Wednesday, October 31, 2007

Research Interview

First of all I would like to thank all the nurses who have been interviewed for allowing us to showcase their projects. Secondly I would like to wish Happy Holidays to everyone!
We are now coming to the end of an exciting year in evidence-based practice and research here at St. Joseph Hospital with many new projects to come in 2008. As you have seen from the other articles our nurses are busy! This issue I would like to introduce you to Kathleen Close, the Colorectal Nurse Navigator here at St. Joseph Hospital and her study is called “Gum Chewing for Post-Colorectal Surgery Patients.”

Q. What is your study about?
A. “My study is about determining ways to prevent ileus following colorectal surgery. We need to know if providing patients with gum after colorectal surgery decreases their incidence of time to flatus and bowel movements and if this leads to a decrease in ileus.”

Q. Is it an EBP/ResearchProject?
A. “This is retrospective pre/post comparative study.”

Q. What made you interested in this project?
A. “As the Nurse Navigator for colorectal patients I am responsible to identify and follow-up on any patients who have been newly diagnosed with any type of colorectal disease. I follow them from the time of diagnosis, through surgery, and then post surgery. I am available to them 24 hours, 7 days a week until they are home and comfortable. Our colorectal cancer patients I keep in touch with on an ongoing basis because I help coordinate our support group. Due to this role I really decided to look in to the research and see if there was any information on decreasing ileus to help these patients after their surgeries. As the Colorectal Nurse Navigator I love my role and I love my patients, therefore I want to decrease any complications they might have if I can.
My daughter heard an article being discussed on the radio one morning from JAMA as a possible health program and told me about it. I had our library pull all the current articles regarding this study and the Japanese study was among the articles I received which is called, “Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy”, (Asao, T. et al. 2002). These researchers found patients undergoing laparoscopic colectomy for colorectal cancer who chewed sugarless gum three times per day passed flatus and defecated sooner than did patients who did not with good significance (p<. 01). I thought this is great! Especially since the amount of literature on this subject is very limited.”

Q. How did you go about doing your research?
A. “After reading this article and a few others, my daughter and I decided I should try to replicate this study. So I presented the idea to the three physicians I work with and we decided this would be a great idea. I then brought the idea to Dana Rutledge in the Nursing Research Department and we worked on the logistics as far as what type of study I should do, how many charts, and what information we should be looking at. We used the other studies I looked at as a basis for data collection. We developed a tool to audit my charts. I then went to the IRB and presented my project. Once approved, I was on my way. Since then I have been working with you to collect my data. We will soon be analyzing the data.”

Q. What are your expected outcomes?
A. “Well initially, I was really hoping we would see a difference with gum chewing, but at this point after collecting the data I noticed there was not a decrease in ileuses. One study actually said that gum chewing might be a safe way to provide benefits of stimulation without the same complications of feeding (Asao, T. et al) but I’m not sure if the data we found actually has the same results. Since we don’t have statistical analysis yet, I do not know statistically what we have actually found. It is so hard to know what your research will lead you too.”
Q. Have you done research before? If so what did you learn?
A. “ Yes, I was involved in drug research with Bristol Meyers on a drug many years ago. The drug was to help with diagnosis and prevention of early Alzheimer’s but the medication never made it to the market. I never actually found out what the results were. I thought the medication actually made a difference but the patients may have done better because we gave them a lot of attention, so it could have been a placebo effect.”
Q. Will you do an EBP/research project again?
A. “Yes. I enjoy doing research. My results may help other people regardless of positive or negative outcomes. Research also helps find new and exciting questions and answers. I don’t really find research to be that difficult once you start. The biggest problem has been getting other people excited initially about the project. But once I got everyone on board, it took off. Working with you made data collection easier since we had a great system worked out for getting the charts from medical records. Once I got a system with auditing the charts, it actually went fast! I am looking forward to our analysis.


Asao, T. et al. (2002). Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. Journal of the American College of Surgeons, 195, 30-32.

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