Social determinants of health.
The Centers for Medicare and Medicaid Services (CMS) is testing its Accountable Health Communities Model to see if addressing social needs such as food and housing as part of clinical care can improve health outcomes and reduce costs. Minorities are especially affected by such social determinants of health. The CMS model is one example of a new emphasis on integrating care with health-influencing factors beyond the traditional clinical setting.
Electronic health records (EHRs) burnout.
Clinicians may finally see action on a long list of frustrations with EHRs. Chief among the complaints is the data entry burden; nearly half of in-basket messages are generated by the EHR systems, including pending orders, health maintenance reminders, and prior authorization requests. Several initiatives are underway to reduce this administrative burden and improve interoperability so clinicians can more easily access important patient information across systems.
Eastern equine encephalitis (EEE).
Cases of EEE, a rare and often fatal mosquito-transmitted disease, caused 14 deaths in the United States in 2019. Scientists are closely monitoring the situation, unsure whether the outbreak is an anomaly or the beginning of a trend. Typical incidence is seven cases annually; 2019 saw 36, making it the worst outbreak in 15 years. Most of the confirmed cases occurred along the Atlantic and Gulf Coasts and in the Great Lakes region.
New nursing reports.
The Future of Nursing 2020-2030, a new report from the National Academy of Medicine and the Robert Wood Johnson Foundation, will lay out a blueprint for nurses to improve U.S. population health. And in April, the World Health Organization will release its State of the World's Nursing report, which highlights how nurses and midwives play a key role in reducing health disparities.
Better Ebola drugs.
Two promising treatments for Ebola infection that have been undergoing trials in the Democratic Republic of the Congo show significantly better results than older drugs against the highly contagious virus. The monoclonal antibodies REGN-EB3 and mAb114 had death rates of 29% and 34%, respectively, compared with 49% and higher with traditional treatment. Untreated Ebola infection has a 90% death rate.
Medical marijuana.
State laws governing medical marijuana change rapidly, as does research evidence guiding its use, creating challenges for clinicians to stay up to date. To fill the knowledge gap, nursing organizations are developing online courses and guidelines. In some places, advanced practice RNs can now certify patients who merit medical cannabis obtained from state-authorized dispensaries. But many more patients are using commercial cannabinol-based products, complicating the clinical picture. Although studies have shown cannabis to help cachexia, pain, chemotherapy-induced nausea and vomiting, and spasticity from multiple sclerosis or spinal cord injury, more research is underway to refine these findings.
Private nursing schools.
The emergence of health system-owned nursing schools bears watching for its impact on nursing education, hospital staffing, and the market for nursing professionals. The issue arose last year with the purchase of a controlling share in the Galen College of Nursing, one of the biggest nursing schools, with five campuses, by HCA Healthcare, the nation's largest health care system. Among reasons given by HCA, which employs 94,000 nurses in 185 hospitals, was that nursing students from Galen could fill in at HCA facilities during nurse shortages.-Carol Potera