and kept me going on difficult days.”

Biggest Challenges

There were tough days. Echu says that one of her biggest challenges while working with Mercy Ships was being away from her family, home, and community. But another difficult part was when she had to say “No” to people they couldn’t help.

“This is a part of my job that we don`t talk much about. The ship has specific surgeries they do when they sail in a nation. However, there are patients who present with conditions that are not within Mercy Ships scope of practice and that`s when we get to do ‘no’ conversations. Screening nurses initiate that conversation before the chaplaincy team on the ship takes over,” she says. “That was the most challenging thing about my job—having those ‘no’ conversations was never an easy thing to do. Most of the patients we see come with the hope of being helped, but when we have to say no to them, it almost feels like that hope crumbles before their very eyes.”

Greatest Reward

She also, though, had many rewards—the greatest of which was forming relationships with the ship’s community.  “The relationships I built during that time, [ones] that become an integral part of my life. The community is really special. Now, I have friends all over the world,” says Echu, who now lives in Minnesota. “I do not have family here in the United States, but I know friends with whom I worked with on the ship, [and they] are my family while I am here.”

Echu says she will never forget “the amazing patients I got to work with and their families and the joy they always had on their faces even without having much.”

If you’re a nurse thinking about volunteering with Mercy Ships, she says, “Do it! Go and see for yourself. Have an open mind and be ready to learn and receive as well,” she says. “Most volunteers go on the ship with the mindset of giving and serving which is good, but also go with the mindset of receiving. Receiving could be anything—like being welcome in the house of a local, or being encouraged by a patient who doesn`t have much, but they still have a big smile on their faces. It’s an experience that would change your life completely for good.”

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