Monday, December 19, 2011

Danielle's Picks from the Literature - December 2011

LAST PICKS for 2011!!

Here are my picks from the nursing literature over the past few months. SJO and CHOC employees have access to the full text of many of these articles through the Burlew Medical Library.

Evidence-Based Nursing. Safe patient handling: Is your facility ready for a culture change?
Cadmus, Edna; Brigley, Patricia; Pearson, Madelyn;
Nursing Management, 2011 Nov; 42 (11): 12-5

Development of a Radiation Skin Care Protocol and Algorithm Using the Iowa Model of Evidence-Based Practice.
Bergstrom, Kelli;
Clinical Journal of Oncology Nursing, 2011 Dec; 15 (6): 593-5
Abstract: Limited evidence-based standards of care exist in the management of irradiated skin; therefore, the development of a skin care protocol is necessary to improve patient outcomes. This article describes the use of the Iowa Model of Evidence-Based Practice to Promote Quality Care as a framework to identify and validate current evidence. The resulting radiation therapy algorithm provided a succinct guideline for nurses to direct the prevention and management of skin damage secondary to radiation therapy, thus improving quality care.

Putting Evidence Into Practice.
Von Ah, Diane; Jansen, Catherine; Allen, Deborah Hutchinson; Schiavone, Rosalina M.; Wulff, Jennifer;
Clinical Journal of Oncology Nursing, 2011 Dec; 15 (6): 607-15
Abstract: Cognitive impairment is a clinically complex symptom commonly experienced by cancer survivors. Although research in this area has grown, many questions remain regarding underlying mechanisms, trajectory, and specific interventions nurses can offer patients to prevent, treat, and manage cognitive impairment effectively. As part of the Oncology Nursing Society (ONS) Putting Evidence Into Practice (PEP) initiative, a comprehensive examination of the current literature was conducted to identify effective interventions for cognitive impairment in cancer survivors. The studies were categorized into nonpharmacologic interventions, including complementary and alternative therapies and cognitive training, and pharmacologic interventions, including psychostimulants and erythropoietin-stimulating agents. Using the ONS PEP Weight of Evidence Classification Schema, the levels of evidence for these interventions were consistent with the categories of effectiveness not established or not recommended for practice. Additional research is needed to identify effective preventive and treatment strategies for cognitive impairment in cancer survivors.

A discussion of approaches to transforming care: contemporary strategies to improve patient safety.
Burston, Sarah; Chaboyer, Wendy; Wallis, Marianne; Stanfield, Jane;
Journal of Advanced Nursing, 2011 Nov; 67 (11): 2488-95
Abstract: A discussion of approaches to transforming care: contemporary strategies to improve patient safety. Journal of Advanced Nursing 67(11), 2488-2495. Abstract Aim. This article presents a discussion of three contemporary approaches to transforming care: Transforming Care at the Bedside, Releasing Time to Care: the Productive Ward and the work of the Studer Group®. Background. International studies of adverse events in hospitals have highlighted the need to focus on patient safety. The case for transformational change was identified and recently several approaches have been developed to effect this change. Despite limited evaluation, these approaches have spread and have been adopted outside their country of origin and contextual settings. Data sources. Medline and CINAHL databases were searched for the years 1999-2009. Search terms included derivatives of 'transformation' combined with 'care', 'nursing', 'patient safety', 'Transforming Care at the Bedside', 'the Productive Ward' and 'Studer Group'. Discussion. A comparison of the three approaches revealed similarities including: the foci of the approaches; interventions employed; and the outcomes measured. Key differences identified are the implementation models used, spread strategies and sustainability of the approaches. The approaches appear to be complementary and a hybrid of the approaches such as a blend of a top-down and bottom-up leadership strategy may offer more sustainable behavioural change. Implications for nursing. These approaches transform the way nurses do their work, how they work with others and how they view the care they provide to promote patient safety. Conclusion. All the approaches involve the implementation of multiple interventions occurring simultaneously to affect improvements in patient safety. The approaches are complementary and a hybrid approach may offer more sustainable outcomes.

A Practical Communication Strategy to Improve Implementation of Evidence-Based Practice.
Diedrick, Lee A.; Schaffer, Marjorie A.; Sandau, Kristin E.;
Journal of Nursing Administration, 2011 Nov; 41 (11): 459-65

Putting Evidence Into Practice.
Feight, Deborah; Baney, Tara; Bruce, Susan; McQuestion, Maurene;
Clinical Journal of Oncology Nursing, 2011 Oct; 15 (5): 481-92
Abstract: Radiation dermatitis, or radiodermatitis, is a significant symptom caused by radiation therapy for the treatment of cancerous and noncancerous conditions. Radiodermatitis can negatively affect patients' physical functioning and quality of life. The Oncology Nursing Society coordinated a Putting Evidence Into Practice (PEP) project team to develop a PEP resource summarizing current evidence for the management of patients with radiodermatitis. Oncology nurses play an important role in educating, assessing, and monitoring patients for this symptom. Many common nursing interventions for radiodermatitis are based on tradition or opinion and have not been researched thoroughly. In addition, evidence to support some current interventions in practice is lacking. This article presents information concerning radiodermatitis, summarizes the evidence-based review for its prevention and management, and identifies gaps in the literature, as well as opportunities for research, education, and practice.

Factors affecting evidence translation for general practice nurses.
Mills, Jane; Field, John; Cant, Robyn;
International Journal of Nursing Practice, 2011 Oct; 17 (5): 455-63
Abstract: Factors affecting evidence translation for general practice nurses This paper explores the domains of influence affecting practice nurses' ability to find, evaluate and use clinical evidence. A cross-sectional survey of general practice nurses ( n = 590) in Victoria, Australia in 2008 provided data for a principal components analysis. The research replicates a study undertaken in the UK using the Developing Evidence-Based Practice Questionnaire. Five domains of influence on nurses' translation of evidence were identified: skills in finding/reviewing evidence; barriers to finding/reviewing evidence; knowledge from published sources; knowledge from other sources; and barriers or facilitators to change. Each domain was interpreted as underlying the relationship of nurses with evidence-based practice and was comparable to the original study's findings when subjected to factor analysis. Findings from this study show that the Developing Evidence-Based Practice Questionnaire-Au is a valid and useful instrument in determining the influences on practice nurses' ability to effect knowledge translation and conduct practice based on evidence. Given these findings, a new model is proposed that explains the influence of a number of domains on Australian general practice nurses' translation of knowledge into practice.

Spotlight on Outcomes. Data-Driven Decision Making: A Nursing Research and Evidence-Based Practice Dashboard.
Mick, JoAnn;
Journal of Nursing Administration, 2011 Oct; 41 (10): 391-3 (

Engaging and Developing Research Leaders in Practice: Creating a Foundation for a Culture of Clinical Inquiry.
Stanley, Terry; Sitterding, Mary; Broome, Marion E.; McCaskey, Marjorie;
Journal of Pediatric Nursing, 2011 Oct; 26 (5): 480-8
Abstract: This article describes the first formative year experience of a research council in a children''s hospital within a Magnet-designated hospital system. The vision, transformational leadership structure, and implementation strategies used during the first year of formation of a Nursing Research and Evidence-Based Practice Council (NREBPC) are delineated and reflect Magnet components and sources of evidence (American Nurses Credentialing Center [ANCC], 2008). The use of the nursing excellence framework (ANCC, 2008) coupled with principles of adult learning to expand the knowledge and skills of nurses on the NREBPC are described and examples provided. Initial outcomes in terms of nurses'' leadership for research studies and planned documentation of additional metrics that have the potential to improve care through the development of a culture of inquiry are proposed.

Engaging with children in research: Theoretical and practical implications of negotiating informed consent/assent.
Lambert, Veronica; Glacken, Michele;
Nursing Ethics, 2011 Nov; 18 (6): 781-

Impacting Practice Through Evidence-Based Education.
Sciarra, Erica;
Dimensions of Critical Care Nursing, 2011 Sep-Oct; 30 (5): 269-75
Abstract: Evidence-based practice has been demonstrated to positively impact patient outcomes, yet nurses are having difficulty incorporating it into their practice. The purpose of this study was to determine the educational needs of intensive care unit nurses regarding evidence-based practice and to implement a strategy to meet those needs. Evidence-based practice education in this pilot study was shown as an effective catalyst to nurses beginning and participating in evidence-based practice that could potentially improve patient outcomes.

The experience of critiquing published research: Learning from the student and researcher perspective.
Knowles, Judie M; Gray, Morag A;
Nurse Education in Practice, 2011 Nov; 11 (6): 390-4
Abstract: This paper commences with affirmation of the importance of research critique within academic programmes of study, and the context of this skill within the nursing profession. Judie (student) shares an experience from a Professional Doctorate in Education (EdD) assignment that involved selecting and critiquing a piece of published research. "The qualities of an effective mentor" (Gray and Smith, 2000) was critiqued using the Critical Appraisal Skills Programme (CASP, 2006) framework. Morag was the researcher and co-author (Gray and Smith, 2000) and was subsequently contacted by Judie for the purposes of validating her critique assignment. On the tenth anniversary since publication of her PhD research findings Morag reflects on the original article in the light of Judie's critique and shares evaluative comments. Some of the assignment critique is validated by Morag, whilst some of the evaluation demonstrates unreliability of critique shown by Judie. Discussion surrounding sufficiency of research critique through systematic examination of a published article, versus an original research report such as a thesis ensues. The student and researcher/author reveal their learning from this collaborative experience and conclude with recommendations for; setting critique assignments; authors publishing their research findings; and students undertaking critique assignments.