Medical doctor with assistant intubates male patient in the critical care unit.

Nurses Urged to Assist with Health Ranking Data, Nurse-Led Study Decreases Ventilator Times After Cardiac Surgery, and Other Nursing News

Medical doctor with assistant intubates male patient in the critical care unit.

The United Health Foundation calls upon GAPNA nurses to help provide guidance for data collection and analysis related to U.S. health rankings. Nurses at Duke University Hospital have helped develop a protocol to safely decrease ventilator times after cardiac surgery. A nursing podcast discusses current events and hot topics in the nursing field—one conversation at a time. Read on for more nursing news and insights.

Nurses urged to assist with health ranking data

Officials with the United Health Foundation (UHF) have called upon nurses affiliated with the Gerontological Advanced Practice Nurses Association (GAPNA) to assist in providing guidance for data collection and analysis related to health rankings in the United States.

The call to action stems from findings announced in United Health Foundation’s (UHF) recently released America’s Health Rankings 2021 Senior Report. The report, released in partnership with GAPNA, highlights nearly 50 areas and examines the impact of social, economic, and environmental factors on seniors’ overall health. The data reveal significant mental and behavioral health challenges faced by seniors before the COVID-19 pandemic began and provide insight that is expected to help improve healthcare for seniors.

Among the reports key findings and highlights are:

  • Seniors faced increasing mental/behavioral health challenges. Leading up to the pandemic, seniors experienced a number of worsening behavioral health outcomes, including a 39% increase in drug deaths, a 3% increase in suicide from 2014-16 and 2017-19, and an 11% increase in frequent mental distress from 2016-19. Before the pandemic, the risk of social isolation for seniors in a given state was correlated with higher rates of frequent mental distress.
  • Prior to the pandemic, seniors across the country experienced improvements in clinical care factors, including a 13% increase in geriatric providers. Flu vaccinations among seniors rose 6% between 2017 and 2019.
  • Disparities by geography, race/ethnicity and other factors persist. Health improvements for older adults were not experienced equally across the country, with populations in rural states and certain racial and ethnic populations facing greater challenges.

The call to action is a reflection of the key role that groups like the UHF see advanced practice nurses having in promoting the health and well-being of America’s seniors, according to GAPNA officials. Access the full report online.

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Nurse-led study safely decreases ventilator times after cardiac surgery

Nurses at Duke University Hospital have helped to safely decrease ventilation times among patients after cardiac surgery, according to a recent report. The success is credited to a new extubation protocol and more efficient workflow processes.

The study, “Reducing Intubation Time in Adult Cardiothoracic Surgery Patients With a Fast-track Extubation Protocol,” co-authored by two nurses, examines how a nursing research committee developed a uniform approach to advance patients toward extubation, with a goal of early extubation within six hours.

For cardiac surgery patients, extubation within six hours after being admitted to the intensive care unit (ICU) after surgery is associated with fewer adverse outcomes, shorter ICU stays and lower costs, the report claims. Early extubation within the six-hour window requires coordination across units and disciplines, with a focus on patient safety, speed and efficiency.

High rates of variability in extubation times among cardiac surgery patients in Duke’s 32-bed, high-volume, high-acuity cardiothoracic intensive care unit (CTICU) led to a new fast-track extubation (FTE) protocol and redesigned patient care processes. As a result, the proportion of patients extubated within the recommended six-hour window improved from 47.5% to 72.5%, without increasing morbidity or mortality.

The study is co-authored by Myra Ellis, MSN, RN, CCRN-CSC, a clinical nurse in the CTICU and chair of the CTICU nursing research committee at Duke University Hospital, Durham, NC.

“Members of the interdisciplinary team were key stakeholders in the redesign of care processes, which allowed us to develop a sustainable and consistent protocol,” Ellis said in a prepared statement. “We worked together to identify barriers and implement workable solutions.”

Barriers to extubation fell into three groups: process-specific, people-specific, and patient-specific. Process-related issues included a lack of clarity about which patients were deemed eligible for early extubation by the surgical team and lack of a clear plan to initiate the weaning and extubation process. Inappropriate use of sedation to lower blood pressure and inadequate pain management were also considered process-specific barriers.

People-specific issues included interdisciplinary communication, poor patient progression during shift change, and an absence of cross-coverage when respiratory therapists were away from the unit transporting patients.

The most common patient-specific barrier was metabolic acidosis. Others included hemodynamic instability, bleeding, respiratory acidosis, and altered mental status.

During the study period, people- and process-related barriers for patients in the FTE cohort decreased from 48% to 17%. Reintubation rates, lengths of stay and 30-day mortality did not differ between the pre-intervention and FTE patient cohorts.

The final analysis included more than 300 patients. The committee reportedly used personal, social, and structural sources of influence to guide the interventions and encourage sustained behavior change.

Podcast spotlight: Cup of Nurses

The Cup of Nurses podcast is known for discussing current events and hot topics in the nursing field “one conversation at a time.” Hosted by Matt Solarczyk and Peter Findura, a pair of nurses staffed in the intensive care unit, this podcast’s conversations combine personal experience and modern science to educate, promote, and improve health, well-being, and career aspirations.

The most recent episode, “Google’s AI Skin App & Skin Cancer,” discusses Google’s newly released artificial intelligence (AI)-powered app to identify common skin conditions and sunscreen health dangers of specific ingredients. Google Health has new tools that will allow users to identify different dermatology issues through AI and a smartphone camera.

For more nursing news, insights, and other healthcare resources, visit our Resource Center. Need Nursing CE courses? Find individual CE courses in your state, or save time and money with the Elite Nursing Passport Membership.