Danielle's Picks from the Literature - December 2013

Happy Holidays!  Here are my picks from the nursing literature for December. SJO and CHOC staff have access to the articles by contacting Burlew Medical Library.

1. Nurse Educ Today. 2014 Jan;34(1):132-7. 

doi: 10.1016/j.nedt.2012.09.006. Epub 2012 Sep 30.

Embracing a culture in conducting research requires more than nurses' enthusiasm.

Loke JC, Laurenson MC, Lee KW.

Abstract

AIMS:

This study explored the perceptions of clinical nurses about their research knowledge and experiences to highlight any gaps in nurse education in supporting research activities in healthcare organisations.

BACKGROUND:

Nurses' research activities have been encouraged by moving hospital-based nurse education into higher education institutions whereby there is a stronger emphasis on teaching and developing nursing research at both undergraduate and post graduate levels. They were further encouraged by the introduction of advanced nurse practitioner roles, in the hope to increase opportunities for research participation. Whilst nurses' research activities have been explored in many countries, nurses in Singapore where there is a strong emphasis on evidence-based practice have not been investigated.

METHODS:

A mixed-methods exploratory descriptive design, using a questionnaire based on open and closed questions was employed to obtain the views of clinical nurses about their capacity and organisational support in conducting research. The questionnaires were distributed to convenient samples who attended one of the 4 research seminars held on separate occasions between July and August 2011 in Singapore.

RESULTS:

A total of 146 nurses were recruited. Whilst nurses demonstrated strong enthusiasm in conducting research, this characteristic feature was not adequate for them to embrace a research culture in organisations. Active participation as co-investigators was not possible in healthcare organisations where skewed distribution of resources towards medical and nurse researchers was perceived.

CONCLUSIONS:

The results suggest a need for a significant shift in focus on educational training from imparting research contents to providing opportunities to experience the research process. Organisational support in terms of protected time and financial support ought to be in place for nursing research experience. The findings also demonstrated that in places where organisational support was available, awareness of research opportunities such as educational and organisational support needed to be strengthened. This in turn would enable more nurses particularly those who provide direct patient care to conduct research within the context of the competing nursing practice demands.

2. Nurse Pract. 2013 Dec 10;38(12):1-7. 

doi: 10.1097/01.NPR.0000437576.14143.b9.

Lean methodology: An evidence-based practice approach for healthcare improvement.

Johnson PM, Patterson CJ, Oʼconnell MP.

Abstract

Lean methodology, an evidence-based practice approach adopted from Toyota, is grounded on the pillars of respect for people and continuous improvement. This article describes the use of Lean methodology to improve healthcare outcomes for patients with community-acquired pneumonia. Nurse practitioners and other clinicians should be knowledgeable about this methodology and become leaders in Lean transformation. 

3. J Adv Nurs. 2013 Dec;69(12):2622-34. 

doi: 10.1111/jan.12152. Epub 2013 Apr 18.

Re-examining definitions of spirituality in nursing research.

Reinert KG, Koenig HG.

Abstract

AIM:

To discuss the definition of spirituality and its limitations for nursing research. It proposes a definition that will capture more accurately the role of spirituality in health outcomes.

BACKGROUND:

Studies have increasingly examined spirituality in nursing research as a coping mechanism attenuating the negative impact of traumatic stress on mental health. Existing definitions of spirituality in nursing research include elements of positive emotional states (meaning, purpose, general well-being) which confound mental health outcomes.

DATA SOURCES:

Medline and CINAHL databases were searched from 2007-2011 for research articles examining spirituality definitions and measures used by nurse researchers.

DISCUSSION:

An analysis of the definitions of spirituality in nursing research reveals inconsistencies and confounding mental health concepts. The authors propose defining spirituality in the context of religious involvement when conducting research, while using a broader definition of spirituality when providing spiritual care. They argue such definition provides a more appropriate method of measuring this concept in research aimed at evaluating mental health outcomes while preserving the currently used patient-defined definition of spirituality when providing spiritual care.

NURSING IMPLICATIONS:

A consistent definition of spirituality in nursing research evaluating mental health outcomes, distinct from 'spiritual care' in a clinical setting, is essential to avoid tautological results that are meaningless. Appropriate definitions will enable nursing researchers to more clearly identify resilience mechanisms and improved health outcomes in those exposed to traumatic stress.

CONCLUSION:

A definition of spirituality that focuses on religious involvement provides a more uniform and consistent measure for evaluating mental health outcomes in nursing research.

4. Nurse Educ Today. 2013 Dec;33(12):1550-6. 

doi: 10.1016/j.nedt.2013.01.005. Epub 2013 Feb 8.

Enhancing communication with distressed patients, families and colleagues: the value of the Simple Skills Secrets model of communication for the nursing and healthcare workforce.

Jack BA, O'Brien MR, Kirton JA, Marley K, Whelan A, Baldry CR, Groves KE

Abstract

BACKGROUND:

Good communication skills in healthcare professionals are acknowledged as a core competency. The consequences of poor communication are well-recognised with far reaching costs including; reduced treatment compliance, higher psychological morbidity, incorrect or delayed diagnoses, and increased complaints. The Simple Skills Secrets is a visual, easily memorised, model of communication for healthcare staff to respond to the distress or unanswerable questions of patients, families and colleagues.

OBJECTIVES:

To explore the impact of the Simple Skills Secrets model of communication training on the general healthcare workforce.

DESIGN AND METHODS:

An evaluation methodology encompassing a quantitative pre- and post-course testing of confidence and willingness to have conversations with distressed patients, carers and colleagues and qualitative semi-structured telephone interviews with participants 6-8 weeks post course.

PARTICIPANTS:

During the evaluation, 153 staff undertook the training of which 149 completed the pre- and post-training questionnaire. A purposive sampling approach was adopted for the follow up qualitative interviews and 14 agreed to participate.

RESULTS:

There is a statistically significant improvement in both willingness and confidence for all categories; (overall confidence score, t(148)=-15.607, p=<0 .05="" 6.171="" 8.171="" a="" additional="" and="" approach="" between="" carers="" clinical="" communicating="" confidence="" course="" data="" difference="" differently="" from="" greatest="" improvement="" in="" including:="" is="" mean="" method="" model="" no="" obtained="" of="" overall="" p="" post="" practice="" pre-course="" qualitative="" registered="" reported.="" score="" several="" significant="" skills.="" staff.="" statistical="" structured="" support="" t="" the="" themes="" there="" thinking="" to="" value="" was="" were="" willingness="" with="">

CONCLUSION:

This model can be suggested as increasing the confidence of staff, in dealing with a myriad of situations which, if handled appropriately can lead to increased patient and carers' satisfaction. Empowering staff appears to have increased their willingness to undertake these conversations, which could lead to earlier intervention and minimise distress.

 

5. Appl Nurs Res. 2013 Nov;26(4):263-8. 

doi: 10.1016/j.apnr.2013.05.004. Epub 2013 Aug 6.

Why isn't evidence based practice improving health care for minorities in the United States?

Lee H, Fitzpatrick JJ, Baik SY.

Abstract

Achieving health equity by improving the health care of all racial/ethnic groups is one of the key goals of Healthy People 2020. The implementation of evidence based practice (EBP) has been a major recommendation to achieve health equity in hopes of eliminating the subjectivity of clinical decision making. However, health disparities among racial/ethnic minorities are persistent in spite of the adoption of standardized care based on evidence. The EBP with racial and ethnic minorities is often seen as a possible cause of health and health care disparities. Three potential issues of using EBP to reduce health disparities have been identified: (1) a lack of data for EBP with ethnic/racial minority populations; (2) limited research on the generalizability of the evidence based on a European-American middle-class; and (3) sociocultural considerations in the context of EBP. Using EBP to reduce disparities in health care and health outcomes requires that nurse professionals should know how to use relevant evidence in a particular situation as well as to generate knowledge and theory which is relevant to racial/ethnic minorities. In addition, EBP implementation should be contextualized within the sociocultural environments in which patients are treated rather than solely focusing on the health problems.

 

6. J Emerg Nurs. 2013 Nov;39(6):657-9. doi: 10.1016/j.jen.2013.09.004.

Translating research to practice: bringing emergency nursing research full circle to the bedside.

Carman MJ, Wolf LA, Baker KM, Clark PR, Henderson D, Manton A, Zavotsky KE.

7.  Nurse Educ Today. 2013 Nov;33(11):1295-300. 

doi: 10.1016/j.nedt.2013.03.010. Epub 2013 Apr 21.

IMPAD-22: a checklist for authors of qualitative nursing research manuscripts.

Salzmann-Erikson M.

Abstract

OBJECTIVE:

The aim of this paper is to develop a checklist for authors preparing qualitative nursing research manuscripts, specifically focusing on the method section.

DESIGN:

Literature review.

DATA SOURCES:

15 articles were purposefully selected from three different nursing journals.

REVIEW METHODS:

Evans' four step process was used to synthesize the method sections of the included articles.

RESULTS:

Four main categories were identified 1) Ingress and Methodology, 2) Participants, 3) Approval, and 4) Data: Collection and Management. Based on the categories and sub-categories, a 22-item checklist was developed.

DISCUSSION AND CONCLUSIONS:

Earlier guidelines for formal reporting were developed for qualitative research in general. The main advantage and contribution of IMPAD is that it provides a 22-item checklist specifically aimed towards the method section, and furthermore, it was developed specifically for authors within the field of nursing research.

8. Clin J Oncol Nurs. 2013 Oct;17(5):544-9. 

doi: 10.1188/13.CJON.544-549.

The experience of implementing evidence-based practice change: a qualitative analysis.

Irwin MM, Bergman RM, Richards R.

Abstract

The Oncology Nursing Society (ONS) and ONS Foundation worked together to develop the Institute for Evidence-Based Practice Change (IEBPC) program to facilitate the implementation of evidence-based practice (EBP) change in nursing. This analysis describes the experience of 19 teams of nurses from various healthcare settings who participated in the IEBPC program. Qualitative analysis of verbatim narratives of activities and observations during the process of implementing an EBP project was used to identify key themes in the experience. EBP implementation enabled participants to learn about their own practice and to experience empowerment through the evidence, and it ignited the spirit of inquiry, team work, and multidisciplinary collaboration. Experiences and lessons learned from nurses implementing EBP can be useful to others in planning EBP implementation. 

9. Intensive Crit Care Nurs. 2013 Oct;29(5):256-60. 

doi: 10.1016/j.iccn.2013.03.004. Epub 2013 May 11.

APN-led nursing rounds: an emphasis on evidence-based nursing care.

Mahanes D, Quatrara BD, Shaw KD.

Abstract In today's healthcare environment, nursing staff are challenged to care for patients with increasingly complex needs in an ever-changing environment. Nurses are expected to stay up to date on a tremendous number of institutional initiatives, best practice guidelines, and policies and procedures. These practice imperatives are often disseminated through passive means of information-sharing such as staff meetings and electronic mail. In this setting, it is difficult for nurses to simultaneously focus on incorporating practice updates while continuing to value basic nursing functions such as oral care, skin care, and incontinence management. The concept of Interventional Patient Hygiene emphasises that basic nursing functions are not only tasks, but also important evidence-based interventions that contribute to improved health for the patient. Interventional Patient Hygiene facilitates the integration of science and practice. This article describes a quality improvement intervention, Advanced practice nurse-led nursing rounds, which supports Interventional Patient Hygiene and be used to help staff integrate best practices while balancing the multiple priorities inherent in nursing care. 

10. J Contin Educ Nurs. 2013 Oct;44(10):447-54. 

doi: 10.3928/00220124-20130801-45. Epub 2013 Aug 8.

A hospital nursing research enhancement model.

Edward KL, Mills C.

Abstract

Evidence-based practice is fundamental to nursing, yet there are many reports in the literature of the difficulty associated with incorporating research activity that leads to evidence-based practice into daily practice. This study used a hospital-based research enhancement model (HREM) to plan, develop, and implement a research outreach ward-based seminar (ROWS) program and evaluate its effectiveness as a means for nurses to increase their knowledge and capacity in research and evidence-based practice. A survey was used to collect both quantitative and qualitative data for evaluation of the program. A total of 78 evaluations were returned after ROWS attendance. Three main themes from the survey were explored. These include accessibility of research, appreciation and application of research, and training in research. The results suggested that nurses are interested in participating in research activities, including projects, best practice forums, journal clubs, and seminars. The HREM can address some common barriers to an evidence-based practice culture and the application of evidence-based practice within nursing.

11. J Nurs Adm. 2013 Oct;43(10):509-16. 

doi: 10.1097/NNA.0b013e3182a3e7ff.

Using a shared governance structure to evaluate the implementation of a new model of care: the shared experience of a performance improvement committee.

Myers M, Parchen D, Geraci M, Brenholtz R, Knisely-Carrigan D, Hastings C.

Abstract

Sustaining change in the behaviors and habits of experienced practicing nurses can be frustrating and daunting, even when changes are based on evidence. Partnering with an active shared governance structure to communicate change and elicit feedback is an established method to foster partnership, equity, accountability, and ownership. Few recent exemplars in the literature link shared governance, change management, and evidence-based practice to transitions in care models. This article describes an innovative staff-driven approach used by nurses in a shared governance performance improvement committee to use evidence-based practice in determining the best methods to evaluate the implementation of a new model of care. 

12. J Nurs Adm. 2013 Oct;43(10 Suppl):S42-50. 

doi: 10.1097/01.NNA.0000435150.13788.34.

Creative approaches to increasing hospital-based nursing research.

Wilson B, Kelly L, Reifsnider E, Pipe T, Brumfield V.

13. J Nurs Adm. 2013 Oct;43(10 Suppl):S28-35. 

doi: 10.1097/01.NNA.0000435148.24090.ea.

National survey of hospital nursing research, part 1. Research requirements and outcomes.

Kirkpatrick McLaughlin M, Gabel Speroni K, Patterson Kelly K, Guzzetta CE, Desale S.

 

14. J Nurs Adm. 2013 Oct;43(10 Suppl):S36-41. 

doi: 10.1097/01.NNA.0000435149.31714.7b.

National survey of hospital nursing research, part 2. Facilitators and hindrances.

Patterson Kelly K, Turner A, Gabel Speroni K, Kirkpatrick McLaughlin M, Guzzetta CE.

15. J Nurs Care Qual. 2013 Oct-Dec;28(4):319-26. 

doi: 10.1097/NCQ.0b013e3182852ce7.

Exploring factors associated with nurses' adoption of an evidence-based practice to reduce duration of catheterization.

Conner BT, Kelechi TJ, Nemeth LS, Mueller M, Edlund BJ, Krein SL.

Abstract Hospitalized adult patients are at increased risk for adverse outcomes, particularly when undergoing invasive procedures that include indwelling urinary catheterization. This study identified factors associated with nurses' adoption of an evidence-based practice to reduce the duration of catheterization and potential for catheter-associated urinary tract infections in hospitalized adults.