Description

Publications in this journal

• The state of the science in the prevention and management of osteoarthritis: experts recommend ways to increase nurses' awareness and knowledge of osteoarthritis.

  Authors: Laura Robbins, Marjorie G Kulesa

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):74-81.

  OVERVIEW:: In July 2011 a symposium on osteoarthritis convened experts in many areas-nursing, epidemiology, rheumatology, public policy, geriatrics, pharmacotherapy, physical therapy, andOVERVIEW:: In July 2011 a symposium on osteoarthritis convened experts in many areas-nursing, epidemiology, rheumatology, public policy, geriatrics, pharmacotherapy, physical therapy, and complementary modalities-to discuss the importance of nurses in reducing the disability caused by osteoarthritis. The planning committee included representatives from AJN, the National Association of Orthopaedic Nurses, and the Hospital for Special Surgery. Symposium attendees recommended ways in which nurses could take on greater leadership roles in research, policy, education, and clinical practice for the early diagnosis and management of this prevalent condition.

• The Impact of Osteoarthritis in the United States: A Population-Health Perspective: A population-based review of the fourth most common cause of hospitalization in U.S. adults.

  Authors: Louise Murphy, Charles G Helmick

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):85-91.

  OVERVIEW:: Arthritis, of which osteoarthritis (OA) is the most common type, is the most frequent cause of disability among adults in the United States. The authors reviewed the epidemiologicOVERVIEW:: Arthritis, of which osteoarthritis (OA) is the most common type, is the most frequent cause of disability among adults in the United States. The authors reviewed the epidemiologic literature to identify studies that describe the population-based burden of OA-that is, the burden in all adults in the community. They found that 27 million adults-more than 10% of the U.S. adult population-had clinical OA in 2005, and in 2009 OA was the fourth most common cause of hospitalization. OA is the leading indication for joint replacement surgery; 905,000 knee and hip replacements were performed in 2009 at a cost of $42.3 billion. Obesity is a strong risk factor for OA of the knee and hip. Nurses can improve the quality of life of people with OA by raising awareness among their patients and peers of the substantial OA burden and the strategies, such as physical activity, that can reduce it.

• Assessing for Risk and Progression of Osteoarthritis: The Nurse's Role: Understanding pathophysiology, epidemiology, and risk will aid nurses who are seeking to expand their role in management.

  Authors: Mary Carol Antonelli, Terence W Starz

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):98-102.

  OVERVIEW:: The authors review the primary and secondary risk factors for osteoarthritis (OA), its pathophysiology and epidemiology, the evidence-based approaches to slowing progression, and the roleOVERVIEW:: The authors review the primary and secondary risk factors for osteoarthritis (OA), its pathophysiology and epidemiology, the evidence-based approaches to slowing progression, and the role of nurses encountering OA in primary care and other settings.

• Pharmacologic Management of Osteoarthritis-Related Pain in Older Adults: A review shows that many drug therapies provide small-to-modest pain relief.

  Authors: M Carrington Reid, Rouzi Shengelia, Samantha J Parker

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):109-14.

  OVERVIEW:: Because pain is a common and debilitating symptom of osteoarthritis in older adults, the authors reviewed data on the efficacy and safety of commonly used oral, topical, and intraarticularOVERVIEW:: Because pain is a common and debilitating symptom of osteoarthritis in older adults, the authors reviewed data on the efficacy and safety of commonly used oral, topical, and intraarticular drug therapies in this population. A search of several databases found that most studies have focused on knee osteoarthritis and reported only short-term outcomes. Also, treatment efficacy was found to vary by drug class; the smallest effect was observed with acetaminophen and the largest with opioids and viscosupplements.Acetaminophen and topical agents had the best safety profiles, whereas oral nonsteroidal antiinflammatory drugs and opioids had the worst. Little data were available on patients ages 75 years old and older and on patients from diverse racial and ethnic groups. Most drug therapies gave mild-to-moderate pain relief; their long-term safety and efficacy and their effects in diverse populations (particularly older adults) remain undetermined.

• Panel discussion: issues and strategies for nurses caring for adults with osteoarthritis: at the july 2011 symposium, three nurses discussed best practices and challenges.

  Authors: Miki Patterson

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):122-3.

• Engaging the volunteer in you.

  Authors: Mary Jo Satusky

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):71-2.

• Osteoarthritis: The Patient's Experience: Kathy Geller describes her life with this chronic illness.

  Authors: Joy Jacobson

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):84.

• Making osteoarthritis a public health priority: several initiatives are placing this chronic illness on the national agenda.

  Authors: Patience H White, Mary Waterman

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):92-7.

  OVERVIEW:: National, state, and local policymakers and society at large are paying growing attention to osteoarthritis. This movement is fueled by organizations and coalitions that are championingOVERVIEW:: National, state, and local policymakers and society at large are paying growing attention to osteoarthritis. This movement is fueled by organizations and coalitions that are championing important initiatives. This article spotlights several initiatives sponsored by the Arthritis Foundation and other organizations.

• Rehabilitation Interventions for Pain and Disability in Osteoarthritis: A review of interventions including exercise, manual techniques, and assistive devices.

  Authors: Maura Daly Iversen

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):103-8.

  OVERVIEW:: Osteoarthritis (OA) results in progressive destruction of articular cartilage and bone at the joint margins, leading to impairments extending far beyond the synovial joint. RehabilitationOVERVIEW:: Osteoarthritis (OA) results in progressive destruction of articular cartilage and bone at the joint margins, leading to impairments extending far beyond the synovial joint. Rehabilitation interventions that target specific impairments and activity restrictions can help restore independence and promote healthy living. Such interventions include exercise, physical modalities (ice, heat, ultrasonography), manual techniques (mobilization and manipulation), and assistive devices. The predominance of evidence on the effects of rehabilitation interventions for knee and hip OA suggest that they afford modest pain relief, reduced disability, and improved function. Research is needed to identify the modes of exercise and the effective doses for relief of symptoms and functional limitations.

• Complementary and Alternative Modalities to Relieve Osteoarthritis Symptoms: A review of the evidence on several therapies often used for osteoarthritis management.

  Authors: Judith Fouladbakhsh

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):115-21.

  OVERVIEW:: Conventional medical treatment of osteoarthritis often successfully relieves pain but can also produce adverse gastrointestinal and cardiovascular effects, especially with long-term use.OVERVIEW:: Conventional medical treatment of osteoarthritis often successfully relieves pain but can also produce adverse gastrointestinal and cardiovascular effects, especially with long-term use. Hence, many patients use complementary and alternative medicine (CAM) to prevent, control, and manage the pain of osteoarthritis. The author reviews the evidence on the efficacy and safety of several CAM therapies often used for osteoarthritis management, including mind-body therapies, supplements, and body-based treatments.

• Strategies to support self-management in osteoarthritis: five categories of interventions, including education.

  Authors: Teresa Brady

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 31(2):124-30.

  OVERVIEW:: This overview of successful strategies for supporting self-management in patients with osteoarthritis (OA) defines the concepts of self-management, self-management support (SMS), andOVERVIEW:: This overview of successful strategies for supporting self-management in patients with osteoarthritis (OA) defines the concepts of self-management, self-management support (SMS), and self-management education (SME); describes five categories of SMS interventions; identifies common elements across SMS categories; and provides evidence for and examples of self-management tools that are useful in OA. SMS categories include SME, other skill-building and behavior-change interventions, supportive provider interactions, ongoing supportive follow-up, and environmental changes. Where available, relevant OA-specific SMS strategies are used to illustrate these categories.

• Spica cast care: a collaborative staff-led education initiative for improved patient care.

  Authors: Cynthia Reed, Lee Carroll, Susan Baccari, Herminia Shermont

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 30(6):353-8; quiz 359-60.

  One of the most challenging aspects for nurses caring for incontinent children in spica casts is maintaining healthy skin integrity. Noting an increase in the number of phone calls from parents ofOne of the most challenging aspects for nurses caring for incontinent children in spica casts is maintaining healthy skin integrity. Noting an increase in the number of phone calls from parents of discharged children in spica casts concerning diaper rash and skin breakdown, inpatient orthopedics staff nurses lead an interdisciplinary quality improvement and educational initiative. They standardized pediatric spica cast care and education by creating an intranet narrated PowerPoint presentation for staff and parents of children with spica casts. A take-home DVD of this education module is now produced and given to parents, reinforcing nursing discharge teaching and giving parents the opportunity to review these new skills at home as needed. The purpose of this article is to share this experience of improving patient outcomes and empowering other orthopedics nurses to develop creative educational solutions.

• Practical preparation for hip replacement surgery valuable insider tips.

  Authors: Pat Camillo

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 30(6):367-72.

• Bilateral femoroacetabular impingement.

  Authors: Erin S Hart, Alison Turner, Jeffrey Kreher

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 30(6):397-8.

• Perceptions of self-image and physical appearance: conversations with typically developing youth and youth with idiopathic scoliosis.

  Authors: Lisa Merenda, Kimberly Costello, Anna Marie Santangelo, Mary Jane Mulcahey

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 30(6):383-90.

  To report how youths, both with and without idiopathic scoliosis (IS), respond to questions about their self-image and perceptions of body shape. An additional purpose is to describe themes thatTo report how youths, both with and without idiopathic scoliosis (IS), respond to questions about their self-image and perceptions of body shape. An additional purpose is to describe themes that emerged as important to youths with IS to better understand scoliosis from their perspective. Descriptive qualitative and quantitative methods were utilized. Subject interviews were conducted, as part of a larger cognitive interviewing study on the Spinal Appearance Questionnaire, using a cross-sectional sample of 76 females between 8 and 16 years of age with IS and who were typically developing (TD), without scoliosis. IS and TD subjects revealed similar findings when asked what makes them look good versus their peers; self-image ratings were also positive. Predominant themes from open-ended responses include physical appearance, feelings, brace wear, and discomfort. Self-image and body shape did not differ significantly between groups. The identified themes warrant further exploration as they are significant and important to youth with scoliosis.

• Caring for the caregivers.

  Authors: Mary Jo Satusky

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 30(6):349-50.

• Postoperative total joint replacement class for support persons: enhancing patient and family centered care using a quality improvement model.

  Authors: Amanda Mazaleski

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 30(6):361-4; quiz 365-6.

  Thorough patient education is imperative to smooth transitions and positive patient outcomes. Often postoperative patients are exhausted, overwhelmed and taking sedating medications, making retentionThorough patient education is imperative to smooth transitions and positive patient outcomes. Often postoperative patients are exhausted, overwhelmed and taking sedating medications, making retention of patient education information and instructions a challenge. Healthcare providers must find innovative opportunities to educate not only patients but also their loved ones to ensure positive outcomes after discharge. The Plan, Do, Study, Act quality improvement model wa utilized to organize and evaluate a weekly postoperative class for support persons of patients who have undergone total joint replacement surgery in an effort to enhance patient- and family-centered care. Results gathered from post-class surveys thus far indicate that the knowledge gained from the postoperative class has increased perception of caregiver preparedness for the recovery phase once the patient is discharged from the hospital.

• Mulitmodal analgesia for postoperative total knee arthroplasty.

  Authors: Cecilia Otten, Karen Dunn

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 30(6):373-80; quiz 381-2.

  Postoperative pain after a total knee arthroplasty (TKA) is a major concern for the patient and nurse. Pain after a TKA can be severe and, when inadequately controlled, can impair or preventPostoperative pain after a total knee arthroplasty (TKA) is a major concern for the patient and nurse. Pain after a TKA can be severe and, when inadequately controlled, can impair or prevent functional rehabilitation with physiologic, psychologic, and economic consequences (). With multiple pain management regimens, healthcare providers need data on approaches that provide optimal postoperative pain relief with minimal side effects. This retrospective study examined whether there were differences between regional anesthetics used for TKAs in their ability to control postoperative pain with fewer side effects. Retrospective chart review of two hundred fifty seven charts. Patients who received all 3 anesthetic modalities (intrathecal morphine sulfate, single-shot femoral nerve block, and wound catheter) had better pain control postoperative TKA and requested less opioids.

• Effects of preoperative education on patient outcomes after joint replacement surgery.

  Authors: Marge Kearney, Mary Kay Jennrich, Sheri Lyons, Rochelle Robinson, Barbara Berger

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 30(6):391-6.

  This descriptive study compared the outcomes of the patients who did and did not attend a hospital-based preoperative education class. The sample consisted of 150 patients undergoing total hip orThis descriptive study compared the outcomes of the patients who did and did not attend a hospital-based preoperative education class. The sample consisted of 150 patients undergoing total hip or total knee replacement. Patients completed a survey about their preparation and expectations for surgery and their experiences after surgery. Charts were reviewed for length of stay, complications, ambulation distance, and pain score. Postoperative complications were assessed during a follow-up phone call about 30 days after discharge. Patients who attended the preoperative education class reported feeling better prepared for surgery and better able to control their pain after surgery. There were no significant differences between groups in length of stay, ambulation distance, pain level, or complication rate. Knowledge gained from the hospital's preoperative education class did affect patient experiences. Further comparisons of face-to-face versus online structured education are warranted.

• Volunteering, mentoring, and relational aggression: all in the same profession?

  Authors: Elizabeth Ann Carlson

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 30(6):399-400.

• Verbal Abuse in the Workplace: Has Civility Disappeared?

  Authors: Carol L Watters

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 29(1):46-50.

• Preparing NAON's future leaders: are you prepared to take the lead?

  Authors: Frederick M Brown

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 29(2):76.

• Patients speak out: development of an evidence-based model for managing orthopaedic postoperative pain.

  Authors: Pamela Pulido, Mary E Hardwick, Michelle Munro, Laura May, Denise Dupies-Rosa

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 29(2):92-8.

  Perioperative pain management after total joint replacement continues to be a concern for orthopaedic nurses. In our institution, the results of routine post-hospital stay surveys had shown belowPerioperative pain management after total joint replacement continues to be a concern for orthopaedic nurses. In our institution, the results of routine post-hospital stay surveys had shown below average scores in the area of pain management. This began as a quality management issue, became a pain subcommittee issue, and drew in the research nurses to ask what we can learn from this process. Changing the method of handling pain management is not easy, but it makes a difference in patients' hospital experiences. We learned that cooperation and expertise from multiple departments within the institution and some organizations outside the institution is needed to bring about change. We learned that education of not just staff members but also patients on pain management affected the outcome. This article describes our journey to enhance pain management in our institution.

• An integrative review of Tai Chi research: an alternative form of physical activity to improve balance and prevent falls in older adults.

  Authors: Angela Conrad Wooton

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 29(2):108-16; quiz 117-8.

  The purpose of this integrative review is to analyze the current research literature on Tai Chi (TC) and its potential effect on balance and prevention of falls in older adults. The evidence forThe purpose of this integrative review is to analyze the current research literature on Tai Chi (TC) and its potential effect on balance and prevention of falls in older adults. The evidence for improving balance is somewhat conflicting because few research studies identify which balance exercises are effective. The question of how TC achieves improvements in balance remains. To promote functional independence and improve quality of life in the later years of one's life, it is important to improve balance and prevent falls in older adults. TC poses challenges related to the complexity of the practice. By reviewing the current research literature on TC focusing on balance and falls in older adults, strategies may be developed to incorporate TC to improve balance and modify the known risk factors for falling. This article also discusses potential applications and limitations of the current research.

• A systematic review of healthcare professional-led education for patients with osteoporosis or those at high risk for the disease.

  Authors: Cynthia A Smith

  Orthopaedic nursing / National Association of Orthopaedic Nurses. 29(2):119-32.

  The effect of healthcare professional-led education for patients with osteoporosis or those at high risk for the disease on adherence with treatment recommendations was investigated. Eight databasesThe effect of healthcare professional-led education for patients with osteoporosis or those at high risk for the disease on adherence with treatment recommendations was investigated. Eight databases were searched using multiple key words, and combinations of key words, to find the highest level of evidence available. Four randomized controlled trials, 2 quasi-experimental trials, and 3 descriptive longitudinal comparative studies were identified and assessed. Eight of the 9 studies showed improved adherence with treatment recommendations for patients with osteoporosis or those at high risk for the disease after the healthcare professional-led educational intervention. A professional nurse may be in the best position to lead this type of education, with 6 of the 9 studies using nurses as educators.

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