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

Wednesday, January 18, 2012

More tips for getting published in the nursing literature!

Last year the British Journal of Nursing published a compilation of articles for nurses on publishing in the professional literature. Tips include recommendations on getting started, writing structure, and how to choose the right journal. The entire series is available to St. Joseph Hospital, Orange and CHOC staff through the Burlew Medical Library's CINAHL database.

Writing for professional publication. Part 1: Motivation.
Fowler J
British Journal of Nursing (BJN) (BR J NURS), 2010 Sep 9; 19(16): 1062.

Writing for professional publication. Part 2: Subject matter.
Fowler J
British Journal of Nursing (BJN) (BR J NURS), 2010 Sep 23; 19(17): 1121.

Writing for professional publication. Part 3: Following journal guidelines.
Fowler J
British Journal of Nursing (BJN) (BR J NURS), 2010 Oct 28; 19(19): 1260.

Writing for professional publication. Part 4: Supporting your statements.
Fowler J
British Journal of Nursing (BJN) (BR J NURS), 2010 Nov 25; 19(21): 1374.

Writing for professional publication. Part 5: Creating interest.
Fowler J
British Journal of Nursing (BJN) (BR J NURS), 2011 Jan 13; 20(1): 49.

Writing for professional publication. Part 6: Writing the abstract.
Fowler J
British Journal of Nursing (BJN) (BR J NURS), 2011 Jan 27; 20(2): 120.

Writing for professional publication. Part 7: Structure and presentation.
Fowler, J
British Journal of Nursing (BJN) (BR J NURS), 2011 Feb 10; 20(3): 190.

Writing for professional publication. Part 8: Targeting the right journal
Fowler, J
British Journal of Nursing (BJN) (BR J NURS), 2011 Feb 23; 20(4): 254.

Writing for professional publication. Part 9: Using client case studies.
Fowler, J
British Journal of Nursing (BJN) (BR J NURS), 2011 Mar 10; 20(5): 330.

Writing for professional publication. Part 10: Publishing a project report.
Fowler, J
British Journal of Nursing (BJN) (BR J NURS), 2011 Apr 14; 20(6): 371.

Writing for professional publication. Part 11: Writing conference.
Fowler, J
British Journal of Nursing (BJN) (BR J NURS), 2011 Apr 21; 20(7): 451.

Writing for professional publication. Part 12: Summary of the series.
Fowler, J
British Journal of Nursing (BJN) (BR J NURS), 2011 Apr 28; 20(8): 509.

Tuesday, January 10, 2012


Welcome to Vickie’s Research Corner.
Over the past several years here we have had so many interesting research studies. I would like to introduce you to Irma Patrick; she is currently the manager of Cardiac/Renal. She has worked at St. Joseph’s Hospital since 1997. She just finished her Masters in Nursing with a focus in Leadership at California State University Fullerton this past year. As part of her Master’s project, Irma decided to try her hand at research. Her study was called “Use of Healing touch Self-Care Technique to Reduce Stress in Bedside Nurses: A Pilot Study.
When asked how she became interested in her study she stated that “I decided to research Healing Touch. I developed interest in energy work after attending a meditation seminar in Hawaii. I then decided to take a Healing Touch class. Once I started my Masters program I realized I have an avenue to perform research in this area and wanted to get away from just studying clinical practice.”
Healing Touch Program (2009) explains that human energy system is made up of an energy field (aura), energy centers (chakras), and energy tracts (meridians) and that they work interdependently and influence physical, emotional, mental and spiritual life. Desired outcomes of HT are achieved when there is an unimpeded flow of energy and balancing of the energy field.
According to her literature review nurses who perceive themselves as healers often feel unsupported in their work environments. Often many nurses do not have a good work balance and do not practice self-care. Alternative therapies allowing nurses to self heal may help to decrease stress and avoid burnout. Several studies identified that healing touch reduced stress.
Irma worked with her chair who happened to be our own Dana Rutledge. They developed the pilot study. The study questioned if performing healing touch self-care technique for 15 minutes during a work shift reduce levels of stress during the shift. This study was a randomized clinical controlled trial. Eight nurses from each shift from the Cardiac Renal Unit were invited and they must have attended a Watson’s Caritas Summit and volunteered for the study. Nurses were randomized into two groups- intervention of Healing Touch and the control group who just took a break for 20 minutes and could do whatever they wanted on their break.
The results of the study were very positive! The tool used measured positive and negative feelings of the intervention pre and post intervention. The results demonstrated that both groups experiences increased positive feelings and decreased negative feelings (p<0.001). There was a significant time effect with decreasing negative feelings (p=0.038) with nurses in the Healing Touch group having a greater decrease in negative feeling than those in the control group. Overall Irma was very happy with her study especially since she has never done a study before. She would eventually like to do a larger study and continues to work on her Healing Touch study with a goal of certification through ANCC.- Irma and 8 other volunteers offered brief Healing Touch sessions to attendees of the Cultivating Optimal Healing Environments Conference held at St Joes on May 3, 2011. She will be taking the Level 4 Healing Touchclass in February at The Sisters of St. Joseph of Orange Center for Spiritual Development.