Thursday, February 13, 2014

Danielle's Picks from the Literature - February 2014

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

1.  Introducing AORN's New Model for Evidence Rating.

2.  Nurses As Knowledge Workers: Is There Evidence of Knowledge in Patient Handoffs?
Matney, Susan A.; Maddox, Lory J.; Staggers, Nancy; 
Western Journal of Nursing Research, 2014 Feb; 36 (2): 171-90.  

3.  Evidence-Based Prevention of Pressure Ulcers in the Intensive Care Unit.
Cooper, Karen L.; 
Critical Care Nurse, 2013 Dec; 33 (6): 57-67. 

Abstract: The development of stage III or IV pressure ulcers is currently considered a never event. Critical care patients are at high risk for development of pressure ulcers because of the increased use of devices, hemodynamic instability, and the use of vasoactive medications. This article addresses risk factors, risk scales such as the Norden, Braden, Waterlow, and Jackson-Cubbin scales used to determine the risk of pressure ulcers in critical care patients, and prevention of device-related pressure ulcers in patients in the critical care unit. 

4.  Twitter and nursing research: how diffusion of innovation theory can help uptake.
Archibald, Mandy M.; Clark, Alexander M.; 
Journal of Advanced Nursing, 2014 Mar; 70 (3): e3-5.  

5.  RESEARCH CORNER. What's the impact of quality bundles at the bedside?
Welchel, Catherine; Berg, Lisa; Brown, Annette; Hurd, Debra; Koepping, Dianne; Stroud, Shalan; 
Nursing, 2013 Dec; 43 (12): 18-21.  

Abstract: Background: Managing quality bundles can be challenging for clinical nurses. A study was undertaken to examine quality bundle volumes by patient and nursing perceptions in managing those volumes. Methods: Quantitative and qualitative data were collected from more than 400 patients and their clinical nurses in five hospitals to provide insight into bedside complexities related to quality bundles. Quantitative findings: Patients were assigned up to six bundles; critical care patients had the most bundle assignments. Qualitative findings: Nurses (N = 180) responded to a three-item survey about managing quality bundles. Although 39% of the respondents said they were always aware of the nursing interventions, only 16% responded that they could always complete them. Discussion and conclusions: Strategies to effectively implement quality interventions are critical to nursing workflow and, ultimately, patient care. Workflow assessments, embedded reminders, checklists, and improved data transparency at the bedside are needed to improve quality bundle compliance. 

6.  Evidence-based nursing. Transforming care through leadership and research alignment.
Sellars, Bridgett B.; Mayo, Ann; 
Nursing Management, 2013 Dec; 44 (12): 12-5. 

7.   How DNP and PhD nurses can collaborate to maximize patient care.
Moore, Kate; 
American Nurse Today, 2014 Jan; 9 (1): 48-9. 

8.  A multimodal approach to EBP.
Walter, Monica R.; Aucoin, Julia; Brown, Rosemary; Thompson, Julie A.; Taylor Sullivan, Dori; 
Nursing Management, 2014 Jan; 45 (1): 14-7.  

9.  Interventions to minimise the initial use of indwelling urinary catheters in acute care: A systematic review.
Murphy, Catherine; Fader, Mandy; Prieto, Jacqui; 
International Journal of Nursing Studies, 2014; 51 (1): 4-13.  

Abstract: Background: Indwelling urinary catheters (IUC) are the primary cause of urinary tract infection in acute care. Current research aimed at reducing the use of IUCs in acute care has focused on the prompt removal of catheters already placed. This paper evaluates attempts to minimise the initial placement of IUCs. Objectives: To evaluate systematically the evidence of the effectiveness of interventions to minimise the initial placement of IUCs in adults in acute care. Design: Studies incorporating an intervention to reduce the initial placement of IUCs in an acute care environment in patients aged 18 and over that reported on the incidence of IUC placement were included in the review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist has been used as a tool to guide the structure of the review. Data sources: MEDLINE, CINAHL, EMBASE, National Health Service Centre for Review and Dissemination and Cochrane Library. Review methods: A systematic review to identify and synthesise research reporting on the impact on interventions to minimise the use of IUCs in acute care published up to July 2011. Results: 2689 studies were scanned for eligibility. Only eight studies were found that reported any change (increase or decrease) in the level of initial placement of IUCs as a result of an intervention in acute care. Of the eight, six had an uncontrolled before-after design. Seven demonstrated a reduction in the initial use of IUCs post-intervention. There was insufficient evidence to support or rule out the effectiveness of interventions due to the small number of studies, limitations in study design and variation in clinical environments. Notably, each study listed the indications considered to be acceptable uses of an IUC and there was substantial variation between the lists of indications. Conclusions: More work is needed to establish when the initial placement of an IUC is appropriate in order to better understand when IUCs are overused and inform the development of methodologically robust research on the potential of interventions to minimise the initial placement of IUCs.

10.   Embracing a culture in conducting research requires more than nurses' enthusiasm.
Loke, Jennifer C.F.; Laurenson, Mary C.; Lee, Kah Wai; 
Nurse Education Today, 2014 Jan; 34 (1): 132-7. 

Abstract: Summary: 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.

Wednesday, February 05, 2014

St. Joseph Hospital Nurses Publish APN Article

Congratulations to Megan Liego, DNP, ACNP-C, RN, Sue Dragoo, DNP, WHNP, RN and their colleagues for publishing on the application of an acute care nurse practitioner (ACNP) model into the hospital setting.

Journal of Nursing Administration. 
2014 Jan;44(1):47-50. doi: 10.1097/NNA.0000000000000020.
Improving outcomes through the proper implementation of acute care nurse practitioners.
Liego M, Loomis J, Van Leuven K, Dragoo S.
The Value-Based Purchasing Program is forcing hospitals to improve outcomes and decrease costs. This has led to recognition of new care models to improve outcomes and reimbursement. One model is the application of an acute care nurse practitioner (ACNP) into the hospital setting. Model success is dependent on proper implementation to create a synergistic relationship with the organization, ACNP, and patient to improve the quality of care and decrease costs for the hospital.