Tuesday, October 04, 2016

Congratulations to St. Joseph Hospital Emergency Care Center nurses!

St. Joseph Hospital Emergency Care Center nurses Belinda Leos, RN, MSN, Sherry Endo, RN, MSN, Robert Garcia, RN, MSN, CMSRN, and Beth Winokur, RN, PhD, CEN were awarded first place in the research category for their poster, Evaluating Fall Tools for the Emergency Setting at the National Emergency Nursing Annual Scientific Assembly.

Other presentations at this conference by our ECC staff included the poster, A Recipe for Success: Integrating a Sepsis Bundle into the Emergency Department by Laura Derr, RN, BSN, CEN, Dixie Stiles, RN, MSN, CEN, and Soledad Mathus, RN, BSN. Beth Winokur, RN, PhD, CEN and Juleene McGowan, RN, BSN, CEN, presented poster and podium entitled “A Picture is Worth a 1000 Words: Using Pictographs to Improve Health Care Literacy.” Jeannine Loucks, RN-BC, MSN, and Beth Winokur, RN, PhD, CEN also presented their research poster – Have No Fear: The Effects of Education on Perceived Competence to Care for Behavioral Health Patients.

Wednesday, September 21, 2016

Danielle's Pick from the Literature - September 2016

Here are my picks from the literature for September 2016. Articles are accessible to St. Joseph Nurses via the Burlew Medical Library website. Or contact the library at 714-771-8291 for assistance.

1. Nursing research ethics, guidance and application in practice. Doody, Owen; Noonan, Maria; British Journal of Nursing, 7/28/2016; 25(14): 803-807.

Abstract: Ethics is fundamental to good research practice and the protection of society. From a historical point of view, research ethics has had a chequered past and without due cognisance there is always the potential for research to do harm. Research ethics is fundamental to research practice, nurse education and the development of evidence. In conducting research, it is important to plan for and anticipate any potential or actual risks. To engage in research, researchers need to develop an understanding and knowledge of research ethics and carefully plan how to address ethics within their research. This article aims to enhance students’ and novice researchers’ research ethics understanding and its application to nursing research.

2. An Integrative Review of Engaging Clinical Nurses in Nursing Research. Scala, Elizabeth; Price, Carrie; Day, Jennifer; Journal of Nursing Scholarship, Jul2016; 48(4): 423-430.

3. The practice of nursing research: getting ready for 'ethics' and the matter of character. Sellman, Derek; Nursing Inquiry, Mar2016; 23(1): 24-31.

4. Clinical Nurse Specialist Roles in Conducting Research. Albert, Nancy M.; Rice, Karen L.; Waldo, Mary J.; Bena, James F.; Mayo, Ann M.; Morrison, Shannon L.; Westlake, Cheryl; Ellstrom, Kathleen; Powers, Jan; Foster, Jan; Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, Sep/Oct2016; 30(5): 292-301.

5. Fostering Clinical Nurse Research in a Hospital Context. Hatfield, Linda A.; Kutney-Lee, Ann; Hallowell, Sunny G.; Del Guidice, Mary; Ellis, Lauren N.; Verica, Lindsey; Aiken, Linda H.; Journal of Nursing Administration, May2016; 46(5): 245-249.

6. Effectiveness of an education intervention to strengthen nurses' readiness for evidence-based practice: A single-blind randomized controlled study. Saunders, Hannele; Vehviläinen-Julkunen, Katri; Stevens, Kathleen R.; Applied Nursing Research, Aug2016; 31 175-185.

7. Effects of Education Programs on Evidence- Based Practice Implementation for Clinical Nurses. Jae Youn Sim; Keum Seong Jang; Nam Young Kim; Journal of Continuing Education in Nursing, Aug2016; 47(8): 363-371.

8. The Imperative: Integrating Evidence-Based Practice into the Clinical Nurse Leader (CNL) Role. Gibson, Lynette M.; South Carolina Nurse, Jul-Sep2016; 23(3): 14

9. Incorporating Evidence-Based Practice Learning Into a Nurse Residency Program. Jackson, Nichole; Journal of Nursing Administration, May2016; 46(5): 278-283.

10. Implementing and Sustaining Evidence Based Practice Through a Nursing Journal Club. Gardner Jr., Kevin; Kanaskie, Mary Louise; Knehans, Amy C.; Salisbury, Sarah; Doheny, Kim K.; Schirm, Victoria; Applied Nursing Research, Aug2016; 31 139-145.

Thursday, February 25, 2016

St. Joseph Hospital Nurses Publish Article

Congratulations to Beth Winokur, PhD, RN, CEN, Dana Rutledge, PhD, RN and Amy Hayes, MSN, RN for their newly published article on factors that motivate or impede nurses employed by a Magnet® organization to pursue a baccalaureate education. SJO employees have access to the full article through Burlew Medical Library. Contact library staff for more details.


Abstract: The aim is to explore factors that motivate and obstacles that impede nurses from pursuing baccalaureate education when employed by a Magnet® organization. In the Future of Nursing (2011), the Institute of Medicine concluded that the baccalaureate should be the minimum education for nurses. Magnet organizations are encouraged to meet the Institute of Medicine goal of 80% of nurses with a baccalaureate by 2020. In February 2014, a 15-item on-line survey was sent to nurses at a western Magnet-designated hospital to assess factors that motivate registered nurses to achieve a baccalaureate. Descriptive statistics and a general thematic analysis were completed. A 20% response rate (N = 191) was achieved. Most respondents (78%) entered nursing as associate degree/diploma graduates, and most (84%) either had a baccalaureate or master's degree or were currently enrolled in school. Encouragement from other nurses was the factor most frequently selected as facilitating return to school. Impeding factors included age and family responsibilities. A minority of nurses reported that they did not believe that a baccalaureate would make them a better nurse. Findings suggest that peer and leadership support play a larger role in facilitating baccalaureate completion more than previously reported. Additional research is needed to explore the role of registered nurse to registered nurse encouragement in facilitating educational advancement.
(Index words: Magnet; Baccalaureate education; Nursing education; Motivation; Education, post RN; School re-entry) J Prof Nurs 0:1–9, 2016.

Thursday, February 11, 2016

Danielle's Picks from the Literature - February 2016

Here are my picks from the literature for February 2016. Articles are accessible to St. Joseph Nurses via the Burlew Medical Library website. Or contact the library at 714-771-8291 for assistance.

Building research capacity and productivity among advanced practice nurses: an evaluation of the Community of Practice model. Journal of Advanced Nursing, Mar2016; 72(3): 605-619.

Nurses' Research Capacity, Use of Evidence, and Research Productivity in Acute Care. Journal of Nursing Administration, Jan2016; 46(1): 12-17.

Advancing Nursing Research in Hospitals Through Collaboration, Empowerment, and Mentoring. Journal of Nursing Administration, Dec2015; 45(12): 600-605.

Bridging the Research-to-Practice Gap: The Role of the Nurse Scientist. Seminars in Oncology Nursing, Nov2015; 31(4): 298-305.

Nurses' Use of Evidence-Based Practice in Clinical Practice After Attending a Formal Evidence-Based Practice Course.Connor, Linda; Dwyer, Patricia; Journal for Nurses in Professional Development, Jan/Feb2016; 32(1): E1-E8.

Evidence-based nursing. Designing a unit practice council structure. Nursing Management, Jan2016; 47(1): 15-18.

Strategies to promote practice nurse capacity to deliver evidence-based care. Journal of Health Organization & Management, 2015; 29(7): 988-1010.

Magnet Accreditation Leads to Greater Patient Satisfaction. American Association of Critical-Care Nurses; Jan2016; v.8. n.1, 7-7.

Hospital Magnet Status, Unit Work Environment, and Pressure Ulcers. Journal of Nursing Scholarship, Nov2015; 47(6): 565-573.

Doctor of Nursing Practice: The Role of the Advanced Practice Nurse. Seminars in Oncology Nursing, Nov2015; 31(4): 263-272.

Monday, August 17, 2015

Clinical Inquiry Series

Question: I’ve heard that inductions increase the cesarean section (C/S) rate. An article from AWHONN email this week reports research showing that inductions decrease the C/S rate. Which is true? And how can we decrease our C/S rate?

Answer: A review of the literature proves to be quite controversial. There were no randomized control trials found in the literature most likely due to the fact that pregnant women are a vulnerable population because of the risks to mother/infant. The majority of studies are retrospective and findings conflict. Two studies, one a systematic review and a large retrospective study found a decrease in C-section(C/S) rate when induction was used compared to usual care (spontaneous labor, induced at a later time, etc.)(Caughey et al., 2009; Wilson et al.,2010).
Other studies (Ehrenthal, Jiang & Strobino 2010; Glantz, 2010) discussed that problems exist in how researchers define the study population. These authors highlight that multiple factors, including increasing gestational age, alter the results mentioned above. Therefore after including these additional variables, they report that induction increases the C/S rate.
Two other articles (Klein 2010; Nicholson et al. 2009) mention the AMOR-IPAT scoring system. AMOR–IPAT stands for Active Management of Risk in Pregnancy at Term- Upper limit of Optimal Delivery. In their studies utilizing this scoring system (algorithm) assists with finding the ideal gestation for each woman and determines her best delivery date. This scoring system in two studies states that when this scoring system is utilized for induction it reduces the C-Section rate.
Final answer is the evidence is conflicting and there are many factors that influence the C-section rate. Maternal obesity for instance was not taken into consideration. Awareness and informed consent is imperative when deciding whether or not to induce. Ultimately this is something that should not be taken lightly and should be discussed thoroughly by the patient and her provider.

References: Akinsipe, C. D., Villalobos, L. E., & Ridley, R. T. (2012). A systematic review of implementing an elective labor induction policy. Journal of Obstetrics and Gynecology and Neonatal Nursing, 41(1) 5-16. doi:10.1111/j.1552-6909.2011.01320.x
Caughey, A. B., Sundaram, V., Kaimal, A. J. Gienger, A., Cheng, Y. W., McDonald, K. M., . . .Bravata, D. M. (2009) Systematic review: Elective induction of labor versus expectant management of pregnancy. Annals of Internal Medicine, 151(4) 252-263.
Ehrenthal, D. B., Jiang, X., & Strobino, D. M., (2010) Labor induction and the risk of cesarean delivery among nulliparous women at term. Obstetrics & Gynecology, 116(1) 35-42.
Glantz, J. G. (2010) Term labor induction compared with expectant management. Obstetrics & Gynecology, 115(1).
Nicholson, J. M., Cronholm, P., Kellar, L. C., Stenson, M. H., & Macones, G. A. (2009). The association between increased use of labor induction and reduced rate of cesarean delivery. Journal of Women’s Health, 18(11) 1747-1758.
Wilson, B. L., Effken, J., & Butler, R. J. (2010) The relationship between cesarean section and labor induction. Journal of Nursing Scholarship, 42(2) 130-138. doi:10.1111/j.1547-5069.2010.01346.x

Thursday, August 06, 2015

St. Joseph Hospital Nurses Publish Article

Congratulations to Mary Gonzales, RN, MSN & Dana Rutledge, RN, PhD for their newly published article on pain and anxiety during IR procedures.  SJO employees have access to the full article through Burlew Medical Library.  Contact library staff for more details.

Pain and Anxiety During Less Invasive Interventional Radiology Procedures
Mary Gonzales, MSN, RN
Dana N. Rutledge, PhD, RN
Journal of Radiology Nursing
June 2015; 34(2) 88-93

The purpose of this study was to describe patient-reported pre-, intra-, and postprocedure pain and anxiety levels for adults undergoing less invasive interventional radiology procedures. Most of the 53 outpatients were males, English speakers (91%), aged between 40 and 70 years, and having a chest port or arm port insertion procedure. Pain levels greater than 4 (0-10 scale) were experienced by a minority of participants (before, n = 1; during, n = 7; and after, n = 3). Many patients undergoing arm port and chest port insertions (22-68%) experienced some level of preprocedural anxiety. This is the first study to document the presence of pain and anxiety levels of outpatients receiving dialysis arteriovenous graft fistulogram or declotting procedures, chest port or arm port insertions, or tunneled dialysis catheter placements. Radiology nurses need to be aware of the pain and anxiety experiences of these patients and should be assessing and managing these in collaboration with their medical colleagues.

Friday, April 10, 2015

Clinical Inquiry Series

The RNs at St. Joseph Hospital are curious and inquisitive when it comes to best nursing practice.  Our nurses are encouraged to submit their clinical practice questions to our Research Department for review of the best evidence to guide patient care.  Here is another in our series entitled "Clinical Inquiry". 

Q: What laboring positions are most effective in turning a posterior baby anterior?  We currently use far left or lateral, upper LE on over bed table, and "frog" position.  I have also seen hands on knees used.

A: What does the evidence say?
There are many beliefs regarding the best way to position a laboring woman to turn an OP baby to the occiput anterior (OA) position.  A review of the literature notes conflicting evidence for the hands and knees position (Kariminia et al., 2004) (Stremler et al., 2005).  There is not enough evidence at this time to confirm if all other positions (left lateral, right lateral or frog position) assist with rotating the baby from OP to OA position (Simkin, 2010).  The evidence does show that the hands and knees position reduces back pain during labor (Hunter et al., 2007).  None of the aforementioned positions have been shown to be harmful.  At this time, the evidence in conflicting or there is not enough evidence to say one position is better than another to rotate an OP baby.


1: Desbriere R, Blanc J, Le Dû R, Renner JP, Carcopino X, Loundou A, d'Ercole C.
Is maternal posturing during labor efficient in preventing persistent occiput
posterior position? A randomized controlled trial. Am J Obstet Gynecol. 2013
Jan;208(1):60.e1-8. doi: 10.1016/j.ajog.2012.10.882. Epub 2012 Oct 26. PubMed
PMID: 23107610.

2: Simkin P. The fetal occiput posterior position: state of the science and a new
perspective. Birth. 2010 Mar;37(1):61-71. doi: 10.1111/j.1523-536X.2009.00380.x.
Review. PubMed PMID: 20402724.

3: Stremler R, Halpern S, Weston J, Yee J, Hodnett E. Hands-and-knees positioning
during labor with epidural analgesia. J Obstet Gynecol Neonatal Nurs. 2009
Jul-Aug;38(4):391-8. doi: 10.1111/j.1552-6909.2009.01038.x. PubMed PMID:

4: Hunter S, Hofmeyr GJ, Kulier R. Hands and knees posture in late pregnancy or
labour for fetal malposition (lateral or posterior). Cochrane Database Syst Rev.
2007 Oct 17;(4):CD001063. Review. PubMed PMID: 17943750.

5: Hart J, Walker A. Management of occiput posterior position. J Midwifery Womens
Health. 2007 Sep-Oct;52(5):508-13. Review. PubMed PMID: 17826716.

6: Stremler R, Hodnett E, Petryshen P, Stevens B, Weston J, Willan AR. Randomized
controlled trial of hands-and-knees positioning for occipitoposterior position in
labor. Birth. 2005 Dec;32(4):243-51. PubMed PMID: 16336365.

7: Kariminia A, Chamberlain ME, Keogh J, Shea A. Randomised controlled trial of
effect of hands and knees posturing on incidence of occiput posterior position at
birth. BMJ. 2004 Feb 28;328(7438):490. Epub 2004 Jan 26. PubMed PMID: 14744821;
PubMed Central PMCID: PMC351839.