AAN News & Opinion
Lesbian, gay, bisexual, and transgender health disparities are a global concern
Increasingly, initiatives by civil societies, governmental and nongovernmental agencies, and international partners have highlighted inequities in health care access and health outcomes for lesbian, gay, bisexual, and transgender (LGBT) people throughout the world. The United States Agency for International Development promotes LGBT human rights globally through its LGBT Global Development Partnership and has a vision that “…the basic and universal human rights of LGBT persons are respected and they are able to live with dignity, free from discrimination, persecution, and violence” (USAID, 2015).Call to action: Nursing action necessary to prevent one million heart attacks and strokes by 2017
Despite repeated national attempts to prevent and manage cardiovascular disease (CVD), it remains a leading public health problem in the United States today with costs estimated to exceed $289 billion (Anonymous, 2014; Mozaffarian et al., 2015). Several risk factors contribute to the burden of CVD. One third of all Americans have hypertension, and approximately half of those affected do not have it controlled (Mozaffarian et al., 2015; Lloyd-Jones et al., 2009; Ong, Cheung, Man, Lau, & Lam, 2007).Removing reimbursement barriers to increase the use of screening, brief intervention, and referral to treatment to prevent risky alcohol use
Better preparation and positioning of nurses to identify and address modifiable risks associated with preventable behavioral health care issues is one of the strongest and most feasible actions that can be taken by health care providers to reduce harm from alcohol use. (This recommendation was a product of the “Harm Reduction To Transform Health Care” Policy Dialogue presented at the 2013 American Academy of Nursing annual meeting.) One modifiable risk that affects the health of about 25% of the U.S.Elder justice: Preventing and intervening in elder mistreatment
In the United States, as many as 1 in 10 older adults and 47% of persons with dementia living at home experience some form of mistreatment (IOM, 2014). Elder mistreatment results in diminished well-being and quality of life, and violates the rights of older adults to be safe and free from violence. Elder mistreatment can occur anywhere–in the home, in care and residential facilities and in the community. It can also be malignantly contagious within settings and families and across the lifespan (Dong, 2012).Putting “health” in the electronic health record: A call for collective action
The American Academy of Nursing (Academy) endorses the capturing of social and behavioral determinants of health in the electronic health record (EHR). For this to happen, action must be taken to identify specific social and behavioral determinants of health (SBHD) to be included in a parsimonious panel to foster standardization and promote interoperability.Policy agenda for nurse-led care coordination
The Care Coordination Task Force (CCTF) was convened in mid-2014 by the leadership of the American Nurses Association (ANA) and the American Academy of Nursing (AAN) to review major position papers and policy briefs on care coordination published between 2012 and 2013 by expert panels of both organizations, and to recommend specific and actionable federal policy priorities to advance nursing's contributions to effective care coordination. Nurses have been and continue to be pivotal in the development and delivery of innovative care coordination practice models.Position statement: Employment discrimination based on sexual orientation and gender identity
The American Academy of Nursing opposes discrimination based on sexual orientation and gender identity. This position is consistent with its support for diversity and efforts to eliminate health disparities. Employment discrimination adversely affects physical and mental health (Institute of Medicine, Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities, 2011; Sears & Mallory, 2011). By perpetuating social stigma and adding to minority stress, it contributes to health disparities among lesbian, gay, bisexual, and transgender (LGBT) people, including those who have not directly experienced workplace discrimination.American Academy of Nursing position statement on reparative therapy
Reparative therapies, sometimes called conversion therapies or sexual orientation change interventions, have been widely discredited by most major health care professional organizations for their lack of scientific justification, failure to achieve intended results, questionable clinical practices, disregard and lack of respect for normal human differences, and inherently harmful effects on mental and physical health of individuals being pressured to change (APA, 2009; AMA, 2014). The American Psychological Association's Task Force on Appropriate Therapeutic Responses to Sexual Orientation (2009) carried out a systematic review of the literature and “concluded that efforts to change sexual orientation are unlikely to be successful and involve some risk of harm…” (pg.Reconsideration of do not resuscitate orders in the surgical/procedural setting
The American Academy of Nursing has long endorsed advance care planning and end-of-life conversations as essential components in the care of all persons but especially for those with critical, chronic, or complex conditions (American Academy of Nursing, 2010; The Palliative and End of Life Care Expert Panel, 2013; Tilden et al., 2012). The Institute of Medicine affirms the importance and necessity of having such conversations with patients in their recent report titled Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life (Institute of Medicine, 2014).Implementing culturally competent care
Today there are more migrants in the world than ever before — about 232 million international migrants in 2013 (United Nations, 2013). Nurses are one cohort of these migrants as countries increasingly employ immigration as a strategy to address their nursing shortages (International Centre for Nurse Migration, 2014). This movement of peoples across geographic borders and the transfer of nurses from one country to another challenges nurses to understand cultures different from their own in order to provide safe, quality care.Same-sex partnership rights: Health care decision making and hospital visitation
Although progress toward ensuring the rights of same-sex partners to visit and make decisions regarding the care of a hospitalized partner or partner's child has been made, policies and guidelines are inconsistently applied and sometimes completely ignored. Denying these rights is a violation of human rights and is detrimental of to the health and well-being of lesbian, gay, bisexual, and transgender (LGBT) people.American Academy of Nursing announced engagement in National Choosing Wisely® Campaign
As Part of Campaign, The Academy Released the List of Five Commonly Used Treatment Approaches That Are Not Always Necessary or AdvisableAmerican Academy of Nursing: Improving health and health care systems with advanced practice registered nurse practice in acute and critical care settings
Patients in acute care hospitals receive more than 18 million days of intensive care unit care annually at an estimated cost of nearly 1% of the gross domestic product (Health Research Services Administration [HRSA], 2006). A significant need for acute/critical care services remains, especially in the context of an aging American population. Advanced practice registered nurses (APRNs) working in acute care settings are well positioned and well prepared to reduce health care costs while improving access, addressing health systems issues, and providing high-quality care.American Academy of Nursing: Hepatitis C testing in the birth cohort 1945-1965: Have you been tested?
In July 2012, the American Academy of Nursing endorsed the recommendations of the Expert Panel on Emerging Infectious Diseases to accelerate efforts to remove barriers for hepatitis C screening and testing (Zucker, 2012). One month later, the Centers for Disease Control and Prevention announced its “Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945–1965.” These baby boomers account for 76.5% of HCV cases in the United States (MMWR, 2012).American Academy of Nursing: Ethics Policy-Maintaining high standards
Ethics is a branch of philosophy concerned with moral principles that guide decisions on how to live and how to behave. It is also defined as an evaluation of a moral choice based on ideas about what is morally right or wrong (Beauchamp & Childress, 2013). Ethics provides an opportunity to describe and understand standards of conduct in nursing practice. The nursing profession has long held to high ethical standards with the most recent benchmark being the development of the Code of Ethics for Nurses with Interpretive Statements (American Nurses Association [ANA], 2001).Core competencies in human milk and breastfeeding: Policy and practice implications for nurses
The American Academy of Nursing endorses human milk and breastfeeding as the preferred method of infant feeding and has a long history of policy work and publications from the Expert Panel on Breastfeeding of the Academy. The Academy has members who serve the United States Breastfeeding Committee (USBC), and our members actively participated in the development of the core competencies for health professionals. In 2013, the Academy endorsed these core competencies for health professionals, further underscoring our commitment to improving the landscape of breastfeeding in the United States.The mechanics of writing a policy brief
According to Nannini and Houde (2010), reports addressing the interests and needs of policy makers are frequently referred to as policy briefs. These reports are intended to be short and easy to use, containing information that can be reviewed quickly by policy makers. The contents of these reports are based on systematic reviews of the literature addressing refereed, rigorously evaluated science to advance policy making based on the best evidence. In a very important way, policy briefs give policy makers context to the issues that are intended to be addressed in their roles.Promoting the mental health of families
The American Academy of Nursing has identified the development of healthy families, particularly those that are underserved, as one of its priorities. This is a broad mandate that focuses on physical and mental health promotion, maintenance, and treatment, recognizing that physical and mental health is intertwined. Mental health status is particularly precarious in families living in poverty and those confronted with chronic health problems, limited access to care, and the stigma associated with mental health problems.A call to action: Engage in big data science
Numerous landmark reports in recent years have described the core problems and challenges of health care access, quality, safety, efficiency, and effectiveness today (Committee on Patient Safety, 2012; Smith, Saunders, Stuckhardt, & McGinnis, 2013). The significance of these problems as measured by the annual cost of medical errors is estimated at $17.1 billion dollars (Van Den Bos, 2011); 63.1% of these errors were judged preventable (Landrigan et al., 2010). The Affordable Care Act, the anticipated influx of approximately 32 million newly insured Americans in 2014, and the need to show quality and meaningful use require action on these important challenges.A call to action: Expanded research agenda for women's health
Recently, reports were released by the National Institutes of Health, Office of Research on Women's Health, and the Institute of Medicine suggesting women's health research agendas. These reports stimulated commentary from the American Academy of Nursing's Women's Health Expert Panel. This commentary identified the need for an expanded research agenda for women's health that was published in Nursing Outlook (Shaver, Olshansky, & Woods, 2013). The following call to action highlights the most critical areas that were not included in these reports.Advance care planning as an urgent public health concern
The American Academy of Nursing extensively engages in the work of policy improvement for better end-of-life care for all Americans. The Academy's work is evident in at least three specific recent activities:Advance care planning as an urgent public health concern
The American Academy of Nursing endorses end-of-life conversations as essential for the care of patients with life-limiting conditions so that patients’ values and preferences for their care and treatment are honored. These conversations, formally known as advance care planning, should rightfully occur among health professionals, patients, and patients’ families.The imperative for patient-, family-, and population-centered interprofessional approaches to care coordination and transitional care: A policy brief by the American Academy of Nursing’s Care Coordination Task Force
The American Academy of Nursing (AAN), representing nurse policy leaders, scientists, and clinicians, applauds the Centers for Medicare and Medicaid Services’ (CMS) recognition and support of evidence-based care coordination and transitional care. As CMS moves forward with policies for care coordination under Medicare and Medicaid, the AAN urges the agency to consider the framework it uses for thinking about care coordination and the evidence to support that framework. The Academy seeks to share its perspectives on crucial elements of such a framework to support the integration of care coordination and transitional care into the U.S.Expert panel on nursing theory guided practice position paper: Nursing knowledge and the impact on Nursing's Preferred Future a plan for enhancing Raise the Voice Phase II
The American Academy of Nursing (AAN) strives to lead the nation and “… serve the public and nursing profession by advancing health policy and practices through the generation, synthesis and dissemination of nursing knowledge”.1 Still the story of how nurses everywhere are positioned to revolutionize our healthcare system remains untold. One strategy that the AAN can use to reveal this story and take the lead in advancing policy is to make explicit the disciplinary knowledge integral to the implementation of the innovative experiments of the AAN-led Edge Runners initiative.Hepatitis C screening and testing: A call for a national response
The purpose of this brief is to convey the immediate need to coordinate and integrate hepatitus C virus (HCV) screening and testing for HIV co-infected and HCV-infected clients, into primary care. In 2000, 1.25 million persons were estimated to be chronically infected with hepatitus B virus (HBV), and 2.7 million are chronically infected with HCV.1 Furthermore, 55% to 85% of new HCV infections become chronic.2 Of the 1.0 million people chronically infected with HIV, 250,000 also have HBV, and ∼ 50,000 also have HCV, the leading cause of hepatocellular carcinoma.Women’s health in jeopardy: Failure to curb unintended pregnancies: A statement from the AAN Women’s Health Expert Panel
Care of and access to health care for women across the age span has always been at the forefront of nursing’s advocacy through education, practice, and research. One well-recognized method to improve the health status of women and children lies in managing unintended pregnancies; however, evidence shows that little progress has been made on this front. Threatening to roll back what little progress has been made, as well as the potential to achieve better management of unintended pregnancies, contemporary health policy fails to consistently ensure access to high-quality reproductive health care for all women in the United States.The Fellow selection review process
The American Academy of Nursing (AAN) is an organization dedicated to serving the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge.1Carpe diem: Nursing making inroads to improve mental health for elders
With 1 in every 5 adults over age 65 having mental illness, a projected 15 million will need services by 2030.1 Few nurses have specialized in geriatric mental health for a number of reasons: (1) The paucity of educational programs to prepare specialists, (2) the societal stigma associated with both aging and mental illness, (3) underpayment for services, and (4) lack of role models.2 Here we summarize the major accomplishments of the Academy’s Geropsychiatric Nursing Collaborative (GPNC), a Hartford-funded project designed to foster nursing’s contribution to the mental health of older Americans.Leadership needed to address the global nursing and midwifery workforce shortage
An estimated 4.2 million health care workers are needed to address the global shortage of human resources for health (HRH) to achieve global health and development goals.1 Internationally, nurses and midwives comprise the majority of the global health care workforce,2 and the World Health Assembly has passed several resolutions over the past 20 years recognizing the importance of strengthening the nursing and midwifery (N&M) workforce. For example, in 2001, Resolution WHA54.12 recommended establishing mechanisms to address the global shortage of nurses and midwives, and to strengthen their contribution at all levels including within the WHO itself.Performance measurement—A strategic imperative and a call to action: An overview of forthcoming papers from the American Academy of Nursing Expert Panel on Quality
In 2010, the American Academy of Nursing Expert Panel on Health Care Quality identified performance measurement in the transforming health care delivery system as a strategic imperative and agreed that a synthesis of key concepts was needed to guide policy and provide direction for the Academy and nursing’s partners in health care. Envisioned as a “call to action,” the Expert Panel affirmed the foci of target papers, recruited members as lead authors and co-authors, and launched an ambitious effort to develop 6 substantive position papers in 2011.The Future of Nursing Campaign for Action: State-level implementation efforts
The Robert Wood Johnson Foundation (RWJF), in collaboration with AARP, has embarked on a national Campaign for Action that builds upon the findings in the landmark Institute of Medicine (IOM) report The Future of Nursing: Leading Change, Advancing Health. This Campaign seeks to advance comprehensive health care change by fully using the expertise and experience of all nurses.The surgeon general’s call to breastfeeding action-policy and practice implications for nurses
The lack of breastfeeding in the United States is a public health crisis. The World Health Organization, the American Academy of Pediatrics, and multiple other professional organizations all recommend that infants are exclusively breastfed for the first 6 months; in the United States, however, only 13.6% of infants receive exclusive human milk for this time period.1-3 A 2010 study in the United States reported that 911 infant deaths could be prevented if breastfeeding rates were improved.4 On January 20, 2010, with the release of the Surgeon General’s Call to Breastfeeding Action, the US government released the most comprehensive plan to date of what needs to occur to improve breastfeeding outcomes and the health of our nation.Advance care planning as an urgent public health concern
The American Academy of Nursing endorses end-of-life conversations as essential for the care of patients with life-limiting conditions so that patients’ values and preferences for their care and treatment are honored. These conversations, formally known as advance care planning, should rightfully occur among health professionals, patients, and patients’ families.An update from the American Academy of Nursing's Workforce Commission
Since its inception in 2000, the American Academy of Nursing (AAN) Workforce Commission has focused on addressing the multiple factors that impede nursing workflow and the ability to achieve optimal clinical and operational outcomes. The Commission focused attention on ways technology could diminish demand on nurses' time by eliminating waste and enabling workflow, returning precious minutes of care to patients in acute care hospitals. Reducing demand is one strategy to abate cyclic nursing shortages.Guest Editorial: Intercontinental nursing
I regularly visit colleagues in Europe, North America, Australia, and South East Asia, and in my capacity as Editor-in-Chief of the Journal of Clinical Nursing, I process manuscripts from all of these parts of the world and more. Clearly, there would be little point in visiting other countries and continents if everything were the same as it was at home; it is the differences that draw us to travel and work in other countries and cultures, and the differences are apparent. For example, there could hardly be a greater contrast in cultures between Europe and South East Asia.Guest Editorial: History Matters
Washington is abuzz with history. Almost every commentator uses history to explain the foundations of critical issues and remind us how our modern problems and their solutions are shaped by historical perspectives. Thomas Freidman asks us to look back first to the Great Depression and later to the recession of the early 1970s to understand our current economic predicament and to develop useful strategies to overcome our own financial downturn. Our President, Barack Obama, has turned to economic historians Ben Bernanke and Christine Romer to chair, respectively, the Federal Reserve and the Council of Economic Advisors.The Academy's work on healthcare reforms
For those of us in Washington, DC, the last few months of healthcare reform debate represent what we have been anxiously waiting for—an opportunity to reform healthcare delivery so that more people receive the care they need. And even more importantly for us, it is an opportunity to enhance the healthcare system so that it recognizes and utilizes the expertise and innovations that nurses can bring to healthcare delivery. To this end, the American Academy of Nursing (AAN) volunteers and staff have been working diligently to bring forward the messages of the value of nurse innovations to health care the importance of meaningful technology and high quality in healthcare delivery and nursing's contribution to cost-effective care.Nurse Edge Runners—The hallmark of the Raise the Voice campaign
Nurse “Edge Runners”—the practical innovators who are leading the way in bringing new thinking and new methods to a wide range of healthcare challenges—are the hallmark of the American Academy of Nursing's Raise the Voice campaign. Edge Runners have developed options that help people stay healthy and cope better with illnesses, while producing exemplary financial and clinical outcomes. Furthermore, nurse-led innovations address people's needs and wants for a humane and effective health care system, reducing disparities while increasing efficiency and quality of patient care.AAN News
During his campaign and since taking office, President Barack Obama has made it clear that he wants major healthcare reform to happen as soon as possible. Learning from the 1990's healthcare reform debate, his team made the early decision that the White House would promote broad principles, not specific legislation. President Obama has, however, put the challenge to Congressional leaders to get the job done. And the Congressional leaders have taken up his challenge through direct action, unleashing years of pent-up energy to make healthcare reform a reality.An update from the American Academy of Nursing's Workforce Commission
The American Academy of Nursing formed the Workforce Commission in 2000 to develop strategies for combating the nursing shortage by reducing the demand on nurses' time. Over the past 4 years, the Commission's work has focused on describing the benefits of deploying technology to enhance patient safety, enable efficient workflows, and improve nurse retention. They are currently disseminating the results of their Technology Targets Project with continued funding from the Robert Wood Johnson Foundation.American Academy of Nursing's Raise the Voice Campaign
We are all aware that America's healthcare system is in desperate need of repair. Health care is inaccessible to many, expensive for most, and fragmented for all. Enabling the system to deliver the best possible care at an acceptable cost requires not just reformation but transformation—moving American health care away from its current hospital-based, acuity-oriented paradigm toward a patient-centered, convenient, helpful, and affordable system.Translating nursing knowledge into practice: An uncommon partnership
Evidence-Based Nursing Practice (EBNP) has the potential to transform and improve the quality of health care and the safety of patients. This will only occur to the extent that nursing research is made accessible and actionable for use by nurses at the bedside. The estimate that research can take up to 17 years to be translated into practice1 speaks to the enormous gap between academic and practice settings. Health information science and technology has been heralded as a significant factor in the translation of research and best evidence into the practice arena.Creating the context for technology: New realities for structure, media, space, and time
Context—circumstances in which an event occurs; a setting.1Technology—the use of scientific knowledge to solve practical problems; (Gr. tekhnologia—systematic treatment of an art or craft)1The newest and most exciting space—is where machines are actually in charge but have enough awareness to seek out people to help them when they get stuck. —Joe FlowersParticipating in national standards initiatives: A call to action
Nearly 3 million nurses are practicing in this country and constitute the largest single group of healthcare workers. Increasingly, they use information and communication technology in the form of patient monitoring systems, computers, the Internet, email, cellular phones, and other devices. Such technology should enhance nurses' ability to provide high-quality care that is based on best practices/evidence-based practice, improve the education of students, and advance the research agenda. However, many nurses in front line and management positions are frustrated by a lack of coordination, integration, and standardization when they use healthcare information systems.Bringing nurses into the boardroom
A large Midwest health system was implementing a new electronic health record (EHR) system expected to cost between $200 and $300 million. The board knew that other large health systems had phased in implementation of similar technology, requiring staff to come online first to allow any glitches to be worked out, with physicians coming on board after the initial training and testing. While acknowledging the need to be respectful of physicians' time, a nurse board member spoke out in strong support of shifting staff and physicians simultaneously – providing concrete, clinical examples of why this would be preferable – to eliminate the need for operating two different systems during the transition.Cognitive informatics: An essential component of nursing technology design
The implementation of various information technology (IT) systems designed to support, enhance and even transform healthcare delivery is inevitable. What is less certain, however, is whether or not these systems will be utilized to their greatest capacity and whether nurses will appreciate how IT systems can contribute to the knowledge base of nursing and to clinical practice. One might wonder why this seemingly counterintuitive discrepancy over information system usage and appreciation exists. The answer may very well lay behind the scenes in the infrastructure of the IT system and its user interfaces, especially in how closely the functions of the system resemble human cognition and practice patterns of the nurses utilizing them.Integration of nursing informatics in a specialty organization
Nursing specialty organizations have an essential role in building informatics capacity in the practice setting. Too frequently, however, discussions and publications about the integration of informatics overlook the needs of currently practicing frontline nurses. Clinical leaders cannot wait for a workforce educated with new informatics curricula. Strategies to advance information literacy and computer literacy in specialty practice are needed now. In addition, health information technology (HIT) needs to be shaped to collect specialty practice clinical data to support evidence-based decision-making.Information technology core competencies: From now to tomorrow
“Health Information Technology (HIT) can't change healthcare, but it has to be part of healthcare change.”1 According to John Loonsk, the Director of the Office of Interoperability and Standards at the Office of the National Coordinator for Health Information Technology in the Department of Health and Human Services, there are current critical healthcare needs that can be facilitated by the use of HIT. These include the avoidance of medical error, improvement of resource utilization, acceleration of knowledge diffusion, reduction of variability in healthcare delivery and access, empowerment of consumers, strengthening of data privacy and protection, and promotion of public health.Using a standardized language to increase collaboration between research and practice
Research and practice are struggling to move from an era of separate silos to an era of genuine collaboration in order to support their common goal: improving the quality of health care. Many forces are converging to encourage collaboration1:Implications of the American Nurses Association Scope and Standards of Practice for nursing informatics for nurse educators: A discussion
In January 2008, the third revision of the Scope and Standards of Practice for Nursing Informatics was published. This document “articulates the essentials of nursing informatics, its accountabilities and activities for both nursing informatics specialists and generalists. Its standards are those by which all nurses practice nursing informatics, and reflect and specify practice priorities and perspectives.”1
