Sarah Sheets Cook

Promoting patient safety through informatics-based nursing education

The Institute of Medicine (IOM) Committee on Quality of Health Care in America identified the critical role of information technology in designing safe and effective health care. In addition to technical aspects such as regional or national health information infrastructures, to achieve this goal, healthcare professionals must receive the requisite training during basic and advanced educational programs. In this article, we describe a two-pronged strategy to promote patient safety through an informatics-based approach to nursing education at the Columbia University School of Nursing: (1) use of a personal digital assistant (PDA) to document clinical encounters and to retrieve patient safety-related information at the point of care, and (2) enhancement of informatics competencies of students and faculty. These approaches may be useful to others wishing to promote patient safety through using informatics methods and technologies in healthcare curricula.

Systemic lupus erythematosus: a genetic review for advanced practice nurses.

Purpose: To review the symptom presentation, genetic aspects, and available treatment options for individuals diagnosed with systemic lupus erythematosus (SLE). Primary care providers should be vigilant in identifying symptoms, which may be related to SLE, perform adequate assessment, and diagnostic testing in order to arrive at an early diagnosis. Data sources: Extensive literature review of textbook, clinical, medical, and nursing journals. Conclusions: Lupus is a multigenic autoimmune disease, which requires the clinician to be hypervigilant by collecting a thorough family history and performing a complete physical assessment of the patient. There is an array of treatment modalities, both experimental and proven therapies, which improve signs and symptoms associated with SLE. Numerous medications are available for symptom management: anti‐inflammatory agents for patients with musculoskeletal presentation, and steroids or antimalarials for those with more extensive organ involvement. Implications for practice: In SLE, the overall aim of management is to determine the extent of disease and prevent extensive organ involvement. Therefore, when diagnosed in a timely manner, most patients will survive and are able to manage their disease.Purpose: To review the symptom presentation, genetic aspects, and available treatment options for individuals diagnosed with systemic lupus erythematosus (SLE). Primary care providers should be vigilant in identifying symptoms, which may be related to SLE, perform adequate assessment, and diagnostic testing in order to arrive at an early diagnosis. Data sources: Extensive literature review of textbook, clinical, medical, and nursing journals. Conclusions: Lupus is a multigenic autoimmune disease, which requires the clinician to be hypervigilant by collecting a thorough family history and performing a complete physical assessment of the patient. There is an array of treatment modalities, both experimental and proven therapies, which improve signs and symptoms associated with SLE. Numerous medications are available for symptom management: anti-inflammatory agents for patients with musculoskeletal presentation, and steroids or antimalarials for those with more extensive organ involvement. Implications for practice: In SLE, the overall aim of management is to determine the extent of disease and prevent extensive organ involvement. Therefore, when diagnosed in a timely manner, most patients will survive and are able to manage their disease.

Faculty practice: A new perspective on academic competence

The new, universal scholarly faculty practice plan at the Columbia University School of Nursing evolved from an analysis of the factors influencing nursing practice and education. Begun as part of a three-pronged revitalization effort for the school, the project explores new partnerships in nursing education and service as a means of addressing the crisis in delivery of nursing services and education. Experiences from existing models for faculty practice, fiscal implications for educational programming, and management of academic and practice commitments are major factors in the analysis. This article discusses the process by which the faculty seeks to maintain the teaching of clinical excellence in a changing national market for nursing education. Specific issues discussed include differences in faculty ideologies, determining teaching/practice ratios, and strategies for implementation. Samples of individual faculty practices and a discussion of evaluation and recognition of issues are also included.

Pharmacogenetics and the pharmacological management of depression.

Depression is a chronic disease seen in many healthcare settings. Current pharmacological treatment options are successful in two-thirds of patients. One CYP450 enzyme, CYP2D6, is responsible for the metabolism of 30% of all drugs including many antidepressants. Phenotypes of metabolizer status affect antidepressant treatment outcomes and adverse drug reactions.

Patient Safety Issues in Advanced Practice Nursing Studentsʼ Care Settings

The purpose of this project was to identify and characterize patient safety issues across advanced practice nursing (APN) care settings including ambulatory care visits. A total of 162 registered nurses enrolled in an APN education program completed an online survey. Respondents reported patient safety issues related to diagnosis or management and treatment in almost half of 489 encounters. The most common issues were clinician communication problems with patients, which occurred during 42.4% of encounters. Adoption of information technology may be a pathway for improving patient safety issues in APN practice settings.

Febrile Seizures, Genetic (Generalized) Epilepsy With Febrile Seizures Plus, and Dravet's Syndrome

PURPOSE This article discusses febrile seizures, generalized epilepsy with febrile seizures plus, and Dravets syndrome. CONCLUSIONS It can be difficult for patients and their families to comprehend what it means to have a seizure disorder with a genetic cause. Nurses caring for patients with seizure disorders require knowledge of the condition, its causes, treatment, and prognosis to better care for and inform their patients. PRACTICE IMPLICATIONS It is important for all specialists working with pediatric populations to understand possible causes of seizure disorders linked to febrile episodes, its diagnosis, and treatment, and their responsibility to provide pertinent education to patients and their families.

Deconstructing DNA. Understanding genetic implications on nursing care.

Nursings role in genetics has been well understood for many years. And most nurses who work in maternal/child health engage in genetic‐related activities on a daily basis. As such, its important for all nurses who care for women and their newborns to be able to adequately assess and meet the genetic health care needs of women and children throughout their life spans—and acquiring and keeping abreast of emerging knowledge has never been easier, thanks to technology and the number of programs now available to help nurses to stay up to date.

New Frontiers in Feminist Political Economy

This outstanding volume summarises the gains and setbacks in progressing from the early stages of getting women into development thinking and practice, to the current state of a global feminist political economy that challenges dominant orthodoxies in economic thinking. It celebrates the lives and work of Professors Diane Elson and Ruth Pearson. As scholars, public intellectuals, and activists, the pair have shaped the field of feminist economics/political economy, and inspired a generation of scholars. This Festschrift volume provides both a fitting tribute to their scholarship and activism, and a significant addition to the literature on contemporary feminist political economy (FPE). The collection maps important shifts from a gendered analysis of development to a global political economy focused not ‘simply on the market economy with growth and accumulation as its primary goals’ but on the ‘provisioning of human needs and human well-being’ (p. 7). An excellent introduction by Shirin Rai and Georgina Waylen summarises key contributions of Diane Elson and Ruth Pearson, from the work on ‘nimble fingers’ to an elaboration of the links between production and reproduction – including its extension to global supply chains – and Diane Elson’s work on male bias in macro-economics. The volume focuses on four central themes of FPE emanating from their work: understanding economies as gendered structures and economic crises as crises also of social reproduction; assessing economic policies through the lens of women’s rights; analysing global transformations in women’s work; and making visible the unpaid or care economy (p. 6). It locates the analyses within the context of a global crisis that ‘exposes yet again the inadequacies of the dominant models’ (p. 1), a theme elaborated by Diane Elson in her concluding chapter. A valuable contribution of the chapter lies in its tracing of major developments in debates from Women in Development (WID) through Gender and Development (GAD) to a global FPE. Early observations of Diane Elson, Ruth Pearson and others in the Subordination of Women (SOW) collective, that the issue was not ‘that women missed out on “development”’ but that they ‘were incorporated into the spread of global capitalism in gender specific and often exploitative ways’ (p. 3) and that women remain the most flexible supply of global labour (p. 11), serve as a starting point for many of the subsequent chapters. These offer a robust critique of the view (now strongly back on the development policy agenda) that women’s labour force participation is the best route to overcome their subordination – an argument that ignores women’s role in the domestic sphere where work is unregulated and unrewarded (p. 31) and their overwhelming responsibility for the reproduction of labour on a daily and generational Book reviews

Nurses and Technology: Maintaining a Balance Between Intervention and Nurturing for Childbearing Women

Invasive and noninvasive medical technology are employed frequently in the health care of women, particularly childbearing women, often without any demonstrable benefit. Nurses are in a position to be advocates for their childbearing patients and to define and implement a realistic balance between supportive or facilitative caring and technical interventions.