《今日美国护士》2016年8月总第11卷第8期
American Nurse Today
August 2016 Vol. 11 No. 8
Continuing Education
Urgent care for stroke patients: Timing is everything
中风患者的急诊护理：时间就是一切
For stroke patients who meet certain criteria, thrombolytic therapy to break down blood clots is the primary treatment option. Tissue plasminogen activator (tPA), the most frequently used thrombolytic, is a protein that catalyzes the conversion of plasminogen to plasmin, the major enzyme that breaks down clots. To be eligible for tPA, the patient must reach a certified stroke center as soon as possible after symptom onset. By some estimates, only 3% to 5% of stroke patients get to thehospital in time to receive tPA.
Features
Conservative treatment for the silent epidemic of pelvic organ prolapse
沉默流行病盆腔器官脱垂的保守治疗
Pelvic organ prolapse (POP) is the protrusion of the pelvic organs against the vaginal walls towards or through the vaginal opening. The number of women suffering with POP is difficult to determine, but reports indicate that symptoms affect up to 50% of females as they age.
Leading the Way
The power of Lean Six Sigma
精益6西格玛的力量
Lean and Six Sigma are well-established quality improvement tools. Combining the two creates a synergistic effect, boosting effectiveness. In the hospital where I work, we used Lean Six Sigma to reduce hospital acquired pressure ulcers (HAPU) by 60%. In this article, I answer common questions related to these tools so you can apply them in your own organizations.
Practice Matters
Suicide, physician-assisted suicide and mercy killing: Similarities, differences, cautions, and precautions
自杀、医生协助自杀和安乐死：相同点、差异、注意事项及预防措施
The easiest, and most objective way to begin a discussion of intentionally caused death (and this much I can tell you: this topic will dominate the medical-ethical world for the next decade) is with the dictionary definitions* of each type.
Transforming nursing practice: The patient-centered medical home
转变护理实践：以病人为中心的医疗之家
Primary care faces many challenges. Healthcare reform has and will continue to have a direct impact on primary care practices across the nation, with current trends in health care transforming nursing, advanced practice nursing, and the delivery of health care as we know it in a variety of ways. The implementation of patient-centered medical homes (PCMH) is one example of how economic constraints placed upon the current healthcare system have transformed nursing practice. Nurses and advanced practice nurses (APNs) will play an integral role in the implementation of new U.S. healthcare models such as the PCMH.
Physician and nurse engagement: From concept to collaboration
医生和护士参与：从概念到协作
In today’s complex healthcare environment, it’s crucial for all members of the healthcare team to work together in a collaborative, collegial manner in an effort to provide the best patient care. Physicians and nurses play a prominent role in this process. On the surface, the idea of physicians and nurses working well together seems straightforward, but in reality, things are not quite so simple.
Inside ANA
Incorporating the consumer voice to advance health policy
听消费者声音推动卫生政策进步
There is growing awareness that engaging patients, families, and consumers as partners in designing healthcare systems and developing health policy may have a significant impact on cost and outcomes. Patient engagement has been defined as “patients, families, their representatives, and health professionals working in active partnership at various levels across the healthcare system . . . to improve health and health care.” Importantly, this definition is understood to include “other consumers and citizens.”
Career Sphere
Retirement countdown: Are Baby Boomer Nurses prepared for what lies ahead?
退休倒计时：婴儿潮一代出生护士为此作好准备了吗？
Baby Boomers (born from 1946 – 1964), eager to step away from the pressures and responsibilities of the workplace and embark on the next chapter of their lives, now retire at a rate of 10,000 per day. Given that most workers heading into retirement lack sufficient income to fund living and healthcare expenses, many Boomers struggle to determine their financial “readiness to retire.” Boomers should indeed be concerned with what may lie ahead during their golden years, which current life span projections suggest may be up to 30 years after employment. Many wonder if their retirement nest egg will last that long. Unfortunately, research suggests that for the majority of aging American workers, retirement savings may fall seriously short of that needed to fund a reasonably comfortable retirement.
Mind/Body/Spirit
Look for inspiration in your fellow nurses
从你的护士同伴中寻找灵感
In a perfect world, we nurses would be inspired daily by our patient experiences. They would come in such abundance that overtime, computer crashes, and 10-minute meal breaks would be minor nuisances brushed off like a piece of lint on our scrubs.
The reality is this: Some days are hard. Some are plain repetitive. (I can say that because I’ve worked on an endoscopy unit. I remember a Monday we did 14 colonoscopies, nothing else.)
Strictly Clinical
Keep kids moving
让小孩动起来
One-third of American children are overweight or obese. Although many factors contribute to this epidemic, one cause for the rise in childhood obesity is a decrease in physical activity. We now live in a society where more children are driven to school than walking themselves. Video games and social media are now the entertainment of choice instead of riding bikes or playing tag. More than half of communities are without sidewalks and parks, which makes physical activity difficult or dangerous.
Drugs and Devices
Effectiveness of abaloparatide in patients with osteoporosis
Abaloparatide对骨质疏松症患者的有效性
Subcutaneous abaloparatide reduces the risk of new vertebral and nonvertebral fractures over 18 months in patients with osteoporosis, according to a study in JAMA.
Hepatitis C treatment safe, effective for those treated for opioid addiction
丙型肝炎药物治疗阿片成瘾安全、有效
Elbasvir–grazoprevir for hepatitis C is safe and effective for treating patients receiving opioid-agonist therapy for substance abuse, according to a study in Annals of Internal Medicine.
FDA updates warning for fluoroquinolone antibiotics
FDA更新氟喹诺酮类抗生素通告
The Food and Drug Administration (FDA) has approved safety labeling changes for a class of antibiotics called fluoroquinolones to enhance warnings about their association with disabling and potentially permanent side effects and to limit their use in patients with less serious bacterial infections.
FDA approves injection for type 2 diabetes
FDA批准2型糖尿病注射药
On July 28, the Food and Drug Administration (FDA) approved Adlyxin (lixisenatide), a once-daily injection to improve glycemic control, along with diet and exercise, in adults with type 2 diabetes.
Take Note - Practice Updates
Stroller- or carrier-related injuries
婴儿车或载具相关损伤
From 1990 through 2010, almost 361,000 children aged 5 years and younger were treated in U.S. hospital emergency departments for stroller- or carrier-related injuries, about two children every hour, according to a study in Academic Pediatrics.
Mindfulness reduces depression
正念可以减少抑郁
Eight weeks of mindfulness training helped alleviate depression and reduce stress in African-American women with lower socioeconomic status, according to a study in Complementary Therapies in Clinical Practice.
Medicaid expansion and ED use
医疗补助计划的扩张和使用
The expansion of Medicaid insurance coverage in the Patient Protection and Affordable Care Act did not increase hospital emergency department (ED) visits, but did strongly affect payer mix, according to a study in Health Affairs.
Mediterranean diet may slow cognitive decline
地中海饮食可以减缓认知能力下降
Adherence to a Mediterranean diet is associated with slower rates of cognitive decline, reduced conversion to Alzheimer’s disease, and improvements in cognitive function, according to a systematic review in Frontiers in Nutrition.
Placental syndromes increase risk of cardiovascular disease
胎盘综合症增加心血管疾病风险
The short-term risk of developing cardiovascular disease is higher in women who experience placental syndromes and preterm birth or small-for-gestational-age infants, according to a study in the American Journal of Obstetrics & Gynecology.
ADHD drugs may reduce risky sexual behavior in teens
多动症药物可以降低青少年危险性性行为
A study in Labour Economics reports that drugs used to treat attention-deficit/hyperactivity disorder (ADHD) in children may reduce the likelihood of risky sexual behavior outcomes, substance abuse disorders, and injuries.
Positive attitude towards aging helps older adults manage stress
对老年人的积极态度有助老人的压力管理
A study in the Journal of Gerontology reports that older adults who have a more positive view of aging are better able to deal with daily stressors.
Hospitals that admit higher percentage of heart failure patients to ICU have lower quality results
ICU心脏衰竭患者收治率高的医院保健质量较低
Hospitals with the highest rates of ICU admission for patients with heart failure have lower quality of care and higher 30-day mortality, according to a study in CHEST.
Editorial
A Capital idea?
上一篇：《高级护理杂志》总第72.9期
下一篇：《精神科护理档案》总第30.4期
当前位置：
