Most-cited articles · 2021
The 50 most-cited articles in AJN American Journal of Nursing, 2021
Ranked by OpenAlex citation count on 29 October 2026, out of 381 eligible articles AJN American Journal of Nursing published in 2021. Ranks are frozen; this page will not change. Number one, with 118 citations: Cross-Sectional Studies.
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- 2026-10-29
The most-cited AJN articles of 2021 cluster around a few themes: clinical research methods for nurses, workforce well-being and burnout, and practice issues shaped by the COVID-19 pandemic. The top paper is "Cross-Sectional Studies" by Bernadette Capili, with 118 citations, part of a series teaching nurses the concepts underpinning evidence-based practice. Other highly cited works address suicidal ideation and help seeking among U.S. nurses, well-being and resilience among health care workers during the pandemic, and the 4Ms of an Age-Friendly Health System.
For readers, the list offers a view of which AJN articles researchers cited most often in the following years, spanning research methodology, nurse and health care worker well-being, patient safety topics such as oral care and monitoring, and policy or leadership subjects. Citation counts reflect scholarly attention rather than a judgment of quality, and the ranking draws on OpenAlex data for 381 eligible articles.
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- 1top 0.3%
Cross-Sectional Studies
Bernadette Capili
118 citationsOpen accessdoi:10.1097/01.naj.0000794280.73744.feOpenAlex
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Editor's note: This article is one in a series on clinical research by nurses. The series is designed to give nurses the knowledge and skills they need to participate in research, step by step. Each column will present the concepts that underpin evidence-based practice-from research design to data interpretation. The articles will be accompanied by a podcast offering more insight and context from the author. To see all the articles in the series, go to http://links.lww.com/AJN/A204.
- 2top 0.6%
Original Research: Suicidal Ideation and Attitudes Toward Help Seeking in U.S. Nurses Relative to the General Working Population
Elizabeth A. Kelsey, Colin P. West, Pamela F. Cipriano, Cheryl Peterson, Daniel Satele and 2 more
64 citationsdoi:10.1097/01.naj.0000798056.73563.faOpenAlex
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PURPOSE: Although previous studies have revealed professional consequences of burnout among nurses, less is known about the potential personal consequences. This study investigated the prevalence of suicidal ideation and attitudes toward help seeking among U.S. nurses relative to other workers, and the extent to which personal and professional factors, including burnout, were related to suicidal ideation. METHODS: In November 2017, a cross-sectional survey was sent to 86,858 nurses who were members of the American Nurses Association and to a probability-based sample of 5,198 U.S. workers. The survey included questions regarding suicidal ideation, burnout, symptoms of depression, individual and professional characteristics, and willingness to seek professional help if a serious emotional problem arose. Multivariable logistic regression analyses were conducted to identify factors associated with suicidal ideation after controlling for other factors. RESULTS: Among the 7,378 nurse respondents, 403 (5.5%) reported having suicidal ideation within the past year. Most nurses (84.2%)…
- 3top 0.8%
Original Research: Well-Being and Resilience Among Health Care Workers During the COVID-19 Pandemic: A Cross-Sectional Study
Lindsay Thompson Munn, Tsai-Ling Liu, Maureen Swick, Robert Rose, Britney Broyhill and 2 more
50 citationsdoi:10.1097/01.naj.0000767352.47699.0cOpenAlex
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BACKGROUND: Poor well-being among health care workers, often observed as professional burnout, is a well-documented phenomenon. The coronavirus disease 2019 (COVID-19) pandemic has further stressed the health care workforce, but its specific effects on this workforce remain unknown. This study examined well-being and resilience among health care workers during the COVID-19 pandemic. METHODS: The study used a cross-sectional survey design. Data collection took place through anonymous surveys of nurses (LPNs and RNs), advanced practice providers (NPs, physician assistants, and certified nurse midwives), certified registered nurse anesthetists, respiratory therapists, health care technicians, and therapy service professionals (physical, occupational, and speech therapists). Of the 6,120 health care workers recruited to participate in the study, data from 2,459 participants were analyzed using logistic regression and linear regression. RESULTS: The study found that several factors significantly increased the likelihood of at-risk well-being. These included having a lower level of…
- 4top 1.1%
The 4Ms of an Age-Friendly Health System
Erin E. Emery‐Tiburcio, Laurin Mack, Mary C. Zonsius, Ellen L. Carbonell, Michelle Newman
47 citationsOpen accessdoi:10.1097/01.naj.0000799016.07144.0dOpenAlex
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This article is the first in a new series, Supporting Family Caregivers in the 4Ms of an Age-Friendly Health System, published in collaboration with the AARP Public Policy Institute as part of the ongoing Supporting Family Caregivers: No Longer Home Alone series. The 4Ms of an Age-Friendly Health System (What Matters, Medication, Mentation, and Mobility) is an evidence-based framework for assessing and acting on critical issues in the care of older adults across settings and transitions of care. Engaging the health care team, including older adults and their family caregivers, with the 4Ms framework can help to ensure that every older adult gets the best care possible, is not harmed by health care, and is satisfied with the care they receive. The articles in this new series present considerations for implementing the 4Ms framework in the inpatient hospital setting and incorporating family caregivers in doing so. Resources for both nurses and family caregivers, including a series of accompanying videos developed by AARP and the Rush Center for Excellence in Aging and funded by the…
- 5top 1.4%
Original Research: Oral Care as Prevention for Nonventilator Hospital-Acquired Pneumonia
Karen K. Giuliano, Daleen Penoyer, Aurea Middleton, Dian L. Baker
46 citationsOpen access (CC-BY-NC-ND)doi:10.1097/01.naj.0000753468.99321.93OpenAlex
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BACKGROUND: Nonventilator hospital-acquired pneumonia (NV-HAP) presents a serious and largely preventable threat to patient safety in U.S. hospitals. There is an emerging body of evidence on the effectiveness of oral care in preventing NV-HAP. PURPOSE: The primary aim of this study was to determine the effectiveness of a universal, standardized oral care protocol in preventing NV-HAP in the acute care setting. The primary outcome measure was NV-HAP incidence per 1,000 patient-days. METHODS: This 12-month study was conducted on four units at an 800-bed tertiary medical center. Patients on one medical and one surgical unit were randomly assigned to receive enhanced oral care (intervention units); patients on another medical and another surgical unit received usual oral care (control units). RESULTS: Total enrollment was 8,709. For the medical control versus intervention units, oral care frequency increased from a mean of 0.95 to 2.25 times per day, and there was a significant 85% reduction in the NV-HAP incidence rate. The odds of developing NV-HAP were 7.1 times higher on the medical…
- 6top 1.6%
CE: Psychedelic-Assisted Therapy
Andrew Penn, Caroline G. Dorsen, Stephanie Hope, William E. Rosa
42 citationsOpen accessdoi:10.1097/01.naj.0000753464.35523.29OpenAlex
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Psychedelics are a class of psychoactive substances that were studied extensively between 1943 and 1970 as potential therapies for treating a host of mental health disorders, including addiction. Despite promising early results, U.S. psychedelic research was halted in the early 1970s with the enactment of the Controlled Substances Act. As the field of psychedelic-assisted therapy develops, nurses can decide the role they will play in the continuing clinical and scholarly research of these substances, which may soon be used in controlled settings to treat some of the most widespread mental health disorders. To prepare for this task, this article proposes that nurses * become familiar with the history, relevant language, and scientific findings related to the field of psychedelic research. * learn about existing psychedelic-assisted therapy and research resources. * examine their thoughts, judgments, and opinions about therapeutic psychedelic use. * consider the potential role of nursing in psychedelic-assisted therapies going forward.
- 7top 1.9%
Nurses Achieving the Sustainable Development Goals: The United Nations and Sigma
Connie Sobon Sensor, Pennie Sessler Branden, Valerie Clary‐Muronda, Janice Evans Hawkins, Dawn Fitzgerald and 4 more
41 citationsOpen accessdoi:10.1097/01.naj.0000742544.07615.dbOpenAlex
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This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article highlights SDGs 5 (gender equality), 8 (decent work and economic growth), and 17 (partnerships for the goals), along with the advocacy of these goals by Sigma Theta Tau International Honor Society of Nursing in the UN system.
- 8top 2.1%
A Call to the CMS: Mandate Adequate Professional Nurse Staffing in Nursing Homes
Ann Marie Kolanowski, Tara Cortes, Christine Mueller, Barbara J. Bowers, Marie P. Boltz and 17 more
41 citationsdoi:10.1097/01.naj.0000737292.96068.18OpenAlex
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Editor's note: This article is by 22 nursing gerontology experts who are all advocates of nursing home reform. They are listed at the end of this article.
- 9top 2.4%
Continuous Physiological Monitoring Improves Patient Outcomes
Courtney Stellpflug, Laura Pierson, Devin Roloff, Elton A. Mosman, Tera L. Gross and 3 more
37 citationsdoi:10.1097/01.naj.0000742504.44428.c9OpenAlex
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BACKGROUND: General patient acuity is increasing in the United States, with more patients having multiple comorbidities and acute-on-chronic conditions. Hospitalizations may also be complicated by serious adverse events, often unrelated to the admitting medical diagnosis. In our facility, the late detection of patient deterioration on general medical units often resulted in increased length of stay (LOS) in the ICU and poor patient outcomes. PURPOSE: The purpose of this project was to improve patient surveillance and better identify early signs of patient deterioration through the use of continuous vital sign monitoring technology. METHODS: To improve detection of patient deterioration, a nurse-led monitoring and response system was developed using a wearable, wireless device for continuous vital sign surveillance. The patient data the device provided was used with early warning scores and sepsis screening protocols for timely goal-directed interventions. RESULTS: Ninety-seven percent of patient deterioration events were recognized and treated as a result of this continuous…
- 10top 2.7%
Measurement in Nursing Research
Alexa Colgrove Curtis, Courtney Keeler
30 citationsdoi:10.1097/01.naj.0000753668.78872.0fOpenAlex
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Editor's note: This is the fourth article in a series on clinical research by nurses. The series is designed to give nurses the knowledge and skills they need to participate in research, step by step. Each column will present the concepts that underpin evidence-based practice-from research design to data interpretation. The articles will be accompanied by a podcast offering more insight and context from the authors. To see all the articles in the series, go to http://links.lww.com/AJN/A204.
- 11top 2.9%
CE: Nurses Are More Exhausted Than Ever: What Should We Do About It?
Alison M. Trinkoff, Carol M. Baldwin, Eileen R. Chasens, Jacqueline M. Dunbar‐Jacob, Jeanne M. Geiger-Brown and 9 more
29 citationsOpen accessdoi:10.1097/01.naj.0000802688.16426.8dOpenAlex
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ABSTRACT: For nurses, the challenges posed by demanding work environments and schedules often lead to fatigue, and this can be exacerbated during crises like the COVID-19 pandemic. In this article, the authors discuss causes and challenges of nurse fatigue and consider several evidence-based strategies and solutions for individual nurses and organizations. Barriers to implementation, including a negative workplace culture and inadequate staffing, are also described, and several resources are presented.
- 12top 3.2%
CE: Postpartum Depression: A Nurse's Guide
Barbara Alba
24 citationsdoi:10.1097/01.naj.0000756516.95992.8eOpenAlex
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ABSTRACT: Despite extensive research, the etiology behind postpartum depression (PPD) remains a mystery. Experts have theorized about various potential risk factors, including hormonal fluctuations, genetics, prior history of depression, low socioeconomic status, adolescent pregnancy, and certain personality traits. This article provides foundational information about PPD, reviewing the risk factors for and the consequences of this mood disorder. Postpartum blues and postpartum psychosis are briefly discussed for context, although they differ from PPD. Screening and treatment options are explained, and nursing implications for practice are presented.
- 13top 3.5%
The ICN Global Nursing Leadership Institute: Integrating the SDGs into Leadership and Policy Development
William E. Rosa, Camille Burnett, Chesanny Butler, Prescola Rolle, Jane Salvage and 2 more
23 citationsOpen accessdoi:10.1097/01.naj.0000803204.19511.8aOpenAlex
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This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article discusses the International Council of Nurses Global Nursing Leadership Institute and its integration of the SDGs into a global leadership and policy development program.
- 14top 3.7%
COVID-19: Impact on Nurses and Nursing
Nicole Fauteux
23 citationsdoi:10.1097/01.naj.0000751076.87046.19OpenAlex
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Recent surveys provide clues to the pandemic's effect on the profession.
- 15top 4%
Cohort Studies
Bernadette Capili, Joyce K. Anastasi
20 citationsOpen accessdoi:10.1097/01.naj.0000803196.49507.08OpenAlex
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Editor's note: This is the seventh article in a series on clinical research by nurses. The series is designed to give nurses the knowledge and skills they need to participate in research, step by step. Each column will present the concepts that underpin evidence-based practice-from research design to data interpretation. The articles will be accompanied by a podcast offering more insight and context from the authors. To see all the articles in the series, go to http://links.lww.com/AJN/A204.
- 16top 4.2%
A New Framework for Practice–Academic Partnerships During the Pandemic—and into the Future
Nancy M. Spector, Michelle Buck, Sarah Phipps
19 citationsdoi:10.1097/01.naj.0000803192.68710.8fOpenAlex
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ABSTRACT: During the COVID-19 pandemic, many health care facilities closed their doors to nursing students, depriving them of the experience of caring for patients, a foundation of nursing education. The purpose of this article is to report on how the National Council of State Boards of Nursing convened nurse leaders from around the country to explore this problem and develop possible solutions.Coming together virtually, these leaders recommended a national model, the practice-academic partnership, to provide nursing students with in-person clinical experiences during the pandemic. This model is unique in its recognition of the important role of nursing regulatory bodies in these partnerships. The practice-academic partnership model creates clinical education opportunities for students during a public health crisis, such as the COVID-19 pandemic. Further, the model could be applied to meet the chronic challenges nursing education programs have often faced in securing clinical sites, even in the absence of a global or national public health emergency. We provide the context in which…
- 17top 4.5%
Original Research: Nurses' Experiences of Caring for Patients and Families During the COVID-19 Pandemic: Communication Challenges
Christine A. Pariseault, Linda Carman Copel, Michelle A. McKay
17 citationsdoi:10.1097/01.naj.0000805644.85184.d2OpenAlex
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OBJECTIVE: The purpose of this study was to gain a better understanding of the perceptions and experiences of nurses caring for patients and families under the COVID-19 pandemic's socially restrictive practices and policies. BACKGROUND: The COVID-19 global pandemic has affected the delivery of health care to patients and their families, with many aspects altered because of the need for social distancing, social isolation, and visitation restriction policies. These policies have created communication challenges for interdisciplinary health care teams, patients, and families. As frontline caregivers, nurses have felt strongly the impact of these challenges. METHODS: A qualitative descriptive study was conducted among 17 RNs who were caring for patients during the COVID-19 pandemic and were recruited via social media posts on Facebook, Twitter, and LinkedIn. Watson's theory of human caring served as the conceptual framework for the study. RESULTS: Several themes emerged regarding nurses' experiences of communication with patients and families. These include communication challenges and…
- 18top 4.8%
Care Coordination: A Concept Analysis
Amanda Anderson, Sharon Hewner
17 citationsdoi:10.1097/01.naj.0000803188.10432.e1OpenAlex
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ABSTRACT: Care coordination is both a well-known concept discussed in a wide range of multidisciplinary health care literature and a familiar nursing role in clinical practice; however, the definition of care coordination lacks role clarity across disciplines and within the nursing profession. Despite variations, defining factors of care coordination practice exist; however, role ambiguity limits the effective implementation of evidence-based care coordination in practice and policy. Following Walker and Avant's eight-step concept analysis method, we aim to further clarify care coordination as a concept and practice role and examine the value that nursing brings to its implementation.
- 19top 5%
Nurses Promoting Inclusive, Safe, Resilient, and Sustainable Cities and Communities: Taking Action on COVID-19, Systemic Racism, and Climate Change
Elizabeth C. Schenk, Teddie Potter, Cara Cook, Katie Huffling, William E. Rosa
17 citationsOpen accessdoi:10.1097/01.naj.0000758540.26343.2eOpenAlex
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This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article highlights SDG 11-making "cities and human settlements inclusive, safe, resilient and sustainable."
- 20top 5.3%
CE: Hypertensive Emergencies: A Review
Essie P. Mathews, Faith R. Newton, Kartavya Sharma
16 citationsdoi:10.1097/01.naj.0000794104.21262.86OpenAlex
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ABSTRACT: While acute blood pressure elevations are commonly seen in the ED, not all require emergency treatment. True hypertensive emergencies are characterized by a rapid elevation in blood pressure to a level above 180/120 mmHg and are associated with acute target organ damage, which requires immediate hospitalization for close hemodynamic monitoring and IV pharmacotherapy. Recognizing the clinical signs and symptoms of hypertensive emergency, which may vary widely depending on the target organ involved, is critical. High blood pressure levels that produce no signs or symptoms of target organ damage may be treated without hospitalization through an increase in or reestablishment of previously prescribed oral antihypertensive medication. However, all patients presenting with blood pressure this high should undergo evaluation to confirm or rule out impending target organ damage, which differentiates hypertensive emergency from other hypertensive crises and is vital in facilitating appropriate emergency treatment. Drug therapy for hypertensive emergency is influenced by end-organ…
- 21top 5.6%
Secondary Medication Administration and IV Smart Pump Setup
Karen K. Giuliano, Jeannine W.C. Blake, Robert Butterfield
16 citationsOpen access (CC-BY-NC-ND)doi:10.1097/01.naj.0000767808.75464.c3OpenAlex
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ABSTRACT: Secondary infusion by large-volume IV smart pump is used extensively in the acute care setting for one-time or intermittent administration of medications such as antibiotics, electrolyte replacements, and some oncology drugs. Consistent and accurate delivery of secondary medications requires a full understanding of the system and setup requirements. Unfortunately, it is not uncommon for nurses to find a secondary medication only partially administered when their programming should have resulted in a complete infusion. This article discusses the technical requirements that every nurse should know when administering secondary medications using an IV smart pump.
- 22top 5.8%
The Future of Nursing 2020-2030
Susan B. Hassmiller
15 citationsdoi:10.1097/01.naj.0000751020.95176.0cOpenAlex
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Charting a path to achieve health equity.
- 23top 6.1%
Nurses Spreading Misinformation
Pamela J. Grace
12 citationsdoi:10.1097/01.naj.0000803200.65113.fdOpenAlex
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ABSTRACT: Nurses are trusted to be truthful and to provide considered, substantiated information in a neutral way. Yet the COVID-19 crisis has highlighted how some nurses engage in misinformation on social media and in other venues. This article explores the reasons why people believe they are fully informed, including the possible influence of confirmation biases. It also describes the augmented ethical responsibilities of nurses to examine in depth what they think they know and understand and to account for cognitive biases. Strategies for nurse leaders, managers, and educators are provided to facilitate good practice and help ensure nurses are held accountable for their actions and social media postings.
- 24top 6.3%
CE: Chemotherapy-Induced Peripheral Neuropathy
Robert Knoerl
12 citationsdoi:10.1097/01.naj.0000742060.56042.e7OpenAlex
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ABSTRACT: Chemotherapy-induced peripheral neuropathy (CIPN) occurs in more than 68% of patients receiving the neurotoxic chemotherapy agents commonly used to treat breast, gastrointestinal, gynecologic, and hematologic malignancies. CIPN, often experienced initially as numbness, tingling, or pain in the upper or lower extremities, may progress to the point where the resultant decline in physical function requires a reduction in the chemotherapy dose. This article provides nurses with strategies to use in assessing, managing, and educating patients who are at risk for or who are already experiencing CIPN. Currently, the American Society of Clinical Oncology endorses only one treatment for CIPN: duloxetine 60 mg/day. Discussing CIPN with patients before chemotherapy is initiated and throughout the course of treatment promotes its early identification and management, which may minimize its impact on physical function and chemotherapy dosing, reducing the patient's risk of experiencing chronic symptoms after chemotherapy ends.
- 25top 6.6%
Sampling Design in Nursing Research
Alexa Colgrove Curtis, Courtney Keeler
12 citationsdoi:10.1097/01.naj.0000737304.14564.51OpenAlex
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Editor's note: This is the third article in a series on clinical research by nurses. The series is designed to give nurses the knowledge and skills they need to participate in research, step by step. Each column will present the concepts that underpin evidence-based practice-from research design to data interpretation. The articles will be accompanied by a podcast offering more insight and context from the author.
- 26top 6.9%
CE: Nursing Orientation to Data Science and Machine Learning
Roxanne O'Brien, Matt W. O'Brien
11 citationsdoi:10.1097/01.naj.0000742064.59610.28OpenAlex
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ABSTRACT: Nurses collect, use, and produce data every day in countless ways, such as when assessing and treating patients, performing administrative functions, and engaging in strategic planning in their organizations and communities. These data are aggregated into large data sets in health care systems, public and private databases, and academic research settings. In recent years the machines used in this work (computer hardware) have become increasingly able to analyze large data sets, or "big data," at high speed. Data scientists use machine learning tools to aid in analyzing this big data, such as data amassed from large numbers of electronic health records. In health care, predictions for patient outcomes has become a focus of research using machine learning. It's important for nurses and nurse administrators to understand how machine learning has changed our ways of thinking about data and turning data into knowledge that can improve patient care. This article provides an orientation to machine learning and data science, offers an understanding of current challenges and…
- 27top 7.1%
Transgender and Gender Diverse Nursing Care
Caitlin M. Nye, Amanda Anderson
10 citationsdoi:10.1097/01.naj.0000794272.25624.e5OpenAlex
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This column is designed to help new nurses in their first year at the bedside-a time of insecurity, growth, and constant challenges-and to offer advice as they learn what it means to be a nurse. Because content on the care of patients who are transgender and gender diverse (TGD) is largely missing from undergraduate nursing curricula, most nurses will learn to care for TGD patients when first working at the bedside. This article offers guidance on providing affirming care to TGD patients, including discussions of gender and pronouns, privacy considerations, and communication and advocacy.
- 28top 7.4%
Minimum Nurse-to-Patient Ratios Improve Staffing, Patient Outcomes
Karen Esther Rosenberg
10 citationsdoi:10.1097/01.naj.0000790644.96356.96OpenAlex
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According to this study: Minimum nurse-to-patient staffing ratios not only improve nurse staffing and patient outcomes but also yield a good return on investment.Staffing improvements of one fewer patient per nurse led to improvements in mortality, readmissions, and length of stay.
- 29top 7.7%
CE: Reimagining Injurious Falls and Safe Mobility
Ann L. Hendrich
10 citationsdoi:10.1097/01.naj.0000790188.10474.10OpenAlex
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ABSTRACT: Injurious falls remain among the most common, dangerous, and costly adverse events in hospitals, despite the widespread implementation of fall prevention programs. Many current health care system policies and nursing practices oversimplify fall prevention by focusing on limiting the person's mobility and making the environment safer, or simply documenting a fall risk score. But most falls are caused by factors intrinsic to that individual; merely limiting their mobility can increase preventable hospital complications and readmissions, and still leaves them at risk for falls. This article proposes a new approach to reducing injurious falls in older adults-one grounded in evidence-based protocols known to positively impact the health of older adults. The approach, called by the acronym ERA-Electronic health record integration, Risk factors that matter, Assessment and care plans-allows nurses to use a validated fall risk assessment tool to reframe fall risk factors as part of the comprehensive care plan, and to map modifiable risk factors to interventions that address the…
- 30top 7.9%
Addressing What Matters
Ellen L. Carbonell, Mary C. Zonsius, Grisel Rodriguez-Morales, Michelle Newman, Erin E. Emery‐Tiburcio
9 citationsdoi:10.1097/01.naj.0000815440.19544.edOpenAlex
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This article is the second in a series, Supporting Family Caregivers in the 4Ms of an Age-Friendly Health System, published in collaboration with the AARP Public Policy Institute as part of the ongoing Supporting Family Caregivers: No Longer Home Alone series. The 4Ms of an Age-Friendly Health System (What Matters, Medication, Mentation, and Mobility) is an evidence-based framework for assessing and acting on critical issues in the care of older adults across settings and transitions of care. Engaging the health care team, including older adults and their family caregivers, with the 4Ms framework can help to ensure that every older adult gets the best care possible, is not harmed by health care, and is satisfied with the care they receive. The articles in this series present considerations for implementing the 4Ms framework in the inpatient hospital setting and incorporating family caregivers in doing so. Resources for both nurses and family caregivers, including a series of accompanying videos developed by AARP and the Rush Center for Excellence in Aging and funded by The John A.…
- 31top 8.2%
Another Monoclonal Antibody Granted EUA to treat COVID-19
Diane S. Aschenbrenner
9 citationsdoi:10.1097/01.naj.0000767788.97481.65OpenAlex
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The Food and Drug Administration has granted emergency use authorization to sotrovimab for the treatment of mild to moderate COVID-19 in patients at increased risk for progression to severe illness.Sotrovimab is a monoclonal antibody that works directly against the spike protein of SARS-CoV-2 to block its attachment and entry into a human cell.
- 32top 8.4%
Monoclonal Antibody Approved to Treat Ebola
Diane S. Aschenbrenner
9 citationsdoi:10.1097/01.naj.0000742484.81331.b2OpenAlex
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Ansuvimab-zykl (Ebanga), a human monoclonal antibody, has been approved to treat Zaire ebolavirus (Ebolavirus) infection.The most common adverse effects of the drug are fever, tachycardia, diarrhea, vomiting, hypotension, tachypnea, and chills; these are also common symptoms of Ebolavirus infection.
- 33top 8.7%
CE: Acute Ischemic Stroke
Heather H. Washington, Kimberly Glaser, Nneka L. Ifejika
8 citationsdoi:10.1097/01.naj.0000790184.66496.1dOpenAlex
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ABSTRACT: Stroke, the most common form of cerebrovascular disease, is a leading cause of death and disability throughout the world. There have been no significant advances in the development of effective therapeutics for hemorrhagic stroke, and for ischemic stroke highly effective, evidence-based therapies such as alteplase and mechanical thrombectomy are widely underutilized. Improving outcomes for patients experiencing ischemic stroke requires faster recognition and appropriate intervention within the treatment window (the first 24 hours after symptom onset). This article discusses the pathophysiology underlying the various types of ischemic stroke; the risk factors for ischemic stroke; stroke presentation; and the evidence-based treatments, nursing assessments, and monitoring protocols that are critical to patient recovery.
- 34top 9%
CE: Monitoring Adult Patients for Intolerance to Gastric Tube Feedings
Norma A. Metheny
8 citationsOpen access (CC-BY-NC-ND)doi:10.1097/01.naj.0000767356.16777.f1OpenAlex
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ABSTRACT: Gastric tube feeding is a common and valuable intervention for patients in a variety of care settings. While tube feeding can save the lives of patients for whom oral feeding isn't possible, intolerance to tube feeding is a potential complication. This article discusses risk factors for feeding intolerance; the assessment of signs and symptoms of feeding intolerance; the various means of assessing gastric emptying, including the practice of monitoring gastric residual volume (GRV); the controversy surrounding GRV monitoring in assessing feeding tolerance; and the special considerations for monitoring feeding tolerance in acutely and critically ill adults with coronavirus disease 2019. The author, a nurse researcher with extensive experience in the area of enteral feeding, briefly summarizes recommendations and guidelines for enteral feeding published by national and international health care organizations between 2015 and 2020, and offers her perspective on best nursing practices for monitoring food tolerance in adults.
- 35top 9.2%
Lessons from Fukushima: Potassium Iodide After a Nuclear Disaster
Eriko Sase, Christopher Eddy, Barbara J. Polivka
8 citationsdoi:10.1097/01.naj.0000734144.20889.b0OpenAlex
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ABSTRACT: The release of radioactive iodine after a nuclear disaster, such as those that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan 10 years ago and Three Mile Island in Pennsylvania in 1979, increases thyroid cancer risk among people who are exposed. Certain populations are especially vulnerable, including pregnant and breastfeeding women, children, and neonates. Potassium iodide (KI) can effectively block radioactive iodine from being absorbed by the thyroid gland if taken immediately after a radiation release. This article examines lessons learned from Fukushima to enhance disaster readiness and nursing actions. Nurses should be directly involved in vulnerability assessments, emergency planning, and in ensuring the availability, accessibility, and distribution of KI within U.S. nuclear power plant emergency planning zones before a crisis occurs.
- 36top 9.5%
Controversial Approval of New Drug to Treat Alzheimer's Disease
Diane S. Aschenbrenner
7 citationsdoi:10.1097/01.naj.0000794244.40800.99OpenAlex
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Aducanumab (Aduhelm), the first new drug to treat Alzheimer's disease since 2003, has received accelerated approval from the Food and Drug Administration (FDA).This drug's approval has been highly contentious in the medical and scientific community owing to contradictory study findings and the FDA's advisory panel not recommending its approval.
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Preventing Violence to Achieve Peaceful and Inclusive Societies
Pamela F. Cipriano, Katie Ann Blanchard, William E. Rosa
7 citationsOpen accessdoi:10.1097/01.naj.0000790652.74669.ecOpenAlex
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This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article highlights SDG 16: "Promote peaceful and inclusive societies for sustainable development, provide access to justice for all, and build effective, accountable, and inclusive institutions at all levels."
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Addressing Hospital-Acquired Hypoglycemia
Lucille Hughes, Maura Caragher
7 citationsdoi:10.1097/01.naj.0000751116.58400.46OpenAlex
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BACKGROUND: Hospitalized patients who have diabetes often experience hospital-acquired hypoglycemia, a potentially serious adverse event; as a result, management of this condition has become an important quality of care indicator in the inpatient environment. A growing body of research and evidence-based clinical guidelines support proper timing of point of care (POC) blood glucose (BG) measurements, mealtime insulin administration, and meal delivery to reduce the incidence of both hypoglycemic and hyperglycemic events. Monitoring and improving the timing of these three patient care interventions are recognized as a crucial step in the safe and effective care of patients with diabetes. PURPOSE: The objective of the QI project was to improve the timing of mealtime insulin administration related to bedside BG monitoring and meal delivery for patients with diabetes who receive mealtime insulin; a secondary goal was to decrease the number of episodes of recurrent hypoglycemia. The overall strategy was to change staff members' approach to mealtime insulin management from a series of…
- 39top 10.3%
Original Research: Concussions at School: The Experiences and Knowledge of School Nurses
Katy Pietz, Janessa M. Graves, Elizabeth H. Weybright, Bruce E. Pinkleton, Tracy Klein
7 citationsdoi:10.1097/01.naj.0000733428.67589.5eOpenAlex
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BACKGROUND: School nurses' knowledge about and confidence in managing concussions are important to ensure continuity of care between a student's school and home environments. This mixed-methods study explored concussion-related knowledge, confidence, and management experiences among urban and rural school nurses in Washington State. METHODS: Public school nurses, identified via state educational service district websites and recruited by e-mail, completed an online survey assessing their concussion knowledge and confidence levels. Following the survey, a subset of respondents participated in semistructured interviews aimed at exploring their confidence in managing concussions. RESULTS: Of the 945 school nurses to whom the survey was sent, 315 responded (33% response rate). Most survey respondents held an RN license (89.6%) and were from urban areas (90.8%). Overall, the respondents exhibited accurate concussion knowledge; only one significant difference was noted based on rural-urban status. Correct responses were given for most questions (67.4% to 98.7% correct responses). In…
- 40top 10.5%
Family History a Risk for Early-Onset Colorectal Cancer
Betsy Todd
6 citationsdoi:10.1097/01.naj.0000803208.63531.04OpenAlex
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First-degree relatives of people with early-onset colorectal cancer are six times more likely than the general population to be diagnosed with this condition.First-, second-, and third-degree relatives of people with early-onset colorectal cancer are at higher risk for both early-onset colorectal cancer and colorectal cancer at any age.
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Supporting Frontline Staff During the COVID-19 Pandemic
Charlotte Clements, Jennifer Barsamian, Nicolette Burnham, Claire Cruz, Ann Marie Grillo Darcy and 5 more
6 citationsOpen access (CC-BY)doi:10.1097/01.naj.0000790632.18077.c1OpenAlex
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ABSTRACT: The coronavirus disease 2019 (COVID-19) pandemic that emerged in early 2020 put unprecedented physical, mental, and emotional strain on the staff of health care organizations, who have been caring for a critically ill patient population for more than a year and a half. Amid the ongoing pandemic, health care workers have struggled to keep up with new information about the disease, while also coping with the anxiety associated with caring for affected patients. It has also been a continual challenge for nurse leaders to provide adequate support for staff members and keep them informed about frequently changing practices and protocols. In this article, nursing leaders at an academic medical center in Boston reflect on the initial COVID-19 patient surge, which occurred from March to June 2020, and identify key actions taken to provide clinical and emotional support to frontline staff who cared for these patients. Lessons learned in this period provide insight into the management of redeployed staff, use of emotional support and debriefing, and relationship between access to…
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New Treatment for Relapsed or Refractory Large B-cell lymphoma
Diane S. Aschenbrenner
6 citationsdoi:10.1097/01.naj.0000753644.07326.f6OpenAlex
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Lisocabtagene maraleucel (Breyanzi), a personalized cell-based gene therapy, has been approved to treat adults with various relapsed or refractory large B-cell lymphomas.
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Pulse Oximetry May Be Inaccurate in Patients with Darker Skin
6 citationsdoi:10.1097/01.naj.0000742448.35686.f9OpenAlex
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Study highlights the need for symptom assessment in addition to oximetry measurement.
- 44top 11.6%
Monoclonal Antibodies Receive EUA to Treat Mild to Moderate COVID-19
Diane S. Aschenbrenner
6 citationsdoi:10.1097/01.naj.0000734112.15618.f4OpenAlex
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A combination of two monoclonal antibodies, casirivimab and imdevimab, has received emergency use authorization for the treatment of mild to moderate COVID-19.Casirivimab and imdevimab come in separate packages but must be combined into one IV infusion after dilution.
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The Flu Pandemic of 1918: A Nurse's Story
Deborah Johnson
5 citationsdoi:10.1097/01.naj.0000799012.83102.aeOpenAlex
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ABSTRACT: In the spring of 1918, a virus swept across the world, killing approximately 50 million people by the summer of 1919. My grandmother, Kathryn ("Katie") Ann Darmody-an Irish immigrant who settled in New York State in 1904-was among the nurses who responded to this pandemic, which became known as the 1918 influenza pandemic (or, erroneously, the Spanish flu). Today, as the world contends with the COVID-19 pandemic, my grandmother's experiences resonate with new meaning-a reminder of how, then as now, nurses have been at the forefront of public health. Her story, transmitted across generations, is one I now share with a new generation of nurses.
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Novel Deployment of Pediatric Biocontainment Unit Nurses in Response to COVID-19
Stephanie Heather Kinlay, Jon Whiting, Pascale Audain, Paula Conrad, Amy Kulma and 2 more
5 citationsdoi:10.1097/01.naj.0000799008.92892.b4OpenAlex
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ABSTRACT: Most existing biocontainment units (BCUs) in U.S. hospitals are designed to care for a limited number of patients infected with epidemiologically significant pathogens. The COVID-19 pandemic presented substantial challenges to hospital preparedness and operations because of its high incidence rate and the high risk of transmission to staff members. This article describes a novel practice innovation: a hospital-wide deployment of nurses on a trained BCU team to support hospital staff in safely caring for patients with COVID-19. Their responsibilities included assisting in the development of guidelines and providing training on safety protocols and the appropriate use of personal protective equipment. The authors show how this deployment contributed significantly to staff education and support during the pandemic.
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COVID-19 Vaccine Roundup
5 citationsdoi:10.1097/01.naj.0000798964.08895.72OpenAlex
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AJN, American Journal of Nursing 121(11):p 16, November 2021. | DOI: 10.1097/01.NAJ.0000798964.08895.72
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Sugar-Sweetened Beverage Intake Linked to Early-Onset Colorectal Cancer Risk
Karen Esther Rosenberg
5 citationsdoi:10.1097/01.naj.0000794268.40128.c1OpenAlex
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According to this study: Among women, a higher intake of sugar-sweetened beverages in adulthood and adolescence is associated with a substantially higher risk of early-onset colorectal cancer.Reducing the intake of sugar-sweetened beverages in this population may reduce the incidence of early-onset colorectal cancer.
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Preventing Medjacking
Veneine Cuningkin, Elizabeth Riley, Larronda Rainey
5 citationsdoi:10.1097/01.naj.0000794252.99183.5eOpenAlex
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ABSTRACT: Advances in medical device technology have led to greater connectivity with other devices, networks, and systems, raising concerns about associated security risks. Many clinicians, as well as the patients who rely on these lifesaving devices, are unaware of these risks and how they can be mitigated. This article describes several types of cyberattacks, including medjacking, hacking, and ransomware, and what nurses can do to guard against security threats and educate patients.
- 50top 13.2%
Implementing a Multidisciplinary Prone Positioning Team
Ellen H. Elpern, Patricia Nedved, Tyler T. Weiss, Ankeet Patel, Flor Cerda
5 citationsdoi:10.1097/01.naj.0000753652.63203.78OpenAlex
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ABSTRACT: The coronavirus disease 2019 pandemic has escalated clinical needs while interrupting regular processes and straining resources. Striving to deliver optimal care to infected patients with respiratory failure, Rush University Medical Center in Chicago created a multidisciplinary team to provide manual prone positioning safely and efficiently. Team members' experiences, which they shared through a survey, help to illustrate the advantages of a multidisciplinary approach and suggest opportunities to enhance the effectiveness of such a team.
How to read this list
The cohort is every article, review and book chapter OpenAlex attributes to AJN American Journal of Nursing with publication year 2021, excluding retracted works and paratext such as editorials and errata. The top 50 by citation count are listed; the percentile is the rank divided by the cohort size. 50 of the 50 entries have an abstract in OpenAlex. Counts were read on 29 October 2026 and will not be updated on this page, so a quoted rank stays verifiable. Full rules on the methodology page.
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