Friday, April 27, 2007

American Journal of Critical Care has a new look and adds some "evidence based" features

Michael Muscat, Managing Editor of American Journal of Critical Care, has provided me with this description of the newly redesigned AJCC. Burlew Medical Library users can access via the library's web site the full text of this journal, including the current May 2007 issue featuring the new features and redesign.

"Score another point for evidence-based nursing care and practice. The American Journal of Critical Care (AJCC), the peer-reviewed scientific journal published by the American Association of Critical-Care Nurses (AACN), has just been revised with a new reader-friendly format and more attention paid to everyday clinical challenges. New features include the Clinical Pearls page, which summarizes bedside applications from select articles in the issue, and the AJCC Patient Care Page, which offers AACN best practices following related content in select articles. The May 2007 issue, for example, includes an AJCC Patient Care Page advising readers to seek protocols to address the issue of family presence during CPR and invasive procedures in the ICU. AJCC journal club articles are now accompanied by the EBR or Evidence-Based Review section, which spotlights the primary investigator of the chosen research study and discusses the methodology and implications of that article for clinical practice. The journal is geared toward clinicians in high acuity and critical care and is coedited by a nurse and a physician: Kathy Dracup, dean of the UCSF School of Nursing, and Peter Morris, an associate professor of medicine at Wake Forest University. Those interested should visit the journal's Web site at The first redesigned issue appeared May 1. "

Monday, April 23, 2007

E-Journal Club #2

Deep Vein Thrombosis in Hospitalized Patients: A Review of Evidence-based Guidelines for Prevention

Kehl-Pruett, Wendy ARNP, MSN, CCRN

Dimensions of Critical Care Nursing, Volume 25(2), March/April 2006, pp 53-59

Author’s Abstract

“Deep vein thrombosis affects many hospitalized patients because of decreased activity and therapeutic equipment. This article reviews known risk factors for developing deep vein thrombosis, current prevention methods, and current evidence-based guidelines in order to raise nurses' awareness of early prevention methods in all hospitalized patients. Early prophylaxis can reduce patient risk of deep vein thrombosis and its complications.”

I originally found this article too simplistic, since at our hospital we utilize the “vent bundle” concept in which anticoagulation therapy and compression teds are highlighted at our unit rounds which take place each day, usually day shift and night shift. Does your unit utilize “unit rounds”?

The “unit rounds” we have for both night shift and day shift seem to be the best way we have to disseminate evidence based practice, from all participants of the healthcare team. It is also the best way to educate and remind staff of a process, old or new, that we intend to focus on until it is accepted practice. Some of our physicians order both the stocking TEDS as well as the compression teds. Is this overkill?

Friday, April 13, 2007

Julie's picks from the nursing literature: March 2007

These articles especially captured my attention from the recent nursing literature dealing with research or EBN
1. Welk DS. How to read, interpret, and understand evidence-based literature statistics. Nurse Educator. 2007 Jan-Feb; 32(1): 16-20. (10 ref) Burlew carries this journal AN: 2009505151 NLM Unique Identifier: 17220762.
3. Fineout-Overholt E. Johnston L. Teaching EBP: implementation of evidence: moving from evidence to action. Worldviews on Evidence-Based Nursing. 2006 4th Quarter; 3(4): 194-200. (21 ref) AN: 2009481523.
4. Abbott CA. Dremsa T. Stewart DW. Mark DD. Swift CC. Adoption of a ventilator-associated pneumonia clinical practice guideline. Worldviews on Evidence-Based Nursing. 2006 4th Quarter; 3(4): 139-52. (43 ref) AN: 2009481519
5. Felber SH. Sylvanus TL. Wilson C. Kapoor R. Library and nursing research collaboration. Journal of Hospital Librarianship. 2006; 6(3): 19-30. (13 ref) AN: 2009383611.
6. Johansson P. Dahlstrom U. Brostrom A. Consequences and predictors of depression in patients with chronic heart failure: implications for nursing care and future research. Progress in Cardiovascular Nursing. 2006 Fall; 21(4): 202-11. (52 ref) Burlew has some online access, no print issues. AN: 2009373963 NLM Unique Identifier: 17170596.
7. Vollman KM. Ventilator-associated pneumonia and pressure ulcer prevention as targets for quality improvement in the ICU. Critical Care Nursing Clinics of North America. 2006 Dec; 18(4): 453-67. (135 ref) Burlew carries this journal AN: 2009350169 NLM Unique Identifier:
8. Fonteyn M. Polinski K. Lynch K. McKenna C. Gorman D. Saint-Eloi S. An evidence-based policy to guide nurses in using a power injector to instill contrast media. Oncology Nursing Forum. 2007 Jan; 34(1): 199. Burlew carries this journal AN: 2009484138.
9. Bradshaw A. Price L. Rectal suppository insertion: the reliability of the evidence as a basis for nursing practice. Journal of Clinical Nursing. 2007 Jan; 16(1): 98-103. (35 ref) Burlew has some online access, no print issues. AN: 2009481114 NLM Unique Identifier: 17181671.
10. Hoogerduijn JG. Schuurmans MJ. Duijnstee MSh. de Rooij SE. Grypdonck MF. A systematic review of predictors and screening instruments to identify older hospitalized patients at risk for functional decline. Journal of Clinical Nursing. 2007 Jan; 16(1): 46-57. (39 ref) Burlew has some online access, no print issues. AN: 2009481109 NLM Unique Identifier: 17181666.

Tuesday, April 10, 2007

Making a Poster Presentation

The difference between poster and oral presentations is that with a poster presentation, the poster does most of the 'talking' about your project. That is, the material presented conveys the essence of your message. However, that does not mean that you can abandon the poster during the designated time. You have to 'stand-by-your-poster'! Your task as the presenter is to answer questions and provide further details; to bask in praise or suffer difficult questions; and to convince others that what you have done is excellent and worthwhile. A poster presentation should guide each viewer through the basics of the study or project, freeing the presenter to focus on discussion of essential elements of the work. Decisions about poster format and design contribute to efficient and accurate transfer of information using this medium.

A scientific poster is a communication tool that combines a verbal presentation with a visual aid. They are given to a small group of people, are limited in time and range of view, and are informal and interactive. Posters should look as professional as your professional research or project. Poster size specifications will differ for each presentation venue; always plan to use the space well. Incorporating good basic graphic design principles, using good quality art materials and papers, and the use of color as an organizing tool will contribute to the professional approach of this scientific communication. The average interaction time for a poster presentation is 10-15 minutes. You must use visual short-cuts and plan your verbal presentation carefully to do posters well.

Important characteristics for posters to have:
clear scientific value;
viewer-friendly lay-out, i.e., it has a hierarchical organization (“easy to follow sequence”), contains minimal text, has conveniently arranged and understandable graphs, and avoids (where possible) mathematical formulations.
“It takes intelligence, even brilliance, to condense and focus information into a clear, simple presentation that will be read and remembered. Ignorance and arrogance are shown in a crowded, complicated, hard-to-read poster." Mary Helen Briscoe

Poster Guidelines

Succinct title
Background (review of literature, need for project)
Project description/methodology and context (sample, setting, etc.)
Implications for nursing

Here are two templates I have shared with nurses in the Orange County region over the past several years. I found the first template (for a rectangular poster made on Powerpoint for professional reproduction) on the internet several years ago, and did not gain permission to publish it. This template allows someone to make a poster for use on a bulletin board surface (attached with tacks or velcro) or for reproduction on foamcore board. The trifold template (you need MS PowerPoint to view) is a modification of the first template that allows someone to reproduce a poster and tack it on a 3x5' tri-fold poster board (for table top display).

Monday, April 09, 2007

SJH Critical Care E-journal Club

Once again, I am starting the e-journal club here at St. Joseph’s. I will post a journal review article every two weeks or so to those people that have requested to be on my mailing list. I will post a summary or the author’s abstract on this blog site so that people can comment here. Judy Rousch, RN, BSN

Kalisch, Beatrice J., PhD, RN, FAAN. “Missed Nursing Care: a Qualitative Study”, Journal of Nursing Care Quality, Vol.21, No. 4, pp. 306-313.

Author’s Abstract:

“The purpose of this study was to determine nursing care regularly missed on medical-surgical units and reasons for missed care. Nine elements of regularly missed nursing care (ambulation, turning, delayed or missed feedings, patient teaching, discharge planning, emotional support, hygiene, intake and output documentation and surveillance) and 7 themes relative to the reasons for missing this care were reported by nursing staff.”

I found this study simple and yet profound at the same time. Through an e-mail, the author confided that as a consultant to hospitals, these same themes kept coming up over and over again.

I was amazed at the honesty of the replies from the staff interviewed. Would we have the kind of insight this article lets us see if the unit manager asked the staff the same questions? Do some units have an authentic ability to see and handle these issues? How do you feel these time constraint issues are handled on your unit?

Wednesday, April 04, 2007

Cochrane Database of Systematic Reviews-- news

All documents in the Cochrane Database of Systematic Reviews are now in PDF format. That means no more tweaking the document to make sure that all the tables print and a document that is shorter in its final print version.

Other Cochrane News

"Two Cochrane Reviews to be published in January The Cochrane Library 2007,
Issue 1, report on smoking cessation:

• A recently licensed nicotine receptor stimulant trebles the odds of
stopping smoking. The new anti-smoking drug varenicline was first licensed for use in the UK on 5th December 2006. An early Cochrane Review of its effectiveness shows that it can
give a three-fold increase in the odds of a person quitting smoking. Varenicline is
the first new anti-smoking drug in the last ten years, and only the third, after NRT
and bupropion, to be licensed in the USA for smoking cessation.

• New evidence boosts the conclusion that some antidepressants can
double a smoker’s chance of quitting. The most recent Cochrane review concluded antidepressants bupropion (Zyban) and nortriptyline double a person’s chances of giving up smoking and have few side-effects, but selective serotonin reuptake inhibitors (SSRIs) such as
fluoxetine (Prozac) are not effective. A recently licensed nicotine receptor stimulant trebles the odds of stopping smoking. The new anti-smoking drug varenicline was first licensed for use in the UK on 5th December 2006. An early Cochrane Review' of its effectiveness shows that it can
give a three-fold increase in the odds of a person quitting smoking. Varenicline is the
first new anti-smoking drug in the last ten years, and only the third, after NRT and
bupropion, to be licensed in the USA for smoking cessation.