As trust in official sources erodes, where can we turn for credible health information?As trust in official sources erodes, where can we turn for credible health information?
BACKGROUND: Burn injuries have far-reaching physical, psychological, and social consequences for children and their families. The posttraumatic stress experienced by primary caregivers of burn-injured children can signif...BACKGROUND: Burn injuries have far-reaching physical, psychological, and social consequences for children and their families. The posttraumatic stress experienced by primary caregivers of burn-injured children can significantly influence the child's recovery process and overall prognosis while imposing a psychological toll on the caregiver. Exploring the posttraumatic stress of caregivers is therefore of critical clinical and practical importance. PURPOSE: This study aimed to systematically evaluate the prevalence of posttraumatic stress among primary caregivers of pediatric burn survivors and identify the key factors that contribute to it. METHODS: We conducted a cross-sectional study of the primary caregivers of children who were hospitalized for burn injuries between January 2024 and June 2025. Caregivers were assessed using the Posttraumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C), which categorizes 17 symptoms of posttraumatic stress within three dimensions. To identify independent risk factors associated with PCL-C scores, we employed both univariate and multiple linear regression analyses. RESULTS: A total of 240 primary caregivers were included in the study; these caregivers had a mean (SD) PCL-C score of 41.22 (5.09). Among the three PCL-C dimensions, reexperiencing symptoms was the most prevalent, followed by hyperarousal symptoms and avoidance symptoms. Multiple linear regression analysis revealed the following independent PTSD risk factors: the severity of the child's burn injury (β = 0.122, P = 0.001); the caregiver's place of residence (β = 0.116, P = 0.04), educational level (β = 0.123, P = 0.02), and marital status (β = 0.125, P = 0.02); the monthly per capita household income (β = 0.109, P = 0.02); and witnessing the burn incident (β = 0.127, P = 0.005). The final regression model explained 59.5% of the variance in scores (F = 27.10, P < 0.001). CONCLUSION: Primary caregivers of children with burn injuries experience a high prevalence of posttraumatic stress, which is influenced by a combination of child-related, caregiver-related, and incident-related factors. Health care providers should develop individualized interventions addressing these specific factors to support caregiver mental health and ultimately improve outcomes for both children and their families.
BACKGROUND: According to a recent national survey, most RNs in the United States have personally experienced workplace racism from patients, colleagues, and leaders, with half witnessing racism against their colleagues....BACKGROUND: According to a recent national survey, most RNs in the United States have personally experienced workplace racism from patients, colleagues, and leaders, with half witnessing racism against their colleagues. Subtle forms of racism called microaggressions can be difficult to recognize and address, but repeated exposure can negatively affect nurses' physical and mental health, job performance, and patient safety. PURPOSE: The aim of this review was to explore the literature on nurses' workplace experiences with racial microaggressions in the United States and to identify the impact of racial microaggressions on nurses and patients. METHODS: This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. PubMed and CINAHL were searched from database inception to November 2024. Studies on nurses' workplace experiences with bias and discrimination in the United States were included because racial microaggressions were often mentioned in these studies. No limit on year of publication was included. Studies from countries other than the United States and studies on nursing students were excluded. RESULTS: The search yielded 11 studies meeting the inclusion criteria; seven were qualitative, three were quantitative, and one used mixed methods. Nurses' workplace experiences with racial microaggressions were categorized into five themes: (1) experiencing racial microaggressions, (2) impact on nurses, (3) responding to racial microaggressions, (4) impact on patient care, and (5) recommendations for nursing practice. Nurses of color experienced racial microaggressions ranging from jokes or comments about their race to overt exclusion to patients refusing their care. Nurses were affected by microaggressions in numerous ways, including threats to their well-being. Nurses responded to microaggressions by avoiding conflict, providing education, and disconnecting from patients and peers. Patient safety can be negatively affected as well because bias can deplete nurses' emotional resources and decrease morale. Recommendations for nursing practice include education and systemic approaches to addressing microaggressions. CONCLUSIONS: Most nurses experienced racial microaggressions committed by patients and their families, peers, and leaders. Experiences of microaggression in the workplace were shown to have harmful effects on nurses' well-being, job satisfaction, interpersonal relationships, and patient care. To ensure a diverse nursing workforce amid a critical nursing shortage, systemic approaches to address this phenomenon must be developed and employed.
BACKGROUND: The emigration of nurses from low- and middle-income to high-income nations is a global trend, with Nigeria experiencing a significant brain drain in recent years. In response, the Nursing and Midwifery Counc...BACKGROUND: The emigration of nurses from low- and middle-income to high-income nations is a global trend, with Nigeria experiencing a significant brain drain in recent years. In response, the Nursing and Midwifery Council of Nigeria (NMCN) implemented controversial policies, including closing the license verification portal in December 2023, to curtail nurse migration. PURPOSE: This study aimed to ascertain the impact of the license verification portal closure on Nigerian nurses living in the country and abroad. Our objectives were to assess the perceived consequences of this intervention on nurses' professional careers, mental health, and financial status. METHODS: A quantitative, cross-sectional, and descriptive design was used to collect data via an electronic questionnaire from 1,838 Nigerian RNs worldwide. Data were analyzed using IBM SPSS Statistics, version 25. RESULTS: The results showed that 93% of RNs had a negative perception of the portal closure. Moreover, the policy's adverse effects were widespread, with 83% of nurses experiencing career setbacks, 77% reporting mental health issues, and 57% experiencing financial strain. CONCLUSIONS: The NMCN's approach, aimed at combating nurse migration, negatively impacted Nigerian nurses, leading to potentially serious adverse outcomes for patients and public health. Nations need to avoid implementing coercive restrictive measures to curb nurse migration. Instead, improving professional advancement, remuneration, and career development are recommended as more effective retention strategies.
Menstrual health is a fundamental component of well-being, yet it continues to be absent from public health policy. Period poverty is the inability to afford appropriate products to manage menstruation in a dignified and...Menstrual health is a fundamental component of well-being, yet it continues to be absent from public health policy. Period poverty is the inability to afford appropriate products to manage menstruation in a dignified and sanitary way. Gaps in access to affordable menstrual health products put menstruating individuals at risk for losses in education, income, and dignity. Environmental factors can influence the pricing of products, which can make them harder to access. The United States lacks unified menstrual health policies to support equity for menstruating individuals in schools, shelters, and prison settings. Nurses have direct contact with individuals impacted by period poverty and should be aware of policies at the state and federal level. The purpose of this article is to define period poverty and examine federal, state, and local policies addressing menstrual equity.
BACKGROUND: False-positive blood culture results caused by skin contaminants and inadequate aseptic techniques remain a significant concern for U.S. hospitals and health care providers. Blood culture contamination rates...BACKGROUND: False-positive blood culture results caused by skin contaminants and inadequate aseptic techniques remain a significant concern for U.S. hospitals and health care providers. Blood culture contamination rates in the San Joaquin General Hospital ED fluctuated monthly and often exceeded the recommended threshold of less than 3%. PURPOSE: The primary aim of this quality improvement project was to implement an evidence-based intervention to reduce blood culture contamination rates in the ED. Secondary goals were to measure compliance with the initiative and add to the body of knowledge on the financial costs associated with blood culture contamination. METHODS: A new protocol for collecting blood cultures was introduced in the hospital's ED from March 1 to April 30, 2025. This protocol involved using a sterile diversion tube (the Z-tube) to collect the initial blood specimen before proceeding with the blood cultures. To ensure compliance, nurses were instructed to send the diversion tube along with the culture bottles to the microbiology laboratory. Blood culture sets obtained using a Z-tube were designated as the diversion group, and those without as the non-diversion group. Compliance was tracked, and a cost analysis was performed to calculate the additional expenses associated with contaminated blood cultures. RESULTS: Of the 1,904 blood cultures collected during the intervention period, the diversion group included 1,242 (65.2%) blood culture sets and the non-diversion group, 662 (34.8%). Blood culture contamination rates decreased by 85%, from 2.7% (18 of 662 blood culture sets) in the non-diversion group to 0.4% (five of 1,242 blood culture sets) in the diversion group. Additionally, contamination was 86% lower in the diversion group than in the historical control group, the two months preceding the intervention period (0.4% versus 2.9% [56 of 1,931 blood culture sets]). During the intervention period, Z-tube compliance was 65.8%, which was tracked by the number of Z-tubes sent to the laboratory. Our analysis found that the average additional cost for patients with contaminated blood cultures was $10,921 per patient. CONCLUSION: Using a sterile diversion tube was associated with a decrease in the blood culture contamination rate in hospitalized patients, suggesting this is an effective way for hospitals to decrease contamination rates, leading to better patient outcomes and reduced health care costs.
This is the 10th 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 Practic...This is the 10th 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.
Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice worldwide. In 2024, the American College of Cardiology, American Heart Association, American College of Clinical Pharmacy, and Heart...Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice worldwide. In 2024, the American College of Cardiology, American Heart Association, American College of Clinical Pharmacy, and Heart Rhythm Society released updated guidelines on the management of AF, offering comprehensive, evidence-based recommendations to support safe and effective care. This article highlights three core components of AF management: anticoagulation in nonvalvular AF, rate control, and rhythm control. The aim is to help RNs and NPs better understand the scientific rationale behind the most recent guideline updates. Practical considerations related to anticoagulation are addressed, including the use of the CHA2DS2-VASc score, the role of direct oral anticoagulants (DOACs) compared with vitamin K antagonists, and the agents used to reverse the anticoagulation effects of DOACs. The article also compares the effectiveness of rate control with that of rhythm control, with an overview of pharmacological and electrical cardioversion strategies. Finally, the article explores the importance of managing modifiable risk factors.
BACKGROUND: Virtual nursing--defined as patient care delivered by a remotely located experienced nurse using information and communication technologies--has expanded significantly in the aftermath of the COVID-19 pandemi...BACKGROUND: Virtual nursing--defined as patient care delivered by a remotely located experienced nurse using information and communication technologies--has expanded significantly in the aftermath of the COVID-19 pandemic. But few studies have explored patients' experiences with virtual nursing in the medical-surgical acute care setting. PURPOSE: This mixed-methods pilot study aimed to explore patients' experiences with a co-caring virtual nursing model as part of their care in a medical-surgical acute care unit. METHODS: Data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey were used to explore patients' perceptions of their experiences with virtual nursing. In-person, semistructured patient interviews were also conducted prior to discharge. Changes in pre-pilot versus during-pilot HCAHPS survey scores were analyzed using descriptive and inferential statistics. Interview data were analyzed using thematic analysis. RESULTS: Thematic analysis identified three key themes: patients appreciated the virtual nurse as a member of the care team; the technology was easy to use and facilitated bidirectional communication; and patients' concerns about privacy eased with use. Although HCAHPS survey score analysis revealed improvements in patients' perceptions of overall care and medication-related explanations, only changes in their perceptions of nurses' listening, doctors' listening, and doctors' explanations were statistically significant. CONCLUSIONS: The study findings offer confirmation that the expansion of virtual nursing models into medical-surgical acute care settings is associated with improved patient experiences. Many patients reported that they appreciated the virtual nurse and were comfortable with the technology. Some patients voiced concerns about privacy, which eased over time. Others worried that virtual nurses might replace bedside nurses. These findings indicate a need for improvement in how virtual nursing models are introduced to patients. As virtual nursing models expand into more clinical settings and become more widely used, further mixed-methods studies are warranted.