American Journal of Nursing最新文献

{"title":"Provision 5 Is Asking Us to Listen to Nurses Differently.","authors":"Vanessa Abacan","doi":"10.1097/AJN.0000000000000378","DOIUrl":"10.1097/AJN.0000000000000378","url":null,"abstract":"<p><p>An ethical imperative for organizational culture.</p>","PeriodicalId":7622,"journal":{"name":"American Journal of Nursing","volume":"126 10","pages":"9"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Ambulatory New Graduate Nurse Bullying.","authors":"Christina M Matousek, D'Ana Brooks, Joy Elwell, Tracy Carafeno, Ivy M Alexander","doi":"10.1097/AJN.0000000000000375","DOIUrl":"10.1097/AJN.0000000000000375","url":null,"abstract":"<p><strong>Background: </strong>Experiencing bullying as a new graduate RN is considered a rite of passage by some in the nursing profession. However, such behaviors erode new nurses' self-confidence, hinder their professional development, and can negatively affect patient outcomes. Research links workplace incivility and bullying to increased medication errors, patient falls, and greater hospital costs. Within a large, comprehensive cancer center, high rates of these behaviors have been reported, yet staff education on their impact remains limited.</p><p><strong>Purpose: </strong>This quality improvement project aimed to reduce bullying of new graduate RNs, improve their knowledge of these behaviors, and enhance confidence in communication techniques for those who experience them.</p><p><strong>Methods: </strong>A literature review identified cognitive rehearsal training (CRT) as an effective intervention for nurse bullying. Consequently, CRT content was developed featuring scenarios on gossiping, negative nonverbal communication, and direct verbal remarks. Eleven new graduate RNs completed the training, which provided education on identifying harmful behaviors and executing appropriate responses. To determine the intervention's impact, bullying knowledge, bullying exposure/incidence, and perceived confidence in communication were assessed before, immediately after, and 30 days after the intervention using a Bullying Knowledge Questionnaire and the Negative Acts Questionnaire-Revised.</p><p><strong>Results: </strong>Knowledge scores increased by 73% and confidence in communication levels improved by 108% immediately following the intervention, remaining stable for 30 days. Exposure/incidence of bullying decreased by 39% from the initial rate of 54.5% to 33.3% at follow-up. All participants reported satisfaction with the program.</p><p><strong>Conclusion: </strong>These results suggest that CRT can positively impact bullying knowledge, reduce exposure to and incidence of bullying, and improve confidence in communication techniques. However, future research should utilize a larger, more diverse sample size to enhance the generalizability and transferability of these findings.</p>","PeriodicalId":7622,"journal":{"name":"American Journal of Nursing","volume":"126 10","pages":"44-49"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coverage Denials Plague Medicare Advantage Customers.","authors":"","doi":"10.1097/AJN.0000000000000388a","DOIUrl":"10.1097/AJN.0000000000000388a","url":null,"abstract":"<p><p>The problem persists despite increased government oversight.</p>","PeriodicalId":7622,"journal":{"name":"American Journal of Nursing","volume":"126 10","pages":"13-14"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LPNs/LVNs in Long-Term Care, Hospitals, and Home Health: A Comparative Analysis.","authors":"Brendan Martin, Michaela Reid, Yetty Shobo, Daria Waszak, Shin Hye Park","doi":"10.1097/AJN.0000000000000392","DOIUrl":"https://doi.org/10.1097/AJN.0000000000000392","url":null,"abstract":"<p><strong>Background: </strong>Demand for long-term care (LTC) in the United States is projected to surge, but the supply of LPNs/LVNs who constitute a large and growing segment of its workforce has stagnated.</p><p><strong>Purpose: </strong>The aim of this study is to compare demographic and professional characteristics of the LPN/LVN workforce across LTC, hospital, and home health settings.</p><p><strong>Methods: </strong>Data drawn from the 2024 National Nursing Workforce Survey were used to support a detailed descriptive analysis and binary logistic regression models examining potential drivers of emotional exhaustion in the LPN/LVN workforce.</p><p><strong>Results: </strong>LPNs/LVNs in LTC tend to be more racially diverse than those in hospital and home health settings. They are also more likely to report working in rural areas, holding multiple positions, and drawing a higher median salary. LPNs/LVNs working in LTC are also more likely to report higher burnout, workloads, understaffing, and intent to leave compared to their counterparts in hospitals and home health settings.</p><p><strong>Conclusion: </strong>Evidence suggests that the LTC workforce has yet to rebound from COVID-19-related attrition. This deficit, coupled with stagnant enrollment and licensure statistics over the past decade, alongside projected increases in demand for LPNs/LVNs in LTC across the country, underscores a tenuous and unsustainable future for the industry. To safeguard the care of vulnerable populations, interventions are needed that prioritize retention, incentivize reentry into practice, and deploy policies to expand the LPN/LVN pipeline.</p>","PeriodicalId":7622,"journal":{"name":"American Journal of Nursing","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune Thrombotic Thrombocytopenic Purpura: Diagnosis and Management.","authors":"Natasha Rose Carew, Caroline Dorsen, Shelby Pitts, Simon Badin","doi":"10.1097/AJN.0000000000000372","DOIUrl":"10.1097/AJN.0000000000000372","url":null,"abstract":"<p><strong>Abstract: </strong>Thrombotic thrombocytopenic purpura (TTP), the most common type of which is immune-mediated (iTTP), is a rare, life-threatening hematologic disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, and end-organ damage. Prompt recognition and early treatment are essential for survival. Early diagnosis and initiation of treatment are critical in iTTP. Nurses play a key role in recognizing symptoms, supporting patients through treatment, and monitoring for relapse. This review outlines the pathophysiology and clinical presentation of iTTP, along with criteria for diagnosis, with an emphasis on the role of the von Willebrand factor-cleaving protease ADAMTS-13. Current evidence-based treatment strategies are discussed, including therapeutic plasma exchange and immunosuppression with corticosteroids and monoclonal antibody-based therapies. A case study of a middle-aged patient who experienced a relapse of iTTP is presented, illustrating key clinical decision points, challenges in long-term management, and the need for interdisciplinary collaboration.</p>","PeriodicalId":7622,"journal":{"name":"American Journal of Nursing","volume":"126 10","pages":"30-34"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Medication Reconciliation at Discharge: A Cross-Sectional Survey.","authors":"Sachi Sengupta, Jordan La, Skyllar Kuppinger, Alejandro Quezada, Stella Wang, Zaina Sharqawi, Andre A Fabian, Bianca Nguyen, Aram A Namavar, Anna Dermenchyan","doi":"10.1097/AJN.0000000000000374","DOIUrl":"10.1097/AJN.0000000000000374","url":null,"abstract":"<p><strong>Background: </strong>Medication discrepancies remain a persistent patient safety concern despite decades of quality improvement efforts. Research indicates that about half of hospitalized adults experience at least one such discrepancy after discharge, often stemming from unclear clinician roles and poor communication among nurses, physicians, and pharmacists. Understanding nurses' perspectives is critical to designing interventions that will improve medication reconciliation and enhance patient safety at discharge.</p><p><strong>Purpose: </strong>This study aimed to explore RNs' perspectives of medication reconciliation during hospital discharge, focusing on barriers, communication patterns, and opportunities for system improvement.</p><p><strong>Methods: </strong>A cross-sectional survey was administered to nursing staff across medical telemetry, cardiac observation, short-stay, and general observation units at a large quaternary academic teaching hospital between March 21 and April 30, 2022. The survey assessed nurses' comfort with patient education, perceived role responsibilities, and collaboration with other disciplines. Quantitative responses were summarized descriptively, and open-ended responses were analyzed using inductive content analysis to identify recurring themes.</p><p><strong>Results: </strong>Of the 217 nurses invited to participate, 108 completed the survey. Most nurses reported high comfort levels in using teach-back methods (93.5%) and reviewing reconciled medication lists with patients (87%). Responsibility for medication-related discharge tasks was most often viewed as shared, including medication teaching and schedule review as well as communicating medication changes made during hospitalization. Collaboration with pharmacists received the most favorable evaluations, with a majority (60.1%) rating it good or excellent. In contrast, a majority rated as average or worse collaboration with physicians (54.6%), case managers (68.5%), and social workers (63.9%). Free-text responses to open-ended items added further insights.</p><p><strong>Conclusions: </strong>The study findings indicate that while nurses generally feel confident about their ability to provide patient education, their ability to deliver accurate medication information is hindered by incomplete or inconsistent documentation, role ambiguity, and lapses in interdisciplinary communication. Addressing these issues will require targeted educational interventions, improved interprofessional collaboration, and expanded pharmacy integration. Embedding technological tools such as automated notifications into discharge planning workflows could further improve medication reconciliation and ensure safe care transitions. To achieve these goals, nurses must have accurate medication information, role clarity, and integrated interdisciplinary support.</p>","PeriodicalId":7622,"journal":{"name":"American Journal of Nursing","volume":" ","pages":"36-43"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical care consultations in ED expedite specialized care.","authors":"Karen Rosenberg","doi":"10.1097/AJN.0000000000000383a","DOIUrl":"10.1097/AJN.0000000000000383a","url":null,"abstract":"<p><p>ACCORDING TO THIS STUDY.</p>","PeriodicalId":7622,"journal":{"name":"American Journal of Nursing","volume":"126 10","pages":"60"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Conversation with Jen Hamilton.","authors":"Amy M Collins","doi":"10.1097/AJN.0000000000000382","DOIUrl":"10.1097/AJN.0000000000000382","url":null,"abstract":"<p><p>A nurse influencer talks about her career and using her platform for good.</p>","PeriodicalId":7622,"journal":{"name":"American Journal of Nursing","volume":"126 10","pages":"50-51"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measles continues to spread across the United States.","authors":"Karen Roush","doi":"10.1097/AJN.0000000000000388e","DOIUrl":"10.1097/AJN.0000000000000388e","url":null,"abstract":"","PeriodicalId":7622,"journal":{"name":"American Journal of Nursing","volume":"126 10","pages":"13"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the Cover.","authors":"","doi":"10.1097/AJN.0000000000000387","DOIUrl":"10.1097/AJN.0000000000000387","url":null,"abstract":"","PeriodicalId":7622,"journal":{"name":"American Journal of Nursing","volume":"126 10","pages":"19"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}