Development of a COVID-19 alternate care site from ground zero: A nursing perspective

The novel coronavirus disease SARS-CoV-2 (COVID-19) outbreak rapidly generated an unprecedented global, national, and state public health crisis with the need to rapidly develop alternate care sites (ACS) to care for COVID-19 patients within an overburdened health care system. A hospital care model ACS to increase the health care capacity, provide care for mild to moderately symptomatic patients, and offer local self-sustainment for a surge of patients was developed in Memphis, Tennessee located in Shelby County. We completed a temporary conversion of a large unused newspaper publication building to a health care facility for COVID-19 patients. Developing an ACS from ground zero was met with many challenges, and throughout the process important lessons were learned. With the goal to complete the building conversion within a 28-day timeframe, collaboration among the numerous governmental, health care, and private agencies was critical and nursing leadership was key to this process. The purpose of this paper is to describe the development of a COVID-19 ACS in Memphis, TN, which has a large at-risk population with limited access to health care. Specifically, we will discuss the strong leadership role of nursing faculty, key challenges, and lessons learned, as well as provide checklists and models for others in similar circumstances.     

Use of electronic nicotine delivery systems (ENDS) in lesbian,gay, bisexual,transgender and queer persons: Implications for public health nursing

Smoking and rates of tobacco abuse remain higher in lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons. There has been very little scholarly inquiry about the emerging trend of use of electronic nicotine delivery systems (ENDS; e.g., vaping and eCigarettes [eCigs]) in LGBTQ populations. The purpose of this article is to: (a) explore the most recent prevalence data regarding smoking and tobacco abuse in LGBTQ persons, (b) reveal strategies the tobacco industry has historically used in marketing their products to the LGBTQ community, (c) review data from the few studies evaluating use of ENDS in LGBTQ persons, (d) provide evidence-based methods public health nurses can employ to discourage use of ENDS in LGBTQ persons by addressing two identified causes of ENDS use in LGBTQ populations (harassment/discrimination in LGBTQ youth and binge drinking in LGBTQ adults), and (5) encourage cessation among those already using ENDS.     

WHS guidelines for the treatment of pressure ulcers—2023 update

The major populations at risk for developing pressure ulcers are older adults who have multiple risk factors that increase their vulnerability, people who are critically ill and those with spinal cord injury/disease. The reported prevalence of pressure ulcers in the United States is 2.5 million. However, this estimate is derived from acute care facilities and does not include people who are living at home or in nursing facilities. Despite the implementation of hospital and facility-based preventive measures, the incidence of pressure ulcers has not decreased in decades. In addition to the burden of pain, infection and death, it is estimated that hospital-acquired pressure ulcers cost the health system $26.8 billion annually with over 50% of the cost attributed to treating Stage 3 and 4 pressure injuries. Thus, it is critical to examine the literature and develop guidelines that will improve the outcomes of this complex and costly condition. This guideline update is a compendium of the best available evidence for the treatment of Pressure Ulcers published since the last update in 2015 and includes a new section based on changing demographics entitled ‘Palliative wound care for seriously ill patients with pressure ulcers’. The overall goal of the Wound Healing Society Guideline project is to present clear, concise and commercial free guidelines that clinicians can use to guide care, that researchers can use to develop studies that will improve treatment and that both clinicians and researchers can use to understand the gaps in our knowledge base.     

Individual,social, and environmental factors for infection risk among home healthcare patients: A multi-method study

There has been limited research into the individual, social, and environmental factors for infection risk among patients in the home healthcare (HHC) setting, where the infection is a leading cause of hospitalisation. The aims of this study were to (1) explore nurse perceptions of individual, social, and environmental factors for infection risk among HHC patients; and (2) identify the frequency of environmental barriers to infection prevention and control in HHC. Data were collected in 2017–2018 and included qualitative interviews with HHC nurses (n = 50) and structured observations of nurse visits to patients' homes (n = 400). Thematic analyses of interviews with nurses suggested they perceived infection risk among patients as being influenced by knowledge of and attitudes towards infection prevention and engagement in hygiene practices, receipt of support from informal caregivers and nurse interventions aimed at cultivating infection control knowledge and practices, and the home environment. Statistical analyses of observation checklists revealed nurses encountered an average of 1.7 environmental barriers upon each home visit. Frequent environmental barriers observed during visits to HHC patients included clutter (39.5%), poor lighting (38.8%), dirtiness (28.5%), and pets (17.2%). Additional research is needed to clarify inter-relationships among these factors and identify strategies for addressing each as part of a comprehensive infection control program in HHC.     

Ecological study: MSM sex worker advertising amidst Monkeypox in three U.S. cities

The 2022 monkeypox (MPX) outbreak was a source of consternation and stress among men who have sex with men (MSM)—the population disproportionately affected by the recent MPX outbreak. Individuals at high-risk for MPX (e.g., MSM, sex workers) were prioritized for vaccination during early state and city health department vaccine initiatives across the U.S., but little is known about how the MSM sex work market was affected by the MPX outbreak in U.S. cities where MPX incidence was particularly high. To better characterize the potential relationship between MPX incidence and MSM sex worker advertising at the height of the U.S. MPX outbreak, we monitored advertising volume on an Internet advertising platform popular among MSM sex workers and compared these data to city and county health department MPX case reporting data during a 13-week period (July 2nd, 2022- September 24th, 2022) in three U.S. cities with peak MPX incidence: Chicago, New York City, and San Francisco. In each of these cities, we observed a decline in advertising during or immediately following study week(s) with the highest number of weekly MPX cases during the study period, recognizing that observed decreases in advertising could be attributed to transient increase(s) in advertising during large-scale LGBT festivals occurring during the study period.     

Mpox in the United States: Current implications for public health nursing

In 2022, mpox, an orthopoxvirus first isolated in 1958 in cynomolgus monkeys, became a global public health threat. While the virus can be communicated through skin-to-skin contact from any infected person to non-infected person, most cases in the United States have been in gay and bisexual men. Consequently, early public health and community-based efforts concentrated on reducing infections in this population. This article explores current mpox case count epidemiologic data and trends. In addition, vaccination indications, contraindications, adverse events, and national administration data are provided along with directions for nurses and other clinicians moving forward in the outbreak.