Friday, September 15, 2006

Jean Watson's theory selected as framework at St. Joseph Hospital, Orange, California

Saint Joseph Hospital in Orange, California has selected Jean Watson's Theory of Human Caring as the framework on which we base our nursing practice. Burlew Medical Library has prepared a selective bibliography of articles by or about Watson from 1996-. This list of articles is in part 1 (articles available to SJO/CHOC employees) and part 2 (articles which could be ordered for SJO/CHOC employees. SJO/CHOC employees need only contact Burlew Medical Library to request any of these articles. Individuals at other entities should contact their own medical libraries.

Additionally, we will be offering a special viewing of a moving and inspirational DVD on the "Theory of Human Caring" which was produced by SJH nurses.

One hour sessions are scheduled in the Zhoul auditorium on

Monday Sept 18 12:00 noon to 1:00 pm 2006
Tuesday Sept 19 7:30 am - 8:30 am
Tuesday Oct 3 7:30 - 8:30 am
Monday Oct 16 12:00 noon to 1:00 pm
Friday Nov 3 7:30 am - 8:30 am
Monday Nov 6 12:00 noon -1:00 pm

No registration is required and breakfast/lunch will be served to St. Joseph Hospital of Orange staff.

Along these same lines, there is a very cool Nursing Theory Link page out of Clayton State University Department of Nursing where you can read about many nursing theories.

Evidence Based Library Science Conference

Evidence Based Library & Information Practice4th International Conference"Transforming the Profession"May 6-11, 2007, Chapel Hill-Durham, North Carolina, USA The Evidence Based Library and Information Practice Conference(EBLIP4) is an exciting international event that has emerged inresponse to the growing interest among all types of libraries in usingthe best available evidence to improve information practice. The conference on May 6-9, 2007 in Chapel Hill, North Carolina will be followed by two days of continuing education. The conference provides a forum for the presentation of high quality papers and posters aswell as examples of how EBLIP is being implemented in library and information settings around the globe. EBLIP4 invites submissions for contributed papers and posters including both original research and innovative applications of EBLIP in library and information management. Papers that deal with library support of evidence-based practice in other fields such as health, social work and public policy are also welcome.

Full instructions to authors may be found at Chapel Hill-Durham is located in the middle of the Eastern United States close to the Raleigh-Durham international airport. This central location in the Research Triangle area is only a short drive from scenic locations in North Carolina. The beaches are approximately two hours to the east and the mountains are two hours to the west. Washington DC is a 4.5 hour drive or 30 minutes by air. Important Dates

December 1, 2006 Submission deadline for abstracts for papers and posters
February 11, 2007 Final decisions for accepted papers
February 15, 2007 Final decisions for accepted posters
March 15, 2007 Submission deadline for full papers

Carol Perryman MSLISTRLN Doctoral FellowSchool of Information & Library ScienceUniversity of North Carolina at Chapel Hill

Friday, September 08, 2006

Study: Nurses Lack IT training

A new study in eWeek finds that most nurses receive minimal or no IT training. Information literacy is integral to an understanding of how to approach Evidence Based Nursing.

Please post your comments below if you have any great ideas/suggestions on this topic.

Resources for teaching EBM

David Rothman from Syracuse, NY, just posted on his blog a very comprehensive list of resources for teaching EBM/Evidence Based Medicine. Most of the resources were compiled by puting a call out to the MEDLIB-L for assistance.

Wednesday, September 06, 2006

Pressure Ulcers among Eldery Patients Early in Hospital Stay: Abstract with commentary by Dana Rutledge, RN, PhD

Abstract: Pressure Ulcers among Elderly Patients Early in Hospital Stay

Background. Pressure ulcers among elderly hospital patients diminish quality of life and increase the cost of hospital care. Evidence suggests that pressure ulcers can arise after only a few hours of immobility. The goals of this study were to estimate the incidence of hospital-acquired pressure ulcers in the first 2 days of the hospital stay and to identify patient characteristics associated with higher incidence.
Methods. A prospective cohort study was performed between 1998 and 2001. A total of 3233 patients 65 years old or older admitted through the Emergency Department to the inpatient Medical Services at two study hospitals were examined by a research nurse on the third day of hospitalization. Pressure ulcers were ascertained using standard criteria and were classified a either preexisting, possibly hospital-acquired, or definitely hospital-acquired.
Results. There were 201 patients with one or more possibly or definitely hospital-acquired pressure ulcers for a cumulative incidence of 6.25 (95% confidence interval, 5.4% - 7.1%). Most of the pressure ulcers were stage 2, and the majority were in the sacral area or on the heels. In multivariable analysis, pressure ulcer incidence was significantly associated with increasing age, male gender, dry skin, urinary and fecal incontinence, difficulty turning in bed, nursing home residence prior to admission, recent hospitalization, and poor nutritional status.
Conclusions. A small but significant proportion of elderly emergently admitted hospital patients acquire pressure ulcers soon after their admission. New models of care may be required to ensure that preventive interventions are provided very early in the elderly person’s hospital stay.
Baumgarten, M. et al. (2006). Pressure ulcers among elderly patients early in hospital stay. Journal of Gerontology: MEDICAL SCIENCES, 61A, 749-754.

Commentary by Dana N. Rutledge, RN, PhD, Nursing Research Facilitator

Were you surprised at any of the predictors of pressure ulcers in this hospitalized elderly patients? You probably were not. Studies using the Braden Pressure Ulcer Risk Assessment Scale confirm that problems with moisture, mobility/activity, and nutrition are all predictors of pressure ulcer development. What is new about the Baumgarten et al. study is that in 6.2% of the patients, pressure ulcers developed within 3 days of hospital admission!! Earlier studies have not specifically looked at this time interval.
What were the strengths and limitations of the study. Strengths include the large sample size, use of 2 hospitals (one in Pennsylvania, one in Oregon), the large sample of African Americans, and use of trained research nurses to evaluate the study measures. Limitations are that the study involved only a brief one-time observation of the patients and that hospital-acquired and preexisting pressure ulcers may have been somewhat misclassified.
Taking these into account, what is the take home message for the practicing nurse? Elderly patients admitted to medical units may be prone to develop pressure ulcers within 3 days of admission. Thus, given recent trends towards shorter hospital stays, the potential for breakdown is high. Nurses MUST put preventive measures into place early!!

Friday, September 01, 2006

Trip database-- free access

Trip Database :Turning Research into Practice

For the last 4 years, the Trip database has been a subscription service, but as of Sept 2006, it is once again a free resource. TRIP describes itself as " the Internet's leading resource for Evidence-Based Medicine allowing users to easily and rapidly identify the highest quality evidence from a wide range of sources." This site has recently been evaluated by a team from the Centre for Evidence-Based Medicine. Although not nursing focused, this free resource is a great one-stop source for answering clinical questions. The site supports Boolean searching and returns results that you can then filter by such entities as : evidence based synopses, clinical questions, systematic reviews, guidelines, e-textbooks, clinical calculators and even by medical speciality. You can also sign up for the Trip Blog on their web site.

Evidence Based Nursing Blog "Down Under"

I have come across a blog devoted to "Evidence-Based Nursing & Midwifery" which is being published by Stephen Barnett Darwin from Northern Territory, Australia. This site does primarily emphasize evidence based nursing from a OB/midwifery perspective.

A Nursing Evidence Based Practice Tutorial

We previously blogged about "The Evidence Based Knowledge Portal which was developed by the Eskind Biomedical Library at Vanderbilt with grant funding and includes tutorials addressing facets of statistical analysis and critiquing the medical literature as well as virtual practice cases that allow users to explore principles of EBM. This is an amazing tutorial but its orientation is toward medicine rather than nursing. Dana Rutledge recently told me about a great Evidence Based Practice Tutorial from Penn State University Libraries that is very comprehensive and oriented towards nursing. This tutorial also offers audio and some video and details the four overall steps in Evidence Based Practice. Two clinical scenarios are offered and the user also has available to them a listing of appraisal tools and an extensive list of EBP terminology.

Our blog discussed in Evidence Soup blog

Evidence Soup : show me the evidence : looking at uses and absues of evidence in everyday life is a very interesting blog put together by Tracy Allison Altman. This blog is not devoted exclusively to healthcare, but does concentrate on medical/nursing issues. It's interesting that both our blogs have subtitles along the lines of "show me the evidence"!!. On August 11, Evidence Soup gave our blog a nice plug. Thanks.

Julie's August picks from the literature

Some of these recent articles really intrigued me. Employees at St. Joseph Hospital, Orange or Children's Hospital of Orange County can access these online or request them through Burlew Medical Library. Others should consult medical libraries with whom they have privileges.

Accession Number 2009223633 NLM Unique Identifier: 16816597.Author Coopey M. Nix MP. Clancy CM.Title Translating research into evidence-based nursing practice and evaluating effectiveness.Source Journal of Nursing Care Quality. 2006 Jul; 21(3): 195-202. (9 ref)

Accession Number 2009232462 NLM Unique Identifier: 16767023.Author Giuliano KK.Title Continuous physiologic monitoring and the identification of sepsis: what is the evidence supporting current clinical practice?Source AACN Advanced Critical Care. 2006 Apr-Jun; 17(2): 215-23. (36 ref)

Accession Number 2009232451 NLM Unique Identifier: 16767019.Author Albert NM.Title Evidence-based nursing care for patients with heart failure.Source AACN Advanced Critical Care. 2006 Apr-Jun; 17(2): 170-85. (41 ref)

Accession Number 2009211028 NLM Unique Identifier: 16766627.Author Munro CL. Grap MJ. Jablonski R. Boyle A.Title Oral health measurement in nursing research: state of the science.Source Biological Research for Nursing. 2006 Jul; 8(1): 35-42. (47 ref)