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