Patient safety is not yet on par with other medical rules, such as surgical technique or confidentiality, but should be, according to Dr. Allan Korn, CMO for the Blue Cross and Blue Shield Association. He writes that educating hospital boards on quality care and safety issues, using pre-operation checklists and having a single provider oversee a patient's medication regime could help improve safety.

Experts are urging nurses to increase their awareness and be more involved in state and federal legislation that could affect their practice and profession. Nurses should ensure they are "the most informed consumers and most informed voters," says Rose Gonzalez of the ANA.

Moving into 2011, the health care industry faces a range of challenges associated with delivering quality patient care. Implementing electronic health records that work and meet meaningful use requirements, reducing central line infections and minimizing the overuse of imaging involving radiation are among the top 10 health care quality issues this year, according to this article.

Peg McKeon and Mary Walsh, a current and a retired nurse, wrote and produced a 93-minute musical comedy called "Bedside" about three generations of nursing. A video of the play is available for viewing online and has been approved by the Pennsylvania State Nurses Association as an accredited continuing education activity.

Researchers said patients who get general anesthesia are closer to being in a reversible drug-induced coma than a deep sleep. The three-year study found significant differences among sleep, anesthesia and coma, with only a few shared characteristics between the deepest states of sleep and the lightest anesthesia.

A survey of medical travel companies found only about 13,500 U.S. patients were referred for overseas care, compared with previous estimates of 500,000 to 2 million patients. Researchers found patients sought overseas care for lower medical prices, but data showed the costs of medical procedures abroad were similar to the prices Medicare pays. Patients often went to Costa Rica, India and Thailand for medical care, the study found.

The Future of Nursing: Campaign for Action has started to work on improving five key areas of nursing -- including leadership, education and interprofessional collaboration -- to address the call for nurses to take on greater roles in health care. The campaign has identified New Jersey, New York and three other states as sites for Regional Action Coalitions, which will identify nursing best practices and create models that can be replicated by any health facility.

A Gallup survey of 1,037 people showed that 81% said that nurses had "high" or "very high" honesty and ethical standards, putting them at the top rank of the most trusted professionals for the 11th time since 1999. "It's extremely gratifying to know that the public continues to hold the profession in such high esteem," ANA President Karen Daley said, adding that the high regard for nurses puts them in a good position to play a key role in health care reform.

Senior hospital executives should not wait for vacancies in nurse manager positions before honing the leadership skills of their nursing staff, said Patty Kubus, president of Leadership Potential International. Kubus suggests a development plan that officials could adopt to train their nurses, which involves identifying staff with leadership potential, assessing their strong and weak points, and creating programs to improve their skills.

A study showed that using and discussing surgery checklists before, during and after an operation helped 74 Veterans Affairs hospitals reduce surgical deaths by 18% from 2006 to 2008. The program, which borrowed techniques from the airline industry, gave everyone in the operating room an equal chance to speak and was most effective when staff were well-trained on teamwork.

Some health facilities are requiring newly hired nurses to hold a Bachelor in Nursing Science degree or are putting applicants with the degree at hiring priority. "All nurse leaders should be encouraging their staff to attain a minimum of a BSN. It is necessary for the profession as well as for the quality of care provided," a health system chief nursing officer and senior vice president said.

A U.S. study found that 85% of wrong-site operations at hospitals were a result of judgment errors and 100% of wrong-person surgeries were due to lack of communication among operating room staff. An expert said that changing the OR culture to eliminate intimidation and promote teamwork could encourage nurses and other staff to voice their concerns and help improve patient safety.

CDC Director Dr. Thomas Frieden identified smoking, AIDS, obesity and nutrition, teen pregnancy, auto injuries, and health care infections as the six "winnable battles" to be priorities in U.S. health care. Some officials applauded the shortlist as a means to narrow down health care goals, while others said it could negatively affect care for hepatitis C and other diseases that have long received less attention.

Nursing requires skills in critical thinking as well as multitasking when providing patient care. "Critical thinking means pulling it all together to do what is necessary for the safest and best outcome for your patient," said RN and nurse scholar Deborah Thames of Emory University Hospital in Atlanta.

To bridge the gap between school training and professional practice, many hospitals use residency programs to continue educating new nurses, as well as develop their communication and critical thinking skills. The programs could help large hospitals save up to $400,000 annually and improve retention of new nursing staff, an expert on nursing education said.

With help from efficiency experts, Cleveland Clinic developed a quality-improvement program that borrows some of the best principles of manufacturing to provide more coordinated care to patients. Focusing on "continuous improvement," the program has prompted a reorganization of the hospital's 25 centers based on specific diseases or organ systems rather than specialties.

Some U.S. hospitals are now shifting from subjective evaluations to a new system that evaluates the performance of nurses based on patient-satisfaction scores and other goals they achieve. The change in performance reviews is being driven in part by an expected change in how health insurers pay hospitals -- based on patient satisfaction, among other measures -- beginning in October.

Health care experts agree that organizations have to help new nurse managers transition into their responsibilities, including budgeting, patient safety and staff oversight. Shelley Cohen, president of Health Resources Unlimited, listed six principles that hospitals can apply to aid recently promoted nurse managers, including setting realistic expectations, allocating time to observe the assigned unit and regular meetings with nurse directors.

Vestagen Technical Textiles recently introduced lab coats and scrubs made from specially designed fabric that protects doctors and nurses from pathogens that can cause deadly infections. Based on Nanosphere technology, the company is able to make the Vestex scrubs using organosilane, which creates an electric barrier on the fabric's surface to kill bacteria by penetrating the cell membranes.

A Joint Commission sentinel event alert said violent crimes such as assault, murder and rape are increasing at health care facilities and urged providers to follow 13 steps to prevent such events. Hospitals were advised to beef up security in emergency departments, evaluate violence-prevention programs and pre-screen potential employees.

California plans to use $800,000 of $3 million in fines paid by hospitals for so-called "never events" to research how to reduce the risk of leaving objects inside a patient following surgery. State hospitals reported 350 cases of "retained foreign objects" in the past two years, accounting for 14% of all preventable errors during the period.

Clinics run by nurses and nurse practitioners could transform health care to improve chronic disease management, improve patient outcomes and satisfaction, and free up physicians for more complex medical cases, Thomas Aschenbrener says. Expanded access to nursing education and leadership programs to help nurses master the business of health are needed to achieve this, he says

Surgical teams were able to reduce the number of medical errors and cut the risk of patient death by more than half during urgent surgery when they used a checklist introduced by the World Health Organization through the Safe Surgery Saves Lives program, a study found. One researcher said the checklist allowed medical staff to become more team-focused during the procedure.

A HealthGrades study showed bariatric surgeries are increasing in the U.S. but quality and safety vary by hospital. Data showed overall rates for complications and death were decreasing, but patients at top-performing hospitals had a 66.55% lower chance of complications than those at facilities ranked near the bottom.

Bad managers -- and even performance reviews -- can cause workers so much stress that it can negatively affect their health, experts say. "The pile of evidence coming out shows that if you want to be an effective organization or an effective boss, you've got to strike a balance between humanity and performance," says Robert I. Sutton, a Stanford University management professor.

Hospitals in several states including Pennsylvania are increasingly hiring nursing applicants with a bachelor's degree over registered nurses with an associate's degree or diploma school degree. The trend has not reached rural hospitals primarily because of the nurse shortage in those areas.

Nurses understand the link between the environment and health and are leading programs at work that encourage recycling, energy conservation and the use of locally grown organic foods. Nurses "are integrating environment health, knowledge and skills into their professional practice," RN Barbara Sattler, a nursing professor, said.

The new health reform law will affect nurses in many ways, including the reauthorization of the Nursing Workforce Development Programs for nursing education. The law also increases funding for Nurse-Family Partnership programs and school-based health centers.

Workplace violence and abuse is an ongoing, and often increasing, problem for hospital nurses. Facilities are implementing policies and states are passing laws to reduce incidents of violence, but experts say more attention is needed for the issue. "It's such a pervasive state. And it's unacceptable," an ANA official said.

More registered nurses are seeking certification in specialty areas to gain advanced knowledge and improve patient care. Most nurses wait at least two years before seeking certification to get the necessary clinical experience to pass the certification exam.

Ontario hospitals are planning cutbacks due to health care funding shortfalls, and experts say job losses and salary freezes could spark an exodus of nurses and physicians to the U.S., where demand for health care is expected to increase due to health reform.

Reducing infection spread, correctly identifying patients and using medications safely are among the 10 best practices nurses can use to ensure patient safety. The list also calls for eliminating venous thromboembolism, developing customized hospital discharges and preventing patient falls.

A government report said there were 3.1 million licensed registered nurses in the U.S. in 2008, an increase of more than 5% from 2004. About half had a bachelor's degree or higher in 2008, and those with a master's or doctorate increased 46.9% from 2004 to 2008.

U.S. medical centers last year offered average salaries of $189,000 to certified nurse anesthetists, compared with $173,000 for primary care physicians, according to an annual survey. Salaries for CRNAs have increased with demand, as the number of surgical procedures has increased in recent years.

Being proactive is a key to having a satisfying nursing career over the long-term and each stage offers opportunities for improvement, experts say. New nurses should hone their clinical skills and get involved in their professional community while midcareer nurses may want to explore cross-training, committee work or managerial positions.

Most health system executives said there will be a surge in the adoption of electronic health record systems and health information exchanges this year as health providers try to streamline patient data sharing and meet meaningful use criteria. Health organizations also will push for the implementation of point-of-care technologies that can help boost efficiency and enhance clinical processes, according to some hospital CIOs.

Nursing experts say there will be greater opportunities for nurses as patient care becomes more complex, the population ages and chronic disease increases. And if health reform passes, it could increase the need for better-educated nurses and allow advanced practice nurses to lead multidisciplinary health teams in the community, experts say.

Critical thinking is an integral part of perioperative nursing and nurses hone those skills through practical experience, a review said. Researcher Jackie Jones, a registered nurse at Kennesaw State University in Georgia, said group exercises involving new and experienced nurses help novices learn practical applications of critical thinking.

Nurse authors are penning a variety of fiction, nonfiction and poetry books to bring the profession to life. Some, including oncology nurse Theresa Brown, who writes for The New York Times, use blogs and columns in newspapers and online media to talk about patient care and career issues.

The National Athletic Trainers' Association offers tips for people who are looking to start or change an exercise routine, including to consider your fitness level and mental toughness. The group also recommends setting realistic goals and perhaps consulting a professional to ensure your plans are achievable.

A Texas nurse who was brought up on criminal charges for filing an anonymous complaint accusing a doctor of unethical conduct was acquitted by a jury Thursday in a case that watchdog groups warned could have a chilling effect on health care workers and patients.

Stitches are better than staples when it comes to fewer postsurgery problems for women who have cesarean deliveries, according to U.S. researchers. The study showed lower wound separation and complication rates for women who had sutures.

Increasing educational requirements for registered nurses and faculty shortages will increase the demand for flexible online nursing programs. A higher-education consultant said establishing an online nursing degree program is a low-risk venture for nursing schools.

ClearCount Medical Solutions secured FDA approval in December for its SmartWand-DTX, a system that uses RFID technology to allow users to track surgical sponges during low-risk surgical procedures. The company also signed a deal with a major distributor to market its products.

Keeping surgical patients at a normal body temperature throughout the perioperative period can improve patient outcomes, according to nurse experts. Nurses use a variety of ways to keep patients warm, including forced-air warming gowns, blankets, socks and circulating-water mattresses.

The HHS has introduced the country's first health security strategy focused on managing large-scale health threats. "The National Health Security Strategy is a call to action for each of us so that every community becomes fully prepared and ready to recover quickly after an emergency," said HHS Secretary Kathleen Sebelius. The strategy includes 10 objectives for achieving health security.

Christine Bromley spent years teaching her cardiac and diabetes patients how to eat right and finally discovered one secret that every dieter can use: a 9-inch plate. The Fort Lauderdale, Fla., nurse began her own business, One Helping Helps Many, that sells the dinner plates designed to maintain portion control.

The Senate voted 61-39 in favor of a proposal that would require health insurers to cover preventive services for women, including mammograms. Sen. Barbara A. Mikulski, D-Md., introduced the proposal as an amendment to the health care reform bill.

Almost 40,000 applicants were turned away from U.S. nursing schools this year, mainly because of faculty and resource shortages, according to the American Association of Colleges of Nursing. Data from 511 schools showed enrollment in baccalaureate nursing programs did increase 3.5% from 2008 to 2009, the ninth year in a row for enrollment gains.

New England chief nursing officers say nurses who want to move up to management or administrative positions should let their supervisors know what they want to do and find a mentor to help them. Getting involved with clinical committee work, keeping a positive attitude and going back for additional education can also help nurses move up the job ladder.

A checklist is a low-tech way to reduce hospital infections, but the problem is getting nurses and physicians to use them. Dr. Peter Pronovost, a Johns Hopkins researcher who led a study showing the benefits of a checklist, said the "power and politics and hierarchy" of getting nurses to ensure physicians followed a checklist can make their use more difficult.

Formal training for nurse preceptors is expanding and even can be found online. The role can provide professional fulfillment as well as a direct impact on care quality. However, "not everyone can be a preceptor. Some people are very clinically strong, but they cannot teach."

U.S. News & World Report's "America's Best Hospitals" rankings list the top 10% of facilities in best nursing care, based on patient satisfaction surveys, with the Mayo Clinic Hospital in Phoenix and New England Baptist Hospital in Boston topping the list. The report also lists the hospitals judged to be the worst 10% for nursing care.

Many women leave the doctor feeling that their symptoms and concerns haven't been taken seriously, and many women eventually diagnosed with a serious autoimmune disease have been told it's all in their head, experts say. Here are the signs and symptoms for the seven most commonly misdiagnosed women's health problems, including polycystic ovary syndrome, chronic fatigue syndrome and irritable bowel syndrome.

The number of health Web sites has increased from about 35 in 2005 to almost 500 due in part to the popularity of social networking and the desire of patients to make informed decisions about their health. One health-focused social networking Web site is Inspire, which allows its 130,000 members to share their health issues and experiences with treatment options.

French researchers developed a mathematical model to show how a so-called superspreader who did not wash his hands and traveled throughout a hospital could increase the nosocomial infection rate. The increase in infection rates from the single superspreader was equal to 23% of all other staff not washing their hands.

Oncology nurse Theresa Brown writes in a New York Times blog post about a colleague who watched a physician admonish a patient for choosing hospice and not the aggressive cancer treatment he recommended. Brown says health care providers may feel the need to save patients but must be brave enough to allow some of them to make their own choices about life and death.

HealthGrades' annual Hospital Quality in America Study found patients at top-rated U.S. hospitals had a 51.5% lower risk of death than hospital patients in general. The company based its evaluation on 17 procedures and diagnoses at 5,000 U.S. hospitals and said that while mortality rates generally have declined in recent years, a "quality chasm" persists.

A CDC study on 1,400 adults and 500 children hospitalized with the H1N1 flu across 10 states showed that 55% of the patients who died from the flu had other medical conditions and most were younger than 65 years old. Asthma, immunosuppression, chronic lung disease and chronic heart disease were the most common underlying conditions among adults, while children had asthma, chronic lung diseases, neurological or neuromuscular diseases, and sickle cell or other blood conditions.

Heart disease in women should be called ischemic heart disease because it is different from the coronary artery version most common in men, cardiologists said. They said the change could help focus attention on the greater symptom burden, functional disability and adverse outcomes experienced by women.

Hospitals are adopting a "manufacturing mindset" toward reducing costs and are training staff to identify and cut out wasteful spending. Kansas University Hospital has formed in-house partnerships that look for cost savings and North Kansas City Hospital has restructured its supply chain processes.

Lawmakers in New York and New Jersey are considering a total of 10 bills that would require all new registered nurses to obtain a bachelor's degree in nursing within 10 years of initial licensure. Some experts are concerned about the impact on nursing education because faculty shortages already force many nursing schools to turn away applicants.

Eight retired Texas nurses who formed a group called the Nightingales volunteer each week at Baylor Hospital at Plano, providing an extra personal touch for patients and families. The hospital's chief nursing officer, Ellen Pitcher, came up with the idea, realizing that retired nurses were an untapped resource and could help patients, families and the nursing staff.

Some herbs, vitamins and supplements can be harmful if taken in large doses or with certain prescription medications, experts say in this CNN review. People should read supplement labels carefully and always tell their health care provider about any supplement or natural remedy they are using

Violence against nurses and other health care workers is a common occurrence, and Oklahoma is among 16 states taking action this year to prevent it. The ANA reports 14 other states already had such legislation or programs in place. The Oklahoma law, which took effect in May, makes assaulting nurses, paramedics, physician or other staff a felony punishable by up to two years in jail and a $1,000 fine.

Elsevier has rolled out a Web-based application that would help nurses avoid CMS' list of 10 "never events." The tool allows nurses to review evidence-based nursing content, guidelines, books, journals, news and patient education information.

Nurse- and nurse practitioner-run clinics across the U.S. have helped to reduce emergency department visits, hospital admissions and health costs, according to the National Nursing Centers Consortium. The group said there are about 250 nurse-managed health centers in the country, many providing needed access to care for the poor and uninsured.

Health care recruiters advise nurses to learn all they can about the hospital or facility where they want to work before heading to a job interview. In very competitive markets, they say it might be wise to consider relocating, taking a lower paying job or going back to school to make yourself more marketable.