Monday, May 18, 2009

Article published in Cancer Nursing by St. Joseph Hospital of Orange Authors

Congratulations to our nurse authors at St. Joseph Hospital of Orange for their newly published article currently listed in the "advance of publication" section of Cancer Nursing. St. Joseph Hospital of Orange and CHOC staff may access this article via our library's "A-Z list of online journals" on our library web site.
Cancer Nurs. 2009 May 13. [Epub ahead of print]
Secondary Traumatic Stress in Oncology Staff.

Quinal L, Harford S, Rutledge DN.

Authors' Affiliations: St. Joseph Hospital, Orange, California (Mss Quinal and Harford and Dr Rutledge); and California State University, Fullerton (Dr Rutledge). The authors can be reached at the following emails: ,,

As empathetic caregivers, oncology staff may be prone to secondary traumatic stress (STS). Secondary traumatic stress results from exposure to persons who have experienced trauma and from giving care to such persons. The presence of STS among oncology staff has not been documented. This correlational descriptive study examined STS among oncology staff at a 500-bed Magnet-designated community hospital by determining the presence of individual symptoms and frequency with which diagnostic criteria for STS are met. Also determined were associations between STS demographic characteristics and specific stress-reduction activities.In this study, 43 staff members from an inpatient oncology unit completed mailed surveys. The Secondary Traumatic Stress Scale assessed the frequency of intrusion, avoidance, and arousal symptoms associated with STS; also assessed were use/helpfulness of stress-reduction activities. In this first study to document the prevalence of STS among oncology staff, prevalence ranged from 16% (Bride's method) to 37% (cutoff-score method). Most common symptoms were difficulty sleeping, intrusive thoughts about patients, and irritability. Least common were avoidance of people, places, and things and disturbing dreams about patients. Current use of massage was significantly predictive of not having STS. Ethnicity of staff member was related to having STS. Further research is warranted evaluating STS prevalence in different groups of oncology staff along with the effect of STS on burnout and job retention.
PMID: 19444086 [PubMed - as supplied by publisher]

Thursday, May 14, 2009

Vickie's Research Corner

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Welcome to Vickie’s Research Corner. Spring is here and just like the flowers blooming so are our new group of Evidence-Based Practice Clinical Experts. In 2005-2006, nurses here at St. Joseph Hospital were interviewed and reported that when a clinical question arises they go to nurses at the highest level of the clinical ladder- Clinical Nurse III/IVs. Dr. Dana Rutledge then reviewed education for Clin III/IVs here at SJH and determined that the majority have had not had training in evidence-based practice (EBP). This then raises the question; if staff are asking Clin III/IVs questions could they (Clin III/IVs) be empowered to appropriately use and facilitate others to use EBP, then is it more likely that EBP is enhanced, are nurses more likely to seek evidence beyond that known by their peers?
Dr. Rutledge, with Katie Skelton’s approval and support, designed a two year study to answer these very questions. Starting in May, 2008, Clin III/IVs were encouraged to apply for a seat in the Clinical Nurse Experts in EBP curriculum. Eleven applicants were selected (via blind peer review). Starting in July they attended a four day didactic class (24 hours) extending over a two week period on multiple aspects of EBP, research, and literature search using library resources. During the course of their training they were asked to fill out questionnaires periodically, attend Nursing Research Council meetings, and attend quarterly meetings to discuss goals and projects. At the end of the two years, Dr. Rutledge will analyze the data she has collected and see if this format for increasing EBP to the bedside is working. This is such an exciting project! We are now currently in the process of getting ready for the second group to attend classes starting in July.
Now I would like to introduce you to two of our Clinical Nurse Experts- Christine Marshall and Wendy Escobedo and discuss their experience in this role:
Christine Marshall has been an RN at SJH for 14 years. She currently works in the Emergency Room as a Clin IV. She became a Clin III when the project was started and has since advanced to a Clin IV. She became interested in becoming a Clinical Nurse Expert when she realized Dana Rutledge would teach the class. She was very inspired by her and thought that having her as a teacher at some point in her life would be so much fun. Since she already had an MSN learning more about EBP made sense. For Christine the class taught her the power of EBP for teaching. She has also learned that this role has gained her the title of facilitator for projects within her own unit. Recently she performed an entire literature search on jaundice products for some colleagues and was the expert for the evidence!
Our second Expert is Wendy Escobedo. Wendy currently works as the Inpatient Care Coordinator for the kidney transplant program; she has been at SJH for 7 years, started here as a new graduate, and has been a Clin IV for 1 year. She decided to become a Clinical Nurse Expert because she wanted to make sure that what she was teaching to nurses and patients was EBP based. For Wendy, this class has really changed her practice. She has performed literature searches, developed teaching protocols, and standards of practice, and just sent in a manuscript for review. For Wendy her main goal as an Expert is to empower nurses to ask questions related to EBP and promote practice change as well as make sure her patients are more educated.
Both Clinical Experts are very interested in performing more research and both have ideas for the future. They both feel this class pushed them more into the world of EBP with a better understanding. Each feels that this class gave them the tools to both effectively and confidently teach both patients and nurses as well as empower nurses to ask that most important question- are we making the right choices and are those choices evidence-based in nursing?

Thursday, May 07, 2009

Julie's picks from the nursing literature: May 09

Here's some recent articles in the nursing literature of special interest to our readers. St. Joseph Hospital,Orange and CHOC staff may access many of these articles through our library web site.

1. Providing effective evidence-based catheter management.Preview Nazarko L; British Journal of Nursing (BJN), 2009 Apr 9; 18 (7): S4-12 (journal article - tables/charts) ISSN: 0966-0461 CINAHL AN: 2010247109

2. The emerging role of PDAs in information use and clinical decision making. Doran D; Evidence-Based Nursing, 2009 Apr; 12 (2): 35-8 (journal article) ISSN: 1367-6539 PMID: 19321815 CINAHL AN: 2010248444

3, To lower or not to lower? Making sense of the latest research on intensive glycaemic control and cardiovascular outcomes. Evidence-Based Nursing, 2009 Apr; 12 (2): 38 (journal article) ISSN: 1367-6539 PMID: 19321816 CINAHL AN: 2010248445

4. Continuous glucose monitoring improved glycaemic control in pregnant women with diabetes and reduced infant macrosomia. O'Brien B; Evidence-Based Nursing, 2009 Apr; 12 (2): 43 (journal article) ISSN: 1367-6539 PMID: 19321820 CINAHL AN: 2010248449

5. Continuous glucose monitoring improved glucose control in adults but not in young adults or children with type 1 diabetes. Allen NA; Evidence-Based Nursing, 2009 Apr; 12 (2): 44 (journal article) ISSN: 1367-6539 PMID: 19321821 CINAHL AN: 2010248450

6. Vitamin E or vitamin C supplements did not differ from placebo for major cardiovascular events and mortality. Young LE; Evidence-Based Nursing, 2009 Apr; 12 (2): 48 (journal article) ISSN: 1367-6539 PMID: 19321825 CINAHL AN: 2010248454

7. Review: early feeding and delayed feeding after PEG placement do not differ for complications or death within 72 hours. Lindeboom R; Evidence-Based Nursing, 2009 Apr; 12 (2): 50 (journal article) ISSN: 1367-6539 PMID: 19321827 CINAHL AN: 2010248456

8. Occlusive dressings and gauze dressings did not differ for healing open wounds in surgical patients. Gethin G; Evidence-Based Nursing, 2009 Apr; 12 (2): 52 (journal article) ISSN: 1367-6539 PMID: 19321829 CINAHL AN: 2010248458

9. Review: compression plus pharmacological prophylaxis reduces VTE more than monotherapy in high-risk patients. Ladak SS; Evidence-Based Nursing, 2009 Apr; 12 (2): 54 (journal article) ISSN: 1367-6539 PMID: 19321831 CINAHL AN: 2010248460

10. Review: anaemia increases mortality risk in patients with chronic heart failure. Tranmer JE; Evidence-Based Nursing, 2009 Apr; 12 (2): 58 (journal article) ISSN: 1367-6539 PMID: 19321835 CINAHL AN: 2010248464

11. Nurses' triage assessments were affected by patients' behaviours and stories and their perceived credibility. Acorn M; Evidence-Based Nursing, 2009 Apr; 12 (2): 61 (journal article) ISSN: 1367-6539 PMID: 19321838 CINAHL AN: 2010248467

12. Nurse-led vs. conventional physician-led follow-up for patients with cancer: systematic review.Preview (includes abstract); Lewis R; Neal RD; Williams NH; France B; Wilkinson C; Hendry M; Russell D; Russell I; Hughes DA; Stuart NS; et al.; Journal of Advanced Nursing, 2009 Apr; 65 (4): 706-23 (journal article - research, systematic review, tables/charts) ISSN: 0309-2402 PMID: 19278415 CINAHL AN: 2010221331

13.Identifying abuse among women: use of clinical guidelines by nurses and midwives.Preview (includes abstract); Svavarsdottir EK; Orlygsdottir B; Journal of Advanced Nursing, 2009 Apr; 65 (4): 779-88 (journal article - research, tables/charts) ISSN: 0309-2402 PMID: 19183236 CINAHL AN: 2010221332