Please see below for a listing of past ORL-Head and Neck Nursing Journal Issues. To purchase articles, please contact us at [email protected].
2025 Volume 43 | Issue 4; E-ISSN: 1064-3842
Message from Guest Editor: From Bedside to Publication: Encouraging Scholarship in Otorhinolaryngology-Head and Neck Nursing
Author Information: Laurie Newton, DNP, RN, CPNP-AC, PC, Otolaryngology, Medical College of Wisconsin
Citation: Newton, L. (2025). From Bedside to Publication: Encouraging Scholarship in
Otorhinolaryngology-Head and Neck Nursing. ORL - Head and Neck Nursing, 43(4), 6.
Keywords: Otorhinolaryngology Nursing Scholarship, Advanced Practice Providers (APPs), Professional Nursing Organizations, Clinical Scholarship Development
Abstract: NA
Submitted: September 21, 2025, CST
Accepted: November 24, 2025, CST
Published: December 01, 2025, CST
Message from the President: The Essential Role of Nurses and Advanced Practice Nurses in Healthcare Leadership
Author Information: Maria Colandrea, DNP, NP-C, CORLN, FFNMRCSI, FAANP, Department of Otolaryngology, Durham Veterans Affairs Medical Center
Citation: colandrea, maria. (2025). The Essential Role of Nurses and Advanced Practice Nurses in Healthcare Leadership. ORL - Head and Neck Nursing, 43(4), 7–8.
Keywords: Nursing, Advanced Practice Nursing, Leadership, Healthcare
Abstract: NA
Submitted: July 24, 2025, CST
Accepted: November 24, 2025, CST
Published: December 01, 2025, CST
Feature Article: Advanced Practice Provider Integration in Pediatric Otolaryngology: A Multi-Site Descriptive Analysis of Care Models Across Four U.S. Children’s Hospitals
1 Department of Otolaryngology, Medical College of Wisconsin, 2 Department of Otolaryngology, Phoenix Children's, 3 Department of Otolaryngology, Medical University of South Carolina, 4 Department of Otolaryngology, Children's Hospital Colorado
Citation: Newton, L., Ashburn, A., Kulseth, H., & Raines, M. (2025). Advanced Practice Provider Integration in Pediatric Otolaryngology: A Multi-Site Descriptive Analysis of Care Models Across Four U.S. Children’s Hospitals. ORL - Head and Neck Nursing, 43(4), 9–18.
Keywords: Pediatric Otolaryngology, Advanced Practice Providers, Nurse Practitioners, Physician Assistants, Models of Care, Scope of Practice, Interprofessional Teamwork, Workforce Planning, Clinical Productivity, Multidisciplinary Care
Abstract:
Background:
Advanced practice providers (APPs), including nurse practitioners and physician assistants, are increasingly essential to pediatric otolaryngology in the context of rising clinical demand and a relatively static surgeon workforce. Although APPs contribute substantially to access, quality, and continuity of care, limited empirical evidence describes how APP roles are structured across pediatric otolaryngology programs or which care models best support safe, efficient, and sustainable practice.
Objective:
To describe and compare APP care models across four large pediatric otolaryngology programs in the United States, examining workforce structure, scope of practice, clinical operations, and implementation strategies to identify best practices for high-quality, efficient, and sustainable care.
Methods:
A multi-site descriptive study was conducted using a standardized data collection template
completed by clinical leaders at four geographically diverse pediatric otolaryngology programs. Variables included APP workforce composition; inpatient, outpatient, and hybrid role distribution; procedural scope and autonomy; scheduling structures; orientation and competency processes; multidisciplinary involvement; telehealth utilization; and workflow innovations supporting provider well-being. Data were analyzed using cross-site descriptive comparison and qualitative content analysis to identify shared and distinguishing features.
Results:
APP teams ranged from 4 to 10 providers and functioned in independent outpatient clinics, inpatient care models, hybrid roles, or rotational assignments. All sites reported that APPs enhanced patient access, continuity, and timeliness of care. Core procedural responsibilities included cerumen removal, microscopy, nasal cautery, foreign body removal, and, at most sites, flexible laryngoscopy and nasal endoscopy; frenotomy and tracheostomy-related procedures varied by program. Orientation processes ranged from informal preceptorships to structured 3-12-month pathways with defined milestones and, in some programs, formal competency checklists. Workflow strategies included protected administrative time, APP-led urgent or fast-track clinics, structured message or call-coverage rotations, and APP leadership or co-management in multidisciplinary tracheostomy, aerodigestive, cleft lip/palate, and cochlear implant clinics. Six themes emerged: APP autonomy, procedural breadth, structured onboarding, workflow innovation, multidisciplinary care, and flexible role design.
Conclusion:
APPs play a critical and expanding role in pediatric otolaryngology, with diverse yet effective models that improve access, operational efficiency, and multidisciplinary coordination. Future research should evaluate outcomes and cost-effectiveness across APP-integrated models.
Submitted: August 24, 2025, CST
Accepted: December 02, 2025, CST
Published: December 01, 2025, CST
Feature Article: Part 2: Elevating Your Career: Building Advanced Skills to Cultivate Leadership and Professional Presence
Author Information: Maria Colandrea, DNP, NP-C, CORLN, FAANP, FFNMRCSI, Department of Otolaryngology, Veterans Affairs Medical Center
Citation: Colandrea, M. (2025). Part 2: Elevating Your Career: Building Advanced Skills to Cultivate Leadership and Professional Presence. ORL - Head and Neck Nursing, 43(4), 19–25
Keywords: Otorhinolaryngology Nursing, Nurses, Leadership, Emotional Intelligence, Self-Concept, Psychological resilience, Health Behavior, Professional Competence, Interprofessional Relations, Health Policy
Abstract:
This second article in a two-part series focuses on advanced, intrinsic skills that empower otorhinolaryngology (ORL) head and neck nurses to strengthen leadership capacity, enhance professional presence, and influence practice at the highest levels. While Part 1 addressed foundational, extrinsic strategies such as professional organization engagement, scholarly contributions, mentorship, and curriculum vitae development, Part 2 shifts to five advanced skills essential for authentic and sustainable leadership: building resilience, fostering self-awareness, enhancing emotional intelligence, cultivating effective habits, and strategically accepting additional responsibilities. Drawing on current evidence and leadership theory, this article offers actionable steps for cultivating trust, strengthening interprofessional collaboration, and influencing healthcare systems and policy. By integrating these intrinsic leadership skills with the foundational strategies from Part 1, ORL head and neck nurses can maximize professional growth, elevate their influence, and contribute to meaningful improvements in patient care and outcomes.
Submitted: September 01, 2025, CST
Accepted: November 01, 2025, CST
Published: December 01, 2025, CST
Case Report: Congenital Cholesteatoma: A Case Report and Clinical Implications
Citation: Mackey, W. L., & Orend, D. (2025). Congenital Cholesteatoma: A Case Report and Clinical Implications. ORL - Head and Neck Nursing, 43(4), 26–33.
Pediatric congenital cholesteatoma is a rare, benign growth of keratinizing squamous epithelium within the middle ear or mastoid. Diagnosis is often challenging due to its insidious onset, minimal early symptoms, and the inherent difficulties of pediatric otologic examination. Surgical intervention is required to prevent progressive local destruction and permanent sequelae caused by the expanding mass. This case study describes a 4-year-old child who initially presented with a presumed foreign body in the ear following a prior misdiagnosis of acute otitis media. The report outlines the child’s presentation, diagnostic workup, surgical management, and subsequent surveillance, with a discussion of diagnostic challenges and implications for clinical care.
Submitted: August 24, 2025, CST
Accepted: November 24, 2025, CST
Published: December 01, 2025, CST
Commentary: Managing Obstructive Sleep Apnea in Children With Down Syndrome: A Commentary
1School of Nursing- DNP student, University of Wisconsin-Madison, 2Otolaryngology, Medical College of Wisconsin, 3Developmental Pediatrics, University of Wisconsin–Madison
Citation: Moerchen, J., Newton, L., & Mayo, R. (2025). Managing Obstructive Sleep Apnea in Children With Down Syndrome: A Commentary. ORL - Head and Neck Nursing, 43(4), 34–37.
Keywords: pediatrics, down syndrome, obstructive sleep apnea, CPAP, surgical management
Abstract:
Obstructive sleep apnea (OSA) is highly prevalent in children diagnosed with Down Syndrome (DS). This is primarily due to their unique craniofacial anatomy, neuromuscular hypotonia, and their potential for multiple levels of baseline airway obstruction. Every child with DS is recommended to have a sleep study performed to determine the level of OSA by age four, even if there are no overt symptoms of sleep disordered breathing. To help treat, frequently the first line of treatment for OSA is an adenotonsillectomy; however, even with this method, many children continue to exhibit residual OSA and require continuous positive airway pressure (CPAP) therapy. Unfortunately, children with DS and their families can struggle with adhering to the CPAP guidelines due to the developmental, behavioral, and integration challenges that many children with DS face. This article provides a detailed overview of OSA in the DS population by emphasizing the importance of sleep for neurodevelopment and discussing the limitations of traditional adherence guidelines, providing strategies to help navigate these challenges. Additionally, this paper will examine emerging inventions, such as hypoglossal nerve stimulation, for patients with persistent OSA.
Submitted: July 30, 2025, CST
Accepted: November 16, 2025, CST
Published: December 01, 2025, CST
Commentary: The Importance of Newborn Hearing Screenings as Early as Possible: A Commentary
Author Information: Gretchen R Sackmann, Au.D.
Citation: Sackmann, G. R. (2025). The Importance of Newborn Hearing Screenings as Early as Possible: A Commentary. ORL - Head and Neck Nursing, 43(4), 38–40.
Keywords: Sensorineural Hearing Loss, Newborn, Neonatal Intensive Care Units, Hearing Tests, Early Intervention, Auditory Brain Stem Response, Otoacoustic Emissions, Mass Screening, Risk Factors, Follow-Up Studies
Abstract:
Early identification of congenital and early-onset hearing loss is essential to optimizing neurodevelopmental, communicative, and academic outcomes. Universal newborn hearing screening programs have significantly reduced delays in diagnosis; however, high-risk infants, particularly those in neonatal intensive care units, continue to experience disproportionate rates of delayed screening and loss to follow-up. This commentary synthesizes current evidence supporting newborn hearing screening as early as medically feasible and highlights persistent clinical gaps that impede timely identification, especially among medically fragile infants with increased vulnerability to sensorineural hearing loss and auditory neuropathy spectrum disorder. Emerging data indicate that automated auditory brainstem response screening can be completed earlier than traditional readiness thresholds, including in infants receiving low-level respiratory support. Clinical, technical, and systems-level considerations are discussed, with emphasis on improving screening accuracy, strengthening family education, and enhancing interprofessional coordination across neonatal and otolaryngology care settings. Nurses play a central role in optimizing testing conditions, ensuring accurate documentation, and supporting families through follow-up and early intervention pathways. Advancing early screening practices is both scientifically and ethically imperative, offering a critical opportunity to reduce loss to follow-up and improve long-term developmental outcomes for infants at highest risk.
Submitted: September 26, 2025, CST
Accepted: November 25, 2025, CST.
Published: December 01, 2025, CST
Highlights from the Hill: State Health Policy Update 2025
1ENT Surgery Service, VA Ann Arbor Healthcare System, 2Otolaryngology, Beachwood Family Health Center, Cleveland Clinic, 3Retired Nurse, 4Durham VA Medical Center, 5Kelsey-Seybold Clinic, 6Multi-ORL, Thomas Jefferson University
Citation: Facione, B., Ross, E., Beshore, S. M., Colandrea, M., Elias, J., Jamison, S. J., Grady, A., & Rozencwaig, H. (2025). State Health Policy Update 2025. ORL - Head and Neck Nursing, 43(4), 41–47.
Keywords: Health Policy, APRN Practice, Workforce Development, Safe Work Environments
Abstract:
This Highlight from The Hill provides a comprehensive overview of state health policy updates in 2025, with a focus on legislative trends that impact public health, nursing practice and advocacy. Authored by members of the Society of Otorhinolaryngology and Head and Neck Nurses (SOHN), this review underscores efforts across multiple states to address critical challenges in healthcare, such as: banning use of harmful chemicals in consumer products, protecting women and health care workers, expanding and encouraging access to behavioral health screening for children in California; as well as providing immigrants a safe environment for accessing healthcare. Laws providing a legal framework for informed consent to patients when utilzing artifical intelligence are reviewed along with policy for use of artificial inteligence in utilization review work. In Texas, North Carolina, New Jersey and Wisconsin policy for maintaining and educating the nurse workforce are highlighted, along with efforts to remove barriers for the Advance Practice Registered Nurse (APRN) to practice to the full extend of their training and education. In Ohio, North Caroline, and New Jerswey they are focused on retaining and attracting a strong nuring workforce through policies that help prevent workplace violence, protect healthcare workers, promote safe staffing ratios, and incentives to train new nurses, as well as remove barriers to APRN practice that bennifit patient care and health care professionals. These updates highlight the growing recognition of nurses’ pivotal role in shaping health policy and the need for their active participation in advocacy. This Highlight from The Hill aims to inform and inspire nursing professionals to engage in legislative processes that prioritize removing barriers to APRN practice, safe work environments, access to safe care, and ensure adeqate funding for workforce development.
Submitted: July 20, 2025, CST
Accepted: November 24, 2025, CST
Published: December 01, 2025, CST
Highlights from the Hill: Vaping and Kids: Harmless or Hazardous?
American youth are being targeted with misleading articles on social media regarding the harms of e-cigarettes with only 24% of over 1000 youth recognizing and agreeing that vaping have negative health effects (Golan et al., 2023). Vaping is the most frequently used form of tobacco among youth. Due to its high concentrations of nicotine it is extremely addiction and even dangerous for young children. The Family Smoking Prevention and Tobacco Control Act (2009) gave the Federal Drug Administration (FDA) authority to regulate the manufacture, distribution, and marketing of tobacco products. Over the past six years, there has been a 70 percent reduction in the number of middle and high school students using e-cigarettes. This is in part due to the prioritization of the FDA on public education, specifically “The Real Cost” campaign. This campaign prevented over a half a million youth from initiating smoking, saved $53 Billion in smoking-related costs; resulting in savings of $180 for every dollar of the nearly $250 million investment. Advocacy is needed by nonprofit organizations and nurses to educate and encourage congress to change FDA regulations that allow taxation of E-cigarette manufactures to ensure there is appropriate funding for FDA. The FDA established the Center for Tobacco Products which consists of almost 1200 public servants. Continued funding to maintain staffing levels can help with review of E-cigarette products, assist with combating the entry of illegal nicotine products with other government agencies, develop and enforce compliance with FDA regulations, and continue E-cigarette campaigns to prevent use in children and teens, as well as provide resources for treatment related to nicotine addiction. Several states have taken the lead to curb the use of e-cigarettes among youth with great success in states like Massachusetts, New York, and California. Recent proposed cuts to the FDA, Medicaid, Federally Qualified Health Centers, and the Federal Health Program for American Indians and Alaskan Native’s raises concerns if the FDA can adequately administer and continue implementing the regulations and laws for the Family Smoking Prevention and Tobacco Control Act (2009), and allow federally funded health programs, which traditionally serve the lower socioeconomic citizens and minority groups of color in the United states, adequate resources to prevent and treat E-cigarette use in children and teens. Parents, teachers, and nurses are called to advocate to prevent use of E-cigarette use in children. The Society of Otorhinolaryngology can contribute to this cause by updating their website to carry the most recent evidence based interventions to prevent and treat e-cigarette use and offer opportunities for advocacy.
Submitted: August 05, 2025, CST
Accepted: November 24, 2025, CST
Published: December 01, 2025, CST
Product Review: Digital Video Otoscope: A Product Review.
1Society of Otorhinolaryngology and Head-Neck Nurses, 2Pediatric Otolaryngology Head & Neck Surgery, Phoenix Children's Hospital
Citation: Ashburn, A. (2025). Digital Video Otoscope: A Product Review. ORL - Head and Neck Nursing, 43(4), 52–53.
Keywords: digital video otoscope, portable otoscope, digital otoscope, otomicroscopy, aural debridement
Abstract:
Aural debridement under otomicroscopy is a cornerstone procedure in otolaryngology. While the operating otomicroscope remains the gold standard due to its superior visualization and precision, its use is often limited by bulkiness, high cost, and difficulty sharing the visual field for educational purposes. These challenges underscore the need for more accessible alternatives that do not compromise procedural efficacy or safety.
The OWL Digital Video Otoscope, developed by Audelation Ltd., is a dual-function, handheld device designed to assess, diagnose, and facilitate aural instrumentation via real-time video imaging on a connected screen. The system includes a high-definition otoscope, disposable instrumentation speculums, a USB-C interface, and foot pedal capture capability. Additional features, such as LED adjustable lighting, focus control, and anti-rotation image stabilization, enhance procedural control and teaching utility.
In clinical use, the OWL system proves especially effective for cerumen removal and basic otologic procedures, particularly in adult patients. Its portability in outpatient, inpatient, and remote care settings, offers flexibility when a full otomicroscopy suite is unavailable. Limitations include the current speculum sizes, which may be suboptimal for pediatric use.
This product review suggests that the OWL Digital Video Otoscope offers practical, portable, and educational advantages that are complement to traditional otomicroscopy, particularly in resource-limited environments or as an adjunct for training purposes
Submitted: August 24, 2025, CST
Accepted: November 25, 2025, CST
Published: December 01, 2025 CST
2025 Volume 43 | Issue 3; E-ISSN: 1064-3842
Message from Guest Editor: Collaborative Success: The Power of Teamwork
Author Information: Erin Sarsfield, MSN, RN, Society of Otorhinolaryngology Head and Neck Nurses
Citation: Sarsfield, E. (2025). Collaborative Success: The Power of Teamwork. ORL - Head and Neck Nursing, 43(3), 6.
Keywords: Interprofessional Practice, Teamwork, Multidisciplinary Care Team, Interdisciplinary, Otorhinolaryngologic Diseases, Patient Care Team, Advanced Practice Nursing, Head and Neck Neoplasms, Continuity of Patient Care
Abstract: NA
Submitted: June 13, 2025, CDT
Accepted: June 22, 2025, CDT
Published: July 01, 2025, CDT
Message from the President: Confronting the Crisis of Workplace Violence and Advocating for Actionable Reform
Author Information: Maria Colandrea, DNP, NP-C, CORLN, FAANP, FFNMRCSI, Department of Otolaryngology, Durham Veterans Affairs Medical Center
Citation: Colandrea, M. (2025). Confronting the Crisis of Workplace Violence and Advocating for Actionable Reform. ORL - Head and Neck Nursing, 43(3), 7-9.
1 Otolaryngology, Children's Mercy Kansas City, 2 Hearing and Speech, Children's Mercy Hospital
Citation: Williams, T., & Schmidt, H. (2025). The Development and Implementation of a Multidisciplinary Hearing Loss Clinic. ORL - Head and Neck Nursing, 43(3), 10-15.
Keywords: Sensorineural Hearing Loss, Congenital Hearing Loss, Pediatrics, Multidisciplinary Care Team, Audiology, Speech-Language Pathology, Genetic Counseling, Nursing, Early Diagnosis, Family-Centered Care, Referral
Abstract:
Background:
Pediatric sensorineural hearing loss (SNHL) affects 1 to 3 per 1,000 live births and can significantly impair speech, language, and cognitive development if not addressed early. The Joint Committee on Infant Hearing (JCIH) recommends a 1-3-6 timeline for screening, diagnosis, and intervention, along with a comprehensive medical evaluation. However, inconsistent follow-up and lack of coordinated care can lead to delays in diagnosis and suboptimal outcomes.
Objective:
To develop and implement a multidisciplinary hearing loss clinic (MDC) aimed at improving diagnostic evaluation, care coordination, and family-centered care for pediatric patients newly diagnosed with SNHL.
Methods:
A pilot MDC was established at a tertiary pediatric hospital, bringing together audiology, otolaryngology, speech-language pathology, and genetic counseling. The clinic operated monthly in a four-hour block, seeing four patients per session. Referrals were generated by audiologists for patients with confirmed SNHL. A care bundle aligned with JCIH recommendations included audiologic counseling, speech-language screening, genetic testing, imaging, and ophthalmology referral.
Results:
Fifteen patients were seen during the pilot phase. Genetic testing was completed in four patients, with two (50%) yielding pathogenic variants (TMPRSS3 and GJB2). Speech and language screenings revealed that 6 of 15 patients required new or continued intervention services. Only 12.9% of patients had previously received genetic testing under the prior model, compared to 100% referral for testing in the MDC. The clinic also implemented a parent mentorship program and distributed standardized educational materials. Families reported improved understanding of the diagnosis and treatment pathway.
Conclusion:
Implementation of a multidisciplinary hearing loss clinic improved adherence to JCIH-recommended evaluations, facilitated timely identification of genetic etiologies, and enhanced family-centered care. The model shows promise for improving outcomes in pediatric SNHL through coordinated, comprehensive evaluation and support.
Submitted: February 28, 2025, CDT
Accepted: June 13, 2025, CDT
Published: July 01, 2025, CDT
Feature Article: Frontline Nursing Perceptions of Care Coordination in a Head and Neck Cancer Multidisciplinary Clinic
Author Information:
Martha J. Ryan, MSN, FNP-C1, Melissa F. Riedel, MPH, ODS-C2, Karoline Fendley, BSN, RN, OCN3
1 Department of Otolaryngology Head & Neck Surgery, Emory Healthcare, 2 Department of Otolaryngology Head & Neck Surgery, Emory University, 3 Emory Healthcare
Citation: Ryan, M., J., Riedel, M., F., & Fendley, K. (2025). Frontline Nursing Perceptions of Care Coordination in a Head and Neck Cancer Multidisciplinary Clinic. ORL - Head and Neck Nursing ,43(3), 16-20.
Keywords: Head and neck cancer nursing, Multidisciplinary Care Team, Patient Care Team, Care Coodination, Quality Improvement, Communication, Surveys and Questionnaires, Health Services Accessibility, Professional Role
Abstract:
Introduction:
The American Nurses Association emphasizes nursing care coordination as critical to improving care quality and outcomes. In multidisciplinary care (MDC) cancer clinics, nurses serve vital coordination roles, yet their perspectives remain underreported. This project aimed to assess frontline nursing perceptions in a tertiary outpatient Head and Neck Cancer (HNC) MDC clinic to better understand their role in this care model.
Methods:
A five-item survey was administered to eleven registered nurses (RNs) involved in daily MDC workflows. Four items used a 5-point Likert scale to assess perceptions of care coordination, communication, and understanding of treatment plans. The fifth was an open-ended item allowing for suggestions and feedback. Descriptive statistics were calculated for Likert items. Open-ended responses were analyzed qualitatively to identify themes.
Results:
All eleven RNs completed the survey. Median scores for all Likert items were 4 (“Agree”), indicating generally positive perceptions. The statement “I find value in my role in the MDC clinic” had the highest mean score (4.27). Eight nurses provided open-ended feedback, which reflected mixed sentiments. Common themes included communication challenges and a desire for increased patient and nurse education. Comments also referenced workflow efficiency and staffing needs.
Conclusion:
This single-site project highlights the important but often overlooked perceptions of frontline nurses in MDCs. Findings suggest a need for improved communication and education to enhance nursing engagement and care coordination. Broader studies may support system-level improvements and contribute to nurse satisfaction, role clarity, and patient outcomes in multidisciplinary oncology and beyond.
Submitted: March 30, 2025, CDT
Accepted: June 20, 2025, CDT
Published: July 01, 2025, CDT
Feature Article: Psychosocial Impacts of Dysphagia and Communication Impairments in Head and Neck Cancer: A Multidisciplinary Approach
Author Information: Jenna Hall, MS, CCC-SLP, Winship Cancer Institute at Emory Midtown, Department of Otolaryngology Head and Neck Surgery, Emory Healthcare
Citation: Hall, J. (2025). Psychosocial Impacts of Dysphagia and Communication Impairments in Head and Neck Cancer: A Multidisciplinary Approach. ORL - Head and Neck Nursing, 43(3), 21-27.
Keywords: Head and Neck Neoplasms, Deglutition Disorders, Communication Disorders, Psychosocial Support Systems, Quality of Life, Otorhinolaryngologic Nursing, Multidisciplinary Care Team, Speech-Language Pathology, Depression, Peer Support
Abstract:
Purpose:
Dysphagia and communication impairments are common consequences of head and neck cancer (HNC) treatment and have profound psychosocial implications. This evidence-based clinical synthesis explores how these impairments affect emotional well-being and quality of life (QoL) and highlights the critical role of otorhinolaryngology (ORL) nurses in delivering integrated, patient-centered psychosocial care.
Methods:
This synthesis draws on multidisciplinary clinical experience from an academic HNC program and integrates findings from peer-reviewed literature, including randomized trials, observational studies, and qualitative analyses. Interventions are organized by treatment phase and include nursing-led and team-based strategies that address both functional and psychosocial needs.
Results:
Six major themes emerged: (1) the disproportionate psychosocial impact of dysphagia and communication impairments, often exceeding physical severity; (2) treatment-specific challenges, including late-onset dysphagia and disfigurement-related speech loss; (3) multidisciplinary care strategies, such as use of augmentative and alternative communication (AAC) tools, prophylactic swallow therapy, and psychosocial screening; (4) workflow and safety gaps that exacerbate communication breakdowns; (5) the value of peer support networks in long-term coping; and (6) nursing-led process improvements to enhance communication safety and patient dignity. ORL nurses played a central role in recognizing distress, facilitating supportive care, and driving system-level improvements.
Conclusions:
The psychosocial burden of dysphagia and communication impairments in HNC survivors is substantial and underrecognized. ORL nurses are uniquely positioned to mitigate these effects through proactive assessment, emotional support, and advocacy for communication access. Integrating psychosocial strategies into routine nursing care improves QoL, preserves patient autonomy, and strengthens interdisciplinary survivorship care pathways.
Implications for ORL Nursing Practice:
This synthesis offers practical, scalable interventions that empower ORL nurses to lead improvements in psychosocial care. By embedding distress screening, facilitating peer support, and advocating for AAC resources, nurses can enhance emotional recovery and functional rehabilitation for patients with HNC.
Submitted: February 28, 2025, CDT
Accepted: June 21, 2025, CDT
Published: July 01, 2025, CDT
Feature Article: Part 1: Building a Professional Foundation: Six Essential Steps to Maximizing Your Professional Development Potential
Author Information: Maria Colandrea, DNP NP-C CORLN FAANP FFNMRCSI, Otolaryngology, Department of Veterans Affairs
Citation: Colandrea, M. (2025). Part 1: Building A Professional Foundation: Six Essential Steps to Maximizing Your Professional Development Potential. ORL - Head and Neck Nursing, 43(3), 28-36.
Keywords: Career Development, Mentorship, Continuing Education, Nursing Societies, Nursing Leadership, Professional Competence, Publishing, Communication, Professional Role, Otorhinolaryngologic Nursing
Abstract:
This article presents a comprehensive framework for emerging professionals seeking to establish a robust career foundation. Focusing on six essential strategies—joining professional organizations, attaining subject matter expertise, publishing scholarly work, enhancing communication skills, crafting a compelling professional portfolio, and engaging in mutually beneficial mentorship—this manuscript provides practical guidance for building credibility and competence. By integrating industry’s best practices with actionable insights, the article aims to empower otorhinolaryngology nurses and nurse practitioners to launch their careers with confidence and set the stage for future leadership and innovation.
Submitted: August 26, 2024, CDT
Accepted: March 11, 2025, CDT
Published: July 01, 2025, CDT
Case Report: Laryngeal Transplantation in the Setting of Active Cancer: A Case Study of Multidisciplinary Nursing Care and Post-operative Recovery
Author Information:
Lorrie A. Jones, DNP, APRN, ACNS-BC, RN-BC, CNRN1, Kris M. Altman, MSN, RN, OCN1, Julia R. Chase, DNP, APRN, AGCNS-BC, RN-BC1, Tracy L. Thomas, MSN, APRN, CCRN, TCRN, ACNS-BC, FCNS1
1 Department of Nursing, Mayo Clinic in Arizona
Citation: Jones, L., A., Altman, K., M., Chase, J., R., & Thomas, T., L. (2025). Laryngeal Transplantation in the Setting of Active Cancer: A Case Study of Multidisciplinary Nursing Care and Post-operative Recovery. ORL - Head and Neck Nursing, 43(3), 37-44.
Keywords: Larynx Transplantation, Head and Neck Neoplasms, Tracheostomy, Postoperative Care, Critical Care Nursing, Multidisciplinary Care Team, Reconstructive Surgical Procedures, Graft Survival, Enteral Nutrition, Delirium Prevention
Abstract:
Introduction:
Laryngeal transplantation is a rare and experimental surgical intervention that offers the potential for restoring speech, swallowing, and breathing in patients with severe laryngeal dysfunction. This case report details the first laryngeal transplant performed in a patient with active cancer, highlighting multidisciplinary perioperative management, nursing care, and patient outcomes.
Case Presentation:
A male patient with laryngeal cancer underwent total laryngeal transplantation as part of an institutional clinical trial. Comprehensive preoperative screening included physical, psychosocial, nutritional, and quality-of-life assessments. The operative course lasted 21 hours and involved complex reconstruction and vascularized composite allograft implantation. Post-operative care included intensive care unit management, flap monitoring, tracheostomy care, enteral nutrition via gastro-jejunostomy tube, early mobilization, and delirium prevention.
Clinical Findings:
The patient exhibited stable hemodynamics, successful ventilator weaning by post-operative day (POD) 2, and improved mobility by POD 4. Enteral nutrition was initiated on POD 5 and titrated to full support by POD 15. Cuffless tracheostomy tube placement and flap viability were achieved by POD 27.
Outcomes:
The patient was discharged on POD 33 with independence in tracheostomy and enteral care. Outpatient follow-up was coordinated between the transplant and otolaryngology teams. Psychosocial support, pet-assisted recovery, and patient education contributed to ongoing rehabilitation and adjustment.
Conclusion:
This case illustrates the critical role of interdisciplinary collaboration and advanced nursing practice in the success of novel reconstructive surgeries. Laryngeal transplantation in select patients can be safely managed with comprehensive planning, evidence-based protocols, and tailored patient education.
Submitted: January 16, 2025, CDT
Accepted: June 20, 2025, CDT
Published: July 01, 2025, CDT
Case Report: The Registered Dietitian’s Role in Nutritional Management of Head and Neck Cancer Patients: A Case Report
Author Information: Mary Timmons, RD, LDN, CNSC, Clinical Nutrition, Critical Care Team, The Johns Hopkins Hospital
Citation: Timmons, M. (2025). The Registered Dietitian’s Role in Nutritional Management of Head and Neck Cancer Patients: A Case Report. ORL - Head and Neck Nursing, 43(3), 5-50
Keywords: Head and Neck Neoplasms, Malnutrition, Laryngectomy, Nutrition Therapy, Enteral Nutrition, Dietitians, Interdisciplinary Communication, Nutritional Support, Postoperative Care, Swallowing Disorders
Abstract:
Background:
Individuals with head and neck cancer (HNC) are at high risk for malnutrition due to tumor location, dysphagia, and the impact of surgical and multimodal therapies. Malnutrition in this population contributes to poor wound healing, increased complications, and prolonged hospital stays. Early, proactive involvement of a registered dietitian (RD) as part of a multidisciplinary team is essential for optimizing nutrition outcomes.
Case Presentation:
A 68-year-old male with a new diagnosis of supraglottic squamous cell carcinoma and laryngeal dysfunction was admitted for a scheduled total laryngectomy with bilateral neck dissection and tracheoesophageal prosthesis placement. On admission, a nursing nutrition screen identified risk for malnutrition, prompting early RD consultation. Comprehensive nutrition assessment revealed significant unintentional weight loss, inadequate oral intake, and clinical signs of moderate to severe malnutrition. The patient was initiated on enteral nutrition postoperatively and required multiple formula and delivery route modifications due to gastrointestinal intolerance, risk of refeeding syndrome, surgical complications, and aspiration events.
Interventions:
The RD implemented a phased nutrition support plan involving tailored enteral formulas, micronutrient repletion, glycemic management, and daily interdisciplinary rounds. Enteral nutrition strategies were adjusted in response to clinical changes, such as switching from nasogastric to gastrostomy and gastrojejunostomy tubes, initiating peptide-based feeds, and modifying medications to reduce gastrointestinal side effects.
Outcomes:
Despite a prolonged and complex hospital course complicated by reoperations and enteral feeding challenges, the patient achieved nutritional adequacy and weight stabilization. Discharge planning included continued enteral nutrition support with education by the nursing team and coordinated follow-up.
Conclusion:
This case highlights the pivotal role of the registered dietitian in identifying and managing malnutrition in patients with head and neck cancer. Early and sustained nutrition interventions, supported by interdisciplinary collaboration, were integral to patient stabilization and recovery.
Submitted: February 27, 2025, CDT
Accepted: June 13, 2025, CDT
Published: July 01, 2025, CDT
Highlights from the Hill: Federal Policy Developments Impacting ORL–Head and Neck Nursing
1 Health Policy and Advocacy Committee, Society of Otorhinolaryngology Head and Neck Nurses, Chicago, IL, 2 Ross and Carol Nese College of Nursing; Center for Immersive Learning and Digital Innovation; and the Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Pennsylvania State University, University Park, PA
Citation: Beshore, S. M., & Pandian, V. (2025). Federal Policy Developments Impacting ORL–Head and Neck Nursing. ORL - Head and Neck Nursing, 43(3), 51-56.
Keywords: Health policy, Nursing administration, Advanced Practice Nursing, Legislation, Otorhinolaryngology, Workplace violence prevention, Research Support, Nursing workforce, Patient Safety, Professional practice trends
Abstract:
Federal health policy is undergoing rapid transformation, presenting both risks and opportunities for the nursing profession—especially for those practicing in otorhinolaryngology–head and neck (ORL–HN) care. This report synthesizes key federal developments affecting ORL–HN nurses, including new proposals for minimum staffing standards, expansion of Advanced Practice Registered Nurse (APRN) scope of practice, initiatives addressing workplace violence, and destabilizing shifts in research leadership and funding at the National Institutes of Health (NIH). The analysis highlights the profound impact these changes have on clinical practice, education, and the sustainability of nurse-led research. In particular, the intersection of federal regulatory action and nursing workforce expansion efforts underscores the critical role of ORL–HN nurses in shaping healthcare delivery. Drawing on the Patton Zalon Ludwick Policy Assessment Framework, the report urges ORL–HN nurses to move beyond awareness to active engagement and advocacy. By leveraging their clinical expertise and policy voice, ORL–HN nurses can influence staffing legislation, support APRN practice reforms, protect essential research infrastructure, and advance equitable, evidence-based care for patients with complex airway and head and neck needs. In this pivotal policy moment, ORL–HN nurses are called not only to deliver care but to drive systemic change.
Submitted: February 25, 2025, CDT
Accepted: April 28, 2025, CDT
Published: July 01, 2025, CDT
Book Review: Cerebrospinal Fluid Rhinorrhea: Comprehensive Guide to Evaluation and Management—Essential Insights for ORL Nurses in Rhinology and Skull Base Care
Author Information: Erin Sarsfield, MSN, RN, Retired, Head & Neck Cancer Clinical Coordinator, Penn State Milton S. Hershey Medical Center
Citation: Sarsfield, E. (2025). Cerebrospinal Fluid Rhinorrhea: Comprehensive Guide to Evaluation and Management—Essential Insights for ORL Nurses in Rhinology and Skull Base Care. ORL – Head and Neck Nursing, 43(3), 57-59.
Keywords: Cerebrospinal Fluid Leak, Rhinorrhea, Cerebrospinal Fluid, Skull Base Surgery, Endoscopic Surgical Procedures, Otorhinolaryngologic Surgical Procedures, Idiopathic Intracranial Hypertension, Postoperative Care, Nursing Care, Neurosurgical Procedures
Abstract:
“Cerebrospinal Fluid Rhinorrhea: Comprehensive Guide to Evaluation and Management” is a carefully designed textbook that sets a new standard for addressing the diagnosis and treatment of cerebrospinal fluid (CSF) leaks. Edited by Raj Sindwani, MD and Christopher Roxbury, MD, this book serves as an invaluable resource for healthcare professionals across otolaryngology, neurosurgery, ophthalmology, neurology, radiology—and especially for Otorhinolaryngology-Head and Neck (ORL) nurses who play an important role in the care continuum. The textbook provides a holistic coverage of CSF rhinorrhea, from understanding its pathophysiology to its diagnosis and management. It thoughtfully includes a range of etiologies—spontaneous, traumatic, and tumor-related—and explores evolving techniques for managing conditions like idiopathic intracranial hypertension (IIH). This emphasis on emerging clinical challenges reflects the book’s relevance to modern practice.
Submitted: December 11, 2024, CST
Accepted: December 11, 2024, CST.
Published: July 01, 2025, CST
2025 Volume 43 | Issue 2; E-ISSN: 1064-3842
Message from Guest Editor: Otology and Neurotology in Practice: Innovation, Patient Care, and the Role of Nurses
Author Information: Kris Estheimer, BSN, RN, CORLN, Otolaryngology, University of Utah Hospital
Citation: Estheimer, K. (2025). Otology and Neurotology in Practice: Innovation, Patient Care, and the Role of Nurses. ORL - Head and Neck Nursing, 43(2), 7-8.
Message from the President: The Expanding Role of Nurses and Nurse Practitioners in Otology: Meeting the Needs of a Changing Healthcare Landscape
Author Information: Maria Colandrea, DNP NP-C CORLN FAANP FFNMRCSI, Department of Otolaryngology, Durham Veterans Affairs Medical Center
Citation: Colandrea, M. (2025). The Expanding Role of Nurses and Nurse Practitioners in Otology: Meeting the Needs of a Changing Healthcare Landscape. ORL - Head and Neck Nursing, 43(2), 9.
1 School of Nursing, DePaul University, 2 Department of Mathematical Sciences, DePaul University
Citation: Byrd, S., Harris, B., & Habtezgi, D. (2025). Evaluating the Impact of an Educational Intervention on Primary Care Provider Referral Patterns for Sudden Sensorineural Hearing Loss. ORL - Head and Neck Nursing, 43(2), 10-14.
Keywords: Sudden Sensorineural Hearing Loss (SSNHL), Primary Care Providers (PCPs), Hearing Loss Diagnosis, Educational Intervention, Otolaryngology Referrals, Hearing Loss Guidelines, Patient Outcomes, Retrospective Pre-Post Study, Knowledge-to-Action Framework, Hearing Loss Management
Abstract:
Background and Purpose:
Sudden sensorineural hearing loss (SSNHL) is an emergent condition that must be promptly identified and managed to reduce the risk for permanent deafness, but the literature suggests a lack of primary care provider (PCP) adherence to current SSNHL guidelines. The purpose of this study is to determine whether an SSNHL educational intervention for PCPs affects the number of referrals to otolaryngology.
Methods:
This study utilized a retrospective pre-post intervention design, to analyze patient ICD-10 and CPT codes for SSNHL presenting in the two years before and the two years after the intervention. Data analysis was used to determine whether there was a significant increase in the number of patients referred for SSNHL following the intervention.
Results:
Based on the chi square test statistic, there was a significant increase in the number of patients seen for SSNHL post-intervention, suggesting this intervention may increase recognition and referral for this condition.
Conclusion:
Educating PCPs about SSNHL has the potential for more timely identification and management and may reduce patient risk for profound hearing loss. The PCP must be knowledgeable about current guidelines and be able to differentiate conductive versus sensorineural hearing loss to diagnose sudden sensorineural hearing loss and to potentially prevent permanent deafness.
Implications for Practice:
Educating PCPs about SSNHL may improve timely identification and patient referral for this disorder and improve patient outcomes.
Submitted: May 23, 2024, CST
Accepted: December 11, 2024, CST
Feature Article: Creating Clarity Amid the Operating Room Clamor: A Mixed Methods Analysis of Noise Related Barriers and Facilitators to Effective Communication
Author Information:
Sarah E. Hughes, BA1, Milisa Manojlovich, PhD, RN, FAAN2,3, Clare E. Jacobson, MD4, Devin L. McCaslin, PhD, AuD5, Michael M. McKee, MD, MPH6, Dhruv Jain, PhD7, Andrew S. Bolze, BA1, Isabel J. Hsu, BA1, Candice Stegink, MA4, Rishindra M. Reddy, MD, MBA4, Kyle H. Sheetz, MD4, Michael J. Brenner, MD5
1 Medical School, University of Michigan–Ann Arbor, 2 School of Nursing, University of Michigan–Ann Arbor, 3 Department of Systems, Populations, and Leadership, University of Michigan–Ann Arbor, 4 Department of Surgery, Center for Surgical Innovation, University of Michigan–Ann Arbor, 5 Department of Otolaryngology - Head and Neck Surgery, University of Michigan–Ann Arbor, 6 Department of Family Medicine, University of Michigan–Ann Arbor, 7 Department of Computer Science and Engineering, University of Michigan–Ann Arbor
Citation: Hughes, S. E., Manojlovich, M., Jacobson, C. E., McCaslin, D. L., McKee, M. M., Jain, D., Bolze, A. S., Hsu, I. J., Stegink, C., Reddy, R. M., Sheetz, K. H., & Brenner, M. J. (2025). Creating Clarity Amid the Operating Room Clamor: A Mixed Methods Analysis of Noise-Related Barriers and Facilitators to Effective Communication. ORL - Head and Neck Nursing, 43(2), 15-25.
The operating room is one of the noisiest healthcare environments, creating critical challenges for patient safety, team efficiency, and surgical outcomes. Operating room nurses, essential for patient care and team coordination, face unique risks from noise exposure and impaired communication, yet their challenges remain underexplored.
Objective:
To assess hearing challenges and communication barriers in operating room teams from nurses’ perspectives, with implications for patient safety and interventions.
Design:
Cross-sectional survey
Methods:
An electronic survey was distributed to operating room personnel, examining hearing difficulties, communication barriers, and current solutions using multiple-choice, Likert-scale, and open-ended formats. Quantitative and qualitative data were analyzed via descriptive statistics and summative thematic analysis.
Results:
Among 225 participants, 51 were nurses (23%), with 25% reporting hearing loss, 63% no hearing loss, and 12% uncertain. All nurses with baseline hearing loss reported auditory challenges in the operating room, while half without hearing loss reported frequent struggles during surgery (p<.0021). Nurses with > 5 years’ operating room exposure had over 5-fold risk of hearing loss (95% confidence interval: 1.3–21.2; p=0.028). Noise from suction devices, alarms, and music hindered communication. Self-accommodations included asking for repetition (62%) and modifying the environment (32%). Nearly all respondents (96%) emphasized improving communication, supporting ambient noise reduction, technology, or behavioral interventions like closed-loop communication.
Conclusions:
Operating room nurses, central to surgical safety and team efficiency, are disproportionately impacted by noise-related communication challenges. Their dual role positions them to lead the implementation of targeted noise mitigation and communication strategies, driving critical improvements in the surgical environment.
Submitted: February 04, 2025, CDT
Accepted: March 07, 2025, CDT
Published: April 01, 2025, CDT
Feature Article: Age-Related Hearing Loss: Evidence-Based Strategies for Early Detection and Management
Author Information:
Sarah E. Hughes, BA1, Clinton R. Brenner2, Alwyn T. Pandian3, Erin J. Ross, DNP, APRN, CNP, CORLN, FAANP4, Carrie L. Nieman, MD, MPH5,6,7, Michael M. McKee, MD, MPH8,9, Devin L. McCaslin, PhD, AuD2, David E. Tunkel, MD10, Milisa Manojlovich, PhD, RN, FAAN11, Margaret I. Wallhagen, PhD, GNP-BC, AGSF, FGSA, FAAN12, Michael J. Brenner, MD, FACS2
1 Medical School, University of Michigan–Ann Arbor, 2 Department of Otolaryngology-Head and Neck Surgery, University of Michigan–Ann Arbor, 3 Center for Immersive Learning and Digital Innovation, Pennsylvania State University, 4 Head and Neck Institute , Cleveland Clinic, 5 Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine , 6 John Hopkins Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health , 7 Center for Equity in Aging, Johns Hopkins University School of Nursing , 8 Department of Family Medicine, University of Michigan–Ann Arbor, 9 Medical School , University of Michigan–Ann Arbor, 10 Department of Otolaryngology Head and Neck Surgery, Johns Hopkins School of Medicine , 11 Department of Systems, Populations, and Leadership, University of Michigan School of Nursing , 12 Department of Physiological Nursing , University of California, San Francisco
Citation: Hughes, S. E., Brenner, C. R., Pandian, A. T., Ross, E. J., Nieman, C. L., McKee, M. M., McCaslin, D. L., Tunkel, D. E., Manojlovich, M., Wallhagen, M. I., & Brenner, M. J. (2025). Age-Related Hearing Loss: Evidence-Based Strategies for Early Detection and Management. ORL - Head and Neck Nursing, 43(2), 26-39.
Age-related hearing loss (ARHL) is common in older adults and has been linked to significant health and social challenges. These challenges include cognitive decline, depression, falls, and overall decreased quality of life. Despite its high prevalence, ARHL remains underdiagnosed and undertreated, partly due to its gradual onset, stigma, and lack of standardized screening and management protocols. This article provides a comprehensive overview of evidence-based strategies for the early detection and management of ARHL, with an emphasis on recent clinical practice guidelines where nurses are instrumental in leading quality improvement efforts. The multifactorial etiology of ARHL, encompassing genetic predispositions, environmental exposures, and physiological aging, is discussed alongside the health and socioeconomic impacts of untreated hearing loss, including cognitive decline and increased healthcare utilization. Routine screening and hearing assessments can be integrated into patient care visits for individuals aged 50 and above to improve early detection and opportunities for hearing loss management. Effective patient education involves individualized, culturally sensitive counseling that addresses the implications of untreated hearing loss and the benefits of early intervention, which can mitigate stigma and encourage proactive management. Assistive technologies such as consumer devices, hearing aids, and cochlear implants play a vital role in promoting hearing health in personalized care plans developed in collaboration with audiologists. Regular monitoring and follow-up are essential to assess adherence, address challenges, and adjust interventions. By adopting these evidence-based strategies, healthcare professionals can improve identification and management of age-related hearing loss, enhancing the overall health and quality of life for the aging population.
Submitted: February 05, 2025, CST
Accepted: February 10, 2025, CST
Published: April 01, 2025, CST
Commentary: Advancing Educational Equity for Children With Hearing Loss: Celebrating the 50th Anniversary of the Individuals With Disability Education Act (IDEA)
Author Information:
Clinton R Brenner1, Alwyn T Pandian2, Sarah E Hughes, BA3, Casey J Stach, AuD4, Ellen S Thomas, MA, CCC-SLP, LSLS Certification, AVT4, Anita F Vereb, PhD, CCC-A4, Terence K Pleasant, MD4, Erin M Khang, LMSW5, Kris Estheimer, BSN, RN, CORLN6
1 University of Michigan, Ann Arbor, MI, 2 Pennsylvania State University, University Park, PA, 3 University of Michigan Medical School, Ann Arbor, MI, 4 Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, 5 School of Social Work, University of Michigan, Ann Arbor, MI, 6 Department of Otolaryngology, University of Utah Hospital, Salt Lake City, UT
Citation: Brenner, C. R., Pandian, A. T., Hughes, S. E., Stach, C. J., Thomas, E. S., Vereb, A. F., Pleasant, T. K., Khang, E. M., & Estheimer, K. (2025). Advancing Educational Equity for Children With Hearing Loss: Celebrating the 50th Anniversary of the Individuals With Disability Education Act (IDEA). ORL - Head and Neck Nursing, 43(2), 40-47.
Keywords: Sensorineural Hearing Loss, Hearing Disorders, Deafness, Education, Special Students with Disabilities, Early Intervention (Education), Assistive Technology Health Policy, School Nursing, Social Determinants of Health
Abstract:
The Individuals with Disabilities Education Act (IDEA) has been pivotal in securing necessary accommodation, specialized instruction, and assistive technologies, thereby promoting educational equity. Despite these advances, children with hearing differences continue to face significant barriers in early identification, intervention, and inclusion, necessitating the continuous advocacy and involvement of interdisciplinary professionals in educational and healthcare settings. The term hearing difference can serve as a more inclusive alternative to hearing loss or hearing impairment, as it acknowledges the broad spectrum of hearing disorders while also helping to reduce self-perceived stigma and societal perceptions of disability. Nurses are instrumental in bridging healthcare and education, facilitating early detection of hearing differences through newborn screenings and routine school assessments. They have a role in coordinating medical and educational services and advocating for individualized accommodations that enhance learning experiences. However, inconsistent screening policies and lack of awareness among parents, educators, and pediatricians about early indicators of hearing differences persist represent barriers to timely intervention. This article explores the broader social determinants affecting access to resources and interventions for children with hearing differences, such as socioeconomic disparities and insurance coverage. It advocates for stronger policies and resources to address these inequities and calls for an expanded role of nurses in promoting comprehensive educational access. As IDEA continues to evolve, there is an ongoing need for innovative approaches, including the integration of advanced technologies and interdisciplinary collaboration, to ensure that all children with hearing differences can achieve their full academic potential and quality of life.
Submitted: February 17, 2025, CDT
Accepted: February 26, 2025, CDT
Published: April 01, 2025, CDT
Feature Article: The Dreaded “Dizzy” Referral: A Case of Adolescent Syncope Misrouted to Otolaryngology
1 Otolaryngology, Medical College of Wisconsin, 2 School of Nursing, University of Wisconsin–Madison, 3 Pediatric Cardiology, UW Health University Hospital
Citation: Newton, L., Weinke, M., & Marriott, E. (2025). The Dreaded “Dizzy” Referral: A Case of Adolescent Syncope Misrouted to Otolaryngology. ORL - Head and Neck Nursing, 43(2), 48-52.
“Dizzy” adolescent patients are often referred to the otolaryngology clinic to rule out any otologic or vestibular disturbances that may be causing them to feel dizzy. However, most commonly, dizziness and fainting are due to a neurally mediated etiology rather than an inner ear disturbance or a neurological etiology. It is common for adolescent patients with reports of “dizziness” to be referred to various specialties which may include cardiology, neurology, or otology based on the presentation of dizziness and fainting. The following case presentation describes the diagnosis and management of dizziness and fainting in an adolescent patient who was referred to pediatric cardiology, highlighting the non-otologic diagnoses that often explain the cause of the chief complaint of “dizziness” in adolescents who do not have otologic signs and symptoms noted in the history and physical examination.
Submitted: July 14, 2024, CST
Accepted: February 27, 2025, CST
Published: April 01, 2025, CST
Commentary: Diagnosing Meniere’s Disease: A Commentary on Advancements and Challenges
1 Department of Otolaryngology, University of Utah Hospital, 2 School of Medicine, University of Utah, 3 Otolaryngology, University of Utah Hospital
Citation: Estheimer, K., Menjivar, D., & Bernardo, J. (2025). Diagnosing Meniere’s Disease: A Commentary on Advancements and Challenges. ORL - Head and Neck Nursing, 43(2), 53-54.
Highlights from the Hill: Expanding Access to Hearing Healthcare for Adults: How Interprofessional Collaboration Can Promote Care Equity From Clinics to Communities
Author Information:
Sarah E Hughes, BA1, Clinton R Brenner2, Bryan Facione, MS, ACNP-BC, CORLN3, Erin J Ross, DNP, APRN, CNP, CORLN, FAANP4, Carrie L Nieman, MD, MPH5,6,7, Michael M. McKee, MD, MPH8, Devin L McCaslin, PhD, AuD9, Milisa Manojlovich, PhD, RN, FAAN10, Margaret I Wallhagen, PhD, GNP-BC, AGSF, FGSA, FAAN11, Michael J Brenner, MD, FACS2
1 University of Michigan Medical School, Ann Arbor, MI, 2 Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, 3 Department of Otolaryngology, VA Ann Arbor Healthcare System, Ann Arbor, MI, 4 Head and Neck Institute, Cleveland Clinic, Cleveland, OH , 5 Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 6 John Hopkins Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 7 Center for Equity in Aging, Johns Hopkins University School of Nursing, Baltimore, MD, 8 Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, 9 Division of Audiology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI, 10 Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, MI, 11 Department of Physiological Nursing, University of California, San Francisco, CA
Citation: Hughes, S. E., Brenner, C. R., Facione, B., Ross, E. J., Nieman, C. L., McKee, M. M., McCaslin, D. L., Manojlovich, M., Wallhagen, M. I., & Brenner, M. J. (2025). Expanding Access to Hearing Healthcare for Adults: How Interprofessional Collaboration Can Promote Care Equity From Clinics to Communities. ORL - Head and Neck Nursing, 43(2), 55-60.
Keywords: Sensorineural Hearing Loss, Age-Related Hearing Loss, Hearing Aids, Audiology, Interprofessional, Health Equity, Health Services Accessibility, Primary Health Care, Patient-Centered Care, Public Health
Abstract:
Age-related hearing loss (ARHL) is a prevalent yet often overlooked public health challenge that requires interprofessional teamwork and advocacy to implement evidence-based interventions. ARHL impacts quality of life, cognitive function, and social well-being, yet access to hearing care remains limited due partly due to socioeconomic disparities, stigma, and gaps in interprofessional collaboration. This paper explores strategies to expand equitable access to hearing healthcare through interprofessional collaboration, policy advocacy, and community outreach. Nurses, otolaryngologists, audiologists, primary care providers, and public health professionals play keys roles in integrating hearing screenings into routine care, facilitating timely interventions, and addressing disparities. By leveraging electronic health record prompts, social determinants of health screenings, and interdisciplinary teamwork, healthcare systems can improve early detection and intervention for ARHL. Strengthening nurse-physician communication and fostering interprofessional collaboration ensures that hearing loss is recognized and addressed as a critical component of patient-centered care. Beyond conventional clinical settings, community-based initiatives and policy reforms can further enhance access to hearing services. Expanding insurance coverage for hearing aids, advocating for inclusive healthcare policies, and fostering partnerships with local organizations can bridge existing gaps in care. Additionally, educational campaigns aimed at reducing stigma and increasing public awareness are essential for promoting the adoption of hearing interventions. By emphasizing collaborative approaches to hearing health, this article highlights the importance of addressing ARHL as a clinical and public health priority. A coordinated, equity-driven framework can expand access to care and reduce the long-term consequences of untreated hearing loss in aging adults.
Submitted: February 07, 2025, CDT
Accepted: March 08, 2025, CDT
Published: April 01, 2025, CDT
Product Review: CaptionCall Technology for Patients With Hearing Loss
Author Information: Kaelin Roy, AuD-CCC-A, Clinical Audiologist; Department of Otolaryngology, University of Utah Health Care
Citation: Roy, K. (2025). CaptionCall Technology for Patients with Hearing Loss. ORL - Head and Neck Nursing, 43(2), 61.
Editor's Corner: Bridging Science and Practice: The Evolving Landscape of Head and Neck Oncology Care
Author Information: Vinciya Pandian, PhD, MBA, MSN, RN, ACNP-BC, FCCM, FAANP, FAAN, FFNMRCSI, Ross and Carol Nese College of Nursing, Pennsylvania State University.
Citation: Pandian, V. (2025). Bridging Science and Practice: The Evolving Landscape of Head and Neck Oncology Care. ORL - Head and Neck Nursing, 43(1), 6-11.
Keywords: Head and Neck Neoplasms, Oncology Nursing, Cancer Prevention, Health Equity, Human Papillomavirus (HPV), Precision Medicine, Artificial Intelligence, Survivorship, Liquid Biopsy, Otorhinolaryngology
Abstract: NA
Submitted: December 23, 2024, CST
Accepted: December 23, 2024, CST
Message from the President: Advancing Excellence in Head and Neck Cancer Care Through Leadership and Professional Development
Author Information: Maria Colandrea, DNP, NP-C, CORLN, FAANP, FNMRCSI, Department of Otolaryngology Head and Neck Surgery, Department of Veterans Affairs
Citation: Colandrea, M. (2025). Advancing Excellence in Head and Neck Cancer Care Through Leadership and Professional Development. ORL - Head and Neck Nursing, 43(1), 12
Keywords: Leadership, Professional Development, Mentorship, Head and Neck, Neoplasms/nursing, Otorhinolaryngology/nursing, Patient-Centered Care, Quality of Life, Interdisciplinary Communication, Evidence-Based Practice
Abstract: NA
Submitted: December 19, 2024, CST
Accepted: December 20, 2024, CST
Feature Article: Evaluating Effective Feeding Methods for Nutritional Management in Head and Neck Cancer Patients Post-Surgery: A Systematic Review
Author Information:
Naomi N S Walter, MSc (N), BSc (N)1 , Dinesh S Kumar, MSc (N), BSc (N)1 , Thejesh Ramanandham, MS (Audiology and Speech-Language Pathology)2 , Ida S Priyadarshini, MSc (N), BSc (N)1 , Naveen S Victor, MBBS, MS (General Surgery)3 , Sheela Durai, PhD, MSc (N)1 , Vinitha Ravindran, PhD, MSc (N)1 , Vinciya Pandian, PhD, MBA, MSN, ACNP-BC, FCCM, FAANP, FAAN, FFNMRCSI4
1 College of Nursing, Christian Medical College, 2 Audiology and Speech-Language Pathology, Christian Medical College and Hospital, 3 Surgery, Prem Sewa Hospital, 4 Ross and Carol Nese College of Nursing, Pennsylvania State University
Citation: Walter, N. N. S., Kumar, D. S., Ramanandham, T., Priyadarshini, I. S., Victor, N. S., Durai, S., Ravindran, V., & Pandian, V. (2025). Evaluating Effective Feeding Methods for Nutritional Management in Head and Neck Cancer Patients Post-Surgery: A Systematic Review. ORL – Head and Neck Nursing, 43(1), 13-25.
Keywords: Head and Neck Neoplasms, Postoperative Nutritional Support, Feeding Methods, Early Oral Feeding, Nasogastric Tube Feeding, Gastrostomy Tube Feeding, Wound Dehiscence, Pharyngo-Cutaneous Fistula, Flap Necrosis, Hospital Length of Stay
Abstract:
Background:
This systematic review evaluates the effectiveness of feeding interventions—early oral feeding, nasogastric tube feeding, and gastrostomy tube feeding—in supporting postoperative recovery in head and neck cancer patients. The primary objective is to identify the most effective feeding strategy based on outcomes such as wound dehiscence, infections, aspiration, pharyngo-cutaneous fistula, flap necrosis, and length of hospital stay.
Methods:
Studies were selected based on specific inclusion criteria, focusing on head and neck cancer patients receiving alternate feeding methods post-surgery. Databases searched included PubMed, CINAHL, Embase, Cochrane, Web of Science, and Scopus, with the last search conducted on April 10, 2023. Risk of bias was assessed using the Cochrane Risk of Bias tools (RoB-2 for randomized studies and ROBINS-I for non-randomized studies). Data were synthesized and results presented in structured tables, comparing clinical outcomes across feeding methods.
Results:
Ten studies involving 623 participants met the inclusion criteria. Early oral feeding was associated with reduced hospital stay and comparable or lower rates of complications, such as wound dehiscence and infections, relative to nasogastric and gastrostomy feeding. Among studies comparing early oral and nasogastric feeding, early oral feeding showed a potential advantage in recovery time, although gastrostomy feeding presented mixed outcomes with occasional higher infection rates.
Discussion:
This review highlights the benefits of early oral feeding in enhancing recovery and minimizing complications. Limitations include heterogeneity in study designs, small sample sizes, and variability in outcome definitions, which may affect the robustness of these findings.
Submitted: November 03, 2024, CST
Accepted: December 04, 2024, CST
Feature Article: Approaching Social Determinants of Health in Otolaryngology – Head Neck Surgery: Linking Needs to Resources to Promote Health Equity
Author Information:
Prasanth Pattisapu, MD, MPH1,2,3, Naomi B. Gizaw, BA4, Lily Wu, BSN, RN5, Erin M Khang, LMSW6, Valerie McNeal, BSN, RN5, Kathy Herman, BSN, RN5, Kerrigan Coleman, BA5, Emily F. Boss, MD, MPH7, Michael J. Brenner, MD, FACS5
1 Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, 2Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital,3 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Nationwide Children's Hospital, 4 Weinberg College of Arts & Sciences, Department of Neurobiology, Northwestern University, 5 Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, 6 School of Social Work, University of Michigan–Ann Arbor, 7Department Otolaryngology-Head and Neck Surgery, Johns Hopkins University
Citation: Pattisapu, P., Gizaw, N. B., Wu, L., Khang, E. M., McNeal, V., Herman, K., Coleman, K., Boss, E.F., & Brenner, M. J. (2024). Approaching Social Determinants of Health in Otolaryngology – Head Neck Surgery: Linking Needs to Resources to Promote Health Equity. ORL - Head and Neck Nursing, 43(1), 26-35.
Keywords: Social Determinants of Health, Health Equity, Health Disparities, Otolaryngology, Head and Neck Neoplasms, Interprofessional Relations, Healthcare Disparities, Access to Health Services, Health Literacy, Socioeconomic Factors
Abstract:
Social determinants of health influence patient outcomes across all otolaryngology specialties, necessitating collaborative efforts among healthcare teams to promote health equity. Health disparities permeate healthcare, creating inequities related to race, ethnicity, socioeconomic status, environment, access to healthcare, education, gender, and sexual orientation. These disparities impact the diagnosis, management, and outcomes of conditions such as chronic otitis media, obstructive sleep apnea, sinusitis and allergies, hearing and balance disorders, head and neck cancer, and laryngeal or airway-related conditions such as subglottic stenosis, tracheostomy, and other laryngotracheal disorders. Recent updates in Centers for Medicare and Medicaid support capturing data on social determinants of health, which is the first step in linking patients to needed services and resources. Addressing these factors requires interprofessional collaboration involving nurses, providers, social workers, and other professionals, such as pharmacists, surgery schedulers, and community health workers. A holistic approach to otolaryngology considers social and economic factors alongside medical care, leading to positive outcomes in real-world settings, such as early hearing detection in underserved communities and nurse-led programs addressing sinusitis related to poor housing conditions. Other goals include improving digital health literacy, offering financial services, and identifying unmet needs. Ongoing research and the development of targeted educational programs are essential for reducing health disparities and improving care delivery in otolaryngology.
Submitted: October 24, 2024, CST
Accepted: December 18, 2024, CST
Feature Article: Addressing Disparities in Human Papillomavirus (HPV) Vaccination: Public Health Strategies for Head and Neck Cancer Prevention
Author Information:
Christian R. Schaaff, BA1, Haidee Chen, BA2, Vinciya Pandian, PhD, MBA, MSN, ACNP, FCCM, FAANP, FAAN, FFNMRCSI3, Maria Colandrea, DNP, NP-C, CORLN, FAANP, FFNMRCSI4, Nosayaba Osazuwa-Peters, PhD, BDS, MPH, CHES5,6, Michael J. Brenner, MD, FACS7
1 Medical School, University of Michigan–Ann Arbor, 2 David Geffen School of Medicine, University of California, Los Angeles, 3 Ross and Carol Nese School of Nursing, Pennsylvania State University, 4 School of Nursing, Duke University, 5 Department of Head and Neck Surgery & Communication Sciences, Duke University, 6 Duke Cancer Institute, 7 Department of Otolaryngology, University of Michigan–Ann Arbor
Citation: Schaaff, C. R., Chen, H., Pandian, V., Colandrea, M., Osazuwa-Peters, N., & Brenner, M. J. (2025). Addressing Disparities in Human Papillomavirus (HPV) Vaccination: Public Health Strategies for Head and Neck Cancer Prevention. ORL - Head and Neck Nursing, 43(1), 36-48.
Keywords: Human Papillomavirus Vaccines, Vaccination Uptake, Health Disparities, Head and Neck Neoplasms, Oropharyngeal Squamous Cell Carcinoma, HPV Associated Malignancies, Public Health Strategies, Vaccine Hesitancy, Preventive Oncology, Health Equity
Abstract:
In recent years, oropharyngeal squamous cell carcinoma associated with Human Papillomavirus (HPV) has surpassed cervical cancer as the most prevalent HPV-related malignancy in the United States. Despite the availability of a highly effective HPV vaccine, vaccination rates remain suboptimal, with lower uptake in populations affected by healthcare disparities. The growing prevalence of HPV-related head and neck cancer highlights the importance of addressing disparities in HPV vaccine uptake as a public health strategy. Ensuring equitable access to the HPV vaccine can significantly reduce the burden of head and neck cancer in underserved populations. This paper reviews the prevalence of HPV, its strains, and the epidemiology of HPV+ oropharyngeal squamous cell carcinoma. It then explores the multifaceted barriers to vaccination and offers potential solutions. Barriers include limited healthcare access, socioeconomic factors, and vaccine hesitancy, often driven by misinformation and stigma. Overcoming these challenges requires a collaborative, interprofessional approach that engages patients and encompasses partnership among nurses, physicians, policymakers, public health experts, and payers. These stakeholders must work together to improve education, foster community engagement, and create targeted interventions that promote improved vaccine availability and acceptance. Reducing disparities through coordinated efforts will enhance HPV vaccine uptake, reduce cancer incidence, and advance health equity.
Submitted: October 23, 2024, CST
Accepted: December 09, 2024, CST
Feature Article: Trigeminal Nerve Impingement Due to Dental Caries: A Case Report
Author Information:
Seth Patrick Burk, MSN1, Benjamin A. Smallheer, PhD, ACNP-BC, FNP-BC, CCRN, CNE, FAANP1
1School of Nursing, Duke University
Citation: Burk, S. P., & Smallheer, B. A. (2025). Trigeminal Nerve Impingement Due to Dental Caries: A Case Report. ORL - Head and Neck Nursing, 43(1), 49-54.
Keywords: Trigeminal nerve impingement, Dental caries complications, Orofacial pain, Interdisciplinary management, Periapical lucency, Cranial nerve dysfunction, Case report, Dental pathology diagnosis, Ophthalmalgia and hemianopia, Medical and dental collaboration
Abstract:
Introduction:
Trigeminal nerve impingement is a rare manifestation of undiagnosed dental caries. This case report highlights the diagnostic challenges and interdisciplinary management required when medical and dental conditions converge.
Case Presentation:
A 32-year-old female presented with persistent left-sided temporal swelling, hemianopia, ophthalmalgia, periorbital swelling, ear pain, and sinus congestion unresolved after treatment for presumed otitis externa. Further evaluation with imaging revealed a periapical lucency of the left first molar, leading to a diagnosis of trigeminal nerve impingement. The patient underwent a root canal procedure, resulting in complete symptom resolution.
Discussion:
This case underscores the importance of including dental conditions in differential diagnoses for atypical orofacial pain. It highlights the need for interdisciplinary collaboration between medical and dental providers in managing complex presentations.
Conclusion:
Dental caries can have far-reaching systemic effects, as illustrated by this case. Early recognition and intervention can prevent complications and improve patient outcomes.
Submitted: May 06, 2024, CST
Accepted: December 23, 2024, CST
Highlights from the Hill: State Health Policy Updates 2024
1ENT Surgery Service, Veterans Affairs Ann Arbor Healthcare System, 2 Otolaryngology-Head and Neck Surgery, Indiana University Health, 3 Otolaryngology, Beachwood Family Health Center, Cleveland Clinic, 4 Surgical Services, Otolaryngology Head and Neck Surgery, Winship Cancer Institute, Emory University, 5 Retired Nurse, 6 Otolaryngology Head and Neck Surgery, Edward Hines, Jr. VA Hospital
[ a Nurse Practitioner, b Nurse Practitioner, c Nurse Practitioner, d Chief Advanced Practice Provider, e ENT Clinical Coordinator]
Citation: Facione, B., Dukeshire, T., Ross, E., Ryan, M., Beshore, S. M., & Slonina, C. (2025). State Health Policy Updates 2024. ORL - Head and Neck Nursing, 43(1), 55-60
Keywords: Health Policy, State Nursing Policy, Nursing Legislation, Advanced Practice Nursing, Workplace Violence, Health Workforce
Abstract:
This Highlight from The Hill provides a comprehensive overview of state health policy updates in 2024, with a focus on legislative trends that impact nursing practice and advocacy. Authored by members of the Society of Otorhinolaryngology and Head and Neck Nurses (SOHN), this review underscores efforts across multiple states to address critical challenges in healthcare, such as workplace violence, mandatory overtime, safe staffing levels, and barriers to advanced practice nurse autonomy. Key legislative developments include the push for full practice authority in states like Indiana and Michigan, reforms to enhance nurse mobility through licensure compacts in Ohio, and policies addressing workplace safety and staffing in Illinois and Georgia. Additionally, California’s pioneering efforts to establish a unified healthcare financing framework and protect reproductive and gender-affirming care are discussed. These updates highlight the growing recognition of nurses’ pivotal role in shaping health policy and the need for their active participation in advocacy. This Highlight from The Hill aims to inform and inspire nursing professionals to engage in legislative processes that prioritize patient safety, healthcare accessibility, and workforce sustainability.
Submitted: August 18, 2024, CST
Accepted: November 24, 2024, CST
Book Review: Empowering Recovery: A Review of Dr. Itzhak Brook’s the Laryngectomee Guide
Author Information: Carol S Maragos, MSN, ACNP-BC, CORLN, Department of Otolaryngology Head-Neck Surgery, Johns Hopkins Hospital
Citation: Maragos, C. S. (2025). Empowering Recovery: A Review of Dr. Itzhak Brook’s the Laryngectomee Guide. ORL - Head and Neck Nursing, 43(1), 61-62
Keywords: Laryngectomy, Stoma Care, Tracheoesophageal Puncture (TEP), Head and Neck Cancer, Speech Restoration, Patient Education, Otolaryngology Nursing, Psychosocial Adaptation, Post-Surgical Rehabilitation, Laryngeal Cancer Support
Abstract: NA
Submitted: December 09, 2024, CST
Accepted: December 09, 2024, CST
2024 Volume 42 | Issue 4; E-ISSN: 1064-3842
From the Editor-In-Chief: Advancing Pediatric Care in Otolaryngology Through Publication
Author Information: Wendy Lord Mackey, DNP, APRN-BC, CORLN, School of Nursing, Yale University
Citation: Mackey, W. L. (2024). Advancing Pediatric Care in Otolaryngology through Publication. ORL - Head and Neck Nursing, 42(4), 5.
Pediatric nursing plays a vital role in the healthcare continuum, offering comprehensive care to children, adolescents, and their families. This editorial highlights the historical milestones of pediatric nursing, focusing on the contributions of key figures such as Lillian Wald, Mary Brewster, and Dr. Loretta Ford. These pioneers not only transformed the field of nursing but also addressed the healthcare needs of vulnerable populations through innovative care models and advocacy for social justice.
Submitted: September 09, 2024 CST
Accepted: September 09, 2024 CST
Feature Article: Optimizing Fasting Times in Infant Outpatient Surgical Patients
All patients are standardly kept nil per os (NPO) prior to surgery to minimize aspiration risks. However, previous studies have linked prolonged NPO times in infants to patient distress, hemodynamic instability, ketoacidosis and acid-base imbalances. Optimizing NPO times for young pediatric patients helps decrease fasting times, which in turn minimizes the associated safety concerns.
Objectives:
To implement specific education instructions to parents of infants during the pre-operative phone calls and confirm their understanding of this education through the teach-back method.
Methods:
An evidence-based practice project was implemented. The intervention involved adding educational instructions with a teach-back question into the verbal portion of “The Standing Orders with Authentication for Pediatric Patients Receiving Anesthesia and/or Sedation” in the pediatric operating room at a large academic hospital located in Connecticut. The new feature directed the Pre-Anesthesia Visit (PAV) RNs to educate parents of infants under 1 year of age undergoing outpatient surgery about the importance of encouraging clear fluids up until 1 hour before arrival or 2 hours before surgery.
Results:
The average NPO time for the group prior to the intervention was 5.75 hours while the post-intervention group NPO time averaged 3.88 hours.
Conclusion :
Findings demonstrate that the intervention group average NPO time reduced by almost two hours. This suggests that implementing parental education on the importance of clear fluid intake in the preoperative phone calls helped decrease NPO times.
Submitted: July 31, 2024 CST
Accepted: September 15, 2024 CST
Feature Article: Tympanostomy Tube Otorrhea: A Call for Action for Antibiotic Stewardship
Author Information: Wendy Lord Mackey, DNP, MSN, APRN-BC, CORLN, School of Nursing, Yale University
Citation: Mackey, W. L. (2024). Tympanostomy Tube Otorrhea: A Call for Action for Antibiotic Stewardship. ORL - Head and Neck Nursing, 42(4), 13-24.
There is an overuse of oral antibiotics and unnecessary acute care visits for treating children with uncomplicated tympanostomy tube otorrhea (TTO). TTO is an easy to identify condition and the child’s caregiver can be empowered to initiate treatment with topical otic antibiotic drops (TAD) without the need for an urgent care visit.
Project Aims:
(1) Develop an educational program for caregivers of children with TTO to independently initiate treatment when clinically indicated. (2) Implement the educational program and evaluate impact on caregiver self-efficacy and TTO-related actions.
Methods:
This project involved the development and implementation of an educational program for caregivers of children with tympanostomy tubes (TT), including a web-based instructional video, an informational pocket-card, and a post-operative text reminder. These resources were designed to educate, empower, and improve the self-efficacy of caregivers in independently initiating treatment when clinically indicated. A pre- and post-intervention survey was developed and implemented to gather feedback from caregivers regarding their experience with TTs and TTO. In addition, an adapted Bandura Self-efficacy Psychometrics scale was used to measure caregiver self-efficacy in relation to caring for a child with TTO. The survey also collected quantitative data on the incidence of TTO. Descriptive statistics such as mean and standard deviation were used to analyze the data.
Non-parametric testing (Signed Rank test) was used to compare caregiver self-efficacy between pre- and post-scores.
Results:
For the fifty-eight caregivers enrolled in the study, caregiver self-efficacy mean scores were significantly higher (p=<0.0001) after implementing the educational program when compared to pre-intervention scores on all 7 self-efficacy items measured. Most caregivers felt the resources were helpful and valuable for future use. Twenty-one percent of the patients experienced post-operative TTO; 100% of those caregivers reported initiating TAD, with 58% referring to the educational resources. All those who did not refer to the educational material had children who had previously undergone TT placement. No children received oral antibiotics following tube placement related to TTO.
Conclusion:
Implementation of the education program provided caregivers with a valid, reliable, and accessible tool endorsed and prescribed by their clinician. All caregivers found the educational resources useful, significantly increasing their confidence in the care of their child with TTs. Implementing strategies to improve caregiver confidence, efficiency in care, and patient understanding positively impacts patient care.
Implications:
Expanding the implementation to more patients globally, can decrease the unnecessary use of oral antibiotic in the treatment of acute uncomplicated TTO, impacting global antibiotic resistance, improving health utilization and cost, and enhancing clinical outcomes.
Submitted: August 11, 2023 CST
Accepted: November 21, 2023 CST
Feature Article: Quality Improvement: Implementing Oral Cryotherapy Guidelines to Prevent Chemotherapy- Induced Mucositis in Pediatric Oncology
Author Information: Hailey Cleveland, BSN, RN, CPN, Ross and Carol Nese College of Nursing, The Pennsylvania University
Citation: Cleveland, H. (2024). Quality Improvement: Implementing Oral Cryotherapy Guidelines to Prevent Chemotherapy-Induced Mucositis in Pediatric Oncology. ORL - Head and Neck Nursing, 42(4), 25-32.
Keywords: Oral Mucositis, Cryotherapy, Chemotherapy-Induced Mucositis, Pediatric Oncology, Evidence-Based Practice, Quality Improvement, Nursing Compliance, Clinical Practice Guidelines, Cancer Nursing
Abstract:
Background :
Oral mucositis is a common and preventable adverse effect of chemotherapy, significantly impacting pediatric oncology patients’ quality of life, treatment outcomes, and healthcare costs. Despite institutional guidelines, implementation of evidence-based mucositis prevention strategies, such as oral cryotherapy, remains inconsistent in clinical practice.
Local Problem:
A pediatric hematology-oncology unit at a tertiary children’s hospital reported oral mucositis in 50% of patients receiving high-dose chemotherapy. Existing guidelines emphasized post-mucositis care rather than prevention, necessitating the development and implementation of a standardized prevention strategy.
Methods:
A quality improvement project using the Knowledge-to-Action (KTA) framework was conducted to implement an evidence-based oral cryotherapy guideline. The intervention included staff education, validation, and integration of cryotherapy practices for pediatric patients aged 6–21 receiving high-dose chemotherapy. Pre- and post-intervention measures included nursing compliance with mucositis documentation, cryotherapy administration, and staff perceptions of the educational guideline.
Results:
Post-intervention, there was a statistically significant increase in mucositis documentation compliance (p = 0.002) and cryotherapy administration (p = 0.014). Staff perception of the guideline showed high acceptability (p = 0.48), appropriateness (p = 0.45), and feasibility (p = 0.05). Notably, no cases of mucositis were reported among patients who received cryotherapy during the implementation period.
Conclusions:
Implementation of an evidence-based cryotherapy guideline improved nursing compliance with mucositis documentation and cryotherapy practices, reducing the incidence of oral mucositis in a pediatric oncology population. Structured educational interventions and standardized guidelines can effectively enhance clinical practices and patient outcomes. Future efforts should focus on scaling this initiative to diverse settings and exploring strategies to overcome barriers to patient compliance.
Submitted: July 31, 2024 CST
Accepted: September 01, 2024 CST
Feature Article: Persistent Obstructive Sleep Apnea in the Pediatric Patient: Evidence Based Approach to Diagnosis and Management
Author Information: Lisa Gagnon, MSN, APRN-BC, School of Nursing, Yale University
Citation: Gagnon, L. (2024). Persistent Obstructive Sleep Apnea in the Pediatric Patient: Evidence Based Approach to Diagnosis and Management. ORL - Head and Neck Nursing, 42(4), 33-39.
Persistent pediatric obstructive sleep apnea (OSA) is a significant condition affecting children, often persisting after adenotonsillectomy (AT). Recent guidelines provide evidence-based strategies to address diagnostic and therapeutic challenges in this population.
Objective:
To synthesize current evidence on diagnosing and managing persistent pediatric OSA, highlighting diagnostic tools, medical therapies, surgical interventions, and a multidisciplinary approach.
Methods:
A literature review and analysis of Expert Consensus Statements were conducted, focusing on polysomnography (PSG), drug-induced sleep endoscopy (DISE), and validated symptom assessment tools. Three case studies illustrate clinical complexities and management outcomes.
Results:
Persistent OSA is identified using PSG and tools like the Pediatric Sleep Questionnaire (PSQ), while DISE aids in evaluating airway obstructions and informs surgical planning. Medical therapies, such as intranasal steroids and montelukast, improve outcomes in mild to moderate cases. CPAP is effective for severe OSA but is often poorly tolerated. Surgical options, including lingual tonsillectomy, turbinate reduction, and supraglottoplasty, target site-specific obstructions. A multidisciplinary approach, incorporating otolaryngologists, sleep specialists, and nutritionists, is critical to managing complex cases. Shared decision-making with families enhances adherence and outcomes.
Conclusions:
Persistent pediatric OSA requires a tailored, stepwise approach using evidence-based diagnostic tools and interventions. DISE is a pivotal diagnostic tool that guides surgical decisions, while multidisciplinary care ensures comprehensive management. Ongoing research is needed to refine strategies and improve outcomes for this population.
Submitted: August 05, 2024 CST
Accepted: September 17, 2024 CST
Feature Article: Post-operative Facial Swelling Following Adenoidectomy and Turbinate Reduction: A Case Report
Author Information:
Stephanie L Lesser, DNP, PNP1, Amy A Ashburn, DNP, FNP1
1Otolaryngology, Phoenix Children's Hospital
Citation: Lesser, S. L., & Ashburn, A. A. (2024). Post-operative Facial Swelling Following Adenoidectomy and Turbinate Reduction: A Case Report. ORL - Head and Neck Nursing, 42(4), 40-43.
This is a case report regarding a 12-year-old with history of obesity, who underwent adenoidectomy and turbinate reduction in an outpatient surgery center with a community otolaryngologist. He presented to our Children’s Emergency Department (ED) via ambulance with facial swelling and crepitus. Prior to arrival, he had received Benadryl for possible allergic reaction, without noted improvement. Examination in the ED revealed subcutaneous air and crepitus, which led to a concern for a traumatic tracheal injury following intubation at time of surgery. The diagnosis was confirmed with micro laryngoscopy and bronchoscopy (MLB). He was conservatively treated with observation and serial MLB until the injury was healed. The patient was subsequently discharged with return to normal activity and sports. Iatrogenic tracheal rupture (ITR) in pediatric outpatient surgeries, although rare, is a significant consideration for practitioners who may triage these patients through an office or ED setting.
Submitted: May 30, 2024 CST
Accepted: September 17, 2024 CST
Highlights from the Hill: The Opioid Crisis in America: History, Impact, and Legislative Efforts
Author Information: Sharon Jamison, VR-RN, BSN, CORN (E), SOHN Education Coordinator, SOHN
Citation: Jamison, S. (2024). The Opioid Crisis in America: History, Impact, and Legislative Efforts. ORL -Head and Neck Nursing, 42(4), 44-46.
All ORL-Head and Neck Nurses have been exposed in some fashion to opiod medications. Whether it has been to determine the need for opiod use after pain assessment of a patient, writing prescripitions for opiods for pain managment, counseling patient’s and familys on the use and risks of opioid pain medication, or taking opiods as a patient for our own pain releif. It is important for the ORL-Head and Neck Nurse to have some education on the history of opiod use in our country, along with the laws passed and current laws being considered by congress to help control use, prevent abuse, and offer treatment options for opiod addiction.
Submitted: July 23, 2024 CST
Accepted: September 01, 2024 CST
Product Review: Innovations in Otic Self-Care: Assessing the Impact and Safety of Smartphone Otoscopes in Modern Healthcare
Author Information: Michael A. Garza, BSN1 1School of Nursing, Yale University
Citation: Garza, M. A. (2024). Innovations in Otic Self-Care: Assessing the Impact and Safety of Smartphone Otoscopes in Modern Healthcare. ORL - Head and Neck Nursing, 42(4), 47-48.
Keywords: Otoscopy, Smartphone, Ear Diseases, Telemedicine, Patient-Centered Care
Abstract: NA
Submitted: June 24, 2024 CST
Accepted: August 27, 2024 CST
2024 Volume 42 | Issue 3; E-ISSN: 1064-3842
From the Editor: From Exploration to Action: Addressing Social Determinants of Health in Otorhinolaryngology-Head and Neck Nursing
Author Information:
Marci L. Nilsen, PhD, RN, CHPN, FAAN1,2
1Acute and Tertiary Care, University of Pittsburgh School of Nursing, 2Department of Otolaryngology, University of Pittsburgh School of Medicine
Citation: Nilsen, M. L. (2024). From Exploration to Action: Addressing Social Determinants of Health in Otorhinolaryngology-Head and Neck Nursing. ORL - Head and Neck Nursing, 42(3), 5-6.
Keywords: Social Determinants of Health, Health Equity, Patient-Centered Care, Nursing, Inclusive Health Services, Big Data, Artificial Intelligence, Emotional Intelligence, Advocacy
Abstract: NA
Submitted: July 30, 2024 CDT
Accepted: August 05, 2024 CDT
SOHN Presidential Perspectives: Navigating Social Determinants of Health Through the Lens of a Nurse
Author Information: Maria Colandrea, DNP, NP-C, CORLN, FAANP, FNMRCSI, Durham VA Otolaryngology, Department of Veterans Affairs
Citation: Colandrea, M. (2024). Navigating Social Determinants of Health Through the Lens of a Nurse. ORL - Head and Neck Nursing. 42(3), 7.
Keywords: social determinants of health, nursing, presidents perspective, otolaryngology, health equity
Abstract: NA
Submitted: April 02, 2024 CDT
Accepted: June 17, 2024 CDT
Feature Article: Exploring Emotional Intelligence in Otorhinolaryngology Head and Neck Nursing: A Narrative Review
1School of Nursing, Johns Hopkins University, 2Otolaryngology Head and Neck Surgery, Penn State Health, 3Pediatric Otolaryngology, Medical College of Wisconsin/Children’s Wisconsin
Citation: Pandian, V., Sarsfield, E., & Newton, L. (2024). Exploring Emotional Intelligence in Otorhinolaryngology Head and Neck Nursing: A Narrative Review. ORL - Head and Neck Nursing. 42(3), 8-17.
Keywords: emotional intelligence, otorhinolaryngology head and neck nursing, social determinants of health, compassionate care, burnourt, reslilience, job satisfaction
Abstract:
Introduction:
Emotional Intelligence (EI) is vital in nursing, especially in understanding social determinants of health, enhancing patient care and professional satisfaction. However, its relevance and impact in otorhinolaryngology head and neck nursing remain understudied. Our review aims to explore EI’s significance in general, addressing gaps in understanding, training, and its influence on patient outcomes and nurse burnout.
Methods:
A search of PubMed, CINAHL, PsycINFO, and Google Scholar identified relevant studies. Inclusion criteria focused on EI in nursing, with a focus on otorhinolaryngology head and neck nursing. Three reviewers screened articles, and a narrative synthesis approach was used for analysis. A case scenario is also presented to elucidate the nuances of emotional intelligence.
Findings:
Despite the absence of studies directly exploring EI in otorhinolaryngology head and neck nursing, literature highlights its important role in nursing and healthcare overall. Studies extrapolate EI’s significance, emphasizing its capacity to enhance patient care, mitigate burnout, and foster leadership. Research underscores the correlation between elevated EI levels in healthcare professionals and improved patient outcomes, resilience, and job satisfaction. Cultivating EI emerges as a mandate for nurses, promising transformative effects on patient care and professional satisfaction.
Conclusion:
EI emerges as a foundation of nursing practice, despite limited direct investigation among otorhinolaryngology head and neck nurses. This review illuminates the impact of EI on patient outcomes, nurse resilience, and leadership within healthcare. Embracing EI fosters compassionate care, mitigates burnout, and cultivates inclusive healthcare environments. Further research is needed to evaluate the impact of EI in otorhinolaryngology head and neck nursing.
Submitted: February 24, 2024 CDT
Accepted: June 26, 2024 CDT
Feature Article: Integrating Social Determinants of Health Into Otorhinolaryngology and Head and Neck Surgery Care: A Path to Inclusive Nursing Practice for LGBTQ+ Patients
1College of Nursing, Pennsylvania State University, 2Otolaryngology Associates
Citation: Pandian, V., & Bartholomay, K. (2024). Integrating Social Determinants of Health into Otorhinolaryngology and Head and Neck Surgery Care: A Path to Inclusive Nursing Practice for LGBTQ+ Patients. ORL - Head and Neck Nursing, 42(3), 18-25.
Keywords: Social determinants of health, LGBTA+ persons, Health equity, Gender-affirming care, Cultural competency, Health disparities, Access to healthcare, Discrimination, Policy Advocacy, Patient satisfaction
Abstract:
The integration of Social Determinants of Health (SDOH) into otorhinolaryngology and head and neck surgery (ORL-HNS) is critical for addressing the unique healthcare needs of LGBTQ+ patients. LGBTQ+ persons face specific ORL-HNS health issues, such as complications from hormone therapy and gender-affirming surgeries, which are compounded by barriers to accessing affirming and culturally competent care.
This editorial highlights the role of ORL-HNS nurses in recognizing and addressing SDOH to promote inclusive and equitable care for LGBTQ+ patients. By integrating an understanding of SDOH into their practice, nurses can deliver holistic, patient-centered care that addresses both the physical and psychosocial dimensions of health. Practical strategies include continuous education on LGBTQ+ health issues, using inclusive language, creating welcoming environments, and developing customized care plans that account for patients’ broader social contexts.
Nurses are also encouraged to engage in policy advocacy and community engagement to support health equity for LGBTQ+ persons. By fostering open communication, collaborating with multidisciplinary teams, and advocating for systemic changes, ORL-HNS nurses can help mitigate health disparities and enhance the overall healthcare experience for LGBTQ+ patients. This approach not only improves health outcomes but also fosters trust, engagement, and positive patient satisfaction, contributing to a more inclusive and affirming healthcare environment for all.
Submitted: May 20, 2024 CDT
Accepted: July 08, 2024 CDT
Commentary: Conscientization and ‘Big Data’: Toward Emancipatory Praxis in Otorhinolaryngology Nursing Science
Author Information: Chandler Moser, PhD, BSN, CNOR, Center for Nursing Science and Clinical Inquiry, Madigan Army Medical Center
Citation: Moser, C. (2024). Conscientization and ‘Big Data’: Toward Emancipatory Praxis in Otorhinolaryngology Nursing Science. ORL - Head and Neck Nursing, 42(3), 26-28.
Keywords: critical consciousness, nursing science, theory, big data, head and neck, Otorhinolaryngology, critical social theory, health equity, patient outcomes
Abstract:
This essay explores the application of critical social theory (CST) to ‘big data’ in the context of otorhinolaryngology and head-neck (ORL) nursing. CST posits that data is inherently subjective and shaped by power structures, challenging traditional empiricist assumptions of objectivity. Patient outcomes research represents a crucial arena for applying CST insights to dismantle biases and achieve equitable care. ORL nurses’ and nurse scientists’ intimate understanding of head and neck patient populations’ challenges and health inequities positions them to leverage ‘big data’ through a CST lens, revealing sociocultural patterns influencing patient outcomes. While ‘big data’ raises ethical concerns, thoughtfully integrating CST with data analytics can push ORL science toward maximal healthcare equity. Embracing CST as a humanistic ethos and analytical framework allows ORL nurses and and nurse scientists to harness ‘big data’ as a tool for raising critical consciousness and moving healthcare praxis toward emancipatory human flourishing.
Submitted: March 19, 2024 CDT
Accepted: June 25, 2024 CDT
Feature Article: Navigating Survivorship in Otorhinolaryngology: ICU Care and Social Determinants of Health in Postoperative OHNS Patients
Citation: Kim, C., & Pandian, V. (2024). Navigating Survivorship in Otorhinolaryngology: ICU Care and Social Determinants of Health in Postoperative OHNS Patients. ORL - Head and Neck Nursing, 42(3), 29-35.
Keywords: Critical care nursing, Head and neck neoplasms, Healthcare disparities, Intensive care units, Oncology nursing, Perioperative nursing, Social determinants of health, Survivorship, Tracheostomy
Abstract:
This commentary explores Intensive Care Unit (ICU) survivorship within the context of Otorhinolaryngology, Head and Neck Surgery (OHNS), emphasizing the critical intersection of postoperative management and the broader social determinants of health (SDOH). Recent advancements in OHNS have facilitated complex surgeries with minimal damage, yet these procedures often require complex ICU care due to potential complications, in addition to comorbidities and the need for mechanical ventilation such as tracheostomy. Tracheostomy, commonly necessitated by upper airway obstruction or prolonged ventilator dependence, is particularly associated with post-intensive care syndrome (PICS), manifesting as a constellation of physical, cognitive, and mental health impairments. Factors like socioeconomic status, educational level, and social support significantly influence patient outcomes and impact the health trajectories of OHNS patients from ICU discharge through long-term recovery. The role of OHNS nurses is vital in bridging the gap between critical care and rehabilitation, advocating for a multidisciplinary approach that integrates medical and social care to enhance survivorship outcomes. There is a need for standardized SDOH screenings and tailored interventions to address the unique needs of OHNS ICU survivors. By focusing on comprehensive care that encompasses both medical treatment and social support, OHNS nurses need to advocate for systemic changes to improve health equity and patient-centered outcomes in postoperative OHNS care.
Submitted: April 30, 2024 CDT
Accepted: June 26, 2024 CDT
Commentary: Current National Issues and Trends in Health Care Policy and Advocacy
Author Information: Bryan Facione, Masters of Science, Medical Surgical Nursing, Acute Care, Nurse Practitioner, ENT, VA Ann Arbor Healthcare System
Citation: Facione, B. (2024). Current National Issues and Trends in Health Care Policy and Advocacy. ORL -Head and Neck Nursing, 42(3), 36-39.
Keywords: Health Care Policy, Health Care Trends, Health Care Advocacy, Women's Reproductive Rights, Nursing Shortage, Patient Safety
Abstract:
A brief synopsis on current national issues and trends in health care policy that effect the nursing profession and patient care.
Submitted: June 10, 2024 CDT
Accepted: July 23, 2024 CDT
Highlights from the Hill: Reflections on American Nurses Association (ANA) Hill Day: Advocating for Nursing Excellence and Healthcare Reform
Author Information: Vinciya Pandian, PhD, MBA, MSN, ACNP-BC, FCCM, FAANP, FAAN, FFNMRCSI, Ross and Carol Nese College of Nursing, Pennsylvania State University
Citation: Pandian, V. (2024). Reflections on American Nurses Association (ANA) Hill Day: Advocating for Nursing Excellence and Healthcare Reform. ORL - Head and Neck Nursing, 42(3), 40.
Keywords: Health Policy, Nursing Staff, Nurse's Role, Nursing legislation, Professional Role, Health Services Accessibility, Healthcare Reform, Policy Making, Healthcare Disparities, Advocacy
Abstract: NA
Submitted: July 03, 2024 CDT
Accepted: July 18, 2024 CDT
2024 Volume 42 | Issue 2; E-ISSN: 1064-3842
From the Guest-Editor: Innovating Otorhinolaryngology Head and Neck Nursing a Path Forward
Author Information: Vinciya Pandian, PhD, MBA, MSN, RN, ACNP-BC, FCCM, FAANP, FAAN, FFNMRCSI, School of Nursing, Johns Hopkins University
Citation: Pandian, V. (2024). Innovating Otorhinolaryngology Head and Neck Nursing - A Path Forward. ORL - Head and Neck Nursing., 42(2), 6.
Keywords: Nursing, Medical informatics, Education, Patient advocacy, Patient care, Telemedicine, Tracheostomy, Mediccal billing, Evidence-based practice, Head and neck cancer
Abstract: NA
Submitted: March 12, 2024 CDT
Accepted: March 12, 2024 CDT
SOHN Presidential Perspectives: Advocacy Through Nursing: The Importance of Being at the Right Table
Author Information: Maria Colandrea, DNP NP-C CORLN FAANP FFNMRCSI, Department of Otolaryngology, Department of Veterans Affairs, Durham VA
Citation: Colandrea, M. (2024). Advocacy Through Nursing: The Importance of Being at the Right Table. ORL - Head and Neck Nursing., 42(2), 7.
1Otolaryngology, University of Pennsylvania, 2Surgical Services, University of Pennsylvania
Citation: Reger, C., & Culley, K. (2024). Utilizing Digital Patient Education Platforms to Improve Patient Engagement with Preoperative Education. ORL - Head and Neck Nursing., 42(2), 8-12.
Keywords: Otorhinolaryngology Nursing, Patient education, Preoperative, Digital health, Patient engagement, Otolaryngology head and neck surgery
Abstract:
Preoperative education has been shown to enhance surgical outcomes. The current standard of care for patients undergoing surgery in an otolaryngologic setting involves verbal preoperative education during the office visit, supplemented with printed material. Utilizing digital education customized to the specific surgical procedure proves to be an effective method to improve patient knowledge, engagement, satisfaction, and overall health outcomes. Consequently, integration of this approach should be integrated into healthcare guidelines. Nurses play a crucial role in the preoperative education process and can contribute to increasing patient engagement. However, some barriers hinder the implementation of this technology, including issues related to accessibility, amenability, cost and regulation. Providing support for patients and healthcare workers in utilizing this technology effectively can help overcome these barriers. The future of patient education will inevitably include digital platforms, and healthcare organizations and patients should be ready to embrace this evolving technology.
Submitted: November 05, 2023 CST
Accepted: December 21, 2023 CST
Feature Article: Evaluating the Impact of a Nurse-Led Educational Intervention on Postoperative Outcomes in Head and Neck Cancer Patients Undergoing Airway Surgery: A Quality Improvement Project
1 School of Nursing, College of Health Sciences, Old Dominion University, 2 Sentara Norfolk General Hospital, Norfolk, VA
Citation: York, A., Williams-Reed, J., Peleton, W., Lewis, L., Toepp, A., & Goode, V. (2024). Evaluating the Impact of a Nurse-Led Educational Intervention on Postoperative Outcomes in Head and Neck Cancer Patients Undergoing Airway Surgery: A Quality Improvement Project. ORL - Head and Neck Nursing., 42(2), 13-18.
Keywords: Head and neck cancer, Head and neck neoplasm, Tracheostomy, Laryngectomy, Postoperative care, Nursing care, Patient education, Quality improvement, Clinical outcomes, Intensive care units
Abstract:
Background:
Head and neck cancer often requires surgical intervention of the airway, such as laryngectomy or tracheostomy. These high-risk surgeries are associated with serious complications, high mortality rates, and prolonged hospital length of stays. Nurses are uniquely qualified to provide exceptional post-operative care to this patient population, thereby minimizing complications and improving clinical outcomes.
Local Problem:
A quality improvement project done in an intensive care unit and step-down unit, incorporating an evidence-based education program to otorhinolaryngology head and neck nurses demonstrated that nursing knowledge could be improved with education, however no follow-up assessments had been performed to assess impact on patient outcomes.
Purpose:
The purpose of this project was to examine the potential impact of improving nurse knowledge regarding tracheostomies and laryngectomies through a nurse-led evidence-based educational intervention on various clinical outcomes (intensive care unit, stepdown, and overall hospital length of stay, rates of readmissions, emergency room visits, and mortality).
Methods:
This is a retrospective chart review comparing patient outcomes pre- and post-evidence-based education program for nurses caring for postoperative head and neck cancer patients following tracheostomy or laryngectomy. It was conducted at Sentara Norfolk General Hospital. Data was extracted by the Sentara Quality Research Institute team. Descriptive data are provided using means and standard deviation for continuous variables, frequency and percentages for categorical variables. Comparative analysis was performed using a Mann-Whitney U test to compare outcomes pre- and post- the educational intervention.
Intervention:
An educational intervention was provided by PowerPoint presentation to nurses working in the intensive care unit and stepdown unit, caring for postoperative head and neck cancer patients, emphasizing anatomical differences and postoperative care of tracheotomy and laryngectomy patients, with the use of cognitive aids.
Results:
Intensive care unit length of stay significantly decreased from 4 to 2.5 days (p = 0.02) one year post evidence-based education compared to pre-education. The overall hospital length of stay showed a decreasing trend from 20 days (pre-education program) to 18 days (post-education program); however, it was not statistically significant. Other outcomes such as readmission and mortality rates did not show significant differences between the pre- and post-education groups.
Conclusion:
An evidence-based education program for nurses caring for postoperative head and neck cancer patients decreased the intensive care unit length of stay. Evidence-based education should be implemented to not only improve nurses’ knowledge and confidence but also to improve care delivery and improve clinical outcomes such as length of stay.
Submitted: December 05, 2023 CDT
Accepted: March 13, 2024 CDT
Feature Article: Global Predictors of Tracheostomy-Related Pressure Injury During COVID-19: Research Protocol
1Center for Nursing Science and Clinical Inquiry, Madigan Army Medical Center, 2School of Nursing, Johns Hopkins University, 3Biostatistics and Epidemiology, Johns Hopkins University Center for AIDS Research, 4Departments of Surgery, Anesthesiology and Critical Care Medicine, and Emergency Medicine, Johns Hopkins Medicine, 5Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, 6Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 7Otolaryngology-Head & Neck Surgery, University of Michigan Medicine, 8Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University
Citation: Moser, C., Budhathoki, C., Haut, E., Brenner, M., & Pandian, V. (2024). Global predictors of tracheostomy-related pressure injury during COVID-19: Research protocol. ORL - Head and Neck Nursing., 42(2), 19-28.
Keywords: COVID-19, Pressure Injury, Critical Care, Protocol, Tracheostomy, Risk factors, Electronic Health Records, Global Tracheostomy Registry, Patient care
Abstract:
Aims:
To determine the patient factors associated with tracheostomy-related pressure injury (TRPI) using a multilevel, multivariate logistic regression model and to evaluate how care during the COVID-19 pandemic affected TRPI and its predictors.
Design:
Secondary data analysis of a tracheostomy patient database and electronic medical records.
Methods:
This secondary data analysis study will merge and analyze data from the Global Tracheostomy Collaborative and the electronic health records of a large US healthcare system. We will employ a multilevel logistic regression model to investigate the relationships between suspected risk factors for TRPI.
Discussion:
Given the impact of TRPI on patient outcomes and expenditures, it is imperative to standardize TRPI assessment, increase awareness of at-risk patient populations, and implement novel preventive modalities. This will be the first large-sample study quantifying the risk factors for TRPI and the impact of the COVID-19 pandemic.
Conclusion:
This study aims to identify risk factors for TRPI, including the impact of the COVID-19 pandemic, using two large, diverse databases, thereby addressing a critical literature gap. The findings from this study will serve to direct future research in this under-researched adverse outcome of tracheostomy care.
Implications for patient care:
The findings will inform the development of targeted interventions to mitigate the incidence and severity of TRPI, which will translate into improved patient outcomes and reduced healthcare expenditure.
Impact:
The study protocol addresses the prevalence and risk factors of TRPI and examines the effects of the COVID-19 pandemic. The protocol details harmonizing two data sets of patients with a tracheostomy to provide a diverse global sample. This work serves as a reference for upcoming results manuscript publications and future protocol development.
Reporting Method:
This research protocol was reported using relevant components of the SPIRIT guidelines.
Patient or Public Contribution:
Patients, families, and healthcare professionals comprise the learning community of the Global Tracheostomy Collaborative. Patients and family members participate on the Board and inform practices for data usage.
What does this paper contribute to the wider global clinical community?
• Identifying specific risk factors and potential interventions will aid healthcare professionals in developing evidence-based strategies to reduce TRPI incidence and improve patient outcomes worldwide.
• Exploring the COVID-19 pandemic’s impact on TRPI risk will provide crucial knowledge for future pandemic preparedness in tracheostomy care settings.
Trial and Protocol Registration:
This observational study protocol will use previously collected data in a patient database and electronic medical records and was not registered.
Submitted: January 16, 2024 CST
Accepted: February 05, 2024 CST
Feature Article: From Ramsay Hunt to Parotid Cancer: A Case Report
Author Information:
Meredith H. Cummings, PhD(c), BSN, RN, OCN1, Kai-Lin You, PhD(c), MSN, RN 1, Marci L. Nilsen, PhD, RN, CHPN, FAAN1,2
1 School of Nursing, University of Pittsburgh, 2 School of Medicine, University of Pittsburgh
Citation: Cummings, M. H., You, K.-L., & Nilsen, M. L. (2024). From Ramsay Hunt to Parotid Cancer: A case report. ORL - Head and Neck Nursing., 42(2), 29-32.
Keywords: Parotid cancer, Ramsay Hunt Auricularis, Case report, Head and neck cancer, Head and neck neoplasm, Salivary duct carcinoma, Ramsay Hunt Syndrome
Abstract:
Diagnosis of head and neck malignancies remains challenging given the complexity and heterogeneity of the organs and involved anatomical features. Additionally, the presenting symptoms of head and neck cancer may often be vague, mimicking symptoms of less serious illnesses. The following case highlights these challenges. The patient presented to his primary care physician with right facial paralysis involving difficulty closing his eye, as well as intermittent right ear pain. The patient was referred to neurology for a workup to diagnose Lyme Disease or Ramsay Hunt Auricularis. The patient was initially diagnosed with and treated for Ramsay Hunt Auricularis. Despite the treatment, the patient suffered two falls from a loss of consciousness. The cardiologist consulted in the emergency department noted no cardiac etiology. Ultimately, a Computerized Tomography scan and additional imaging revealed a parotid lesion, and the patient was diagnosed with salivary gland carcinoma. The tumor was encircling the internal carotid artery and was subsequently deemed inoperable. No distant metastases were noted. The patient was treated with concurrent chemoradiation using carboplatin and paclitaxel, and leuprolide for androgen receptor-positive cancer. The patient completed this treatment and continues leuprolide every three months. His most recent Positron Emission Tomography scan revealed no evidence of residual disease or recurrent/metastatic disease. The patient still experiences significant long-term treatment effects, such as lymphedema, trismus, and peripheral neuropathy, for which he undergoes rehabilitation services. This unique case is a prime example of the complicated diagnosis and treatment trajectories for patients with head and neck cancer. Frequent follow-up and long-term multidisciplinary care are essential to manage symptoms associated with treatment for all individuals with head and neck cancers.
Submitted: December 20, 2023 CST
Accepted: February 22, 2024 CST
Highlights from the Hill: Empowering Nursing Advocacy: Strategies for Change in Tennessee and Beyond
Author Information: Garrett Johnson, Government Affairs, Tennessee Nurses Association
Citation: Johnson, G. (2024). Empowering Nursing Advocacy: Strategies for Change in Tennessee and Beyond. ORL - Head and Neck Nursing., 42(2), 33.
Media Review: The Essential Guide to Coding in Otolaryngology: Coding, Billing, and Practice Management, Second Edition
Author Information: Maria Colandrea, DNP NP-C CORLN FAANP FFNMRCSI, Otolaryngology, Department of Veterans Affairs
Citation: Colandrea, M. (2024). The Essential Guide to Coding in Otolaryngology: Coding, Billing, and Practice Management, Second Edition. ORL - Head and Neck Nursing., 42(2), 34-35.
Keywords: nurse practitioners, advanced practice nursing, Medical coding, Insurance, Medical billing, Otorhinolaryngology, Medical informatics, Health care economics, Health policy, Current Procedural Terminology
Abstract: NA
Submitted: February 25, 2024 CDT
Accepted: March 12, 2024 CDT
Product Review: Mometsasone Nasal Irrigation
Author Information: Christine Reger, DNP, MSN, CRNP, Department of Otorhinolaryngology, University of Pennsylvania
Citation: Reger, C. (2024). Product Review: Mometsasone Nasal Irrigation. ORL - Head and Neck Nursing., 42(2), 36-37.
From the Editor: Envisioning Excellence: Unveiling the Inaugural Issue of 2024 in the ORL – Head and Neck Nursing Journal
Author Information: Vinciya Pandian, PhD, MBA, MSN, ACNP-BC, FCCM, FAANP, FAAN, FFNMRCSI, School of Nursing, Johns Hopkins University
Citation: Pandian, V. (2024). Envisioning Excellence: Unveiling the Inaugural Issue of 2024 in the ORL Head and Neck Nursing Journal. ORL - Head and Neck Nursing., 42(1), 6.
Keywords: Otorhinolaryngology Head and Neck Nursing, Advanced Practice, Belongingness, Laryngeal diseases
Abstract: NA
Submitted: NA
Accepted: NA
SOHN Presidential Perspectives: The Art of Nursing
Author Information: Maria Colandrea, DNP, NP-C, CORLN, FAANP, FFNMRCSI, Department of Otolaryngology Head and Neck Surgery, Durham Veterans Affairs Medical Center
Citation: Colandrea, M. (2024). The Art of Nursing. ORL - Head and Neck Nursing., 42(1), 7.
Keywords: Art of Nursing, Health equity, Health disparities, Patient advocacy, Compassion, Otorhinolaryngology and Heck-Neck Nurses
Abstract: NA
Submitted: December 18, 2023 CST
Accepted: December 29, 2023 CST
Feature Article: Post-extubation Assessment of Laryngeal Symptoms and Severity (PALSS) in the Intensive Care Unit: Protocol of a Prospective Cohort Study
Sai Phani Sree Cherukuri, MBBS3b, Mounica Koneru, MBBS4c, Vidyadhari Karne, MBBS5d, Farbod Zahedi Tajrishi, MD6e, Swetha Aloori, MBBS2f, Pooja Kota, MBBS7g, Victor Dinglas, MPH2h, Elizabeth Colantuoni, PhD, ScM8i, Lee Akst, MD9j, Alexander T Hillel, MD9k, Dale M Needham, MD, PhD, FCPA1,2,10l, Martin B Brodsky, PhD, ScM, CCC-SLP2,11,12m, PALSS study
team†
1 School of Nursing, Johns Hopkins University,
2 Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University,
3Department of Medicine, MedStar Union Memorial Hospital,
4Department of Pediatrics, Brooklyn Hospital Center,
5Department of Pathology and Laboratory Medicine, University of Southern California,
6Emory University,
7Neurocardiology research program of excellence, University of California, Los Angeles,
8Bloomberg School of Public Health, Johns Hopkins University,
9Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University,
10 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University,
11 Speech-Language Pathology, Head and Neck Institute, Cleveland Clinic,
12 Department of Physical Medicine and Rehabilitation, Johns Hopkins University
[a Associate Professor, Department of Nursing Faculty Assistant Dean, Immersive Learning and Digital Innovation, b Resident, c Resident, d Resident, e Postdoctoral Research Fellow, f
Postdoctoral Research Fellow, g Postdoctoral Research Fellow, h Assistant Director, Outcomes After Critical Illness and Surgery (OACIS) Research Group Research Associate, Pulmonary and Critical Care Medicine, i Senior Scientist, Johns Hopkins University Bloomberg School of Public Health Member, Outcomes After Critical Illness and Surgery (OACIS) Research Group, j Director of the Johns Hopkins Voice Center Associate Professor, Department of Otolaryngology-Head and Neck Surgery, k Professor, l Professor, Division of Pulmonary and Critical Care and Department of Physical and Rehabilitation; Medicine, School of Medicine; and Department of Nursing, School of Nursing; and Director, Outcomes After Critical Illness and Surgery (OACIS) Research Group, m Section Head, Speech-Language Pathology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, United States; Adjunct Associate Professor, Department of Physical and Rehabilitation; Adjunct Associate Professor Division of Pulmonary and Critical Care Medicine; and Member, Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University
†PALSS Study Team
1. Darin Roberts, MD Research program assistant, Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins School of Medicine, Baltimore, Maryland, United States; [email protected] 2. Gaiti Fatima, MBBS Research Associate, University of California, San Fran cisco, United States; [email protected] 3. Mahsa Hajizadeh, MD Postdoctoral research fellow, Johns Hopkins School of Medicine, Baltimore, Maryland, United States; mha [email protected] 4. Maryam Ebadifardazar, MD Postdoctoral research fellow, Johns Hopkins School of Medicine, Baltimore, Maryland, United States; [email protected] 5. Mohammadmoin Dehesh, MD Postdoctoral research fellow, University of Virginia, Char lottesville, Virginia, United States; [email protected] 6. Mounika Lakhamalla, MBBS Resident, Baton Rouge General Medical Center, Baton Rouge, Louisiana, 7. United States; mounikalaku [email protected] Naga Preethi Kadiri, MBBS Postdoctoral research fellow, Outcomes After Critical Ill ness and Surgery (OACIS) Research Group, Johns Hopkins School of Medicine, Baltimore, Maryland, United States; [email protected] 8. Omar Ahmed Abdou Almaadawy, MBBChResident, Medstar Health Union memorial, Baltimore, Maryland, United States; [email protected] 9. Siva Keerthana, MBBS Postdoctoral research fellow, Outcomes After Critical Ill ness and Surgery (OACIS) Research Group, Johns Hopkins School of Medicine, Baltimore, Maryland, United States; [email protected] 10. Sukaina Furniturewala, MBBS Resident, Mount Sinai/Elmhurst Hospital Center, New York, New York, United States; sukaina.furniture [email protected] 11. Vishwanath Thondamala, MBBS Postdoctoral research fellow, Outcomes After Critical Ill ness and Surgery (OACIS) Research Group, Johns Hopkins School of Medicine, Baltimore, Maryland, United States; ]
Citation: Pandian, V., Cherukuri, S. P. S., Koneru, M., Karne, V., Tajrishi, F. Z., Aloori, S., Kota, P., Dinglas, V., Colantuoni, E., Akst, L., Hillel, A. T., Needham, D. M., Brodsky, M. B., & PALSS study team†. (2024). Post-extubation Assessment of Laryngeal Symptoms and Severity (PALSS) in the Intensive Care Unit: Protocol of a prospective cohort study. ORL - Head and Neck Nursing., 42(1), 8-21.
The Post-extubation Assessment of Laryngeal Symptoms and Severity (PALSS) study systematically evaluates patient symptoms related to endotracheal intubation with mechanical ventilation, assesses laryngeal injury and voice function after extubation, and develops a screening tool to identify patients with clinically important, post-extubation laryngeal injury.
Design:
Single-center, prospective observational cohort study conducted in 6 intensive care units (ICU).
Methods:
Patients ≥18 years old who are orally intubated and mechanically ventilated in an ICU and meet eligibility criteria will undergo flexible laryngoscopy, with a sample size goal of 300 completed laryngoscopies. Primary outcome measures include signs and symptoms of laryngeal injury, including voice symptoms and alterations in swallowing, measured using the Laryngeal Hypersensitivity Questionnaire-Acute and Voice Symptom Scale questionnaires respectively. Data will be collected within 72 hours post-extubation and at 7-day follow-up or hospital discharge (whichever occurs first). Data will be analyzed using descriptive statistics, regression models, and predictive modeling using machine learning.
Discussion:
The findings of this study will describe the clinical signs and symptoms of laryngeal injury post-extubation.
Conclusion:
The PALSS study will provide insights for future studies that explore laryngeal injuries using flexible laryngoscopy after endotracheal intubation.
Implications for patient care:
Identifying signs and symptoms of laryngeal injury after endotracheal intubation will facilitate the development of a screening tool that will assist in early identification of post-extubation laryngeal injury, and aid in decreasing short- and long-term complications of endotracheal intubation.
Reporting Method:
SPIRIT
Patient or Public Contribution:
Patients were study participants; and family members provided informed consent when the patient lacked decision-making capacity.
What does this paper contribute to the wider global clinical community?
1. This study protocol aims to present important insights into the effects of endotracheal tubes on the larynx, voice and swallowing, which have significant implications for patient outcomes and clinical practice.
2. The development of a screening tool for laryngeal injury will be a critical contribution to the global clinical community with its aim of improving patient care and preventing short- and long-term complications by enabling bedside nurses, speech-language pathologists, laryngologists, and other clinicians to screen patients more accurately and efficiently for potential laryngeal injuries.
3. This paper provides a valuable methodological example for future studies exploring the assessment of laryngeal symptoms after endotracheal intubation and mechanical ventilation in the intensive care unit setting.
Submitted: NA
Accepted: NA
Feature Article: The Role of Advanced Practice Providers in Otorhinolaryngology Head and Neck Surgery: Results of a National Survey
1 Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University,
2 School of Nursing, Johns Hopkins University
Citation: DeSell, M. (Nina), & Pandian, V. (2024). The Role of Advanced Practice Providers in Otorhinolaryngology Head and Neck Surgery: Results of a National Survey. ORL - Head and Neck Nursing., 42(1), 22-29.
Keywords: Advanced Practice Providers, Otolaryngology Head and Neck Surgery, Nurse Practitioners, Physician Assistants, Job Satisfaction, Professional Role, Certification, Otorhinolaryngology Head and Neck Nursing
Abstract:
Background and objective:
Advanced Practice Providers (APPs), including nurse practitioners, clinical nurse specialists, and physician assistants, have become integral to Otolaryngology Head-Neck Surgery (OHNS) practices. There is currently no specific certification available for APPs caring for OHNS patients, highlighting the need to understand their roles and practices to facilitate appropriate certifications, training, and career advancement opportunities. This study aims to investigate the multifaceted roles, practices, scholarly pursuits, and job satisfaction of APPs providing care to OHNS patients to provide valuable insights for supporting and optimizing collaborations with these providers.
Methods:
A cross-sectional web survey was conducted among members of the Society of Otorhinolaryngology Head and Neck Nurses and the Society of Physician Assistants in Otorhinolaryngology. The survey collected data on demographics, practice settings, specialties, provider roles, job satisfaction, and scholarly activities. Descriptive analysis was performed on the collected data.
Results:
A total of 120 APPs participated in the survey, with the majority working full time in private practices. APPs provided care for adult and pediatric patients in outpatient settings, often collaborating with physicians. APPs reported involvement in various responsibilities, including direct patient care, clinical documentation, and diagnostic tests. Job satisfaction was generally high, despite challenges related to time management, collaboration, billing, and career advancement. APPs actively engaged in scholarly activities to stay up-to-date in their field, although some reported limited financial support for professional development.
Conclusion:
The study provides valuable insights into the diverse roles, practices, and job satisfaction of APPs providing care for OHNS patients. These findings can inform the development of appropriate certifications, training programs, and guidelines for supporting the professional growth of APPs. Understanding the contributions and challenges faced by APPs is crucial for optimizing their integration into OHNS teams and ensuring high-quality patient care in a changing healthcare landscape.
Submitted: NA
Accepted: December 10, 2023
Feature Article: The Power of Belonging: Amplifying Diversity, Equity, and Inclusion in Otorhinolaryngology and Head-Neck Nursing
3 Otolaryngology Head and Neck Surgery, Durham VA Medical Center
Citation: Pandian, V., Mackey, W. L., & Colandrea, M. (2024). The Power of Belonging: Amplifying Diversity, Equity, and Inclusion in Otorhinolaryngology and Head-Neck Nursing. ORL - Head and Neck Nursing., 42(1), 30-38.
Belongingness in otorhinolaryngology and head-neck nursing creates an environment that fosters professional development, job satisfaction, and optimal patient care. The COVID-19 pandemic has added new dimensions to belongingness challenges, impacting healthcare professionals’ sense of connection and support. Despite post-pandemic emphasis on DEI initiatives, the centrality of belongingness remains inadequately addressed, especially within the realm of otorhinolaryngology and head-neck nursing.
Methods:
This literature review comprehensively investigates belongingness within otorhinolaryngology and head-neck nursing, focusing on DEI. Aims include examining the current state, exploring components, evaluating impacts, differentiating frameworks, and investigating strategies. The search strategy involved electronic databases, classic articles, and grey literature from 1990 to 2023.
Findings:
Belongingness, rooted in Maslow’s Hierarchy of Needs, emerges as a fundamental human need influencing nurses’ motivation, personality, and well-being. Organizational culture, leadership, teamwork, and workplace policies significantly impact belongingness. The review identifies frameworks and tools guiding belongingness and emphasizes the importance of diversity and inclusion initiatives.
Discussion:
The profound link between belongingness and job satisfaction in otorhinolaryngology and head-neck nursing suggests that efforts to enhance belongingness are strategic imperatives. Positive organizational culture, transparent communication, and teamwork are vital in fostering an environment where nurses feel connected, valued, and integral to the team.
Conclusion:
This review underscores the specific relevance of belongingness in otorhinolaryngology and head-neck nursing, emphasizing its transformative potential. Strategies prioritizing belongingness, including psychological safety, mentorship, and diversity celebration, are crucial for encouraging an equitable and inclusive future. Recognizing the power of belongingness alongside DEI initiatives strengthens the profession and leads to positive outcomes for both nurses and patients. Future studies should explore innovative strategies to revolutionize belongingness in this specialized nursing field.
Submitted: November 27, 2023 CST
Accepted: December 13, 2023 CST
Highlights from the Hill: Medicaid Unwinding: Impacts, Challenges, and Advocacy Efforts in the Wake of Policy Changes
Author Information: Bryan Facione, MS, ACNP-BC, CORLN, Otorhinolaryngology, Head and Neck, VA Ann Arbor Healthcare System
Citation: Facione, B. (2024). Medicaid Unwinding: Impacts, Challenges, and Advocacy Efforts in the Wake of Policy Changes. ORL - Head and Neck Nursing., 42(1), 39-40.
Keywords: "Medicaid Unwinding", Medicaid, Health Policy, Affordable Care Act, Healthcare Advocacy
Abstract:
The Medicaid and Children’s Health Initiative Program (CHIP) provides health and long-term care coverage to 90 million low-income children, adults, seniors, disabled individuals, and pregnant women in the United States. The Families First Coronavirus Response Act, passed in early 2020, allocated increased federal funding to state Medicaid programs in exchange for continuous enrollment of beneficiaries, preventing gaps in health care coverage during the COVID-19 public health emergency. The unwinding of this continuous enrollment provision began in March 2023, marking the end of the public health emergency. It is estimated that 9.5 million adults and children have been disenrolled from Medicaid and CHIP, primarily due to procedural errors and failures to re-enroll or transition to state or federal marketplace health plans through the Affordable Care Act on HealthCare.gov. Nurses have the opportunity to assist Medicaid beneficiaries by sharing information, resources, and contacts to facilitate the maintenance of Medicaid benefits or transition to marketplace health plans.
Submitted: December 21, 2023 CST
Accepted: December 21, 2023 CST
Media Review: The Evolving Landscape of Social Media in Otorhinolaryngology-Head and Neck Surgery (OHNS): Media Review
1 College of Nursing, Christian Medical College and Hospital, India
Citation: Walter, N. N. S., & Kumar, D. (2024). The Evolving Landscape of Social Media in Otorhinolaryngology-Head and Neck Surgery (OHNS): Media Review. ORL - Head and Neck Nursing., 42(1), 41.
Keywords: patient education, social media, nursing, head and neck, otorhinolaryngology
Abstract: NA
Submitted: NA
Accepted: NA
Product Review: AV Trach Simulator by AVKIN®
Author Information:
Joan Such Lockhart, PhD, RN, CNE, ANEF, FAAN1a
1 School of Nursing, Duquesne University
a Professor Emerita, Duquesne University School of Nursing, Pittsburgh, PA
Citation: Lockhart, J. S. (2024). AV Trach Simulator by AVKIN®. ORL - Head and Neck Nursing., 42(1), 42.
Author Information: Erin Sarsfield, MSN, RN, Cancer Institute, Penn State Milton S. Hershey Medical Center
Citation: Sarsfield, E. (2023). presents and presence in nursing. ORL - Head and Neck Nursing., 41(4) 5.
Keywords: NA
Abstract:
Nurses must be present with patients as well as having presence in order to build the nurse-patient relationship.
Submitted: NA
Accepted: NA
SOHN Presidential Perspectives: Valiant, Versatile, and Visionary: Reflecting on the Legacy of the Society of Otorhinolaryngology-Head and Neck Nurses and Shaping the Future
Author Information: Vinciya Pandian, PhD, MBA, MSN, ACNP-BC, FCCM, FAANP, FAAN, FFNMRCSI, School of Nursing, Johns Hopkins University
Citation: Pandian, V. (2023). Valiant, Versatile, and Visionary: Reflecting on the Legacy of the Society of Otorhinolaryngology-Head and Neck Nurses and Shaping the Future. ORL - Head and Neck Nursing, 41(4) 6-7.
Abstract:
This manuscript commemorates the rich history and legacy of the Society of Otorhinolaryngology-Head and Neck Nurses (SOHN) as the outgoing president reflects on the organization’s journey and its continued commitment to excellence in ORL and Head-Neck patient care. The manuscript explores the core values of valiance, versatility, and vision and pays tribute to esteemed individuals who have made significant contributions to the field. The president also acknowledges the support and dedication of various individuals and entities that have played a pivotal role in SOHN’s success. The manuscript concludes by looking to the future and emphasizing the need for continued innovation and leadership in healthcare.
Submitted: NA
Accepted: NA
Feature Article: A Quality Improvement Project on Patient Outcomes and Parental Satisfaction After Office Frenotomy
1Division of Otolaryngology (Ear, Nose and Throat), Children's Hospital of Philadelphia
[a Pediatric Nurse Practitioner, b Physician Assistant, c Nurse Practitioner, d
Nurse Practitioner, e Clinical Outcomes Research Administrator]
Citation: Jaquith, B., Field, E., Kim, B., Williams, A. B., & Giordano, T. (2023). A Quality Improvement Project on Patient Outcomes and Parental Satisfaction After Office Frenotomy., 41(4) 8-13.
Keywords: NA
Abstract:
Background:
Ankyloglossia, commonly known as tongue-tie, is often implicated in breastfeeding difficulties and maternal reports of pain during breastfeeding. Frenotomy, a routine in-office procedure, is performed to enhance breastfeeding in infants, with indications including dysphagia and weight loss among infants and maternal breastfeeding pain.
Methods:
This quality improvement project aimed to comprehensively evaluate the outcomes of in-office frenotomy procedures for newborns and infants. Primary objectives included assessing whether the procedure decreases maternal pain, improves infant latch, shortens feeding time, promotes weight gain, and supports the breastfeeding dyad.
Results:
A total of 73% of participants reported resolution of the frenotomy’s indication. The most prevalent issue, difficulty latching, was resolved in 70% of mother-baby dyads. Prolonged feeding time and maternal pain during breastfeeding were both resolved in 68% of cases. Reports of maternal pain decreased, with 57% of participants being first-time breastfeeding mothers.
Nursing Implications:
This quality improvement project was initiated and implemented by a team of ORL advanced practice providers in the Otolaryngology Outpatient office. The initiative was ORL nurse-driven and received support from clinic’s leadership. The project’s nursing-focused goals aimed to ascertain whether frenotomies could decrease maternal pain, decrease feeding time, increase weight gain, and ultimately support successful breastfeeding dyads.
Conclusion:
Frenotomy is a safely performed outpatient office procedure that can positively impact breastfeeding outcomes. It should be considered for newborns and infants with ankyloglossia experiencing nursing difficulties.
Submitted: NA
Accepted: NA
Feature Article: Unlocking Silent Suffering: Addressing the Otorhinolaryngologic Needs of Incarcerated Persons Through Carceral Health Education
1 School of Medicine, University of Michigan–Ann Arbor,
2 School of Nursing, Johns Hopkins University,
3 Department of Otolaryngology Head and Neck Surgery, University of Michigan–Ann Arbor
[a Medical Student, b Medical Student, c Medical Student, d Associate Professor, Department of Nursing Faculty; Assistant Dean, Immersive Learning and Digital Innovation, e Associate Professor, Department of Otolaryngology Head and Neck Surgery; President, Global Tracheostomy Collaborative ]
Citation: Kang, Y., Barnard, P., VanAken, G., Pandian, V., & Brenner, M. (2023). Unlocking Silent Suffering: Addressing the Otorhinolaryngologic Needs of Incarcerated Persons through Carceral Health Education. ORL - Head and Neck Nursing., 41(4) 14-22.
Keywords: incarceration, prison, carceral health, nursing, medical education, otolaryngology, otorhinolaryngology, cancer, health inequity, social determinants of health
Abstract:
Mass incarceration in the United States presents major healthcare challenges, and otorhinolaryngology-related needs within carceral settings are underrecognized. Public health crises, as exemplified by the COVID-19 pandemic which led to over 3,000 deaths among incarcerated individuals, can intensify disparities. Both acute otorhinolaryngology conditions, such as craniomaxillofacial trauma, impending airway compromise, and life-threatening infection, as well as more chronic conditions such as cancer, sinusitis, or ear infections can lead to impaired quality of life, disability, or preventable mortality. Incarcerated individuals experience substantial healthcare disparities, which are driven by intrinsic individual and carceral facility factors such as resource scarcity, structural barriers, limited self-advocacy, and social determinants of health, as well as extrinsic factors related to societal misconceptions, inadequate education of healthcare providers on carceral healthcare, and underdeveloped care systems. To address these issues, a comprehensive approach is needed, incorporating experiential learning, bias reduction, and trust building. Early clinical exposure, enhanced public health education, and community outreach efforts are conducive to cultivating structural competence and relevant skills. Carceral health initiatives can thus raise awareness and enhance the healthcare of incarcerated individuals. Healthcare professionals can expand their roles to advocate for equitable care, prioritize rehabilitation over punishment, and support individuals upon reentry into society. Healthcare professionals in otorhinolaryngology, play a pivotal role in addressing the needs of incarcerated individuals, with nurses, physicians, and allied health stakeholders working together. Education, advocacy, and compassionate care provide the basis for a more equitable and humane carceral healthcare system that upholds the dignity and well-being of all individuals.
Submitted: NA
Accepted: NA
Highlights from the Hill: Navigating the Evolving Landscape of Telehealth: Federal Updates, Resources, and Practical Tips
Author Information:
Bryan Facione, MSN, ACNP-BC, CORLN1, Oliver B R Pandian, MS, MBA, CISSP, CISM, CISA2, Vinciya Pandian, PhD, MBA, MSN, ACNP-BC, FCCM, FAANP, FAAN, FFNMRCSI3
1 Department of Otolaryngology, VA Ann Arbor Healthcare System,
2 Office of Information Technology, Baltimore County Government,
3 School of Nursing, Johns Hopkins University
Citation: Facione, B., Pandian, O. B. R., & Pandian, V (2023). Navigating the Evolving Landscape of Telehealth: federal updates, resources, and practical tips. ORL - Head and Neck Nursing., 41(4) 23-25.
Keywords: NA
Abstract: NA
Submitted: NA
Accepted: NA
Media Review: Review of Impact of ENT Resource Nurses in Improving Operating Room Efficiency
Author Information: Michele Farrington, BSN, RN, PMGT-BC, Department of Nursing Services and Patient Care, University of Iowa Health Care
Citation: Farrington, M. (2023). Review of impact of ENT resource nurses in improving operating room efficiency. ORL - Head and Neck Nursing., 41(4), 26-27.
Keywords: NA
Abstract: NA
Submitted: NA
Accepted: NA
2023 Volume 41 | Issue 3; E-ISSN: 1064-3842
From the Editor: Editorial: “Work to Live,” Not “Live to Work”
Author Information:
Laurie Newton, DNP, RN, CPNP-AC, PC1,2
1 Department of Otolaryngology, Medical College of Wisconsin,
2 Children's Wisconsin
Citation: Newton, L. (2023). editorial: “work to live,” not “live to work.” ORL - Head and Neck Nursing., 41(3) 5.
Keywords: editorial, burnout, resiliency, nursing
Abstract: NA
Submitted: NA
Accepted: NA
SOHN Presidential Perspectives: Breaking the Silence: Championing Hearing Advocacy and Equity
Author Information: Vinciya Pandian, PhD, MBA, MSN, ACNP-BC, FCCM, FAAN, FAANP, FFNMRCSI, School of Nursing, Johns Hopkins University
Citation: Pandian, V. (2023). Breaking the Silence: Championing Hearing Advocacy and Equity. ORL - Head and Neck Nursing., 41(3) 6.
Keywords: hearing, advocacy, health equity, disparities
Abstract: NA
Submitted: NA
Accepted: NA
Feature Article: Tympanostomy Tube Otorrhea: A Call for Action for Antibiotic Stewardship
Author Information: Wendy Lord Mackey, DNP, MSN, APRN, CORLN, Yale University; New Haven, CT; Connecticut Pediatric Otolaryngology, Madison, CT
Citation: Mackey, W. L. (2023). Tympanostomy Tube Otorrhea: A Call for Action for Antibiotic Stewardship. ORL - Head and Neck Nursing., 41(3) 7-19.
Tympanostomy tube (TT) insertion is the most common ambulatory surgical procedure performed in children in North America. Tympanostomy tube otorrhea (TTO) is the most common sequela following their placement. Twenty years of sound evidence exists documenting the superiority of ototopical antibiotics therapy (TAD) over oral antibiotics and other management options to treat TTO, and a national guideline strongly recommends their use; yet many providers will prescribe oral antibiotics versus the recommended topical option. This contributes to antibiotic resistance. The World Health Organization (2021) has declared antibiotic resistance a global health crisis.
Aims and Objectives:
To explore the evidence regarding the efficacy of tympanostomy tube otorrhea treatment options in children with tympanostomy tubes, and research the current state of tympanostomy tube use in children.
Design:
Integrative review.
Methods:
Three electronic databases (OVID Medline, Scopus, and Cochrane Reviews) were searched. The search was guided by PRISMA and data collection on variables including TTO treatment options and outcomes in children with TT, adverse events of TTO treatment and general data and demographics regarding tympanostomy tube placement in children. Articles were reviewed individually for study characteristics and appraised for quality and relevance to the objectives.
Results:
Thirty-eight studies were relevant and included in the review of the literature. TTO is a common occurrence in children who have placement of TT. All studies evaluating TTO treatment options in children found topical antibiotic otic drops (TAD) to be superior to all other treatment options including oral antibiotics, saline irrigations, topical steroid drops and a weight and watch approach. Oral antibiotics in addition to topical treatment had no significant advantage. However, TAD that included a steroid component were superior to TAD without steroid. Antibiotic resistance was not identified with TAD treatment. Studies also note caregivers were able to appropriately identify TTO, had low decisional regret following TT placement and note improved quality of life for their child and themselves.
Conclusions:
This article provides an integrative review of the literature regarding the current state of TT in children, with a focus on TTO management highlighting the superiority of TAD over other treatment options with a sound safety profile. Clinicians have a responsibility to evaluate their practice and implement strategies to improve clinical outcomes and reduce antimicrobial misuse. This is a call to action for ORL nurses and all clinicians caring for children with TTs, to consider the evidence when to provide care.
Submitted: NA
Accepted: NA
Feature Article: Otomycosis Discovery During a Pediatric Well-Visit in Primary Care: A Case Study
3 Assistant Professor- Department of Otolaryngology, Medical College of Wisconsin,
4 Children's Wisconsin,
5 Clinical Faculty- School of Nursing, University of Wisconsin–Madison
Citation: Hultgren, A., & Newton, L. (2023). Otomycosis Discovery During a Pediatric Well-Visit in Primary Care: A Case Study. ORL - Head and Neck Nursing, 41(3) 20-23.
Keywords: otomycosis, case study, otitis externa, treatment
Abstract:
A nine-year-old female was seen in the primary care clinic for a well-child physical examination and was found to have left otomycosis. A culture of the left ear canal was obtained due to an appearance that was suspicious for fungal otitis externa. While awaiting culture results, the infection was initially treated as acute bacterial otitis externa due to provider uncertainty and the low incidence of otomycosis seen in the author’s clinic. The patient was then referred to pediatric otolaryngology for further treatment after an E-consultation, and when the culture grew Candida albicans and Aspergillus species. The patient was treated for otomycosis in an otolaryngology clinic with two rounds of canal debridement and instillation of Clotrimazole-Betamethasone (Lotrisone) 1-0.05% cream into the canal. Treatment was effective, and she was discharged from the Otolaryngology care. Many primary care providers may not often encounter fungal acute otitis externa; thus, they could benefit from a review of diagnostic clues and management. This case study will also review current treatment guidelines and further implications for practice for the Otorhinolaryngology nurse and advanced practice provider.
Submitted: NA
Accepted: NA
Highlights from the Hill: A Reflection on the Path to the Future of Nursing
Author Information: Suzanne Beshore, MS, BSN, RN, CORLN, Cameron Park, CA, Retired
Citation: Beshore, S. (2023 A Reflection on the Path to the Future of Nursing. ORL - Head and Neck Nursing., 41(3) 24-26.
Keywords: reflection, future of nursing
Abstract: NA
Submitted: NA
Accepted: NA
Media Review: Management of Dysphagia in Head and Neck Cancer Patients – Review of a New Expert Consensus Statement
Author Information: Michele Farrington, BSN, RN, PMGT-BC, Department of Nursing Services and Patient Care, University of Iowa Health Care
Citation: Farrington, M. (2023). Management of dysphagia in head and neck cancer patients – Review of a new expert consensus statement. ORL - Head and Neck Nursing., 41(3) 27-28.
Keywords: media review, dysphagia, head and neck, cancer
Abstract: NA
Submitted: NA
Accepted: NA
Poetry Corner: Whispers Amidst the Alarms: Navigating the Symphony of Hearing Challenges in Nursing
Author Information: Vinciya Pandian, PhD, MBA, MSN, ACNP-BC, FCCM, FAAN, FAANP, FFNMRCSI, School of Nursing, Johns Hopkins University
Citation: Pandian, V. (2023). Whispers Amidst the Alarms: Navigating the Symphony of Hearing Challenges in Nursing. ORL - Head and Neck Nursing., 41(3) 29-30.
Keywords: poem, hearing, nursing, communication
Abstract: NA
Submitted: NA
Accepted: NA
2023 Volume 41 | Issue 2; E-ISSN: 1064-3842
From the Editor: Guest Editor’s Commentary
Author Information:
Maria Colandrea, DNP, NP-C, CORLN, FFNMRCSI, FAANP
Department of Otolaryngology, Department of Veterans Affairs-Durham HCS
Citation: Colandrea, M. (2023). Guest Editor’s Commentary. ORL - Head and Neck Nursing., 41(2), 5.
Keywords: NA
Abstract: NA
Submitted: NA
Accepted: NA
SOHN Presidential Perspectives: Uniting for Progress: Addressing Key Challenges in Nursing Research
Author Information: Vinciya Pandian, School of Nursing, Johns Hopkins University
Citation: Pandian, V. (2023). Uniting for Progress: Addressing Key Challenges in Nursing Research. ORL -Head and Neck Nursing., 41(2), 6. Keywords: Nursing Research, Evidence-based practice, Otorhinolaryngology, Diversity, Inclusivity, Health Policy
Abstract: NA
Submitted: June 03, 2023 CDT
Accepted: June 10, 2023 CDT
Feature Article: Developing the Body Image After Head and Neck Cancer Treatment (BIHNC) Program: A Qualitative Approach to Addressing Body Image Concerns
1School of Nursing, Vanderbilt University, 2 Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, 3 Departments of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, 4 Head and Neck Research Program, Vanderbilt University Medical Center
Citation: Rhoten, B., Stolldorf, D., Young, B., David, K., Graboyes, E., Langerman, A., & Murphy, B. (2023). Developing the Body Image After Head and Neck Cancer Treatment (BI-HNC) Program: A Qualitative Approach to Addressing Body Image Concerns. ORL - Head and Neck Nursing., 41(2), 7-18.
Keywords: head and neck cancer, body image disturbance, cancer survivor, body image, The Body Image after Head and Neck Cancer Treatment (BI-HNC) Program
Abstract:
Background :
The purpose of this paper is to describe our approach for developing The Body Image after Head and Neck Cancer Treatment (BI-HNC) Program, a novel, six-week psychoeducational, asynchronous web-based program designed to reduce body image concerns and increase body image coping skills.
Methods:
A qualitative design was used. Nineteen head and neck cancer survivors completed semi-structured interviews, while five healthcare professionals either completed a semi-structured interview or participated in a focus group. Data were analyzed using thematic template analysis which provided the framework for topics covered in the BI-HNC program.
Results:
Similar to the population of HNC survivors, roughly two-thirds of participants were male, while females comprised one-third of the sample. Participants were mostly white and non-Hispanic. The oral cavity was the most frequently reported primary tumor site. Almost half were still employed full-time, and eight reported Stage III/IV disease at the time of HNC diagnosis. The majority received radiation and chemotherapy treatment for their disease. Patient themes included: (1) life is different since treatment and will never be the same again; (2) what works and what doesn’t; and (3) what I wish I had known. Healthcare professionals included a licensed practical nurse, two advanced practice registered nurses, a medical oncologist, and a head and neck surgeon. Healthcare professional discussions centered around the lack of time, resources, and confidence to address body image concerns.
Conclusions:
The BI-HNC Program represents a promising step towards addressing body image concerns in HNC survivors and can provide a valuable resource to improve psychosocial well-being and quality of life. Subsequent feasibility and efficacy testing is needed. If efficacious, the BI-HNC may offer an accessible, low-cost, mechanism for addressing body image concerns.
Submitted: NA
Accepted: NA
Feature Article: Exercise Self-Efficacy in Head and Neck Cancer Survivors: A Concept Analysis and Integrative Review
2 School of Nursing, University of Alabama at Birmingham
Citation: Yan, K., Beckie, T., & Wang, H.-L (2023). Exercise Self-Efficacy in Head and Neck Cancer Survivors: A Concept Analysis and Integrative Review. ORL - Head and Neck Nursing., 41(2), 19-32
Keywords: Concept analysis, Literature review, Exercise self-efficacy, Cancer, Head and neck cancer, Survivorship
Abstract:
Aim:
Patients with head and neck cancer, ranging from early (I-II) to advanced stages (III to IV), typically report low levels of engagement in exercise. The aim of this study was to analyze exercise self-efficacy, a crucial concept to promote exercise behavior, within the oncology literature. In particular, we analyzed the concept of exercise self-efficacy as it pertains to patients with head and neck cancer.
Design:
The Walker and Avant method for concept analysis guided our study.
Methods:
A broad search for published studies on exercise self-efficacy in patients with all types and stages of cancer was conducted using PubMed, CINAHL, and Cochrane Database of Systematic Reviews from 2005 to 2022, employing keywords such as “cancer AND exercise AND self-efficacy” and “cancer AND physical activity AND self-efficacy.”
Results:
The concept analysis included 58 references that used the concept of exercise self-efficacy in cancer population. Among these studies, 30 focused on measuring exercise self-efficacy in patients with various cancer types (including head and neck, breast, prostate, colorectal, lymphoma, myeloma, leukemia, melanoma, skin, sarcoma, brain, lung, kidney, testicular, gynecologic, and gastrointestinal cancers) and stages (I to IV). Specifically, 4 studies centered on head and neck cancer survivors. Exercise self-efficacy was defined as an individual’s confidence in initiating and maintaining a specified exercise or physical activity. Our analysis showed that the attributes of exercise self-efficacy include efficacy judgment, targeted efficacy performance, and efficacy domain. The core attribute, the efficacy domain, includes 4 types: (1) exercise task self-efficacy, (2) exercise barrier self-efficacy, (3) exercise maintenance self-efficacy, and (4) disease-specific exercise self-efficacy. Antecedents include (1) exercise experience, (2) peer inspiration, (3) exercise cognition, (4) attitudes towards exercise, (5) professional and social support, and (6) symptoms and associated interpretation. Consequences of exercise self-efficacy encompass exercise adherence and maintenance.
Conclusions:
Although the number of relevant studies regarding exercise self-efficacy in patients with head and neck cancer was limited, our review showed that exercise self-efficacy increases exercise engagement, and can be enhanced by targeting the identified antecedents to promote exercise adherence.
Impact:
An effective exercise behavioral intervention relies on a high-quality screening measure of exercise self-efficacy and strategies that incorporate the identified attributes of exercise self-efficacy. This concept could potentially serve as a screening tool or reference for prescribing personalized exercise interventions.
Submitted: NA
Accepted: NA
Feature Article: Improving Head and Neck Cancer Care Through the Role of Laryngology Nurse Navigators: A Novel Approach for Low-Resource Settings
Citation: Nancy, N., & Pandian, V. (2023). Improving Head and Neck Cancer Care Through the Role of Laryngology Nurse Navigators: A Novel Approach for Low-Resource Settings. ORL - Head and Neck Nursing., 41(2), 33-40.
Keywords: nurse navigators, head and neck cancer
Abstract:
Head and neck cancer is a significant global health issue, particularly in regions with risk factors such as tobacco and alcohol use and HPV infection. Nurses play a crucial role in managing the physical, psychological, and functional challenges faced by these patients, however, providing adequate care can be challenging in resource-limited settings. Nurse navigators can help manage patients and their caregivers throughout the entire disease management process, offering education and guidance, providing psychological and spiritual support, and coordinating clinical care to improve outcomes. Incorporating the laryngeal nurse navigator role can improve standards of care and patient outcomes in developing nations, and nurses in resource-rich settings can help support initiatives to improve access to healthcare resources and training.
Submitted: NA
Accepted: NA
Highlights from the Hill: Nursing Advocacy and Legislative Impact: A Review of State-Level Initiatives
Author Information:
Suzanne M. Beshore MS, BSN, RN, CORLN, Cameron Park, CA, Retired, Michele Farrington, BSN, RN, PMGT-BC1, Anne Lambert De Leo, MSN, RN, CRNP, CORLN2, Bryan Facione, MS, ACNP-BC, CORLN3
1 University of Iowa Health Care,
2 Children's Hospital of Philadelphia,
3 Department of Veterans Affairs
Citation: Beshore, S. M., Farrington, M., De Leo, A. L., & Facione, B (2023). Nursing advocacy and legislative impact: A review of state-level initiatives. ORL - Head and Neck Nursing., 41(2), 41-44.
Keywords: highlights from the hill, nursing advocacy, healthcare laws, health policy
Abstract:
Nurse advocacy plays a crucial role in healthcare legislation, as nurses are often the ones who interact most closely with patients and witness firsthand the impact of healthcare policies on patient outcomes. Understanding the role of nurses as advocates is essential to improving healthcare legislation. The need for nurses in healthcare legislation cannot be overstated. Nurses bring a unique perspective to the policymaking process, as they have firsthand knowledge of the challenges and opportunities facing patients and healthcare providers. Nurses can play a critical role in shaping healthcare legislation by advocating for policies that prioritize patient safety, access to care, and quality outcomes.
Submitted: NA
Accepted: NA
Media Review: 2023 Expert Consensus Statement Review – Management of Pediatric Persistent Obstructive Sleep Apnea After Adenotonsillectomy
Author Information: Michele Farrington, BSN, RN, PMGT-BC,Department of Nursing Services and Patient Care, University of Iowa Health Care.
Citation: Farrington, M. (2023). 2023 Expert Consensus Statement review - Management of Pediatric Persistent Obstructive Sleep Apnea After Adenotonsillectomy. ORL - Head and Neck Nursing., 41(2), 45-46.
Keywords: NA
Abstract: NA
Submitted: NA
Accepted: NA
Poetry Corner: The Future of Nursing: A Technological Revolution
Author Information: Vinciya Pandian, School of Nursing, Johns Hopkins University
Citation: Pandian, V. (2023). The Future of Nursing: A Technological Revolution. ORL - Head and Neck Nursing., 41(2), 48.
Keywords: NA
Abstract: NA
Submitted: NA
Accepted: NA
2023 Volume 41 | Issue 1; E-ISSN: 1064-3842
From the Editor: The Craft of Nursing
Author Information: Wendy Mackey, Yale University
Citation: Mackey, W. (2023). The craft of nursing. (2023). ORL - Head and Neck Nursing., 41(1) 4
Keywords: editorial, nursing
Abstract: NA
Submitted: May 21, 2023 CDT
Accepted: May 21, 2023 CDT
SOHN Presidential Perspective: One Word at a Time!
Author Information: Vinciya Pandian, Department of Nursing Faculty, Johns Hopkins University
Citation: Pandian, V. (2023). One word at a time! (2023). ORL - Head and Neck Nursing., 41(1) 5
Keywords: President's Message
Abstract: NA
Submitted: January 15, 2023 CDT
Accepted: June 01, 2023 CDT
Feature Article: A Novel Approach to Pain Management After Pediatric Tonsillectomy
Author Information: Terri Giordano, Otolaryngology , Children's Hospital of Philadelphia
Citation: Giordano, T. (2023). A novel approach to pain management after pediatric tonsillectomy. ORL – Head and Neck Nursing., 41(1) 6.
According to data from the National Survey on Drug Use and Health, over 6 million individuals greater than 12 years of age misuse prescription pain relievers each year, representing >4% of the US population. Nearly 10% of opioid naïve patients prescribed opioids after low pain short stay surgery were shown to continue use of opioids one year after surgery. Research on postoperative pain management at home for children is affected by multiple factors, including parental attitudes, misconceptions about pain medication, side effects, knowledge deficits, cultural background, parental anxiety, socioeconomic status, ability to assess pain and health literacy. Postoperative nursing interventions performed by otolaryngology nurses should include education for patients and caregivers on how to assess pain and achieve adequate pain management utilizing pharmacologic and nonpharmacologic modalities. The aim of this double-blind randomized control trial was to determine if Celecoxib is effective for pain after tonsillectomy without increasing bleeding or other complications.
Submitted: January 06, 2023 CDT
Accepted: June 01, 2023 CDT
Feature Article: Prevention of Noise Induced Hearing Loss in Youth
Author Information: Tiffany M. Ellis, Otolaryngology, Durham VA Medical Center
Citation: Ellis, T. M. (2023). Prevention of noise induced hearing loss in youth. (2023). ORL - Head and Neck Nursing., 41(1) 12.
Keywords: Noise Induced Hearing Loss, Youth prevention, Sound Exposure, Healthy People Guidelines, Public health
Abstract:
The World Health Organization (WHO) estimates that 1.5 billion young people worldwide could be at risk of noise-induced hearing loss due to unsafe listening activities. Healthy People 2030 recognizes increasing the use of hearing protection when exposed to loud sounds as a goal for 2030. About half of teenagers and young adults in middle and high-income countries are exposed to unsafe levels of sound from personal audio devices and entertainment venues such as bars, concerts, theaters and sporting events. Nurses can help mitigate risks to youth hearing by understanding the process of hearing, being aware of cultural aspects related to loud sound as entertainment and improving educational and policy initiatives at both local and national levels.
Submitted: February 02, 2023 CDT
Accepted: May 21, 2023 CDT
Highlights from the Hill: Have You Heard?
Author Information: Suzanne Beshore, MS, BSN, RN, CORLN, Cameron Park, CA, Retired
Citation: Beshore, S. M. (2023). Have you Heard? (2023). ORL - Head and Neck Nursing., 41(1) 16.
Keywords: hearing aid, Food and Drug Administration, Over the counter, Patient Advocacy, Hearing loss, amplification
Abstract:
More than 30 million Americans report hearing loss that could benefit from hearing aids, yet only about 1 out of 5 have ever used them. Among the reasons for not using hearing aids are lack of access to screening and their high cost. The “Over-the-Counter Hearing Aid Act” was passed in 2017 with the goal of making hearing aids more accessible and affordable for adults with mild to moderate hearing loss. The FDA’s “final rule” was the final step in creating a new regulatory category for these Over-the-Counter (OTC) hearing aids, which took effect in October of 2022. The sale of OTC hearing aids represents a disruption in the healthcare status quo, with pros and cons for consumers. By familiarizing with this new system of care, nurses will be better prepared to educate and support patients attempting to navigate in this new marketplace.
Submitted: January 16, 2023 CDT
Accepted: May 19, 2023 CDT
Commentary: Kid’s Around, Lock Guns Down – Firearm Related Deaths in American Youth
Author Information: Wendy Lord Mackey, Yale University School of Nursing, Connecticut Pediatric Otolaryngology
Citation: Mackey, W. (2023). Kids Around- Lock Guns Down- Firearm Related Deaths in American Youth. ORL - Head and Neck Nursing., 41(1) 20.
Guns are killing American children in staggering numbers, from all intentions including.accidental discharge, homicide, suicide and mass shootings. Death from firearms is currently the leading cause of death for children and youth in the United States, and the incidence continues to increase yearly. This article examines current trends and statistics related to firearm mortality and injury in children, accessability, firearm prevalance in homes with children and parental misconceptions of their children’s knowledge and exposure to guns. The article further explores the direct correlation between the strength of state regulated firearm legislation and death and injury from firearms. As respected health care professionals, our voice matters in educating our patients, the public and advocating and supporting stronger gun legislation to improve the quality and life expectancy of our patients and communities.
Submitted: March 31, 2023 CDT
Accepted: May 19, 2023 CDT
Media Review: A Review of Nurse Staffing Think Tank: Priority Topics and Recommendations
Author Information: Michele Farrington, Department of Nursing Servies and Patient Care, University of Iowa Health Care
Citation: Farrington, M. (2023). A review of nurse staffing think tank: Priority topics and recommendations. ORL - Head and Neck Nursing., 41(1) 27.
Keywords: media review column, nurse staffing, evidence-based recommendations
Abstract: NA
Submitted: January 13, 2023 CDT
Accepted: May 15, 2023 CDT
Poetry Corner: Tribute to Tracheostomy Nurses
Author Information: Vinciya Pandian, School of Nursing, Johns Hopkins University
Citation: Pandian, V. (2023). Angels in scrubs: A tribute to nurses of tracheostomy patients. ORL - Head and Neck Nursing., 41(1) 29.
