“Physicians have a moral duty to maintain a therapeutic relationship with their patients in order to sustain a sense of moral community. We submit it is ethically appropriate to allow a mother to retain the informed choice whether to resuscitate her periviable child immediately upon birth when, in conjunction with the physician, the determination of what is in the best interest of the baby is unclear (zone of ambiguity). If she elects the option of no resuscitation, this delivery room hospice approach provides a commonly justified alternative at older ages to standard neonatal‘comfort care’ measures in association with a painless death for her child. If delivery is imminent and aborting in the clinical setting is not a desirable option, we should consider respecting maternal autonomy, by allowing a vaginal delivery with the promise of offering opioids to assuage the dying process in a patient at high risk for lifelong handicap as with any other hospice condition.”
Author Archives: John
What is health equity and how can it be achieved?
What are some strategies to increase compliance of correctly completing the bedside shift reports?
“Bedside report is an evidence-based practice used to increase patient involvement in their care and improve patient satisfaction. A change management strategy and standardized approach to bedside report can help increase nurse compliance with the process.”
In this study “A change management strategy and standardized approach to bedside report helped increase nurse compliance with the process, leading to improved patient satisfaction.”
Scheidenhelm, S, et. al Hardwiring Bedside Shift Report. (2017). Journal of Nursing Administration., 47(3), 147.
How does nursing work engagement effect patient and hospital outcomes?
“The vital connection of nurse engagement to the experience of care, and ultimately to nurse and patient outcomes, is clear. Quality improvement efforts that equally emphasize initiatives to improve the patient experience and create and sustain a highly engaged nursing workforce are key to achieving desired safety and quality outcomes.”
Dempsey C, Assi MJ. The Impact of Nurse Engagement on Quality, Safety, and the Experience of Care: What Nurse Leaders Should Know. Nurs Adm Q. 2018 Jul/Sep; 42(3):278-283.
Full text for Emory users.
What are modifiable risk factors for cancer?
What are the disparities and barriers to breast feeding and how to help new mothers overcome those impacts?
Despite recognized health benefits for both mothers and infants, significant disparities still exist in the rates of breastfeeding in the United States. This article reviews the evidence related to barriers (prenatal, medical, societal, hospital, and sociocultural) that many mothers face, and explore the known barriers and the impact they have on a woman’s ability to breastfeed her infant.Strategies will be discussed to address (and potentially overcome) some of the most common barriers women face along with a list of resources that can be useful in this effort.
From: Sriraman, Natasha, et al
What are the various cultural beliefs and practices among minority groups regarding cancer prevention?
From Lott, B. et al. (Reference below)
“Minority youth represent a unique population for public health interventions given the social, economic, and cultural barriers they often face in accessing health services. Interventions to increase uptake of Human Papillomavirus (HPV) vaccination in minority youth have the potential to reduce disparities in HPV infection and HPV-related cancers.
Some studies have found that Black, His-panic, and Asian adolescents were more likely to initiate the HPV vaccine series than their white counterparts, however, were less likely to complete the series
Documented barriers to HPV vaccination of minority youth include knowledge, attitudes, and beliefs among parents, geographic location, distance to vaccination centers,immigrant or foreign-born status, acculturation levels, socioeconomic status, insurance status, and high cost of the vaccine”
Lott, B., Okusanya, B., Anderson, E., Kram, N., Rodriguez, M., Thomson, C., . . . Ehiri, J. (n.d.). Interventions to increase uptake of Human Papillomavirus (HPV) vaccination in minority populations: A systematic review. Preventive Medicine Reports., 19, 101163.