Tuesday, December 18, 2012

KP's Nursing Research Series

The Nursing Research Department at Kaiser Permanente is sharing it's Nursing Research Series with the community of nurses at large to, "assist nurses to be a consumer of nursing research, to evaluate the adequacy of research findings in terms of their scientific merit, and to consider their potential for utilization in evidence-based nursing practice".

Check out their Research Series including topics such as: conducting a literature review, developing a research problem, and outcomes research to change nursing practice.  Supplementary materials at the bottom of the page include the informative, "Falls Prevention / Prevention of Injury from Falls Integrative Review".




Monday, November 26, 2012

Danielle's Picks from the Literature - November 2012

Here are my picks of the literature for November. SJO and CHOC staff have access to the articles by contacting Burlew Medical Library.

1. Translating evidence to practice for mechanical venous thromboembolism prophylaxis.
Larkin, Brenda G; Mitchell, Kimberly M; Petrie, Kathryn;
AORN Journal, 2012 Nov; 96 (5): 513-27
Abstract: Perioperative staff nurses at Aurora Health Care, Milwaukee, Wisconsin, questioned variations in the use of mechanical venous thromboembolism prophylaxis and sought to improve the consistency of prophylaxis care and ensure use of evidence-based practices. A work group consisting of perioperative clinical nurse specialists, a nurse clinician, and a staff nurse performed a systematic literature review to determine best practices for the implementation of mechanical venous thromboembolism prevention in the perioperative period. Key practices identified included optimal application times for initiating mechanical prophylaxis before the surgical procedure and the use of unilateral mechanical prophylaxis for some orthopedic procedures. We found no published consensus regarding a cumulative benefit from combining sequential compression devices and graduated compression stockings and no clinical evidence to support the use of alternative configurations for specialty procedural tables to prevent venous thromboembolism. We disseminated the best practices that we identified within our hospital and to the greater nursing community through posters and presentations.

2.  Embedding a Culture of Evidence-based Practice.
Fitzsimons, Emma; Cooper, Joanne;
Nursing Management - UK, 2012 Nov; 19 (7): 14-9.
Abstract: Evidence-based practice (EBP) can improve patient outcomes, cost effectiveness and staff satisfaction, and nursing care should be based on the best available evidence. However, this does not happen consistently. A study tour to the US, funded by the Florence Nightingale Foundation, was undertaken to identify methods of embedding effective EBP in nursing culture. This article presents the findings specifically related to leadership and discusses implications for practice.

3.  The Care Utilizing Evidence initiative.
Beswick, Susan; Martin, Kirsten; Jeffs, Lianne;
Canadian Nurse, 2012 Oct; 108 (8): 20-1

4.  Collaborating With Hospital Librarians to Engage Nurses in Evidence-Based Practice Education.
Winsett, Rebecca P.; Moutseous, Margaret;
Journal of Hospital Librarianship, 2012 Oct-Dec; 12 (4): 309-16
Abstract: Collaboration with the hospital librarian was successful in engaging nurses in evidence-based practice (EBP) education. The experiential learning model guided the course objectives and activities. A single clinical question was used by the class where each topic was introduced along with the resources needed to accomplish each task. Sufficient time was provided for the small groups to complete the assigned task. Once the activity was completed, groups presented findings in an oral presentation. As nurses in a hospital setting may represent three or four different generations, the experiential model was useful in addressing a wide variety of learning needs.

5.  Evidence-based practice for the busy nurse practitioner: Part one: Relevance to clinical practice and clinical inquiry process.
Facchiano, Lynda; Snyder, Charlene Hoffman;
Journal of the American Academy of Nurse Practitioners, 2012 Oct; 24 (10): 579-86
Abstract: Purpose: Evidence-based practice (EBP) continues to gain momentum within health care. The purpose of this four-part EBP series is to provide an introductory overview of the EBP process, emphasizing EBP steps one through three, in order to assist nurse practitioners (NPs) in building EBP skills that can be integrated into clinical practice. The relevance of EBP to the NP's clinical practice, an introduction to the EBP process steps, and clinical inquiry process begin the series. Data sources: Scientific literature review, gray literature, and online evidence-based practice databases and resources. Conclusions: EBP has become increasingly important to NPs, yet there is evidence suggesting it is not being fully implemented in clinical practice. EBP is one way to keep the busy NP's knowledge up to date, enhance clinical judgment, and augment the existing provider-client decision-making process. Implications for practice: The principles of EBP have become the cornerstone strategy for NPs to translate research findings into clinical practice. Practicing in an ever-changing healthcare environment, NPs have a responsibility to provide their clients with the best available evidence, while incorporating that evidence into the provider-client decision-making process.

6.  Evidence-based practice for the busy nurse practitioner: Part two: Searching for the best evidence to clinical inquiries.
Facchiano, Lynda; Snyder, Charlene Hoffman;
Journal of the American Academy of Nurse Practitioners, 2012 Nov; 24 (11): 640-8
Abstract: Purpose: The purpose of this four-part evidence-based practice (EBP) series is to enhance the nurse practitioner's (NP's) EBP skills by reviewing the process of developing a clinical question, searching for the best evidence, and critically appraising and applying the findings. Part two of the series focuses on how to search the published scientific literature for the most relevant studies that will answer a specific clinical question of importance to the NP. Data sources: Scientific literature review, gray searching, PubMed and other online literature databases and resources, and online EBP websites. Conclusions: Technology has allowed multiple healthcare resources to be available at one's fingertips enabling both NPs and their patients to find answers to clinical questions. EBP databases can be categorized as synthesized/filtered, unfiltered, and background information/expert opinion resources. Learning which database can best answer the clinical inquiry can streamline the search process. Implications for practice: For the busy NP, EBP has emerged as an important strategy to maintain valid, accurate, and relevant clinical knowledge. It is expected that this part of the series will enable NPs to identify appropriate databases to answer clinical inquires while refining their search strategy skills, which takes both time and practice.

7.  Evidence-based nursing. The nursing model of care: Don't forget the patient perspective.
Bakker, Denise; Mau, Jean;
Nursing Management, 2012 Oct; 43 (10): 8-11

8.  Making good choices about publishing in the journal jungle.
Clark, Alexander M.; Thompson, David R.;
Journal of Advanced Nursing, 2012 Nov; 68 (11): 2373-5

9.  The Study of Nursing Care project: back to the future for contemporary nursing research?
Smith, Kylie M.; Crookes, Patrick A.;
Journal of Advanced Nursing, 2012 Nov; 68 (11): 2586-93
Abstract: Aims. To discuss the Study of Nursing Care project, an initiative from the late 1970s in the UK. The article explores the impact of the Study of Nursing Care on nursing research, and considers to what extent it presents a useful model for contemporary nursing research. Background. It is acknowledged internationally that the nursing academic workforce is ageing and dwindling. Many possible solutions are being debated with all agreeing that the next generation of evidence based nurse leaders is urgently required. Data sources. In this article, the authors survey existing workforce schemes, describe the Study of Nursing Care series, published in the 1970s, and draw on interviews and correspondence conducted in 2009 with four of the original Study of Nursing Care research assistants. Discussion. The Study of Nursing Care project poses a potential response to academic workforce issues. This article discusses the evolution of the project, its methods and operation and considers its possible implications for contemporary practice. Implications for nursing. The Study of Nursing Care model demonstrates the clear benefits of fully committed funding, a programmatic approach towards research development, and the importance of selecting the right kind of people for the work, in a National scheme. Conclusion. The authors argue that although the clinical outcomes it set out to achieve remain elusive, the project produced a cohort of nurse researchers who went on to give important leadership in nursing, including in nursing academia/research. A contemporary version of the Study of Nursing Care has important potential to generate the next generation of nurse researchers, and leaders, into the twenty-first century.

10.  Participating in Clinical Nursing Research: Challenges and Solutions of The Bedside Nurse Champion.
Burnett, Margie; Lewis, Maureen; Joy, Tameria; Jarrett, Kelly;
MEDSURG Nursing, 2012 Sep-Oct; 21 (5): 309-11

11.  Clinical Inquiry. Engaging Research Partners to Advance Clinical Inquiry.
Bettger, Janet Prvu; Granger, Bradi B.;
AACN Advanced Critical Care, 2012 Oct-Dec; 23 (4): 471-8

12.  Uncovering the common ground in qualitative inquiry: combining quality improvement and phenomenology in clinical nursing research.
Gullick, Janice; West, Sandra;
International Journal of Health Care Quality Assurance 2012; 25 (6): 532-48  

13.  Before You Search the Literature: How to Prepare and Get the Most Out of Citation Databases.
McGrath, Jacqueline M.; Brown, Roy E.; Samra, Haifa A.;
Newborn & Infant Nursing Reviews, 2012 Sep; 12 (3): 162-70
Abstract: Abstract: As evidence-based practice becomes more integrated into routine care, systematically searching of the literature is essential to making informed clinical decisions. To uncover all the evidence and get the most unbiased sense of what is known about a particular phenomenon or caregiving practice, a clear method of searching that is systematic is needed. This article provides a discussion of six steps in a systematic search: (1) constructing the question, (2) choose the appropriate database(s), (3) formulate a search strategy, (4) perform the search, (5) evaluate the results, (6) good results (answer the question) = use the search information, (7) bad results = start over (refine the search strategies). Tips for working with a librarian are also provided. Lastly, a checklist developed to facilitate the steps of the searching process is discussed and provided for use by readers. Nurses are not trained to systematically search the literature, yet evidence-based practice demands that nurses and all health professionals be familiar with the searching process, especially when making evidence-based caregiving decisions.

14.  Advanced nursing roles: A systematic review.
Jokiniemi, Krista; Pietilä, Anna-Maija; Kylmä, Jari; Haatainen, Kaisa;
Nursing & Health Sciences, 2012 Sep; 14 (3): 421-31
Abstract: In this systematic literature review, we analyzed and synthesized the literature on one specialized advance practice nursing role in three countries for the purpose of describing and comparing these roles, as well as discussing whether an international consensus of the advance practice nursing definition is possible. A systematic search on CINAHL and PubMed Medline was conducted in 2011 to search the literature on the nurse consultant in the UK, the clinical nurse specialist in the USA, and the clinical nurse consultant in Australia. The studies ( n = 42) were analyzed and combined using qualitative content analysis method. The roles of the nurse consultant, clinical nurse specialist, and clinical nurse consultant were similar. The variation in the roles appears to derive from organizational or individual choices, not the country in question. The study process comprised a synthesized representation of one specialized advance practice nursing role. More work is needed to further define the concept of the advance practice nursing, as well as its implementation on other cultures beyond this review. Based on this review, an international consensus regarding the definition of advance practice nursing and its subroles is possible.

15.  Focus groups in nursing research: Methodological perspectives.
Jayasekara, Rasika S.;
Nursing Outlook, 2012 Nov; 60 (6): 411-6
Abstract: Abstract: Focus groups have been increasingly used as a data collection method in nursing research. The key feature of focus groups is the active interaction among participants to explore their views and opinions. In this respect, focus groups are distinct from other methods such as Delphi groups, nominal groups, brainstorming, and consensus panels, which seek to determine a consensus between participants. Compared with other data collection methods, it can be concluded that the real strength of focus groups is not simply in exploring what participants have to say, but in providing insights into the sources of complex behaviors and motivations. The aim of this paper is to present an overview of the focus group as a research tool in nursing research, particularly in nursing education.

16.  Nursing research across a large health care system: sparking nurses' clinical inquiry.
Wolf, Ilene Sue; Paoletti, Cathy; Du, Hongyan;
Nursing Administration Quarterly, 2012 Oct-Dec; 36 (4): 332-9
Abstract: : In our journey to achieve Magnet designation, we sought to increase staff nurses' research participation and teach them about the research process by conducting a corporate-wide study, a blind taste test, using potato chips. PURPOSE: : To compare 3 varieties of the same-brand potato chips for overall preference and perception of healthiness. We hypothesized that the potato chip the nurses liked the best would not be the chip they perceived as the healthiest. METHODS: : For this institutional review board-approved study, nurses were recruited via (1) randomly selected units and (2) a convenience sample during cafeteria lunch hours. After informed consent was obtained, nurses rated each potato chip in a blinded manner, based on appearance, crispiness, flavor, saltiness, and greasiness. They indicated which potato chip they perceived to be the healthiest and which they preferred overall, and they completed an anonymous demographic questionnaire. RESULTS: : A total of 263 nurses participated, with 78% being staff nurses. Regular (full fat) was most preferred (37.6%), whereas fat free was least preferred (16%) and also considered the healthiest (45.2%) (P < .0001). CONCLUSIONS: : Nurses preferred the regular chip and chose the fat-free chip as the healthiest, proving our hypothesis that the preferred chip would not be considered the healthiest. IMPLICATIONS: : This study was easy, feasible, and helped promote systemwide nursing research.

17.  Realizing the IOM Future of Nursing Research Within Clinical Practice.
Jones, Dorothy;
Nursing Research, 2012 Sep-Oct; 61 (5): 315















Thursday, November 08, 2012

Recently Published St. Joseph Hospital Nurses

Here are a few of the most recent articles published by SJO nurses, congratulations!

Instrument validation: hospital nurse perceptions of their Behavioral Health Care Competency.
Rutledge DN, Wickman M, Drake D, Winokur E, Loucks J.
Journal of Advanced Nursing
2012 May 2.
doi: 10.1111/j.1365-2648.2012.06025.x. [Epub ahead of print]

Abstract:
Aim: To report the development and psychometric testing of the Behavioral Health Care Competency survey, designed to measure hospital nurse perceptions of behavioral healthcare competency. Background.  Hospital nurses working in general or other non-psychiatric units may lack behavioral healthcare competency to manage disruptive behaviours associated with mental illnesses.
Design.  Instrument development.
Method.  A nurse study team including clinical experts and nurse researchers from three community hospitals in southern California (USA) reviewed content validity of each item and the 31-item instrument and created a behavioral health care competency conceptual model based on the nursing process. Separate institutional review board permissions were obtained from each hospital. The study team collaborated in the timing of survey administration (November 2010), analysis of the results and survey validation.
Results.  A total of 844 nurses completed the survey, representing approximately 23-41% of eligible nurses from each hospital. Using principal component analysis with varimax rotation, 23 items led to a factor structure with four components. Four subscales with adequate alpha coefficients were formed: Resource Adequacy, Patient Assessment, Practice/Intervention Competency, and Psychotropic Recommendation.
Conclusion.  The 23-item hospital nurse Behavioral Health Care Competency survey is an adequate and valid newly developed instrument. Further testing with diverse samples is needed to strengthen generalizability and address unique and specialized nursing care needs.

Reconceptualizing patient safety attendants.
Wiggins, Alexandra; Welp, Cheryl; Rutledge, Dana N.;
Nursing Management, 2012 May; 43(5): 25-7

A model program for perinatal palliative services.
Engelder S, Davies K, Zeilinger T, Rutledge D.
Advances in Neonatal Care. 2012 Feb;12(1):28-36.

Abstract:
Despite the fact that parents of infants with lethal anomalies may not want "full-blown" medical care for their infants after birth, most such infants die in neonatal intensive care units. Although neonatal nurses are trained to administer life-saving treatments, they may suffer from moral distress when faced with caring for babies with incompatible-with-life conditions. This article describes a Perinatal Comfort Care program in which (a) care is provided at the time of diagnoses/antenatally and includes home visits by members of an interdisciplinary hospice team; (b) care is collaborative, community-based, and family-centered, and takes place in labor and delivery and on the mother baby unit; and (c) follow-up to the family continues for 1 year after the death. Neonatal nurses can become involved either by initiating efforts to form a perinatal comfort care program or by joining an existing team.

Thursday, October 25, 2012

Danielle's Picks from the Literature - October 2012

Here are my picks of the literature for October. SJO and CHOC staff have access to the articles by contacting Burlew Medical Library.


1.  The Study of Nursing Care project: back to the future for contemporary nursing research?
Smith, Kylie M.; Crookes, Patrick A.;
Journal of Advanced Nursing, 2012 Nov; 68 (11): 2586-93

Abstract: Aims. To discuss the Study of Nursing Care project, an initiative from the late 1970s in the UK. The article explores the impact of the Study of Nursing Care on nursing research, and considers to what extent it presents a useful model for contemporary nursing research. Background. It is acknowledged internationally that the nursing academic workforce is ageing and dwindling. Many possible solutions are being debated with all agreeing that the next generation of evidence based nurse leaders is urgently required. Data sources. In this article, the authors survey existing workforce schemes, describe the Study of Nursing Care series, published in the 1970s, and draw on interviews and correspondence conducted in 2009 with four of the original Study of Nursing Care research assistants. Discussion. The Study of Nursing Care project poses a potential response to academic workforce issues. This article discusses the evolution of the project, its methods and operation and considers its possible implications for contemporary practice. Implications for nursing. The Study of Nursing Care model demonstrates the clear benefits of fully committed funding, a programmatic approach towards research development, and the importance of selecting the right kind of people for the work, in a National scheme. Conclusion. The authors argue that although the clinical outcomes it set out to achieve remain elusive, the project produced a cohort of nurse researchers who went on to give important leadership in nursing, including in nursing academia/research. A contemporary version of the Study of Nursing Care has important potential to generate the next generation of nurse researchers, and leaders, into the twenty-first century.

2.  The Controversy Over Antidepressant Drugs in an Era of Evidence-Based Practice.
Littrell, Jill Leslie; Lacasse, Jeffrey R.;
Social Work in Mental Health, 2012 Nov-Dec; 10 (6): 445-63
Abstract: Questions regarding the efficacy of antidepressant drugs have been a recent focus of attention in the national news both in print and in the television media. Many clients will have questions regarding what they can believe and how they can address mood problems. Social workers constitute a greater percentage of the mental health work force than any other profession. Thus, social workers will probably be asked by clients about these issues. This article presents information on the efficacy of antidepressants for both the short and long term. It covers adverse effects and withdrawal symptoms. Clients' self-determination should be honored. However, social workers can be of assistance in supplying facts relevant to decision making.

3.  Evidence based electronic system to ensure quality of care in trauma patients.
Mpletsa, Vasiliki; Kaklamanos, Ioannis; Birbas, Konstantinos; Mantas, John;
Studies in Health Technology & Informatics, 2012; 180: 482-6

Abstract: Electronic patient records are important for quality health services. Aim of this study is to support the trauma patient care with the development of an electronic system. A survey was conducted in the Emergency Department (ED) of a University hospital to study the effectiveness of an electronic monitoring system in a group of trauma patients, as well as the acceptance of this electronic system by the health professionals of the ED. A questionnaire collected information about the perceptions of 50 health professionals working in the ED on various aspects of patient care. The 86% (Nu=43) replied that there is lack of staff working in their department, 44% (N=22) is satisfied with the co-operation with other departments and 48% (N=24) believe that they spend precious time in administrative work during the care. For the purpose of a more efficient patient monitoring there was developed an electronic trauma patient monitoring system which was evaluated by the above mentioned professionals. The severity, length of care and the health outcomes of 200 trauma patients, were investigated. Half of the patients (N=100) have been monitored by the electronic system and the other 100 were monitored without the use of the system. The time between the admission and completion of the planned care was significantly lower in the electronic monitoring patient group (100±92 minutes) compared to the control group (149±29 minutes).

4.  Toward Evidence and Theory-Based Skin Care in Radiation Oncology.
Dendaas, Nancy;
Clinical Journal of Oncology Nursing, 2012 Oct; 16 (5): 520-5

Abstract: Dermatitis is a distressing symptom of radiation therapy, and current care guidelines often lack evidence. Using an evidence-based practice (EBP) model, a multidisciplinary group in an academic medical center reviewed the literature to create departmental patient education materials related to skin care that were grounded in evidence. Recommendations not supported by evidence from randomized, controlled trials were viewed within a stress-reduction framework. Until evidence related to the prevention and treatment of radiation dermatitis is more fully developed, skin care recommendations for patients with cancer who receive radiation may need to be based on evidence and theory. In addition, care for patients with radiation dermatitis should encompass strategies aimed at physical and psychosocial stressors.

5.  Integration of Evidence-Based Knowledge Management in Microsystems: A Tele-ICU Experience.
Rincon, Teresa A;
Critical Care Nursing Quarterly, 2012 Oct-Dec; 35 (4): 335-40

Abstract: The Institute of Medicine's proposed 6 aims to improve health care are timely, safe, effective, efficient, equitable, and patient-centered care. Unfortunately, it also asserts that improvements in these 6 dimensions cannot be achieved within the existing framework of care systems. These systems are based on unrealistic expectations on human cognition and vigilance, and demonstrate a lack of dependence on computerized systems to support care processes and put information at the point of use. Knowledge-based care and evidence-based clinical decision-making need to replace the unscientific care that is being delivered in health care. Building care practices on evidence within an information technology platform is needed to support sound clinical decision-making and to influence organizational adoption of evidence-based practice in health care. Despite medical advances and evidence-based recommendations for treatment of severe sepsis, it remains a significant cause of mortality and morbidity in the world. It is a complex disease state that has proven difficult to define, diagnose, and treat. Supporting bedside teams with real-time knowledge and expertise to target early identification of severe sepsis and compliance to Surviving Sepsis Campaign, evidence-based practice bundles are important to improving outcomes. Using a centralized, remote team of expert nurses and an open-source software application to advance clinical decision-making and execution of the severe sepsis bundle will be examined.

6.  Patient health literacy and the practice of evidence-based medicine.
Kistin, Caroline J.;
Evidence Based Medicine, 2012 Oct; 17 (5): 135-6
7.  Using the Theory of Planned Behaviour to predict nurses' intention to integrate research evidence into clinical decision-making.

Côté, Françoise; Gagnon, Johanne; Houme, Philippe Kouffé; Abdeljelil, Anis Ben; Gagnon, Marie-Pierre;
Journal of Advanced Nursing, 2012 Oct; 68 (10): 2289-98

Abstract: Aims. Using an extended Theory of Planned Behaviour, this article is a report of a study to identify the factors that influence nurses' intention to integrate research evidence into their clinical decision-making. Background. Health professionals are increasingly asked to adopt evidence-based practice. The integration of research evidence in nurses' clinical decision-making would have an important impact on the quality of care provided for patients. Despite evidence supporting this practice and the availability of high quality research in the field of nursing, the gap between research and practice is still present. Design. A predictive correlational study. Methods. A total of 336 nurses working in a university hospital participated in this research. Data were collected in February and March 2008 by means of a questionnaire based on an extension of the Theory of Planned Behaviour. Descriptive statistics of the model variables, Pearson correlations between all the variables and multiple linear regression analysis were performed. Results/findings. Nurses' intention to integrate research findings into clinical decision-making can be predicted by moral norm, normative beliefs, perceived behavioural control and past behaviour. The moral norm is the most important predictor. Overall, the final model explains 70% of the variance in nurses' intention. Conclusion. The present study supports the use of an extended psychosocial theory for identifying the determinants of nurses' intention to integrate research evidence into their clinical decision-making. Interventions that focus on increasing nurses' perceptions that using research is their responsibility for ensuring good patient care and providing a supportive environment could promote an evidence-based nursing practice.

8.  Evidence Into Practice: Using Research Findings to Create Practice Recommendations.

Cullen, Laura; Smelser, Jamie; Wagner, Michele; Adams, Susan;
Journal of PeriAnesthesia Nursing, 2012 Oct; 27 (5): 343-51

9.  Beyond PICO: The SPIDER Tool for Qualitative Evidence Synthesis.
Cooke, Alison; Smith, Debbie; Booth, Andrew;
Qualitative Health Research, 2012 Oct; 22 (10): 1435-43
10.  Evidence-Based Assessments in the Ventilator Discontinuation Process.
R. MacIntyre, Neil;
Respiratory Care, 2012 Oct; 57 (10): 1611-8
Abstract: The ventilator discontinuation process is an essential component of overall ventilator management. Undue delay leads to excess stay, iatrogenic lung injury, unnecessary sedation, and even higher mortality. On the other hand, premature withdrawal can lead to muscle fatigue, dangerous gas exchange impairment, loss of airway protection, and also a higher mortality. An evidence-based task force has recommended a daily discontinuation assessment and management process for most ICU patients requiring at least 24 hours of mechanical ventilator support. This process focuses on assessments on the causes for ventilator dependence, assessments for evidence of disease stability/ reversal, use of regular spontaneous breathing trials (SBTs) as the primary assessment tool for ventilator discontinuation potential, use of separate assessments to evaluate the need for an artificial airway in patients tolerating the SBT, and the use of comfortable, interactive ventilator modes (that do not need to be "weaned") in between regular SBTs. More recent developments have focused on the utility of computer decision support to guide these processes and the importance of linking sedation reduction protocols to ventilator discontinuation protocols. These guidelines are standing the test of time, and practice patterns are evolving in accordance with them. Nevertheless, there is still room for improvement and need for further clinical studies, especially in the patient requiring prolonged mechanical ventilation.

11.  Journal Club: A venue to advance evidence-based infection prevention practice.

Manning, Mary Lou; Davis, James;
American Journal of Infection Control, 2012 Sep; 40 (7): 667-9

Abstract: Journal Clubs are a well-recognized strategy used by clinicians to critique and keep up to date with relevant literature. This article provides an example of an assessment of an article appearing in this issue of the American Journal of Infection Control titled, “US School/Academic Institution Disaster and Pandemic Preparedness and Seasonal Influenza Vaccination Among School Nurses.”

12.  Uncovering the common ground in qualitative inquiry: combining quality improvement and phenomenology in clinical nursing research.
Gullick, Janice; West, Sandra;
International Journal of Health Care Quality Assurance, 2012; 25 (6): 532-48

13.  Employing a clinical governance framework to engage nurses in research.

Kinney, Sharon; Lima, Sally; McKeever, Stephen; Twomey, Bernadette; Newall, Fiona;
Journal of Nursing Care Quality, 2012 Jul-Sep; 27 (3): 226-31
Abstract: The theoretical benefits of engaging in quality and research activities are readily apparent; however, engagement of clinical nurses in these pursuits remains challenging. In addition, the separation of quality improvement and research as distinct endeavors can impair desired improvements in patient outcomes. We propose that employing a clinical governance framework to inform nursing research in the clinical setting enhances the engagement of nurses in the generation and utilization of evidence to improve the quality of care.

14.  Making good choices about publishing in the journal jungle.
Clark, Alexander M.; Thompson, David R.;
Journal of Advanced Nursing, 2012 Nov; 68 (11): 2373-5
15.  Balancing interests of hospitals and nurse researchers: Lessons learned.
Marshall, June; Edmonson, Cole; Gemeinhardt, Gretchen; Hamilton, Patti;
Applied Nursing Research, 2012 Aug; 25 (3): 205-11
Abstract: While nurse researchers and administrators in health care organizations need to collaborate to understand the variables that affect nursing practice environments and patient care outcomes, there are inherent risks associated with these collaborations that require careful consideration. A team of academic and hospital researchers found that in studying the off-peak (nights and weekends) nursing environment using institutional ethnography, which involved interviews of nurses and administrators, the subject of the research was frequently the hospitals where these individuals worked. Although the individuals who participated in the research consented to be interviewed about their work, it was less clear how and to what extent the anonymity of their organizations could be maintained. The risks and benefits encountered suggest the need for a decision-making process to be undertaken by collaborative research teams. This decision process and analysis can help ensure a fruitful research relationship that protects sensitive concerns of hospital entities while advancing our understanding of nursing practice environments and patient care outcomes. Important strategies include having all leaders and research team members discuss the agendas of all entities and individuals involved, including clearly delineating the roles, responsibilities, and contributions of all parties. In addition, any constraints or expectations of first right of review of publications needs to be negotiated from the outset. Collaborators need to review their agreements throughout the research process to avoid pitfalls that could adversely impact the relationships as well as the dissemination of knowledge gained.

16.  The five top bad reasons nurses don't publish in impactful journals.
Thompson, David R.; Clark, Alexander M.;
Journal of Advanced Nursing, 2012 Aug; 68 (8): 1675-8

Friday, August 31, 2012

Danielle's Picks from the Literature - September 2012

Here are my picks of the literature for June. SJO and CHOC staff have access to the articles by contacting Burlew Medical Library.

1. Evidence-based nursing. Got accountability? Increasing data transparency.
Meltsch, Tami J.;
Nursing Management, 2012 Jun; 43 (6): 13-5

2. Nurse-directed interventions to reduce catheter-associated urinary tract infections.
Oman, Kathleen S.; Makic, Mary Beth Flynn; Fink, Regina; Schraeder, Nicolle; Hulett, Teresa; Keech, Tarah; Wald, Heidi;
American Journal of Infection Control, 2012 Aug; 40 (6): 548-53
Abstract: Background: Catheter-associated urinary tract infections (CAUTIs) are common, morbid, and costly. Nearly 25% of hospitalized patients are catheterized yearly, and 10% develop urinary tract infections. Evidence-based guidelines exist for indwelling urinary catheter management but are not consistently followed. Methods: A pre/post intervention design was used in this quality improvement project to test the impact of nurse-driven interventions based on current evidence to reduce CAUTIs in hospitalized patients on 2 medical/surgical units. Interventions consisted of hospital-wide strategies including policy and product improvements and unit-specific strategies that focused on a review of current evidence to guide practice. Results: The number of catheter days decreased from 3.01 to 2.2 (P = .018) on the surgery unit and from 3.53 to 2.7 (P = .076) on the medical unit. CAUTI rates were too low to achieve significant reduction. Product cost savings were estimated at $52,000/year. Conclusion: Guidelines derived from research and other sources of evidence can successfully improve patient outcomes. Nurse-driven interventions, combined with system-wide product changes, and patient and family involvement may be effective strategies that reduce CAUTI.

3. INSPIRING CHANGE. Plan for a successful research day!
Mikos-Schild, Sophia; Avelino, Aida; Calvario, Marilou; Mata, Annette;
Nursing, 2012 Aug; 42 (8): 11-2

4. Facilitators and Barriers to Clinical Practice Guideline Use Among Nurses.
Abrahamson, Kathleen A.; Fox, Rebekah L.; Doebbeling, Bradley N.;
American Journal of Nursing, 2012 Jul; 112 (7): 26-36

5. Beyond the central line-associated bloodstream infection bundle: the value of the clinical nurse specialist in continuing evidence-based practice changes.
Richardson, Jeannette; Tjoelker, Rita;
Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 2012 Jul-Aug; 26 (4): 205-11
Abstract: PURPOSE: : The purpose of this project was to demonstrate the value of clinical nurse specialist (CNS)-led efforts to optimize patient outcomes through continued monitoring and management of a previously implemented evidence-based practice project. BACKGROUND: : Central line-associated bloodstream infections (CLABSIs) significantly impact patient morbidity/mortality and cost of care. In 2006, the critical care unit (CCU) of the Portland VA Medical Center implemented national recommendations for the prevention of CLABSIs through use of the Institute of Healthcare Improvement Central Line Bundle. This practice change was led by the CCU and infection control CNSs, and compliance in the completion of bundle items has remained consistently high (>90%). Although the CCU has maintained CLABSI rates below the national benchmark, it experienced a 4-month period of increased incidence in late 2008. DESCRIPTION: : Clinical nurse specialists in CCU and infection control organized a "Hot Team" of nurses from multiple departments throughout the hospital to evaluate processes/data related to the recent increase in infections. Using national guidelines, the team focused on interdisciplinary implementation of strategies beyond the Central Line Bundle components. Consideration of cost and workflow patterns was critical to decision making. OUTCOME: : Infection rates in CCU decreased from a high of 1.5 per 1000 line days down to 0 in June 2011, with the last CLABSI occurring in May 2010. CONCLUSION: : The formation and efforts of a CNS-led team of nurses has been successful in decreasing infection rates through implementation of multiple innovative strategies. IMPLICATIONS: : Clinical nurse specialist surveillance, management, and leadership following project implementation are valuable strategies for continued optimal patient outcomes.

6. Employing a clinical governance framework to engage nurses in research.
Kinney, Sharon; Lima, Sally; McKeever, Stephen; Twomey, Bernadette; Newall, Fiona; Journal of Nursing Care Quality, 2012 Jul-Sep; 27 (3): 226-31
Abstract: The theoretical benefits of engaging in quality and research activities are readily apparent; however, engagement of clinical nurses in these pursuits remains challenging. In addition, the separation of quality improvement and research as distinct endeavors can impair desired improvements in patient outcomes. We propose that employing a clinical governance framework to inform nursing research in the clinical setting enhances the engagement of nurses in the generation and utilization of evidence to improve the quality of care.

7.  Research study or quality improvement project?
Arndt, Jane V; Netsch, Debra S;
Journal of Wound, Ostomy & Continence Nursing, 2012 Jul-Aug; 39 (4): 371-5

8. The Evidence-Based Practice Course as an Opportunity for Writing.
Dewar, Susan R.;
Nurse Educator, 2012 Jul-Aug; 37 (4): 143-4

9. QI, EBP and Research: How Do They Differ?
AACN Bold Voices, 2012 Jun; 4 (6): 18

10. Practice-Based Evidence and Qualitative Inquiry.
Leeman, Jennifer; Sandelowski, Margarete;
Journal of Nursing Scholarship, 2012; 44 (2): 2nd Quarter: 171-9
Abstract: Purpose: Nurses and other healthcare providers continue to underuse interventions demonstrated to be effective at improving health outcomes. We propose in this article that if more evidence-based practice is wanted, greater use must be made of qualitative inquiry to obtain practice-based evidence derived from the experiences and practices of healthcare providers and the contexts of healthcare provision. Approach: We present a framework for the use of qualitative methods to contribute to the following categories of practice-based evidence: (a) practice-based interventions and implementation strategies, (b) causal mechanisms, (c) approaches to adaptation, (d) how-to guidance, (e) unanticipated effects, and (f) relevant contextual factors. Conclusions: Qualitative inquiry has an essential role to play in incorporating more practice-based evidence into the evidence base for nursing practice. Clinical Relevance: This framework can be used by clinicians to plan for the implementation of interventions in practice, by researchers to discuss the practice implications of their findings, and by researchers to launch qualitative studies explicitly designed to capture practice-based evidence.

11. Evidence Into Practice: Publishing an Evidence-Based Practice Project.
Adams, Susan; Farrington, Michele; Cullen, Laura;
Journal of PeriAnesthesia Nursing, 2012 Jun; 27 (3): 193-202

12. The role of the advanced practice registered nurse in ensuring evidence-based practice.
Moseley, Marthe J;
Nursing Clinics of North America, 2012 Jun; 47 (2): 269-81
Abstract: The advanced practice registered nurse (APRN) is vital in role-modeling and ensuring evidence-based practice (EBP) engagement and application at the point of care. This article describes the formulation of national competencies for EBP, specific to the APRN level. The application of selected competencies is delineated and the creation of an APRN action plan to identify necessary EBP competencies is discussed. If EBP skills are lacking, the action plan is used for development of skills in the required areas.

13. Implementing Skin-To-Skin Contact at Birth Using the Iowa Model.
Haxton, Dawn; Doering, Jennifer; Gingras, Linda; Kelly, Lucy;
Nursing for Women's Health, 2012 Jun-Jul; 16 (3): 220-30

14. Clinical research nursing: A critical resource in the national research enterprise.
Hastings, Clare E.; Fisher, Cheryl A.; McCabe, Margaret A.;
Nursing Outlook, 2012 May; 60 (3): 149-156.e3
Abstract: Translational clinical research has emerged as an important priority for the national research enterprise, with a clearly stated mandate to more quickly deliver prevention strategies, treatments and cures based on scientific innovations to the public. Within this national effort, a lack of consensus persists concerning the need for clinical nurses with expertise and specialized training in study implementation and the delivery of care to research participants. This paper reviews efforts to define and document the role of practicing nurses in implementing studies and coordinating clinical research in a variety of clinical settings, and differentiates this clinical role from the role of nurses as scientists and principal investigators. We propose an agenda for building evidence that having nurses provide and coordinate study treatments and procedures can potentially improve research efficiency, participant safety, and the quality of research data. We also provide recommendations for the development of the emerging specialty of clinical research nursing.

15. Quality improvement, evidence-based practice, and nursing research . . . Oh my!.
Raines, Deborah A;
Neonatal Network, 2012 Jul-Aug; 31 (4): 262-4
Abstract: Research is a word that evokes feeling of fear and dread in many nurses. Maybe its memories of the research course required in their nursing education program, hours spent in the library, or deciphering the statistics section in a research article. Most nurses want to focus on nursing skills and are unaware of the relationship between research and nursing care skills, such as administering medications, protecting skin integrity, or educating an anxious parent. Many nurses see research as distinct from patient care and nursing practice, but nothing is further from the truth. Quality nursing care is based on questioning the things nurses do and looking at the relationship between nursing care and patient outcomes. For a long time, nursing practices were based on tradition. Even the emergence of the neonatal intensive care unit (NICU) was grounded in the tradition of the adult intensive care unit. Equipment and practices were downsized without evidence that what worked with an adult patient could be effectively miniaturized and used with neonatal patients. If the goal of nursing practice is excellent care and quality outcomes for patients, then questioning practices, examining outcomes, using evidence, and sharing discoveries are essential components of the nurses' role.

16. Challenges that may arise when conducting real-life nursing research.
White, Edward;
Nurse Researcher, 2012 Jul; 19 (4): 15-20
Abstract: Aim To reveal some of the unexpected occurrences that can arise during real-life investigations to upset the conventional research process. Background As novice investigators develop their careers, they are increasingly likely to encounter aspects of research that are rarely mentioned in nursing textbooks. This paper sets out several such occurrences that may challenge the researcher and the practical consequences for an unsuspecting investigator. Data sources The author's experience in research over the past 30 years. Discussion In seeking to find satisfactory solutions to problems during research, researchers will also face dilemmas that offer at least two possibilities, neither of which may be acceptable. Experienced researchers will recognise this situation and acknowledge the range of trade-offs that characterise social research. Implications for practice/research Novice researchers should be forewarned of some of the challenges they could face when carrying out future research.

Thursday, June 21, 2012

Danielle's Picks from the Literature - June 2012

Here are my picks of the literature for June.  SJO and CHOC staff have access to the articles by contacting Burlew Medical Library.

Evidence Into Practice: Publishing an Evidence-Based Practice Project.
Adams, Susan; Farrington, Michele; Cullen, Laura;
Journal of PeriAnesthesia Nursing, 2012 Jun; 27 (3): 193-202

The Role of Technology in Enhancing Evidence-Based Practice, Education, Heathcare Quality, and Patient Outcomes: A Call for Randomized Controlled Trials and Comparative Effectiveness Research.
Melnyk, Bernadette Mazurek;
Worldviews on Evidence-Based Nursing, 2012 2nd Quarter; 9 (2): 63-65

Evidence-based nursing. The EBP rollout process.
Sparger, Kathy; Selgas, Misleydy; Collins, Patricia Manda; Lindgren, Carolyn L.; Massieu, Mary; Castillo, Angela S.;
Nursing Management, 2012 May; 43 (5): 14-20

Evidence-Based Practice for Obtaining Blood Specimens From a Central Venous Access Device.
Mendez, Sarah J.;
Oncology Nursing Forum, 2012 May; 39 (3): 247-51
Abstract: As part of a scheduled policy and procedure review, the department of nursing education at a large urban academic medical center conducted a literature review to determine the most up-to-date evidence for central venous access device (CVAD) blood draws. The literature review revealed that the dead space blood draw was the best practice methodology because the dead space methodology, defined as the point at which blood is in the attached syringe when aspirating without flushing, reduced the potential for infection with minimal blood loss from blood discard.

Planning for Implementation of Evidence-Based Practice.
Cullen, Laura; Adams, Susan L.;
Journal of Nursing Administration, 2012 Apr; 42 (4): 222-30

Infusing research into practice: a staff nurse evidence-based practice fellowship program.
Gawlinski, Anna; Becker, Elaine;
Journal for Nurses in Staff Development, 2012 Mar-Apr; 28 (2): 69-73
Abstract: This article describes the framework and dynamics of an evidence-based practice mentorship program for staff nurses. Staff development educators can be instrumental as leaders in an evidence-based practice fellowship program, as they foster a thirst for lifelong learning, assist with developing a questioning attitude, and inspire nurses to ask clinical questions. The program serves as a bridge to bring research into real-world patient care that results in improved patient outcomes.

Mentoring nurses in evidence-based projects.
Journal for Nurses in Staff Development, 2012 Mar-Apr; 28 (2): 89-90

Nursing Research: It's Easier Than You Think!.
Guercia, Joan M.; Howard, Beverly J.;
Med-Surg Matters, 2012 Mar-Apr; 21 (2): 1-12

Promoting nursing research and innovation by staff nurses.
Syme, Rachel; Stiles, Carla;
Applied Nursing Research, 2012 Feb; 25 (1): 17-24 Abstract:
Abstract: Promoting nursing research participation is challenging. Since the creation of an internal fund for research and innovation, 11 projects have received funding with a doubling of staff participation. The success of this novel funding opportunity highlights the need for this type of support and demonstrates success in promoting nursing research.

Demystifying nursing research terminology: Part 2.
Welford, Claire; Murphy, Kathy; Casey, Dympna;
Nurse Researcher, 2012; 19 (2): 29-35
Abstract: Aim To provide an explanation of the research methodologies and strategies available. Background There are numerous research methodologies and strategies. The literature is ambiguous in relation to research terminology and this often leads to confusion about which methodology or strategy to adopt. Data sources A review of the most up-to-date literature. Discussion The most commonly adopted methodologies and strategies are discuss Conclusion Part 1 (Welford et al 2011) of this two-part paper explained the research paradigms and the rationales for choosing particular paradigms. Part 2 provides an explanation of the methodologies and strategies available to the researcher. Implications for practice/research This paper will be particularly useful for novice researchers or doctoral students.

Mixing research with hands-on experience.
Dunning, Jeremy;
Cancer Nursing Practice, 2012 Apr; 11 (3): 7

The role of a research nurse in translating evidence into practice.
Houlston, Catherine;
Nursing Management - UK, 2012 Apr; 19 (1): 25-8
Abstract: This article describes the role and experiences of a research nurse working with a nursing team to implement best practice guidelines. The structure of the research project and resources were found to support the change, resulting in better patient care. Challenges promoting change as part of a research project included inflexibility of research paperwork and competing local trust priorities. The research nurse was able to support the clinical team to implement change through education and regular visits to the ward to monitor progress and feedback good practice.

Efficacy of the use of evidence-based algorithmic guidelines in the acute care setting for pain assessment and management in older people: a critical review of the literature.
Harmon, Joanne R.; Higgins, Isabel; Summons, Peter; Bellchambers, Helen;
International Journal of Older People Nursing, 2012 Jun; 7 (2): 127-40

So You Want to Change Practice: Recognizing Practice Issues and Channeling Those Ideas.
Lusardi, Paula;
Critical Care Nurse, 2012 Apr; 32 (2): 55-64
Abstract: Applying the best evidence to support nursing practice and generating new knowledge for use in practice are the hallmarks of excellence and allow practitioners to meet patient care quality and safety priorities. Although identifying a patient care problem comes easily to staff nurses, the process of clarifying the problem and channeling those ideas through to a practice change can be daunting for bedside nurses. This article provides guidance to staff nurses who want to identify a clinical problem and change practice.

Applying research to practice: exploring the barriers.
Hewitt-Taylor, Jaqui; Heaslip, Vanessa; Rowe, Nicholas E.;
British Journal of Nursing (BJN), 2012 Mar 22; 21 (6): 356-9
Abstract: Nurses are not averse to applying research findings to their clinical practice; however, there appears to be a number of barriers to achieving this. Generally, barriers include lack of time and the need to provide more education surrounding the use of research. While these are both valid points, the authors suggest that perhaps the solution to the problem is looking at how research is 'sold' to practitioners. For example, the use of jargon in research is off-putting to many practitioners, which creates an impression that research is associated with academia, rather than a tool for practitioners. Also, there may be an unrealistic expectation of what 'using research' might mean. Research is seen as the pinnacle of evidence, and not a part of evidence-based practice. In this article, the authors propose that teaching and expectations of research should focus on the application of research to practice. Reviewing and critiquing of research should serve the purpose of helping to make decisions about its practical applications, rather than for academic use.

Nurses learn caring theory by being co-researchers in a surgical setting.
Boussaid, Lena; Dahlgren, Monica; Lindwall, Lillemor;
Nurse Education Today, 2012 May; 32 (4): 393-8
Abstract: Summary: This paper present findings from research on the following issues: How nurses from surgical unit learn a caring theory by being co-researchers in a research group. The aim was to describe the learning process of the nurses when they were co-researchers in a research group. The study has a qualitative design and a hermeneutical approach. Data were collected through interviews with seven registered nurses in hospital in mid Sweden. The study shows that nurses learn caring by listening to each other. Four sub-themes emerged through the interpretation: Nurses learn caring theory by listening to each other when they are; giving time to talk to one another, expressing their actions in words, sharing thoughts with others and allowing themselves to be touched by each other''s stories. The new understanding highlights that learning in research groups can be understood as a learning process, where nurses listen to one another and thereby create an expression and meaning of their experiences through caring theory, while at the same time developing their profession. Nurses learn caring theory by being co-researchers in a research group. In order for this to happen, the research collaboration should be characterized by realism and engagement.

Monday, June 11, 2012

Free trial - PsycINFO & PsycTESTS databases

SJO and CHOC RNs and staff are welcome to trial the PsycINFO & PsycTESTS databases for the month of June.  PsycINFO provides access to the Psychological literature and PsycTESTS provides access to psychological tests, measures, scales, assessments and questionnaires.  For more information contact Danielle Linden via email or call 714-771-8000 x17759.

Monday, May 07, 2012

Celebrate Nurses Week - Free Access to Proquest Database

The good folks at Proquest are providing free access to their Nursing & Allied Health Database during Nurses Week.  Happy National Nurses Week and happy searching!

Thursday, April 26, 2012

Danielle's Picks from the Literature - April 2012

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.

1. Educational support for research utilization and capability beliefs regarding evidence-based practice skills: a national survey of senior nursing students
Florin, Jan; Ehrenberg, Anna; Wallin, Lars; Gustavsson, Petter;
Journal of Advanced Nursing, 2012 Apr; 68 (4): 888-97

Abstract: The aim of the study was to investigate Swedish university nursing students' experience of educational support for research utilization and capability beliefs regarding evidence-based practice skills. Background. Nursing programmes are offered at 26 universities in Sweden and even though there are common regulations for nursing education at the national level, substantial variations are found in local curricula. Little is known about students' capability beliefs regarding evidence-based practice skills, particularly in comparison across universities. Methods. A cross-sectional survey design using self-administered postal questionnaires was conducted in 2006. A total of 1440 students (from 26 different universities) participated, constituting 68% of the national population of nursing students in their 6th and final semester. Results. Campus education supported the students to a greater extent than clinical education in following the development of knowledge in an area of interest, using research findings, and acquiring knowledge on how to pursue changes in clinical practice. Perceived support during campus education varied between universities. Students reported high capability beliefs regarding evidence-based practice skills, but large differences were found between universities for: stating a searchable question, seeking out relevant knowledge and critically appraising and compiling best knowledge. Conclusion. The identified differences between universities concerning the students' perceived support for research utilization and their capability beliefs regarding evidence-based practice skills have implications for curricula, pedagogical perspectives in nursing education and the potential to implement evidence-based practice in healthcare settings. Further studies are warranted to investigate students' individual characteristics and organizational characteristics as determinants of research utilization support and capability beliefs regarding evidence-based practice skills.

2. Questioning the use value of qualitative research findings.
Lipscomb, Martin;
Nursing Philosophy, 2012 Apr; 13 (2): 112-25

Abstract: In this paper the use value of qualitative research findings to nurses in practice is questioned. More precisely it is argued that, insofar as action follows belief then, in all but the rarest of cases, the beliefs that nurses in practice can justifiably derive from or form on the basis of qualitative research findings do not sanction action in the world and the assumption, apparently widely held, that qualitative research can as evidence productively inform practice collapses. If qualitative research does not have a substantive action guiding potential then, in consequence, three conclusions are permitted. First, regarding the requirement that nurses ground actions on evidence, regulators should redraft methodologically neutral or permissive guidelines to specify the sorts of research evidence that can serve this function. Second, qualitative methodologies should receive less prominence in nurse education programmes. Third, qualitative researchers should make it clear that their work cannot inform practice. Alternatively, if this claim is advanced the process by which this is to be achieved should be explicitly stated.

3. The role of the clinical research nurse.
Gibbs, Claire Louise; Lowton, Karen;
Nursing Standard, 2012 Mar 7-13; 26 (27): 37-40

Abstract: With increased emphasis on clinical research within the NHS, it is vital that training and educational opportunities are available to enable clinical research nurses to progress in their careers. This article describes the work of the clinical research nurse and examine the advantages and disadvantages of the role. It discusses the history of clinical research nursing and those aspects and guidelines that have shaped the way the role has developed. The lack of a career pathway for nurses who decide to pursue a career in nursing research and/or medical research is considered, and suggestions are made regarding the future of clinical research nursing and education.

4. The institutional review board: purpose and process.
Westlake, Cheryl; Taha, Asma A.;
Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 2012 Mar-Apr; 26 (2): 66-70

5. Involving practice nurses in primary care research: the experience of multiple and competing demands. Boase, Sue; Kim, Youngsuk; Craven, Anthea; Cohn, Simon;
Journal of Advanced Nursing, 2012 Mar; 68 (3): 590-9

Abstract: This paper is a report of a study of the experiences of practice nurses delivering a complex research intervention in an exploratory randomized controlled trial in primary care. Background. As practice nurses increasingly become involved in primary care research, it is important to understand not only what impact this may have on their existing role but also equally on what their potential contribution might be. Method. Fourteen of the 15 practice nurses involved in the delivery of a complex intervention were purposively sampled and interviewed in their workplace between June and October 2007. Interviews were audio-recorded, transcribed and analysed using a Framework Approach and NVivo software. Findings. Time influenced the nurses' engagement with the various aspects of the trial and meant that they constantly had to make judgments and decisions in response to the multiple agendas presented to them: they had to negotiate a range of competing loyalties between their professional clinical role, their role in the research and practice teams and their relationship with patients. The nurses' accounts consequently provide insight into the active role they played both in the trial process and the delivery of the complex intervention. Conclusion. The nurses were key to the delivery of the trial. If practice nurses are to develop a research role in their professional work, it is important to understand their perceptions and the impact such involvement has on them and their practice. Consideration of these factors is consequently valuable when developing research in primary care settings.

6. Mentoring advanced practice nurses in research: Recommendations from a pilot program.
Leung, Doris; Widger, Kimberley; Howell, Doris; Nelson, Sioban; Molassiotis, Alex;
Canadian Oncology Nursing Journal, 2012 Winter; 22 (1): 31-5

Abstract: Advanced Practice Nurses (APNs) need research skills to develop and advance their practice and, yet, many have limited access to research training and support following completion of their advanced degree. In this paper we report on the development, delivery, and evaluation of an innovative pilot program that combined research training and one-to-one mentorship for nine APNs in conducting research relevant to their practice. The program was organized within an academic institution and its affiliated hospitals in Toronto, Canada. Our experience with this program may assist those in other organizations to plan and deliver a similar program for APN research mentorship.

7. Research ethics application: a guide for the novice researcher.
Greaney, Anna-Marie; Sheehy, Agnes; Heffernan, Catrina; Murphy, Joan; Mhaolrúnaigh, Siobhán Ni; Heffernan, Elizabeth; Brown, Gary;
British Journal of Nursing (BJN), 2012 Jan 11; 21 (1): 38-43

Abstract: The aim of this paper is to assist the novice researcher in the research ethics application process. The novice researcher in this context refers to any researcher negotiating a research ethics application for the first time. This may be a student or a more experienced registered nurse engaged in research activity. The paper applies ethical principles to the varied elements of a research ethics application form to explain the theoretical basis of the application criteria. The impetus for this paper arose following an internal audit of the decisions made by the research ethics committee of the nursing department at the Institute of Technology in Tralee, Ireland. The audit revealed the common reasons why full approval was not granted following initial review. This information prompted the development of a paper which would assist novice researchers in avoiding common errors and omissions in the research ethics application process. Despite the specific requirements of individual research ethics committees in different jurisdictions, the fundamental elements of research ethics approval remain unchanged. While the paper has local origins, its relevance holds a wider appeal. The paper takes a structured approach using the three ethical principles of respect for persons, beneficence, and justice, as outlined by the Belmont Report (1979) to provide a framework for discussion. Despite the advent of other frequently used frameworks for research ethics, the principles of the Belmont report remain constant as guidance for good practice in the research ethics context.

8. Let's Get Started: Research and Writing.
Journal of Infusion Nursing, 2012 Jan-Feb; 35 (1): 13-4

9. The Role of the Nurse Research Facilitator in Building Research Capacity in the Clinical Setting. Jamerson, Patricia A.; Vermeersch, Patricia;
Journal of Nursing Administration, 2012 Jan; 42 (1): 21-7

10. Demystifying nursing research terminology: Part 2.
Welford, Claire; Murphy, Kathy; Casey, Dympna;
Nurse Researcher, 2012; 19 (2): 29-35

Abstract: Aim To provide an explanation of the research methodologies and strategies available. Background There are numerous research methodologies and strategies. The literature is ambiguous in relation to research terminology and this often leads to confusion about which methodology or strategy to adopt. Data sources A review of the most up-to-date literature. Discussion The most commonly adopted methodologies and strategies are discuss Conclusion Part 1 (Welford et al 2011) of this two-part paper explained the research paradigms and the rationales for choosing particular paradigms. Part 2 provides an explanation of the methodologies and strategies available to the researcher. Implications for practice/research This paper will be particularly useful for novice researchers or doctoral students.

11. Your role in protecting research participants.
Schneider, Melissa A.;
Nursing, 2012 Jan; 42 (1): 15-7

12. Applying research to practice: exploring the barriers.
Hewitt-Taylor, Jaqui; Heaslip, Vanessa; Rowe, Nicholas E.;
British Journal of Nursing (BJN), 2012 Mar 22; 21 (6): 356-9

Abstract: Nurses are not averse to applying research findings to their clinical practice; however, there appears to be a number of barriers to achieving this. Generally, barriers include lack of time and the need to provide more education surrounding the use of research. While these are both valid points, the authors suggest that perhaps the solution to the problem is looking at how research is 'sold' to practitioners. For example, the use of jargon in research is off-putting to many practitioners, which creates an impression that research is associated with academia, rather than a tool for practitioners. Also, there may be an unrealistic expectation of what 'using research' might mean. Research is seen as the pinnacle of evidence, and not a part of evidence-based practice. In this article, the authors propose that teaching and expectations of research should focus on the application of research to practice. Reviewing and critiquing of research should serve the purpose of helping to make decisions about its practical applications, rather than for academic use.

13. Using the agency for healthcare research and quality patient safety indicators for targeting nursing quality improvement
Zrelak, Patricia A; Utter, Garth H; Sadeghi, Banafsheh; Cuny, Joanne; Baron, Ruth; Romano, Patrick S;
Journal of Nursing Care Quality, 2012 Apr-Jun; 27 (2): 99-108

Abstract: Quantifying the critical impact nurses have on the prevention and early recognition of potential complications and adverse events, such as those identified by the Agency for Healthcare Research and Quality (AHRQ) patient safety indicators (PSI), is becoming increasingly important. In this paper, we describe how the AHRQ PSI may be used to identify nursing-specific opportunities to improve care based on data from the national AHRQ PSI validation pilot project.

14. Translating Research Into Everyday Practice—The Essential Role of Pediatric Nurses.
Christian, Becky J.;
Journal of Pediatric Nursing, 2012 Apr; 27 (2): 184-5

Tuesday, April 03, 2012

New Journal Issue Devoted to EBP



The latest issue of Southern Medical Journal is devoted entirely to Evidence Based Practice. SJO and CHOC employees may request the full-text articles through the Burlew Medical Library.

Highlights from the Table of Contents include:

Southern Medical Journal
Current Issue: March 2012 - Volume 105 - Issue 3
Issue on Evidence-Based Medicine

Evidence-Based Medicine for Clinicians
Mansi, Ishak A.; Banks, Daniel E.
Southern Medical Journal. 105(3):109, March 2012.

The Challenge of Evidence-Based Medicine
Mansi, Ishak A.; Banks, Daniel E.
Southern Medical Journal. 105(3):110-113, March 2012.

Evidence-Based Medicine: Specific Skills Necessary for Developing Expertise in Critical Appraisal
Morris, Michael J.; Fewell, Allyson E.; Oleszewski, Ryan T.
Southern Medical Journal. 105(3):114-119, March 2012.

Statistics for the Nonstatistician: A Primer for Reading Clinical Studies
Mansi, Ishak A.
Southern Medical Journal. 105(3):120-125, March 2012.

Application of the Principles of Evidence-Based Medicine to Patient Care
Wilton, Nouansy K.; Slim, Ahmad M.
Southern Medical Journal. 105(3):136-143, March 2012.

Critical Appraisal Process: Step-by-Step
Timm, Donna F.; Banks, Daniel E.; McLarty, Jerry
Southern Medical Journal. 105(3):144-148, March 2012.

Reasoning and Evidence-Based Medicine: Common Pitfalls
Varma, Jai; Rodriguez, Rechell; Mansi, Ishak A.
Southern Medical Journal. 105(3):167-172, March 2012.

Final Tips in Interpreting Evidence-Based Medicine
Mansi, Ishak A.; Thompson, Jennifer C.; Banks, Daniel E.
Southern Medical Journal. 105(3):173-180, March 2012.

Thursday, March 29, 2012

Danielle's Picks from the Literature - March 2012

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.

1. Nursing research in theory and practice - is implementation the missing link?
Severinsson, Elisabeth;
Journal of Nursing Management, 2012 Mar; 20 (2): 141-3

2. Promoting nursing research and innovation by staff nurses.
Syme, Rachel; Stiles, Carla;
Applied Nursing Research, 2012 Feb; 25 (1): 17-24

Abstract: Promoting nursing research participation is challenging. Since the creation of an internal fund for research and innovation, 11 projects have received funding with a doubling of staff participation. The success of this novel funding opportunity highlights the need for this type of support and demonstrates success in promoting nursing research.

3. Demystifying nursing research terminology: Part 2.
Welford, Claire; Murphy, Kathy; Casey, Dympna;
Nurse Researcher, 2012; 19 (2): 29-35

Abstract: Aim To provide an explanation of the research methodologies and strategies available. Background There are numerous research methodologies and strategies. The literature is ambiguous in relation to research terminology and this often leads to confusion about which methodology or strategy to adopt. Data sources A review of the most up-to-date literature. Discussion The most commonly adopted methodologies and strategies are discuss Conclusion Part 1 (Welford et al 2011) of this two-part paper explained the research paradigms and the rationales for choosing particular paradigms. Part 2 provides an explanation of the methodologies and strategies available to the researcher. Implications for practice/research This paper will be particularly useful for novice researchers or doctoral students.

4. A taste of nursing research: an interactive program introducing evidence-based practice and research to clinical nurses.
Brown, Christine R; Johnson, Ann S; Appling, Susan E;
Journal for Nurses in Staff Development, 2011 Nov-Dec; 27 (6): E1-5

Abstract: Developing and implementing a program to introduce clinical nurses to research and evidence-based practice (EBP) should spark interest and participation. In this article, the authors describe and evaluate a staff development initiative not only to introduce the principles of EBP and research but also to give nurses the opportunity to participate in the research process and development of EBP questions.

5. Nursing research week: promoting staff nurse awareness of research activities through a week long celebration.
Weitzel, Tina; Robinson, Sherry;
Journal for Nurses in Staff Development, 2011 Nov-Dec; 27 (6): 280-4

Abstract: Nursing Research Week was developed and implemented by staff nurses who comprise the Nursing Research Council of a Midwest hospital. Multiple activities based on the literature and designed to appeal to staff nurses with diverse interests and knowledge of research were included. The process of development of the activities and the participants' evaluation are shared.

6. 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

7. Implementing Evidence-Based Practice in the Reality of Clinical Practice.
Rycroft-Malone, Jo;
Worldviews on Evidence-Based Nursing, 2012 1st Quarter; 9 (1): 1

8. Factors Influencing Advanced Practice Nurses' Ability to Promote Evidence-Based Practice among Frontline Nurses.
Gerrish, Kate; Nolan, Mike; McDonnell, Ann; Tod, Angela; Kirshbaum, Marilyn; Guillaume, Louise;
Worldviews on Evidence-Based Nursing, 2012 1st Quarter; 9 (1): 30-39

9. Effectiveness of organisational infrastructures to promote evidence-based nursing practice.
Foxcroft D; Cole N;
Cochrane Database of Systematic Reviews, 2012 (2)

Abstract: Background:; Nurses and midwives form the bulk of the clinical health workforce and play a central role in all health service delivery. There is potential to improve health care quality if nurses routinely use the best available evidence in their clinical practice. Since many of the factors perceived by nurses as barriers to the implementation of evidence-based practice (EBP) lie at the organisational level, it is of interest to devise and assess the effectiveness of organisational infrastructures designed to promote EBP among nurses.; Objectives:; To assess the effectiveness of organisational infrastructures in promoting evidence-based nursing.; Search methods:; We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, LILACS, BIREME, IBECS, NHS Economic Evaluations Database, Social Science Citation Index, Science Citation Index and Conference Proceedings Citation Indexes up to 9 March 2011.; We developed a new search strategy for this update as the strategy published in 2003 omitted key terms. Additional search methods included: screening reference lists of relevant studies, contacting authors of relevant papers regarding any further published or unpublished work, and searching websites of selected research groups and organisations.; Selection criteria:; We considered randomised controlled trials, controlled clinical trials, interrupted times series (ITSs) and controlled before and after studies of an entire or identified component of an organisational infrastructure intervention aimed at promoting EBP in nursing. The participants were all healthcare organisations comprising nurses, midwives and health visitors.; Data collection and analysis:; Two authors independently extracted data and assessed risk of bias. For the ITS analysis, we reported the change in the slopes of the regression lines, and the change in the level effect of the outcome at 3, 6, 12 and 24 months follow-up.; Main results:; We included one study from the USA (re-analysed as an ITS) involving one hospital and an unknown number of nurses and patients. The study evaluated the effects of a standardised evidence-based nursing procedure on nursing care for patients at risk of developing healthcare-acquired pressure ulcers (HAPUs). If a patient's admission Braden score was below or equal to 18 (i.e. indicating a high risk of developing pressure ulcers), nurses were authorised to initiate a pressure ulcer prevention bundle (i.e. a set of evidence-based clinical interventions) without waiting for a physician order. Re-analysis of data as a time series showed that against a background trend of decreasing HAPU rates, if that trend was assumed to be real, there was no evidence of an intervention effect at three months (mean rate per quarter 0.7%; 95% confidence interval (CI) 1.7 to 3.3; P = 0.457). Given the small percentages post intervention it was not statistically possible to extrapolate effects beyond three months.; Authors' conclusions:; Despite extensive searching of published and unpublished research we identified only onelow-quality study; we excluded many studies due to non-eligible study design. If policy-makers and healthcare organisations wish to promote evidence-based nursing successfully at an organisational level, they must ensure the funding and conduct of well-designed studies to generate evidence to guide policy.

10. Clinical nurse specialists shaping policies and procedures via an evidence-based clinical practice council.
Becker, Elaine; Dee, Vivien; Gawlinski, Anna; Kirkpatrick, Theresa; Lawanson-Nichols, Mary; Lee, Betty; Marino, Christina; McNair, Norma; Melwak, Mary A.; Purdy, Isabell; et al.;
Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 2012 Mar-Apr; 26 (2): 74-86

Abstract: In the practice of nursing, organizations with progressive evidence-based practice programs implement structures and processes whereby nurses are engaged in the review of existing research and in the development of clinical practice documents to better align nursing practices with the best available scientific knowledge. At our academic hospital system, clinical nurse specialists (CNSs) took the lead to help transform a traditional nursing policy and procedure committee into a hospital-wide, staff-represented Clinical Practice Council (CPC) that ensures evidence-based nursing practices are reflected in the organization's nursing practice documents for the provision of patient care. Clinical nurse specialists function as mentors and cochairs who are dedicated to ensuring that nursing practice is supported by the latest evidence and committed to guiding staff nurses to continually move their practice forward. The success of the CPC is due to the leadership and commitment of the CNSs. This article describes the structure, process, and outcomes of an effective CPC where CNSs successfully engage frontline clinicians in promoting nursing care that is evidence based. Clinical nurse specialist leadership is increasingly made visible as CNSs effectively involve staff nurses in practice reforms to improve patient outcomes.

11. Does evidence-based nursing practice increase ROI?
Schifalacqua, Marita MacKinnon; Soukup, Maurita; Kelley, Wanda; Mason, Alison Rich; American Nurse Today, 2012 Jan; 7 (1): 32-3

Abstract: A quality-improvement initiative quantified return on investment (ROD from cost avoidance for five healthcare-acquired conditions.

12. Examining Nurses' Attitudes Regarding the Value, Role, Interest, and Experience in Research in an Acute Care Hospital.
Riley, Joann Kay; Hill, Ambrosha N; Krause, Kori B; Leach, Laura B; Lowe, Timothy J; Journal for Nurses in Staff Development, 2011 Nov-Dec; 27 (6): 273-9

Abstract: This study examined nurses' attitudes regarding the value of and their role, interest, and experience in research in an acute care hospital. A correlational design explored the relationship between attitudes about nursing research, involvement, educational background, and experience. The results indicated an increasing level of value and interest in research for those nurses with greater educational attainment, certified specialty, previously taken research course, research experience, and a nursing position in education. The findings suggest that additional education and guided projects are needed for those nurses with little or no previous research experience.

Wednesday, February 22, 2012

Upcoming Webcast - Tips for Evaluating the Evidence

Improving patient outcomes through Evidence Based Practice requires a wide range of skills, both clinical and theoretical. A key component is the ability to survey, assess and interpret the research literature in order to guide or change practice. Ovid, a key provider of electronic nursing journals and books, has opened the following webcast to those interested in building their research assessment skills. Demystifying Research: Simplifying Critical Appraisal will "address the steps needed to critically appraise research evidence and demonstrate how to embrace the process of distilling the pearls that research has to offer." The webcast will be presented live on Wednesday, March 7, 2012 at 9:00AM Pacific Time. Click on the link above to register.

Friday, February 17, 2012

St. Joseph staff publishes in latest Advances in Neonatal Care

Congratulations to Suzanne Engelder, MSW; Kathryn Davies, MSN, RNC; Terry Zeilinger, MSN, RNC; & Dana Rutledge, PhD, RN for their article, "A Model Program for Perinatal Palliative Services" published in Advances in Neonatal Care (2012, volume 12, issue 1). The article describes the innovative Perinatal Comfort Care program available at St. Joseph Hospital in Orange. SJO and CHOC staff can access the article online via the Burlew Medical Library website or by contacting the library directly.

Wednesday, January 25, 2012

Danielle's Picks from the Literature - January 2012

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.

1. Evidence, patient preferences and patient-centred care.
Hopp, Lisa;
International Journal of Evidence-Based Healthcare, 2011 Dec; 9 (4): 335-6

2. Evidence-Based Nursing. Taking care of business with TCAB.
O'Neill, Jennifer A.; Holecek, Nancy; DeLima, Mary;
Nursing Management, 2011 Dec; 42 (12): 19-22

3. Evidence-based practice and research: the challenge for transplant nursing.
White-Williams, Connie;
Progress in Transplantation, 2011 Dec; 21 (4): 299-305
Abstract: Despite the initiative for nurses to engage in evidence-based practice and research, little is known about transplant nurses and the role they play in research and evidence-based practice in nursing care. The definition of evidence-based practice and research and how it relates to the role of the transplant nurse, the facilitators and barriers to research and evidence-based practice, and the implications for the future of research and evidence-based practice in transplant nursing are addressed.

4. Developing Guidelines for Clinical Protocol Development.
Levin, Rona F.; Lewis-Holman, Seon;
Research & Theory for Nursing Practice, 2011; 25 (4): 233-7

5. Promoting the Implementation of Evidence-Based Practice: A Literature Review Focusing on the Role of Nursing Leadership.
Sandström, Boel; Borglin, Gunilla; Nilsson, Roland; Willman, Ania;
Worldviews on Evidence-Based Nursing, 2011 4th Quarter; 8 (4): 212-23
Abstract: Objectives: Despite a growing interest in evidence-based practice (EBP), the implementation into clinical practice of knowledge derived from research has proved to be a cumbersome process. Additionally, the literature seems to present a fragmented picture with research mainly focusing on a few factors of possible importance, among which leadership appears to be one of the more important. Thus, this study aimed to systematically review the literature regarding leadership and its possible influence on the process of implementing EBP. Approach: A literature review was conducted. Electronic database searches were conducted to identify studies on leadership, administrators, managers, implementation, evidence-based and nursing. The search identified 43 potentially relevant papers, of which 36 were excluded after an appraisal was performed by two independent reviewers. Results were extracted and synthesised into a narrative text. Findings: Seven papers were included in the literature review. The findings can be divided into three major areas: (1) characteristics of the leader, (2) characteristics of the organisation and (3) characteristics of the culture. Our findings indicate that leadership is vital for the process of implementing EBP in nursing and also highlights the possible importance of the organisation and the culture in which the leader operates. These factors together with their characteristics were interpreted to be intrinsic in the creation of a nursing milieu that is open and responsive to the implementation of EBP. Conclusions: Although there seems to be scholarly agreement that leadership is a vital part of the process of implementing EBP, more rigorous research is needed concerning the possible role of the leader. Our findings also indicate that leadership cannot be studied in isolation or without being clearly defined.

6. An Exploration of the Roles of Nurse Managers in Evidence-Based Practice Implementation.
Wilkinson, Joyce E.; Nutley, Sandra M.; Davies, Huw T.O.;
Worldviews on Evidence-Based Nursing, 2011 4th Quarter; 8 (4): 236-46
Abstract: Background: Internationally, nurses face ongoing difficulties in making a reality of evidence-based practice. Existing studies suggest that nurse managers (NMs) should play a key role in leading and facilitating evidence-based practice, but the nature of this role has not yet been fully explored or articulated. This is one of the first studies to investigate the roles of NMs in evidence-based practice implementation. Methodology and Methods: Using a case study approach the study explores five propositions in relation to the NMs' potential evidence-based practice role and the extent to which their attitudes, knowledge, and skills support such a role. In doing so, it draws on interviews (n = 51), documentary analysis and observational data. Findings: Data analysis reveals that the role of NMs in facilitating evidence-based practice is underarticulated, largely passive and currently limited by competing demands. Progress in implementing evidence-based practice in the case study sites is largely explained by factors other than the role played by NMs. As such, the findings expose significant discrepancies between NMs' actual roles and those espoused in the literature as being necessary. Contextual factors are important and it is clear that the role of the contemporary NM places considerable emphasis on management and administration to the detriment of clinical practice concerns. Conclusions: The study reveals that NMs are only involved in evidence-based practice implementation in a passive role, not the full engagement described in the literature as being necessary. This study adds previously lacking detail of the roles of NMs. It elucidates why exhortations to NMs to become more involved in evidence-based practice implementation are ineffectivewithout action to address the problems identified.

7. A critical realist approach to knowledge: implications for evidence-based practice in and beyond nursing.
Nairn, Stuart;
Nursing Inquiry, 2012 Mar; 19 (1): 6-17
Abstract: A critical realist approach to knowledge: implications for evidence-based practice in and beyond nursing This paper will identify some of the key conceptual tools of a critical realist approach to knowledge. I will then apply these principles to some of the competing epistemologies that are prevalent within nursing. There are broadly two approaches which are sometimes distinct from each other and sometimes inter-related. On one side, there is the view that all healthcare interventions should be judged on the principles of randomised controlled trials and the other is a preoccupation with language in which healthcare interventions are subjected to a discursive interrogation. These debates are configured through the idea of a hierarchy of knowledge that is accorded uncritical acceptance by some and virulent distaste by others. I will argue that the notion of hierarchy is problematic and is largely argued for in unproductive epistemological terms. What is required is a shift towards a theory that emphasises the contextual nature of the ways that knowledge is produced and disseminated. In other words, there is no single hierarchy of knowledge, but there are multiple hierarchies of knowledge.

8. Determining factors in evidence-based clinical practice among hospital and primary care nursing staff.
De Pedro-Gómez, Joan; Morales-Asencio, José Miguel; Bennasar-Veny, Miquel; Artigues-Vives, Guillem; Perelló-Campaner, Catalina; Gómez-Picard, Patricia;
Journal of Advanced Nursing, 2012 Feb; 68 (2): 452-9
Abstract: Determining factors in evidence-based clinical practice among hospital and primary care nursing staff. Journal of Advanced Nursing 68(2), 452-459. Abstract Aim. The general aim of this study is to identify key factors perceived by nurses to influence evidence-based clinical practice at different centres. Background. During the last decade, there has been an increased interest in the identification of factors that facilitate the transfer of knowledge into clinical practice, among health care professionals. Previous research states that a suitable organisational framework and practice environment seems to have influence on a greater use of scientific evidence by nurses, which can be directly observed in patient outcomes. In consequence, several authors suggest that strategies should be encouraged from managers and nurse executives to guarantee the existence of environments that avoid emotional exhaustion and improve satisfaction of nurses with their work, and at the same time, ensure the use of research-guided nursing decisions. Methods. Following the Spanish validation of the Practice Environment Scale-Nursing Work Index and Evidence Based Practice Questionnaire, a descriptive observational cross-sectional study has been conceived, from 2010 to 2011, in order to identify determining factors in evidence-based clinical practice at different centres. In a second phase, a qualitative study has been designed, using focus groups, to identify practice factors that can lead to a successful implementation of evidence-based clinical practice. Discussion. Organisational and attitudinal interventions are needed in order to implement evidence-based clinical practice that improves the quality of patient care.

9. Whither Nursing Models? The value of nursing theory in the context of evidence-based practice and multidisciplinary health care.
McCrae, Niall;
Journal of Advanced Nursing, 2012 Jan; 68 (1): 222-9
Abstract: Whither Nursing Models? The value of nursing theory in the context of evidence-based practice and multidisciplinary health care. Journal of Advanced Nursing 68(1), 222-229. Abstract Aim. This paper presents a discussion of the role of nursing models and theory in the modern clinical environment. Background. Models of nursing have had limited success in bridging the gap between theory and practice. Data sources. Literature on nursing models and theory since the 1950s, from health and social care databases. Discussion. Arguments against nursing theory are challenged. In the current context of multidisciplinary services and the doctrine of evidence-based practice, a unique theoretical standpoint comprising the art and science of nursing is more relevant than ever. Implications for nursing. A theoretical framework should reflect the eclectic, pragmatic practice of nursing. Conclusion. Nurse educators and practitioners should embrace theory-based practice as well as evidence-based practice.

10. Hourly rounding: challenges with implementation of an evidence-based process.
Deitrick LM; Baker K; Paxton H; Flores M; Swavely D;
Journal of Nursing Care Quality, 2012 Jan-Mar; 27 (1): 13-9
Abstract: Introduction of an evidence-based practice change, such as hourly rounding, can be difficult in the hospital setting. This study used ethnographic methods to examine problems with the implementation of hourly rounding on 2 similar inpatient units at our hospital. Results indicate that careful planning, communication, implementation, and evaluation are required for successful implementation of a nursing practice change.

11. Practice Makes Perfect—Research Makes Perfect Practice.
Christian, Becky J.;
Journal of Pediatric Nursing, 2012 Feb; 27 (1): 90-1

12. Statistical process control in nursing research.
Polit DF; Chaboyer W;
Research in Nursing & Health, 2012 Feb; 35 (1): 82-93
Abstract: In intervention studies in which randomization to groups is not possible, researchers typically use quasi-experimental designs. Time series designs are strong quasi-experimental designs but are seldom used, perhaps because of technical and analytic hurdles. Statistical process control (SPC) is an alternative analytic approach to testing hypotheses about intervention effects using data collected over time. SPC, like traditional statistical methods, is a tool for understanding variation and involves the construction of control charts that distinguish between normal, random fluctuations (common cause variation), and statistically significant special cause variation that can result from an innovation. The purpose of this article is to provide an overview of SPC and to illustrate its use in a study of a nursing practice improvement intervention.

13. Towards improved organisational support for nurses working in research roles in the clinical setting: A mixed method investigation.
Rickard, Claire M.; Williams, Ged; Ray-Barruel, Gillian; Armit, Lyn; Perry, Chris John; Luke, Haida; Duffy, Paula; Wallis, Marianne;
Collegian, 2011; 18 (4): 165-76
Abstract: Background The clinical research workforce within nursing is growing including those employed to lead studies, coordinate research and many hybrid roles. Several studies have reported high job satisfaction among research nurses. However, there have also been reports of limited options for career development and professional integration, likely reflecting typical informal, departmentally based management models. Institution-wide studies of issues related to research nurses are lacking, thus hampering the design and implementation of effective organisational frameworks to support and develop these positions. Aims To explore experiences of nurses employed in research positions regarding organisational structures and support for research career pathways, and determine what reforms would strengthen an effective research specialisation pathway. Methods A mixed-methods, cross-sectional approach, using a 104-item survey and semi-structured interviews of 11 staff in research roles at an acute care hospital in Queensland, Australia. Results Research nurses lack organisational support in many job aspects that they deem important. A management model for the coordination of research nurses within a health district could maximise development of this field. Academic liaison and mentoring for nurses in research, and recognition for effort, are key areas for a management model to target. Conclusion Nurses in research roles need individual mentorship, collective support, and the professional recognition and status that researchers in other settings are afforded. A comprehensive research management model would provide structured organisational support for nurses in research, improve professional development opportunities, ensure efficient use of human resources, synergistic working partnerships, and further contribute to a culture of evidence-based healthcare.

14. Advancing Nursing Administration Through Research.
Hill, Karen S.;
Journal of Nursing Administration, 2011 Dec; 41 (12): 558-64