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]

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.

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.