《今日美国护士》2016年10月总第11卷第10期
American Nurse Today
October 2016 Vol. 11 No. 10
Continuing Education
Reducing intracranial pressure in patients with traumatic brain injury
降低外伤性脑损伤患者的颅内压
Traumatic brain injury (TBI) refers to blunt or penetrating head injury that disrupts normal brain functioning, causing impaired thinking and memory, personality changes, and possible sensory and motor changes. Some people recover completely with no cognitive deficits; others remain in a persistent vegetative state.
Leading the Way
Implementing purposeful daily leadership rounding: A broader approach to measuring quality
实施有目的的每日领导巡查：更加广阔的质量评定途径
Patient satisfaction has long been one way that hospitals measured quality, albeit indirectly. The surgical services division of Rush University Medical Center, an academic medical center in Chicago, IL, planned and implemented a broader approach to measuring quality based on purposeful daily leadership rounding (PDLR) specifically focused on clinical quality and safety outcomes. This article summarizes the process used and highlights key outcomes that were achieved.
Practice Matters
A kinder, gentler workplace, part 2: Impatience
一个更友好、更优雅的工作场所，第2部分：不耐烦
When I was a nursing student making rounds with a surgeon, he decided to remove a patient’s stitches. I hurried to the treatment room for a sterile suture pack and laid it out for him on the tray table. The hemostat didn’t work, so he threw it in my face, cutting me above the right eye.
Preoperative education for patients undergoing total laryngectomy
行喉全切术患者的术前教育
Patients undergoing a total laryngectomy can expect to experience significant lifestyle changes after surgery. Preoperative education is essential in helping them cope with these changes and to recover quickly after surgery. Research shows that surgical patients who perceive they did not receive proper preoperative education experience more dissatisfaction after surgery and have greater difficulty understanding the changes they face. This article focuses on essential aspects of preoperative education for patients undergoing a total laryngectomy.
The seasons of life, change, and grief
生活、变革和悲伤的季节
Just as the seasons of the year change from fall to winter to spring and finally to summer as we journey through life, we experience the seasons of life: wellness, illness, and finally death. The seasons of life will be different for every person, unique to each of us. This article focuses on the incredible relationship between patients and nurses during these times of change, changes that can lead to a profound sense of loss and therefore grief. With the appropriate tools to recognize grief, assess, and gently intervene, it will be the nurse who makes the difference.
Dumped: When nursing homes abandon patients to the hospital
倾销：当养老院将患者丢给医院
Margie is an 86-year-old nursing home resident who has developed a bladder infection. As is the case with many elderly women, she also is confused as a result. On her way out the door to a hospital, she struggles and yells that “they better not tell anyone else” about why she is going to the hospital. When her elderly, out-of-state family members call to check on Margie, they are told that the Health Insurance Portability and Accountability Act (HIPAA) prevents staff from saying anything.
Inside ANA
Immunizations: A nursing tradition
免疫：一项护理传统
The fall and winter seasons are filled with traditions associated with Back to School, Halloween, Veterans Day, Thanksgiving, and other holidays. Immunizations, for influenza in particular, should be included as a tradition.
As influenza season progresses, it’s important that all healthcare professionals, including RNs, are adequately protected so they do not spread disease to their patients. And, providing health care to others puts professionals at high risk for exposure to vaccine-preventable diseases and infections.
Career Sphere
Original research at a small rural hospital—you can do it!
一家小型乡村医院的创新研究 – 你可以做到！
Nurses want to provide evidence-based care that reflects best practices. But they also have uniquely local clinical questions that can’t be readily answered through the literature alone. How can these types of questions be addressed so the answers are relevant and useful? Consider original research.
Mind/Body/Spirit
Building moral resilience to neutralize moral distress
建设道德适应力中和道德痛苦
Moral distress occurs when one recognizes one’s moral responsibility in a situation; evaluates the various courses of action; and identifies, in accordance with one’s beliefs, the morally correct decision—but is then prevented from following through.
Strictly Clinical
How to manage manipulative behavior in geriatric patients
如何处理老年患者的操纵行为
Nursing is regularly rated as one of the most trusted professions, but nurses are also the target of allegations of abuse and negligence of patients. We are at particular risk because of the intimate nature of our jobs, which necessitates closer-than-normal proximity to the patient’s personal issues. Patients who exhibit manipulative behavior such as attention-seeking may be more likely to allege that misconduct has taken place. For this reason, nurses must learn to effectively care for these patients by using therapeutic communication and accountability measures.
Hyperthyroidism: A storm brewing
甲状腺机能亢进：暴风雨前夜
Disorders of the thyroid gland are fairly common and are most prevalent in women, who are 5 to 10 times more likely than men to have thyroid disease. The most common form of hyperthyroidism is Graves’ disease. Patients with Graves’ disease often have other autoimmune disorders such as dermatomyositis and arthritis, as was the case with Ms. Woods. This article discusses hyperthyroidism, including pathophysiology, diagnosis, and management, with the main focus on Graves’ disease.
Drugs and Devices
FDA grants to stimulate product development for rare diseases
FDA授权激励罕见疾病的产品开发
On Oct. 17, the Food and Drug Administration (FDA) announced that it has awarded more than $23 million in research grants over the next 4 years to boost the development of products for patients with rare diseases.Read more
Considerations for drafting marijuana legislation
起草大麻法应考虑的问题
An analysis of marijuana legislation published in PLoS Medicine, which provides a framework for states considering legalization, recommends shaping laws to minimize consumption and protect the public. Read more and access the article.
Take Note - Practice Updates
Role of sleep abnormality in schizophrenia
睡眠异常在精神分裂症中的作用
150 minutes of brisk exercise can reduce risk of diabetes
150分钟轻快运动可以降低糖尿病风险
Walking briskly or cycling for the recommended 150 minutes a week can reduce a person’s risk of developing type 2 diabetes by up to 26%, according to a study published in Diabetologia.Read more and access the study abstract.
Early-onset menopause may predict CVD
绝经提前可能预示CVD
Women who experience hot flashes and night sweats earlier in life are more likely to die from cardiovascular disease (CVD) compared to women with later onset menopausal symptoms, according to a study in Menopause. Read more and read the abstract.
Moderate alcohol use associated with left atrial enlargement
中等饮酒与左心室扩大相关
A study in the Journal of the American Heart Associationreports that moderate alcohol intake (an average of just over one drink per day) is a predictor of left atrial enlargement and subsequent atrial fibrillation. Read more
Editorial
Enhancing innovation skills to inspire future thinking
强化创新技能激励未来思维
I’ve seen it, you’ve seen it — the pace of change has ramped up exponentially. The leaps to new ideas that drive the need for new behaviors are happening all around us. Whether it’s a new app or a new way to learn, we have to adapt to the “new” almost every day.
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