DiversityNursing Blog

Boys’ Second- and Third-Degree Sunburns Show Dangers of No Sun Protection

Posted by Erica Bettencourt

Fri, Jul 31, 2015 @ 03:46 PM


Contributor: Marissa Garey


Boys Sun Burns

When young kids return from a water park, you expect to see smiling faces. However, the mother of two boys, ages 5 and 7, was distressed when she found her sons with second- and third-degree burns. Daycare workers neglected to apply sun protection for the boys as they were exposed to high temperatures for hours at the water park. As for repercussions, the daycare is no longer operating, and the two brave boys are expected to recover with no permanent scarring.

Pictures of two Oklahoma boys with second- and third-degree burns have started to make national headlines after they spent hours at a water park without sun protection, according to their mother.

Shaunna Broadway was horrified to find out her fair-skinned sons, ages 5 and 7, were left without sun protection during a day care trip to a nearby water park.

Broadway said that daycare workers said that they didn’t have sunscreen for the boys and the young boys did not keep their shirts on at the park. The boys ended up in the hospital with second- and third-degree burns and were eventually airlifted to a Texas hospital for further treatment.

A video released by Broadway shows the boys screaming in pain as they receive treatment. She told ABC News she was heartbroken to see her sons injured after they spent hours in triple-digit temperatures.

“It’s been really hard to see them go through this,” she said.

The Oklahoma Department of Human Services confirmed to ABC News that the daycare center has ceased operations.

Experts say this case clearly shows how dangerous a simple trip outdoors can be for those without sun protection.

Dr. Barney Kenet, a New York-based dermatologist, said the boys were likely susceptible to severe sun damage because they appear to have very fair skin.

“Those boys are very fair and [one has] red hair, they are as fair as they can be,” said Kenet. “In high-sun community and so you can get a burn … in 15 minutes when you’re this fair.”

He guessed spending an hour or more in the sun with no protection could lead to the severe burns seen on the boys in the pictures released by Broadway.

He said while the burns look severe in the pictures, the boys will likely not suffer permanent damage.

“The future however is good,” said Kenet. “Both boys will heal up quite well ... it’s highly unlikely they will have scarring.”

He did warn that the boys could be at high risk for health complications in the future as a result of the severe burn.

“Unfortunately severe burns in childhood in this natures are an independent risk factor for skin cancer later in life,” explained Kenet.

Kenet said it’s key to apply broad spectrum sun block every two to three hours when in the sun and to try and avoid being outdoors during peak hours. He said if rambunctious kids refuse to stay indoors parents can double up on sun block and long sleeve rash guards to give protection to vulnerable children.

“They have pristine, very fair and unclimatized skin,” Kenet said of the two boys. “Baby skin, it’s very fair. They have no tan and no protection.“


First Bilateral Hand Transplant in a Child: Zion's Story

Posted by Erica Bettencourt

Thu, Jul 30, 2015 @ 10:34 AM

Zion Harvey

The youngest patient to receive a double-hand transplant is 8-year-old Zion Harvey. A 40 person medical team at The Children's Hospital of Philadelphia performed an 11-hour operation to attach old and new bones. Then the medical team connected Zion's arteries, veins, muscles, tendons, and nerves.

The young boy has had trauma beyond his years yet, when he speaks he is so mature and upbeat. You almost forget he has had both hands and feet removed and has had a kidney transplant, all before the age of 8.

Watch here to see this impressive boy's interview. Zion looks forward to playing with his sister and throwing a football. Before his interview ended, he asked his relatives to stand up and he said to them, "I want to say to you guys, thank you for helping me through this bumpy road." We wish him smooth travels on the rest of his road!

Snoring Children May Suffer From Sleep Apnea

Posted by Erica Bettencourt

Mon, Jul 27, 2015 @ 12:37 PM


Contributor: Marissa Garey



We all know someone who snores; yet, it is less common to know a child who snores. For 3 and ½ year old, Barrett Treadway, snoring is caused by sleep apnea. While this condition is most often diagnosed in overweight adults, it remains possible for children to suffer from obstructive sleep apnea. According to experts, between 1 and 3 percent of children have this condition.

Sleep apnea, if untreated, can impair normal development. A child’s memory, cognitive development, ability to learn efficiently, I.Q., and more can be affected. Treatment for this condition has proven to be effective, but there are still some long-lasting impacts. Dr. David Gozal warns, “The presence of snoring should not be viewed as a normal feature of sleeping children.” For those of you whose children snore, be aware that snoring can be associated with risks, and it can be properly treated.

Barrett Treadway, now 3½, has never been the best of sleepers, but her sleep grew increasingly worse in the last year and a half. She gets up several times a night, often climbs into her parents’ bed and creates havoc with their nights.

“We’ve known for a long time that she snores, but until a mother-daughter trip in May when we shared a bed, I didn’t realize that this was not simply snoring,” her mother, Laura, told me. “She repeatedly stopped breathing, then started again with a loud snort that often woke her up and kept me up all night.”

Barrett has sleep apnea, a condition most often diagnosed in adults and usually associated with obesity. But neither of those attributes describes Barrett, who is young and lithe, although the condition is somewhat more common in overweight children.

In most cases, the problem results when, during sleep, the child’s airway is temporarily obstructed by enlarged tonsils or adenoids or both — lymphoid tissues in the back of the throat — hence the name obstructive sleep apnea. When breathing stops for 10 or more seconds, the rising blood level of carbon dioxide prompts the brain to take over and restart breathing, typically accompanied by a loud snore or snort.

Rarely, a child may have what is called central sleep apnea, in which the brain temporarily fails to signal the muscles that control breathing.

Experts say that between 1 percent and 3 percent of children have sleep apnea that, if untreated, can disrupt far more than a family’s restful nights. Affected children simply do not get enough restorative sleep to assure normal development.

If not corrected, the condition can result in hyperactivity and attention problems in school that are often mistaken for attention deficit hyperactivity disorder (A.D.H.D.) and sometimes mistreated with a stimulant that only makes matters worse.

Affected children can be excessively sleepy during the day. Barrett’s preschool teachers have said she is hard to awaken from her nap. A child’s memory, cognitive development, ability to learn and I.Q. can suffer as well. Daytime irritability is not uncommon. Barrett’s parents report that her low tolerance for frustration when she can’t get her way has worsened in recent months.

However, once the condition is effectively treated, the child’s behavior can improve drastically, and most young children are able catch up on developmental milestones that might have been delayed.

Nonetheless, there can be subtle long-lasting effects, Dr. David Gozal, then at the University of Rochester, and colleagues reported in 2008 in Seminars in Pediatric Neurology. The research found that “children who snored frequently and loudly during early childhood were at increased risk for lower academic performance later in life, well after snoring had resolved.”

Dr. Gozal, a pediatric sleep specialist now at the University of Chicago Medical Center, warned that “the presence of snoring should not be viewed as a normal feature of sleeping children, since it indicates the presence of increased upper airway resistance.”

In 2008, he reported that 1 percent to 9 percent of infants and toddlers and 3 percent to 5 percent of children aged 9 to 14 habitually snore. Even if a snoring child’s sleep is not disrupted, he explained, “snoring is, in fact, associated with a higher risk for neurobehavioral deficits.”

For example, multiple studies have found that hyperactivity and inattentive behavior often affect children who snore habitually, as well as those with obstructive sleep apnea, but behavioral problems improve following surgery to remove the obstructing tissue.

In more severe cases of obstructive sleep apnea, with its breathing pauses and disrupted sleep, Dr. Gozal wrote, the combination of fragmented sleep and a diminished supply of oxygen can result in hard-to-reverse injury to “multiple target organs and systems” if the problem is left untreated or treatment is unduly delayed.

Adenoids and tonsils typically enlarge from infancy through childhood, then shrink during adolescence and adulthood. If during early childhood these tissues grow faster than the bones of the nose and throat, they can reduce the size of a child’s upper airway, making it difficult for the child to breathe when asleep.

Both genetics and ethnicity play a role in a child’s risk of developing obstructive sleep apnea. The combination of genes that determine facial structure and the thickness of oral tissues play a role, and the condition is more common among blacks than whites, even when body weight is taken into account.

In an interview, Dr. Gozal said a proper diagnosis should always precede surgery. He suggested that pediatricians routinely ask parents six questions at every well-child visit:

■ Does your child stop breathing during sleep?

■ Does your child struggle to breathe while asleep?

■ Do you ever shake your child to make him or her breathe again when asleep?

■ How often does your child snore?

■ Do you have any concerns about your child’s breathing while asleep?

■ How loudly does your child snore?

If sleep apnea is suspected, Dr. Gozal said, the next step should be a sleep study to confirm or rule out the diagnosis before considering surgery. “A clinical assessment and physical exam by the pediatrician or an ear, nose and throat specialist is insufficient to make a diagnosis,” he said.

While surgery to remove overly enlarged tonsils and adenoids is most often used to correct sleep apnea in children, milder cases may respond to the use of a steroidal nasal spray and oral anti-inflammatory medication, Dr. Gozal and colleagues have reported.

Even when properly treated, obese children may still have the problem and, without significant weight loss, may need to use a mask attached to a positive airway pressure (PAP) machine to help keep their airways open during sleep.

Although children may have difficulty adjusting to the bulky mask, it can significantly improve their behavior and quality of life, even if used just three hours a night, Carole L. Marcus, a professor of pediatrics at the Children’s Hospital of Philadelphia, and her colleagues reported in 2012 in The American Journal of Respiratory and Critical Care Medicine.

Artist Shirks Fame To Invent Tools That Allow Kids With Disabilities To Paint

Posted by Contributor

Fri, Jul 24, 2015 @ 12:08 PM

Eleanor Goldberg and Marissa Garey



Not many people have instilled a social change like Dwayne Szot, an artist from northern Wisconsin. Dwayne Szot is far from a typical artist—he is an innovative artist who creates work that allows kids with disabilities to complete simple childhood activities. Despite the situation they’ve been given, Szot’s work enables kids with disabilities to paint, draw, blow bubbles, and more. For a kid like Madison, an 8 year old diagnosed with spinal muscular atrophy, Szot’s work has proven to be life changing. Inspired by his foster siblings with disabilities, Szot strives to help kids experience and enjoy life to it’s fullest all over the world.

When Madison was first diagnosed with spinal muscular atrophy, her doctor didn’t know a whole lot about the genetic condition. She flat-out told Madison’s fearful parents that their baby wouldn’t make it to her 2nd birthday.

“That was pretty tough,” Jennifer Miller-Smith, Madison’s mom, told The Huffington Post.

Seven years later, while the second-grader relies on a wheelchair and faces the disease’s degenerative effects, Madison is “thriving,” her mom proudly shared. A lot of that is thanks to Dwayne Szot, an artist who has committed his career to inventing tools that enable kids with disabilities to paint, draw, blow bubbles –- pretty much do anything any typical child gets to do.

Before Madison met Szot, an innovator based out of a small fishing town in northern Wisconsin, the 8-year-old often felt frustrated and helpless. While she wanted more than anything to play with her friends, she was often relegated to the sidelines due to her condition.

SMA causes the body’s muscles to weaken over time, making it impossible to perform such simple tasks as flipping a switch. Those with SMA type 2, like Madison, will never be able to walk or stand up, according to the U.S. Library of National Medicine.

But when Madison met Szot at an SMA conference in Los Angeles two years ago, her world opened up in a way she had always hoped, but wasn’t sure was possible.

Since the late 1980s, when Szot unveiled the first edition of his painting wheelchair, the artist has spent his days building upon his current inventions and developing new ways to engage with kids with limited physical ability.

“What I do in the studio is create a means for a full completeness of experiences,” Szot told HuffPost at an event in west Miami in April. “It’s not just about mark making. It’s about that opportunity to experience and enjoy life to it’s fullest.”

Szot knew from the time he was a child in the foster system in the Midwest that he would pursue a career in art. But it was one that wouldn’t involve fame or fortune.

“I knew growing up that I was never going to be this kind of art guy who put paintings on the wall in a museum,” Szot said. “I wanted to be the kind of art guy who made something that was going to create social change –- that was going to make a difference. And there’d be a usefulness to what I did as an artist.”

Szot was particularly inspired by his foster siblings with disabilities, and how they adapted together to make their everyday routine work.

He recalled how he and the other kids were always late for the school bus. To help his sister with cerebral palsy get there just a bit faster, he started dragging her along in a wagon.

It was those childhood experiences, and simple adaptations, that inform his work today.

Szot, for example, first developed his art roller with a National Endowment for the Arts grant nearly 30 years ago. It involves attaching PVC pipe and a print plate to the base of a walker or a wheelchair. After it’s filled up with paint, the user just rolls and can create a massive mural.

He uses similar technology for the Walk Chalk and Roll, which allows kids in wheelchairs to draw on the sidewalk with chalk.

“It taught our kids that they can do sidewalk chalk and they can create these magnificent paintings and such, with just a little bit of adaptability,” Miller-Smith said of Szot’s tools. “Now that we connected something to [Madison’s] wheelchair -- now she can do it.”

When he’s not toiling in his workshop, Szot takes his tools on the road, both around the U.S. and abroad, to show children with a range of conditions that they no longer need to live their lives as bystanders.

Szot’s inventions have taken him as far as Saudi Arabia and Mexico. But this year, his workshops are all based in the U.S. He’s making stops in Detroit, Chicago and Portland, Maine, among other major cities.


This past spring, Szot set up shop at the Patricia & Phillip Frost Art Museum at Florida International University, which allowed Madison to reconnect with the man who changed her life on her own turf.

Together with Miami-Dade Department of Cultural Affairs, the Children's Trust and All Kids Included, the event invited 200 kids, both those with disabilities and without, to play together using Szot’s tools.


For parents, participants and museum staff seeing Szot’s work for the first time, the experience was eye-opening.

“I use the word ‘genius’ very rarely,” Jordana Pomeroy, the museum’s director, told HuffPost. “And I think it’s very appropriate in describing the work that [Szot] does with kids with physical challenges.”

Newly diagnosed families that are just beginning to grasp what their children’s conditions mean for the long term felt particularly hopeful.

Kaden, 14 months old, was diagnosed with SMA about half a year ago. He’s never crawled or rolled over and will never walk.

Just playing with a toy is a challenge for him since he has to use nearly every muscle to prop himself up and keep himself from falling over, his mom, Katie Myers, said.

But after watching Kaden spend the afternoon painting murals and playing with an adaptive kite, Myers said she felt reassured about her baby’s prospects.

“Being able to see how much he loves life and loves the world, and wants to be a part of the world -- it changes our whole perspective," Myers said. "Despite the situation he’s been given, the world is his.”


VIRAL VIDEO: Little girl with cancer gets married to her favorite hospital nurse

Posted by Erica Bettencourt

Thu, Jul 23, 2015 @ 10:22 AM


The Albany Medical Center Hospital in New York gave a 4-year-old girl the experience of a lifetime. The little girl, Abby, is battling Pre-B Cell Acute Lymphoblastic Leukemia at the Melodies Center for Childhood Cancers which is where she was given a proper wedding.

This little patient walked down a rose petal aisle with her nurses as bridesmaids and her hospital hubby was no other than her favorite Nurse, Matt Hickling. Hickling dressed for the occasion in a tuxedo t-shirt and scrubs.

Lori Ciafardoni published a Facebook post thanking those who donated time and flowers and the hospital staff for pulling off a day to remember for a special little girl in less than 24 hours. Watch the video below to see the ceremony.


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Alzheimer's Drugs In The Works Might Treat Other Diseases, Too

Posted by Erica Bettencourt

Mon, Jul 20, 2015 @ 01:34 PM

Contributor: Marissa Garey and Jon Hamilton


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Ongoing efforts to find a suitable treatment for Alzheimer’s disease are finally looking up. What’s more, this same treatment may target a variety of brain disorders and diseases. Thanks to the biotechnology company, Treventis, there is hope for a daily pill to either stop or lessen the harm of Alzheimer’s disease. Treventis is approaching their research from a new perspective: rather than focusing on a sole protein, they are targeting two toxic proteins. While this research is promising enough, additional companies including Neurophage Pharmaceuticals, are deserving of accolades as well for their impressive efforts toward a potential treatment.

Efforts to find a treatment for Alzheimer's disease have been disappointing so far. But there's a new generation of drugs in the works that researchers think might help not only Alzheimer's patients, but also people with Parkinson's disease and other brain disorders.

Previous efforts to treat Alzheimer's have focused on a single target — usually the protein called beta-amyloid, says Maria Carrillo, chief science officer of the Alzheimer's Association. "The one-target approach is probably not going to be the answer," Carrillo says.

Instead, several teams of scientists reporting their work at the Alzheimer's Association International Conference in Washington, D.C., this week are targeting a process in the brain that leads to toxins involved in several different diseases.

The biotechnology company Treventis is working on one of these potential drugs.

"Our ultimate goal is to discover a pill that can be taken once a day that could either stop or slow Alzheimer's disease," says Marcia Taylor, the company's director of biological research. Treventis hopes to do that with a drug that prevents the build-up of two toxic proteins.

These toxic substances, called beta-amyloid and tau, are the result of a process that begins when a healthy protein inside a brain cell somehow gets folded into the wrong shape.

"Sometimes it gets what I call a kink," Taylor says. Then, when the misfolded protein meets another protein floating around in the cell, "It kind of grabs onto that protein and they both kink up together," she says.

That can trigger a chain reaction that produces clumps of misfolded beta-amyloid and tau proteins that damage brain cells.

"And our compound — because it targets protein misfolding — is actually able to prevent both beta-amyloid and tau from making these clumps," Taylor says. The compound works in a test tube and is currently being tested in animals, she says.

Another potential new treatment could help people with Parkinson's and a disease called Lewy body dementia, as well as those with Alzheimer's.

Previous efforts to treat those diseases have focused on differences in the proteins thought to cause them, says Fernando Goni of New York University. "So what we said is, 'Do they have something in common?' "

The common element is proteins that misfold and then form toxic clumps. Goni and his colleagues decided to go after these clumps, without worrying about which protein they contain. The result is a class of monoclonal antibodies that work like guided missiles to find and neutralize protein clumps in brain cells.

Previous experiments showed that the monoclonal antibodies work on the tau and amyloid clumps associated with Alzheimer's. Studies in mice show that the treatment can reverse symptoms of the disease, Goni says.

"We took animals that already had the disease and we infused them with the monoclonals and after a couple of months they were almost as perfect as the normal mice of that age," he says. Goni also presented evidence at the meeting that these targeted antibodies work on clumps associated with Parkinson's disease and Lewy body dementia, too.

Perhaps the most unusual potential new treatment for Alzheimer's comes from Neurophage Pharmaceuticals, a company that owes its existence to an accidental discovery.

A few years ago, Beka Solomon, a researcher in microbiology and biotechnology at Tel Aviv University in Israel, realized that a virus she was using for another purpose seemed to reverse Alzheimer's in mice. So she continued to study the virus, says Richard Fisher, the chief scientific officer of Neurophage.

"Meanwhile, her son, who had just spent 10 years in Israeli special forces, goes to Harvard Business School," Fisher says. "He needs a project. And he and another colleague at the business school put together a potential company based on [his mother's] discovery."

In 2008, that potential company became Neurophage. "I was the first employee and I thought, 'Wow, this is really crazy,' " Fisher says.

But it wasn't. Scientists were able to figure out how the virus was attacking Alzheimer's plaques and use that information to create a treatment.

And in mice, that treatment appears to work against both Alzheimer's and Parkinson's, Fisher says. The company plans to begin testing its treatment in people in early 2016.

Topics: alzheimers, neuroscience, monoclonal antibodies, Parkinson's Disease

Nurse Practitioners More In Demand Than Most Physicians

Posted by Erica Bettencourt

Fri, Jul 17, 2015 @ 10:44 AM

Bruce Japsen

Contributor: Marissa Garey


It comes as no surprise that primary care doctors are, and have always been, highest in demand. All hospitals and health systems require family physicians, as well as other internists, to service their patients. However, recent data shows that this paradigm is shifting.

To fill the necessary vacancies in medical staff, an increasing number of health systems are looking to Nurse Practitioners and Physician Assistants. According to the Merrit Hawkins’ review, neither of these positions had been among the top 20 in-demand health professionals in 2011. While primary care doctors still rank the highest, NP’s and PA’s have progressed over the past 4 years to be placed among the top 10. Both professional areas have grown to fill critical positions in the healthcare industry.

When it comes to what a hospital or health system needs to fill the vacancies in a medical staff, primary care doctors like family physicians and internists have long been the top need.

But climbing the ranks and jumping past many doctor specialties on the demand scale aren’t physicians at all. They’re nurse practitioners and physician assistants who are filling a critical role for the health care industry, according to national doctor recruiting firm Merritt Hawkins.

The snapshot into the U.S. health care workforce from Merritt Hawkins, a subsidiary of AMN Healthcare (AHS) comes as trends in insurance payment from private health plans, employers and the government under the Affordable Care Act emphasize keeping people well. The value-based care push away from fee-for-service medicine also emphasizes the outpatient care provided by nurse practitioners (NPs) and physician assistants (PAs) working with primary care doctors.

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“In the team-based, population health model, primary care physicians remain recruiting target number one, but PAs and NPs are target 1A,” Travis Singleton, senior vice president at Merritt Hawkins said in a statement to Forbes. “You really can’t build patient access or patient satisfaction without them.”

To be sure, patient satisfaction and quality of care are being built into contracts insurers have with medical care providers as health plans like Aetna AET -0.78% (AET), Anthem (ANTM), UnitedHealth Group UNH -0.67% (UNH) and the nation’s Blue Cross and Blue Shield plans consolidate into larger payers and shift payments to value-based care.

For the ninth consecutive year, the family doctor was the most highly recruited doctor. Internists were second on the Merritt list followed by psychiatrists amid a nationwide shortage of behavioral health specialists.

“Combined, physician assistants and nurse practitioners were fourth on the list,” Merritt Hawkins said in its report. “Four years ago, neither NPs or PAs were among (the firm’s) top 20 assignments either collectively or individually.”

On their own, nurse practitioners ranked fifth behind hospitalists who were fourth and physician assistants were in 10th place, tied on the “in demand” scale with general surgeons. Advanced practitioners are more in demand than several specialties including general surgery, cardiology, urology and neurology.

Merritt Hawkins’ review comes from a database of more than 3,100 recruiting assignments conducted by the firm from April of last year through March of this year.

Topics: nurse practitioners, physicians, medical staff

Baby Can't Stop Smiling When She Sees This...

Posted by Erica Bettencourt

Wed, Jul 15, 2015 @ 03:39 PM

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Do you remember the first time you saw your parents’ faces? For most of us, this happens so early on in our lives, we naturally forget the moment. However, for baby Piper, seeing her parents’ faces for the first time is a moment she may never forget.

As a baby, Piper’s mother realized that Piper had difficulty with simple acts, such as crawling, due to her farsightedness. Lo and behold, when baby Piper can see her parents’ faces, it is truly a beautiful moment.

Baby Piper definitely has something to grin about.

Her mother, Jessica Sinclair, posted this video last month of her daughter's reaction to a new pair of glasses.

"Her reaction melts my heart," she wrote in the description of the video that is now going viral.

Piper was having difficulty crawling, Sinclair told WKRC News in Cincinnati, and doctors discovered she was extremely farsighted.

"A week later we picked up the glasses and she tried them on for a quick second in the office to make sure they fitted properly," she told the news station. "Then we decided to go out to eat ... and then this was her reaction of her first time being able to see our faces."


Contributor: Marissa Garey and  James Gerken



Topics: baby glasses, viral video

Study Confirms What We Knew All Along: Nurses Are Key to Hospital Success

Posted by Erica Bettencourt

Mon, Jul 13, 2015 @ 11:47 AM

Amy Rushlow


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We all know and love Nurses, but isn’t it wonderful when a research study validates something you already know? We think you’ll enjoy this article.

If you’ve ever had a loved one in the hospital, you know how important nurses are. Studies show that the amount of time that nurses spend with patients is related to fewer errors. And according to a new study, investing in nursing is key to patient outcomes, including the risk of dying while in the hospital.

The study’s researchers, a team from the University of Pennsylvania, wanted to understand why certain hospitals have better outcomes than others. Specifically, the UPenn team was trying to explain why hospitals in the Kaiser Permanente health care system — an integrated health network in eight states that includes hospitals, insurance, and doctors’ offices all in one system — have such efficient and high-quality care. 

Other organizations have tried to mimic Kaiser Permanente’s organizational structure in order to improve care, but with mixed results. The researchers thought there might be a different X factor that could explain Kaiser’s success: nurses.

In order to find out, the study looked at more than 550 hospitals in California, New Jersey, Pennsylvania, and Florida, including 25 California-based Kaiser Permanente hospitals and 56 Magnet hospitals. Magnet hospitals are recognized by the American Nurses Credentialing Center for being good workplaces for nurses.

Nurses in each hospital answered surveys about their work environment, level of education, job satisfaction, and the number of patients visited during a typical shift. The researchers also pulled data on patient mortality.

“It turns out that, by and large, nursing differences accounted for much of the mortality difference that we saw in Kaiser Permanente hospitals,” says study author Matthew McHugh, PhD, RN, a professor at the University of Pennsylvania School of Nursing.

The results were clear: The odds of dying were about 20 percent lower in Kaiser Permanente and Magnet hospitals, and differences in nursing accounted for “a sizeable portion of the advantage,” according to the study. The analysis adjusted for factors such as hospital size and the severity of patients’ conditions.

“It turns out that these differences we see in nursing, in terms of work environment, staffing levels, investment in nursing around a highly educated workforce, those things translate into better outcomes,” McHugh tells Yahoo Health. 

There were a few specific factors that made Kaiser and Magnet hospitals stand out from the rest, McHugh explains:

1. Better work environments

Happier nurses mean healthier patients, research shows. “We find that places where nurses have a good experience working are places where nurses are better able to do their jobs. They’re more autonomous, they’re supported by management, and they’re integrated into hospital decision-making,” McHugh says.

Empowered nurses have better relationships with physicians, “so when they say ‘something isn’t right,’ they’ll be taken seriously,” McHugh adds. And patients can receive faster and more efficient care when nurses are authorized to make decisions such as when to remove a catheter, for example.

In fact, a study published last year in the Journal of Nursing Administration found that empowered nursing units are more effective and report better patient care compared to units with less authority.

Tangible changes matter, too. In response to the nurse shortage in the early 2000s, Kaiser Permanente made a deliberate, research-based effort to invest in nursing, says Marilyn Chow, PhD, RN, Vice President of National Patient Care Services and Innovation for Kaiser Permanente. 

study of Kaiser hospitals conducted in 2005 and 2006 found that nurses spent more than 35 percent of their time on documentation. Starting in 2005, the system switched to electronic medical records, which helped streamline paperwork. They also observed that nurses spent a lot of time hunting and gathering equipment and information — checking to see if a medication was ready, for instance. In response, Kaiser Permanente rearranged the work environment to make things more convenient. (Nurses now receive a notification when meds are ready for pickup.)

“We wanted to make sure that we were a place that nurses wanted to work,” Chow tells Yahoo Health. “If you have nurses who are happy and joyful at their work, they will definitely pass that on and be caring and compassionate.”

2. More nurses with Bachelor’s degrees

The role of the nurse is much more complex than it used to be, Chow explains. “The role is not only surveillance, but facilitating and coordinating the care, and not just for one patient, but for four to five patients … there are so many things to take care of,” she says. Patients also arrive sicker and leave the hospital earlier, Chow and McHugh say, which puts an extra demand on nurses to coordinate care and teach patients and family members what to do when they arrive home. 

“Hospitals are very complex, and integrating all of that information requires a certain set of skills and requires you have a pool of knowledge within the overall nursing staff,” McHugh explains. He adds that the study observed a wide variation in nurse education from hospital to hospital, and that variation was associated with adverse events.

3. More nurses, period

Kaiser Permanente hospitals have a 4-to-1 patient-to-nurse ratio, on average, compared to 5-to-1 in non-Magnet hospitals, the UPenn study found.

Having more nurses ensures that there are enough eyes in rooms monitoring patients. It also means that nurses have sufficient time to follow up with patients and communicate effectively. “Nurses are at the bedside and are working with all the other providers. They’re the essential person for monitoring patient condition, and if something bad does happen, intervening and mobilizing the intervention response,” McHugh says.

We all know and love Nurses, but isn’t it wonderful when a research study validates something you already know? We think you’ll enjoy this article

Topics: study, nursing, nurse, nurses, hospital

5 Things Labor Nurses Want You To Know

Posted by Erica Bettencourt

Thu, Jul 09, 2015 @ 10:47 AM

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Shelly Lopez Gray

Recently, a nurse made headlines for dropping a newborn, fracturing the baby's skull. The parents, understandably upset, claim the nurse should have known better than to hold the baby if she was sleepy. As a labor and delivery nurse, here is what I wish I could say to every mother out there, what I'm sure many of us would want to say to the families we care for:

Accidentally hurting your baby is one of our biggest fears. No nurse goes to work thinking they want to hurt someone. None of us leave our house thinking, "I really want to make someone suffer." There are a million and one ways a nurse can accidentally do something wrong. And every day, all day, we are very conscious of this fact and we work hard to provide the best care we possibly can... even if we're short-staffed, even if our assignments are difficult, even if every room on our unit is full. Even though we literally have 20 things to do at any given moment with a handful of different, complicated patients, we strive to provide compassionate care in a timely manner while struggling to chart every single action we take. We know we're going to make mistakes... our only hope is that the mistakes we make do not cause harm.

That nurse made a lot of right decisions. I'm just keeping it real -- but seriously, that nurse could have made a lot of other really bad decisions. She could have dropped the baby and not told anyone. Even though she was probably frightened and distraught that her action caused a baby harm, she chose to do the right thing and immediately get the baby evaluated.

A nurse's mistake can have many consequences. No one is asking why the nurse had the baby in the first place. I would bet any amount of money that she was trying to allow an exhausted mother to get a few minutes of uninterrupted sleep. And although I do not agree with this practice, I'm sure her intentions were pure. What people who are not nurses do not understand is that our mistakes can have many consequences. If we make a mistake, we can be peer-reviewed, which means our actions are brought before a committee to determine our nursing fate. We could lose our nursing license, leaving us unable to work or financially support ourselves or our family. If it's deemed we were neglectful, criminal charges could be filed against us, and we could face hefty fines or even jail time. And our actions at work and at home are all up for examination and scrutiny.

That nurse is suffering right now. I don't say this to diminish any anguish the family must feel that their baby was hurt while in the care of a healthcare provider. But wherever that nurse is right now, I promise you that she has been suffering. As I said before, no nurse goes to work wanting to hurt someone. She has had to endure being judged by her peers, questioning whether or not her facility would support her, and knowing that she caused a family distress. This is an incident that she will never forget, an incident that will probably taint her 30-year memory of nursing.

If you would have dropped your baby while in the hospital, the nurse would also be blamed. I don't believe healthy mothers and healthy babies should be separated while in the hospital. I don't believe a nurse should take a baby from a mother, even at her request, so that the mother can get uninterrupted sleep. This may not be a popular opinion, but as nurses, we need to see how these mothers interact with their babies even when they're exhausted and sleep-deprived. But this leads to another issue... even if this mother would have dropped her own baby, the nurse and hospital would still be blamed. It would have been all about rounding and if it was documented that the nurse educated the patient not to sleep with the baby in the bed or if the room was free of clutter. As nurses, we have to be everything to everyone.

We are all human. As I drive to work tomorrow, I will think of the patients I will meet and care for. And as I walk through the doors of my hospital, I will think the same thing I have thought every single day since I graduated from nursing school: Just don't hurt anyone. I know I will make mistakes. I'm human. But I hope I never make a mistake that hurts or kills someone. And that is a fear that lives inside of every nurse everywhere. My thoughts are with this family, and my thoughts are also with this nurse. To every nurse out there -- May the mistakes we make tomorrow bring no harm to the patients we try to give so much to.

Until my next delivery ♥


Topics: nursing, nurses, patients, hospital, labor nurses

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