tag:blogger.com,1999:blog-232458192024-03-06T20:47:31.600-08:00Nursing Research: Show me the evidence!The St. Joseph Hospital (Orange, California) Nursing Research Blog communicates our nursing research activities to PSJH caregivers and other interested parties. Content includes: announcements of publications, Nursing Grand Rounds, nursing journal clubs, evidence-based nursing classes, ongoing nursing research and relevant library announcements and news. Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.comBlogger281125tag:blogger.com,1999:blog-23245819.post-34084834930382451022020-02-28T13:20:00.001-08:002020-02-28T13:20:24.656-08:00St. Joseph Orange RNs publish new article<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzJUbV22JD6HnVHKDnF__D_7YRFG13EHcyCdNkKk76qhyphenhyphen4lDGYvFOJk18Yl9fX_AWG1UFWMuuElX84NiocLpjTHP4do4vNEK43rHR13tK1QqlkOBbfYnztcNY8ttereIbivPEO/s1600/webcast.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="300" data-original-width="300" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzJUbV22JD6HnVHKDnF__D_7YRFG13EHcyCdNkKk76qhyphenhyphen4lDGYvFOJk18Yl9fX_AWG1UFWMuuElX84NiocLpjTHP4do4vNEK43rHR13tK1QqlkOBbfYnztcNY8ttereIbivPEO/s200/webcast.jpg" width="200" /></a></div>
<span style="background-color: white; color: #333333; font-family: "trebuchet ms" , "verdana" , "arial" , sans-serif; font-size: 12.61px;">Congratulations to the following St. Joseph Orange RNs for their newly published article on postpartum father-infant massage: Carol Suchy, RN, MSN, IBCLC; Gloria Morgan, RN, MSN, RNC-LRN; Sue Duncan, RN, MSN, RNC-OB; Susan Villar, RN, MSN, RNC-OB; Frieda Fox, BA, IBCLC; Dana Rutledge, RN, PhD. PSJH caregivers have access to the full article through </span><a href="http://www.providence.org/library" style="background-color: white; color: #666666; font-family: "Trebuchet MS", Verdana, Arial, sans-serif; font-size: 12.61px;" target="_blank">Burlew Medical Library</a><span style="background-color: white; color: #333333; font-family: "trebuchet ms" , "verdana" , "arial" , sans-serif; font-size: 12.61px;">. Contact library staff </span><span style="background-color: white; color: #333333; font-family: "trebuchet ms" , "verdana" , "arial" , sans-serif; font-size: 12.61px;">for more details. </span><br />
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<p>
MCN Am J Matern Child Nurs. 2020 Feb 5. doi: 10.1097/NMC.0000000000000613.</br>
<b>Teaching Father-Infant Massage during Postpartum Hospitalization: A Randomized Crossover Trial.</b></br>
Suchy C, Morgan G, Duncan S, Villar S, Fox F, Rutledge DN.<br /></p>
<p>Abstract</br>
PURPOSE:
The purpose of this study was to evaluate acceptability and impact of infant massage video instruction on fathers' behaviors in early postpartum.</br>
METHODS:
A randomized crossover design was used. Participants were fathers of healthy term infants born at a Magnet hospital in Southern California. Measures included a demographic survey, Father-to-Infant Bonding Scale, Father-Infant Observation Scale, and postdischarge phone interview. Study nurses observed father-infant interactions for 5 minutes. Fathers were randomized to one of two groups: fathers in group 1 saw the massage video before they were observed with their infants and fathers in group 2 saw the video after. Fathers completed the Bonding Scale at baseline in person and again within a week of discharge by phone. Statistics were descriptive and comparative. Responses to interview questions were categorized and described.</br>
RESULTS:
Ninety-eight fathers aged 18 to 44 years participated. Over half of fathers identified as Hispanic and the majority spoke English at home. Most fathers had positive responses to infants on individual Bonding Scale items. Fathers differed significantly in observed interactions with infants depending upon timing of massage instruction; fathers observed immediately after the video had more total interactions, specifically fingertip touching. Poststudy evaluations were predominantly positive.</br>
CLINICAL IMPLICATIONS:
We found a brief infant massage instruction offered by video was well accepted by fathers and increased observed father-infant interactions.</br>Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-8847726092305788692020-01-31T13:33:00.002-08:002020-01-31T13:33:48.783-08:00New article published by St. Joseph Orange RN<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5GxdIpbm22rolH1055z_jE_gNspi4CtId04LIxiUJbsNDplTUnKNFREV4yfDqsaz2HvoMdWKDAPQoTRSzhuFbm6DTpPcy7UyXGehNdwQR9VWeSdUHUhqb5o_Ca19hJ3N18Ai0/s1600/computeruser.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="384" data-original-width="512" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5GxdIpbm22rolH1055z_jE_gNspi4CtId04LIxiUJbsNDplTUnKNFREV4yfDqsaz2HvoMdWKDAPQoTRSzhuFbm6DTpPcy7UyXGehNdwQR9VWeSdUHUhqb5o_Ca19hJ3N18Ai0/s200/computeruser.JPG" width="200" /></a></div>
Congratulations to Beth Winokur, PhD, RN, CEN for her newly published article on viral myocarditis. PSJH caregivers have access to the full article through <a href="http://www.psjhealth.org/library" target="_blank">Burlew Medical Library</a>. Contact <a href="mailto:burlewmedicallibrary@stjoe.org" target="_blank">library staff</a> for more details.<br />
<b>Viral Myocarditis<br />
Dimensions of Critical Care Nursing<br />
March/April 2020; 39(2)75-80<br />
Narovlyanskaya, Oksana MSN, RN; Winokur, Elizabeth J. PhD, RN, CEN</b><br />
Abstract
In recent years, more young patients are being admitted to hospitals with the diagnosis of heart failure secondary to myocarditis; many of these patients will progress to needing a heart transplant. Research shows that heart failure is increasing in prevalence and incidence and is expected to have 46% increases in prevalence by 2030, with hypertension, diabetes, and obesity pointed as risk factors (Cardiac Fail Rev. 2017;3(1):7-11). Nurses need to be aware of and educated on the infectious processes responsible for heart failure, presumable pathogens, new and emerging diagnostic tests, and possible treatments. This article explores the viral pathogens commonly found to cause myocardial inflammation, their sequelae, and treatment.Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-33243835753962227452019-02-18T14:26:00.003-08:002019-02-18T14:26:59.498-08:00St. Joseph Hospital RN published in Journal of Emergency Nursing<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5GxdIpbm22rolH1055z_jE_gNspi4CtId04LIxiUJbsNDplTUnKNFREV4yfDqsaz2HvoMdWKDAPQoTRSzhuFbm6DTpPcy7UyXGehNdwQR9VWeSdUHUhqb5o_Ca19hJ3N18Ai0/s1600/computeruser.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="384" data-original-width="512" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5GxdIpbm22rolH1055z_jE_gNspi4CtId04LIxiUJbsNDplTUnKNFREV4yfDqsaz2HvoMdWKDAPQoTRSzhuFbm6DTpPcy7UyXGehNdwQR9VWeSdUHUhqb5o_Ca19hJ3N18Ai0/s200/computeruser.JPG" width="200" /></a></div>
Congratulations to Beth Winokur, PhD, RN, CEN for her newly published article on management of meconium aspiration in the emergency department. PSJH caregivers have access to the full article through <a href="http://www.psjhealth.org/library" target="_blank">Burlew Medical Library</a>. Contact <a href="mailto:burlewmedicallibrary@stjoe.org" target="_blank">library staff</a> for more details.<br />
<br />
Journal of Emergency Nursing<br />
2019 Jan;45(1):6-11. doi: 10.1016/j.jen.2018.06.007. <br /><b>
A Sticky Situation: Meconium Aspiration in the Emergency Department.</b><br />
Huang L., Winokur E.J.<br />
<br />
<br />
<ul>
<li>The current literature on meconium aspiration syndrome indicates that there is insufficient evidence to support the need for routine tracheal intubation for nonvigorous neonates born in meconium-stained fluid in contrast to no intubation for suctioning.</li>
<li>
This article contributes information on management of the nonvigorous infant born with meconium aspiration syndrome.</li>
<li>
Key implications for emergency nursing practice found in this article are signs and symptoms of meconium aspiration, the updated American Heart Association guidelines for management of a nonvigorous infant born in meconium-stained fluid, and equipment to prepare for a precipitous delivery and possible intubation.</li>
</ul>
Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-21284341643795418342019-01-03T13:15:00.000-08:002019-01-03T13:15:23.774-08:00St. Joseph RNs publish article in Journal of Nursing Measurement<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvHhrepaq928TSaJPgYljYnLNImcTzggw086d7Pkef5QGx1QIn9ZOD_-s8m-rzd14i2qPsUxN6nTbrcVzXSn48YM7pD2glfvptitfqM5TGl6xFUmm_VrWWNoC9drSZ9NZpBnUp/s1600/book.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="101" data-original-width="135" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvHhrepaq928TSaJPgYljYnLNImcTzggw086d7Pkef5QGx1QIn9ZOD_-s8m-rzd14i2qPsUxN6nTbrcVzXSn48YM7pD2glfvptitfqM5TGl6xFUmm_VrWWNoC9drSZ9NZpBnUp/s1600/book.jpg" /></a></div>
<br />
<div class="MsoNormal">
Congratulations to Dana Rutledge, PhD, RN, Mary Wickman, PhD, RN and Beth
Winokur, PhD, RN, CEN for their newly published article on measuring hospital nurse perceptions of meaning and joy in work at St. Joseph Hospital. SJO employees have access to the
full article through Burlew Medical Library. Contact <a href="mailto:burlewmedicallibrary@stjoe.org" target="_blank">library staff</a> for more
details.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b>Instrument Validation: Hospital Nurse Perceptions of Meaning
and Joy in Work</b><o:p></o:p></div>
Rutledge, Dana N., PhD, RN, Wickman, Mary, PhD, RN, Winokur, Elizabeth J., PhD, RN<br />
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal">
Journal of Nursing Measurement<o:p></o:p></div>
<div class="MsoNormal">
2018; 26(3)<o:p></o:p></div>
<div class="MsoNormal">
Abstract<o:p></o:p></div>
<div class="MsoNormal">
</div>
<div class="MsoNormal">
Background and Purpose: When workers experience meaning and
joy in work (MJW), job satisfaction and retention are enhanced. No measure for
MJW among nurses exists. The purpose of this work was to develop/test the MJW
Questionnaire (MJWQ). Methods: The initial MJWQ was piloted with a convenience
sample of post-licensure nursing students. Factor analyses established MJWQ
subscales for the MJWQ: “value /connections,” “meaningful work,” “caring.”
Subsequently, 463 employed nurses validated MJWQ psychometrics. Results: The
MJWQ demonstrated acceptable construct validity and internal consistency (α =
.94). Scores were significantly associated with job satisfaction (r = .686).
Conclusions: Initial testing supports adequate measurement of MJW for hospital
nurses in varying roles. Testing in other settings, evaluation of sensitivity
in determining intervention effectiveness, and inclusion in multivariate
analyses of workforce engagement are suggested.<o:p></o:p></div>
<br />Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-56533478788342436332018-07-27T09:30:00.003-07:002018-07-27T09:30:54.232-07:00St. Joseph RNs publish article in Clinical Journal of Oncology Nursing<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvHhrepaq928TSaJPgYljYnLNImcTzggw086d7Pkef5QGx1QIn9ZOD_-s8m-rzd14i2qPsUxN6nTbrcVzXSn48YM7pD2glfvptitfqM5TGl6xFUmm_VrWWNoC9drSZ9NZpBnUp/s1600/book.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvHhrepaq928TSaJPgYljYnLNImcTzggw086d7Pkef5QGx1QIn9ZOD_-s8m-rzd14i2qPsUxN6nTbrcVzXSn48YM7pD2glfvptitfqM5TGl6xFUmm_VrWWNoC9drSZ9NZpBnUp/s1600/book.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="101" data-original-width="135" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvHhrepaq928TSaJPgYljYnLNImcTzggw086d7Pkef5QGx1QIn9ZOD_-s8m-rzd14i2qPsUxN6nTbrcVzXSn48YM7pD2glfvptitfqM5TGl6xFUmm_VrWWNoC9drSZ9NZpBnUp/s1600/book.jpg" /></a></div>
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvHhrepaq928TSaJPgYljYnLNImcTzggw086d7Pkef5QGx1QIn9ZOD_-s8m-rzd14i2qPsUxN6nTbrcVzXSn48YM7pD2glfvptitfqM5TGl6xFUmm_VrWWNoC9drSZ9NZpBnUp/s1600/book.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><br /></a><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvHhrepaq928TSaJPgYljYnLNImcTzggw086d7Pkef5QGx1QIn9ZOD_-s8m-rzd14i2qPsUxN6nTbrcVzXSn48YM7pD2glfvptitfqM5TGl6xFUmm_VrWWNoC9drSZ9NZpBnUp/s1600/book.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><br /></a><br />
<br />
Congratulations to Kathy Keener, MSN, RN, OCN and Beth Winokur, PhD, RN, CEN for their newly published article on educating chemotherapy patients at St. Joseph Hospital. SJO employees have access to the full article through <a href="http://www.psjhealth.org/library">Burlew Medical Library</a>. Contact library staff for more details.<br />
<strong>Clin J Oncol Nurs. 2018 Aug 1;22(4):444-449. doi: 10.1188/18.CJON.444-449.</strong><br /><strong>
Digitally Recorded Education: Effects on Anxiety and Knowledge Recall in Patients Receiving First-Time Chemotherapy.</strong><br /><strong>
Keener KA, Winokur EJ.</strong><br />
Abstract<br />
BACKGROUND:<br />
Prechemotherapy information is overwhelming, and retention of critical information can be challenging. Patients from a Southern California infusion clinic had varying degrees of retention when nurses used traditional one-on-one teaching with supplemental handouts.<br />
OBJECTIVES:<br />
The intent of this article is to determine the effectiveness of standardized, digitally recorded education as an alternative teaching method for increasing knowledge recall and decreasing anxiety in English- and Spanish-speaking patients receiving first-time chemotherapy.<br />
METHODS:<br />
Baseline data were obtained from five patients who received traditional teaching. Using a pre-/post-test design, 92 patients receiving digitally recorded education completed a paper-and-pencil instrument that rated their anxiety and knowledge recall.<br />
FINDINGS:<br />
The digitally recorded education method produced significant decreases in anxiety and increases in knowledge recall.Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-47618831894165794732018-01-04T12:00:00.000-08:002018-01-04T12:00:06.584-08:00St. Joseph RNs publish in Journal of Emergency Nursing<p>Congratulations to Beth Winokur, PhD, RN, CEN, Jeannine Loucks, MSN, RN-BC, PMH and Glenn H. Raup, PhD, RN, MSN, MBA, CEN for their newly published article on caring for behavioral health patients at St. Joseph Hospital. SJO employees have access to the full article through <a href="http://www.burlewmedicallibrary.org/">Burlew Medical Library</a>. Contact library staff for more details.</p>
<p>J Emerg Nurs.<br>
2018; 44 26-32<br>
<b>Use of a Standardized Procedure to Improve Behavioral Health Patients' Care: A Quality Improvement Initiative.</b><br>
Winokur EJ, Loucks J, Raup GH.</p>
<p>
Abstract<br>
PROBLEM:
Meeting the complex needs of behavioral health (BH) patients in the emergency department is an ongoing challenge. Delays in care can have adverse consequences for patient and staff safety and delay transfer to specialized care.<br>
METHODS:
A quality improvement, nurse-driven initiative using a standardized procedure (STP) was developed and implemented in our busy Southern California Emergency Department, which focused on improving time to first medication and reduction of restraints. The project used a multidisciplinary team to develop the STP scoring tool and corresponding medications. Improvement was seen in all quality metrics. Time to first medication decreased from 43 minutes to less than 5 minutes. Adopting the STP resulted in a 50% decrease in use of restraints and time in restraints. Staff injuries remained low, with less than 3.6% of staff sustaining physical injuries.<br>
DISCUSSION:
The STP is an effective method to initiate immediate treatment of patients with signs of anxiety and aggression and thus reduce risk of violence. Additional benefits are reduced time to disposition and earlier initiation of specialized BH care. This process can be replicated in other emergency departments with similar clinical environments through the use of STPs or protocols based on state regulations. Contribution to Emergency Nursing Practice.</p>Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-86892504445989566282017-10-13T15:41:00.000-07:002017-10-13T15:41:20.114-07:00St. Joseph RNs publish in Journal for Nurse Practitioners<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvHhrepaq928TSaJPgYljYnLNImcTzggw086d7Pkef5QGx1QIn9ZOD_-s8m-rzd14i2qPsUxN6nTbrcVzXSn48YM7pD2glfvptitfqM5TGl6xFUmm_VrWWNoC9drSZ9NZpBnUp/s1600/book.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgvHhrepaq928TSaJPgYljYnLNImcTzggw086d7Pkef5QGx1QIn9ZOD_-s8m-rzd14i2qPsUxN6nTbrcVzXSn48YM7pD2glfvptitfqM5TGl6xFUmm_VrWWNoC9drSZ9NZpBnUp/s200/book.jpg" width="200" height="150" data-original-width="135" data-original-height="101" /></a></div><p>Congratulations to Deidra Bonner, MSN, RN and Beth Winokur, PhD, RN, CEN, on their newly published article on keratoconus. SJO employees have access to the full article through <a href="http://www.burlewmedicallibrary.org">Burlew Medical Library</a>. Contact library staff for more details.</p>
The eyes have it: A review of keratoconus, the nurse practitioner perspective.</br>
Bonner, D. & Winokur, E.J.</br>
The Journal for Nurse Practitioners</br>
2017; 13(8) 532-7</br>
<p>Abstract</br>
Keratoconus, a chronic, progressive ocular disease, is characterized by thinning and protrusion of the cornea. Etiology is not wholly understood; however, associations with heredity and environmental factors have been established. Keratoconic patients present with irregular astigmatism, diminishing visual acuity, and a continuous need to have prescriptive changes to spectacles and contact lenses. Keratoconus is a principal indicator for corneal transplantation. It affects both sexes and all races, beginning in adolescence. Nurse practitioners are uniquely positioned to interrupt the preventable contributors to keratoconus through assessment, prompt referral, and treatment of the physiologic and environmental factors linked to development and advancement.</p>
Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-88672119218862221942017-08-02T11:23:00.000-07:002017-08-02T11:23:20.054-07:00St. Joseph RNs publish in Journal of Emergency NursingCongratulations to Andrea Pallares, RN and Beth Winokur, PhD, RN, CEN, on their newly published article on the recognition of West Nile Encephalitis. SJO employees have access to the full article through <a href="http://www.burlewmedicallibrary.org/">Burlew Medical Library</a>. Contact library staff for more details.<br />
J Emerg Nurs.
2017 Jul 13.
doi: 10.1016/j.jen.2017.06.003. [Epub ahead of print]<br />
West Nile Encephalitis in the Emergency Department: Prevalence and Recognition.<br />
Pallares AC, Winokur EJ.
Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-25729993093628505172017-05-25T15:51:00.000-07:002017-05-25T15:51:17.468-07:00St. Joseph RNs publish in JEN: Journal of Emergency NursingCongratulations to Beth Winokur, PhD, RN, CEN, Jeannine Loucks, MSN, RN-BC, PMH and Dana Rutledge, PhD, RN for their newly published article on psychiatric education for nurses at St. Joseph Hospital. SJO employees have access to the full article through <a href="http://www.burlewmedicallibrary.org">Burlew Medical Library</a>. Contact library staff for more details.</p>
<p>
<b>Effect of Concentrated Psychiatric Education on Perceived Competence to Care for Behavioral Health Patients.</b></br>
Winokur EJ, Loucks J, Rutledge DN</p>
<p>
Abstract
Increasing numbers of behavioral patients are presenting to emergency departments, where competency of staff to care for this group is unknown.
METHODS:
This pre-post study measured the effects of a 7-hour conference on perceived competency of nurses and allied health professionals to care for behavioral health (BH) patients, as measured by the 23-item Behavioral Health Care Competency (BHCC) survey.
RESULTS:
Of 102 participants, most were emergency nurses (72%), acute care nurses and case managers (20%), and allied health personnel (trauma technicians and paramedics) (8%). Before the conference, participants had moderate average perceived competency in caring for BH patients. BHCC scores differed significantly by job category, with emergency nurses scoring higher than did nonemergency nurses and allied health personnel. Overall competence of participants increased significantly after the conference. The effect size, as reflected by partial eta squared, was 0.265. Significant increases in scores from before to after the conference occurred for the total BHCC and 2 competencies: practice/intervention and resource adequacy.
DISCUSSION:
This study provides needed research demonstrating improved perceived competency of nurses and allied health professionals to care for BH patients in emergency departments after brief concentrated education. Improvements occurred despite the fact that participants had initial baseline competencies that were higher than those of general hospital nurses from a historical sample.
Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-85684771832225156502016-12-22T11:13:00.003-08:002016-12-22T11:13:55.098-08:00Picks from the literature - December 2016<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqLDjx0BlFlkFWC-fT6VoQrdqo0bLr_3LfGKFpv6BwSo_xNXe2MoVxK3Fucxn-fuz_56suTI-pMtGH45g519f69TT0blj-vz-NuXBJplOZVaEjxiganvprtdTmvksug6w7RO-4/s1600/carrot.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqLDjx0BlFlkFWC-fT6VoQrdqo0bLr_3LfGKFpv6BwSo_xNXe2MoVxK3Fucxn-fuz_56suTI-pMtGH45g519f69TT0blj-vz-NuXBJplOZVaEjxiganvprtdTmvksug6w7RO-4/s200/carrot.jpg" width="200" height="200" /></a></div></br>Here are my picks from the literature for December 2016. Articles are accessible to St. Joseph Nurses via the Burlew Medical Library website. Or contact the library at 714-771-8291 for assistance.</p>
<p>
1. The integration and evaluation of a social-media facilitated journal club to enhance the student learning experience of evidence-based practice: A case study.</br>
Ferguson, Caleb; DiGiacomo, Michelle; Gholizadeh, Leila; Ferguson, Leila E.; Hickman, Louise D.;</br>
Nurse Education Today, Jan2017; 48 123-128.</p>
<p>
2. Engaging patients in understanding and using evidence to inform shared decision making.</br>Cohen, Monique D.;
</br>Patient Education & Counseling, Jan2017; 100(1): 2-3. </p>
<p>
3. Engaging patients in the uptake, understanding, and use of evidence: Addressing barriers and facilitators of successful engagement.</br>
Street Jr., Richard L.; Volk, Robert J.; Lowenstein, Lisa; Michael Fordis Jr., C.;</br>
Patient Education & Counseling, Jan2017; 100(1): 4-4.</p>
<p>
4. Updated evidence-based guide to smoking cessation therapies.</br>
Siddiqui, Faraz; Huque, Rumana; Dogar, Omara;</br>
British Journal of Community Nursing, Dec2016; 21(12): 607-611. </p>
<p>
5. Developing Competency to Sustain Evidence-Based Practice.</br>
Fisher, Cheryl; Cusack, Georgie; Cox, Kim; Feigenbaum, Kathryn; Wallen, Gwenyth R.; </br>
Journal of Nursing Administration, Nov2016; 46(11): 581-585.</p>
<p>
6. Factors that affect nurse practitioners' implementation of evidence-based practice.</br>
Hellier, Susan; Cline, Thomas; </br>
Journal of the American Association of Nurse Practitioners, Nov2016; 28(11): 612-621.</p>
<p>
7. Promoting Bedside Nurse-Led Research Through a Dedicated Neuroscience Nursing Research Fellowship.</br>
Stutzman, Sonja; Olson, DaiWai; Supnet, Charlene; Harper, Caryn; Brown-Cleere, Shelley; McCulley, Becky; Goldberg, Mark; </br>
Journal of Nursing Administration, Dec2016; 46(12): 648-653.</p>
<p>
8. Nurse staffing and patient outcomes: Are we asking the right research question?</br>
Welton, John. M.; </br>
International Journal of Nursing Studies, Nov2016; 63 A1-A2.</p>
<p>
9. Turning a clinical question into nursing research: the benefits of a pilot study.</br>
Henson, Angela; Jeffrey, Carol; </br>
Renal Society of Australasia Journal, Nov2016; 12(3): 99-105. </p>
<p>
10. Creative Approaches to Increasing Hospital-Based Nursing Research.</br>
Wilson, Barbara; Kelly, Lesly; Reifsnider, Elizabeth; Pipe, Teri; Brumfield, Valerie;</br>
Journal of Nursing Administration, Oct2016 Supplement; S27-S35. </p>
<p>
11. Nurses' Research Capacity, Use of Evidence, and Research Productivity in Acute Care.</br>
Duffy, Joanne R.; Culp, Stacey; Sand-Jecklin, Kari; Stroupe, Lya; Lucke-Wold, Noelle; </br>
Journal of Nursing Administration, Oct2016 Supplement; S43-S48. </p>
<p>
12. Fostering Clinical Nurse Research in a Hospital Context.</br>
Hatfield, Linda A.; Kutney-Lee, Ann; Hallowell, Sunny G.; Del Guidice, Mary; Ellis, Lauren N.; Verica, Lindsey; Aiken, Linda H.; </br>
Journal of Nursing Administration, Oct2016 Supplement; S49-S53. </p>Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-21979535038225932212016-11-03T09:37:00.000-07:002016-11-03T09:37:29.244-07:00St. Joseph Hospital RNs publish in AORN Journal<p>Congratulations to Vivian Norman, MSN, RN, CCRN-K, Kim Rossillo, BSN, RN, PCCN and Katie Skelton, MBA, RN, NEA-BC for their newly published article on creating a healing environment at St. Joseph Hospital. SJO employees have access to the full article through <a href="http://www.burlewmedicallibrary.org">Burlew Medical Library</a>. Contact library staff for more details.</p>
<b>Creating Healing Environments Through the Theory of Caring</b>
November 2016; 104(5) 401–409
<p>
Abstract:
We describe the journey of personnel at one hospital to create a healing environment for patients and staff members at all levels through the implementation of Watson’s Theory of Human Caring and her Caritas Processes (ie, loving kindness, authentic presence, spirituality, being the environment, believing in miracles). We used experiential teaching and learning to explore the nursing theory with staff members. Positive outcomes include using Caritas Processes care plans in our electronic medical record, greater ease in the understanding and application of Watson’s theory, integrating a blessing for nurses during National Nurses Week, inclusion of ministry formation courses to extend the mission of the hospital’s founding religious order to current and future employees, and positive patient feedback. As a result of theory application, our nurses are more open to discussing caring, authentic presence and, when appropriate, prayer in their clinical narratives and how it is affecting patients and themselves.</p>Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-64125353871465166422016-10-04T15:39:00.000-07:002016-10-04T15:39:38.032-07:00Congratulations to St. Joseph Hospital Emergency Care Center nurses!<p>St. Joseph Hospital Emergency Care Center nurses Belinda Leos, RN, MSN, Sherry Endo, RN, MSN, Robert Garcia, RN, MSN, CMSRN, and Beth Winokur, RN, PhD, CEN were awarded first place in the research category for their poster, <i>Evaluating Fall Tools for the Emergency Setting</i> at the National Emergency Nursing Annual Scientific Assembly. </p>
<p>Other presentations at this conference by our ECC staff included the poster, <i>A Recipe for Success: Integrating a Sepsis Bundle into the Emergency Department</i> by Laura Derr, RN, BSN, CEN, Dixie Stiles, RN, MSN, CEN, and Soledad Mathus, RN, BSN. Beth Winokur, RN, PhD, CEN and Juleene McGowan, RN, BSN, CEN, presented poster and podium entitled “<i>A Picture is Worth a 1000 Words: Using Pictographs to Improve Health Care Literacy.</i>” Jeannine Loucks, RN-BC, MSN, and Beth Winokur, RN, PhD, CEN also presented their research poster – <i>Have No Fear: The Effects of Education on Perceived Competence to Care for Behavioral Health Patients</i>.</p>Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-18577408111308501302016-09-21T15:32:00.001-07:002016-09-21T15:32:34.337-07:00Danielle's Pick from the Literature - September 2016<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiglPDl_ALLPJOaUWUOpP7O2Iuj0S3ybxP4bAgNDkoepLothQwJlTDVvouYI_LVm5jD8XrYOLBATBMernidtzewc2VZvfeytenUHrb5lXsXjTtKPNhITmrCi5WRQITCyu7jzJdB/s1600/carrot.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiglPDl_ALLPJOaUWUOpP7O2Iuj0S3ybxP4bAgNDkoepLothQwJlTDVvouYI_LVm5jD8XrYOLBATBMernidtzewc2VZvfeytenUHrb5lXsXjTtKPNhITmrCi5WRQITCyu7jzJdB/s200/carrot.jpg" width="200" height="200" /></a></div><p>Here are my picks from the literature for September 2016. Articles are accessible to St. Joseph Nurses via the <a href="http://www.burlewmedicallibrary.org">Burlew Medical Library website</a>. Or contact the library at 714-771-8291 for assistance.</p>
<p>1. Nursing research ethics, guidance and application in practice.
Doody, Owen; Noonan, Maria;
British Journal of Nursing, 7/28/2016; 25(14): 803-807.</p>
<p>Abstract: Ethics is fundamental to good research practice and the protection of society. From a historical point of view, research ethics has had a chequered past and without due cognisance there is always the potential for research to do harm. Research ethics is fundamental to research practice, nurse education and the development of evidence. In conducting research, it is important to plan for and anticipate any potential or actual risks. To engage in research, researchers need to develop an understanding and knowledge of research ethics and carefully plan how to address ethics within their research. This article aims to enhance students’ and novice researchers’ research ethics understanding and its application to nursing research.</p>
<p>2. An Integrative Review of Engaging Clinical Nurses in Nursing Research.
Scala, Elizabeth; Price, Carrie; Day, Jennifer;
Journal of Nursing Scholarship, Jul2016; 48(4): 423-430. </p>
<p>3. The practice of nursing research: getting ready for 'ethics' and the matter of character.
Sellman, Derek;
Nursing Inquiry, Mar2016; 23(1): 24-31. </p>
<p>4. Clinical Nurse Specialist Roles in Conducting Research.
Albert, Nancy M.; Rice, Karen L.; Waldo, Mary J.; Bena, James F.; Mayo, Ann M.; Morrison, Shannon L.; Westlake, Cheryl; Ellstrom, Kathleen; Powers, Jan; Foster, Jan;
Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, Sep/Oct2016; 30(5): 292-301.</p>
<p>5. Fostering Clinical Nurse Research in a Hospital Context.
Hatfield, Linda A.; Kutney-Lee, Ann; Hallowell, Sunny G.; Del Guidice, Mary; Ellis, Lauren N.; Verica, Lindsey; Aiken, Linda H.;
Journal of Nursing Administration, May2016; 46(5): 245-249. </p>
<p>6. Effectiveness of an education intervention to strengthen nurses' readiness for evidence-based practice: A single-blind randomized controlled study.
Saunders, Hannele; Vehviläinen-Julkunen, Katri; Stevens, Kathleen R.;
Applied Nursing Research, Aug2016; 31 175-185. </p>
<p>7. Effects of Education Programs on Evidence- Based Practice Implementation for Clinical Nurses.
Jae Youn Sim; Keum Seong Jang; Nam Young Kim;
Journal of Continuing Education in Nursing, Aug2016; 47(8): 363-371. </p>
<p>8. The Imperative: Integrating Evidence-Based Practice into the Clinical Nurse Leader (CNL) Role.
Gibson, Lynette M.;
South Carolina Nurse, Jul-Sep2016; 23(3): 14</p>
<p>9. Incorporating Evidence-Based Practice Learning Into a Nurse Residency Program.
Jackson, Nichole;
Journal of Nursing Administration, May2016; 46(5): 278-283. </p>
<p>10. Implementing and Sustaining Evidence Based Practice Through a Nursing Journal Club.
Gardner Jr., Kevin; Kanaskie, Mary Louise; Knehans, Amy C.; Salisbury, Sarah; Doheny, Kim K.; Schirm, Victoria;
Applied Nursing Research, Aug2016; 31 139-145. </p>Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-72226231859250716612016-02-25T10:03:00.002-08:002016-02-25T10:03:26.116-08:00St. Joseph Hospital Nurses Publish ArticleCongratulations to Beth Winokur, PhD, RN, CEN, Dana Rutledge, PhD, RN and Amy Hayes, MSN, RN for their newly published article on factors that motivate or impede nurses employed by a Magnet® organization to pursue a baccalaureate education. SJO employees have access to the full article through <a href="http://www.burlewmedicallibrary.org/">Burlew Medical Library</a>. Contact library staff for more details.</p>
MAGNET® FACILITY NURSES: PURSUING A BACCALAUREATE DEGREE IN NURSING</br>
ELIZABETH J. WINOKUR, PHD, RN, CEN, DANA N. RUTLEDGE, PHD, RN, AND
AMY HAYES, MSN, RN</p>
Abstract: The aim is to explore factors that motivate and obstacles that impede nurses from pursuing baccalaureate education when employed by a Magnet® organization. In the Future of Nursing (2011), the Institute of Medicine concluded that the baccalaureate should be the minimum education for nurses. Magnet organizations are encouraged to meet the Institute of Medicine goal of 80% of nurses with a baccalaureate by 2020. In February 2014, a 15-item on-line survey was sent to nurses at a western Magnet-designated hospital to assess factors that motivate registered nurses to achieve a baccalaureate. Descriptive statistics and a general thematic analysis were completed. A 20% response rate (N = 191) was achieved. Most respondents (78%) entered nursing as associate degree/diploma graduates, and most (84%) either had a baccalaureate or master's degree or were currently enrolled in school. Encouragement from other nurses was the factor most frequently selected as facilitating return to school. Impeding factors included age and family responsibilities. A minority of nurses reported that they did not believe that a baccalaureate would make them a better nurse. Findings suggest that peer and leadership support play a larger role in facilitating baccalaureate completion more than previously reported. Additional research is needed to explore the role of registered nurse to registered nurse encouragement in facilitating educational advancement. </br>
(Index words: Magnet; Baccalaureate education; Nursing education; Motivation; Education, post RN;
School re-entry) J Prof Nurs 0:1–9, 2016.Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-90237335269813985912016-02-11T16:07:00.000-08:002016-02-11T16:07:41.219-08:00Danielle's Picks from the Literature - February 2016<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNbpxbHFwgi_pcO_AAYCS8KDf0KRPKC6GPaXHFUGCGNuDbBLrYwBXw0l_85YIU_rO-UGz91nre5ThTlc9qGDmxw42iD8Ut8EmwllhlnuhAOLo8GCgd6_5GEOZvBDn-M_DodoLS/s1600/carrot.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNbpxbHFwgi_pcO_AAYCS8KDf0KRPKC6GPaXHFUGCGNuDbBLrYwBXw0l_85YIU_rO-UGz91nre5ThTlc9qGDmxw42iD8Ut8EmwllhlnuhAOLo8GCgd6_5GEOZvBDn-M_DodoLS/s320/carrot.jpg" /></a></div>Here are my picks from the literature for February 2016. Articles are accessible to St. Joseph Nurses via the <a href="http://www.burlewmedicallibrary.org">Burlew Medical Library</a> website. Or contact the library at 714-771-8291 for assistance.</p>
<b>Building research capacity and productivity among advanced practice nurses: an evaluation of the Community of Practice model. </b>
Journal of Advanced Nursing, Mar2016; 72(3): 605-619. </p>
<b>Nurses' Research Capacity, Use of Evidence, and Research Productivity in Acute Care. </b>
Journal of Nursing Administration, Jan2016; 46(1): 12-17. </p>
<b>Advancing Nursing Research in Hospitals Through Collaboration, Empowerment, and Mentoring. </b>
Journal of Nursing Administration, Dec2015; 45(12): 600-605.</p>
<b>Bridging the Research-to-Practice Gap: The Role of the Nurse Scientist. </b>
Seminars in Oncology Nursing, Nov2015; 31(4): 298-305. </p>
<b>Nurses' Use of Evidence-Based Practice in Clinical Practice After Attending a Formal Evidence-Based Practice Course.</b>Connor, Linda; Dwyer, Patricia;
Journal for Nurses in Professional Development, Jan/Feb2016; 32(1): E1-E8. </p>
<b>Evidence-based nursing. Designing a unit practice council structure. </b>
Nursing Management, Jan2016; 47(1): 15-18. </p>
<b>Strategies to promote practice nurse capacity to deliver evidence-based care. </b>
Journal of Health Organization & Management, 2015; 29(7): 988-1010. </p>
<b>Magnet Accreditation Leads to Greater Patient Satisfaction. </b>
American Association of Critical-Care Nurses; Jan2016; v.8. n.1, 7-7.</p>
<b>Hospital Magnet Status, Unit Work Environment, and Pressure Ulcers. </b>
Journal of Nursing Scholarship, Nov2015; 47(6): 565-573. </p>
<b>Doctor of Nursing Practice: The Role of the Advanced Practice Nurse. </b>
Seminars in Oncology Nursing, Nov2015; 31(4): 263-272.
Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-33892178471322607322015-08-17T15:12:00.001-07:002015-08-17T15:12:57.798-07:00Clinical Inquiry Series<p>Question:
I’ve heard that inductions increase the cesarean section (C/S) rate. An article from AWHONN email this week reports research showing that inductions decrease the C/S rate. Which is true? And how can we decrease our C/S rate?</p>
<p>Answer:
A review of the literature proves to be quite controversial. There were no randomized control trials found in the literature most likely due to the fact that pregnant women are a
vulnerable population because of the risks to mother/infant. The majority of studies are retrospective and findings conflict. Two studies, one a systematic review and a large retrospective study found a decrease in C-section(C/S) rate when induction was used compared to usual care (spontaneous labor, induced at a later time, etc.)(Caughey et al., 2009; Wilson et al.,2010).</br>
Other studies (Ehrenthal, Jiang & Strobino 2010; Glantz, 2010) discussed that problems exist in how researchers define the study population. These authors highlight that multiple factors, including increasing gestational age, alter the results mentioned above. Therefore after
including these additional variables, they report that induction increases the C/S rate.</br>
Two other articles (Klein 2010; Nicholson et al. 2009) mention the
AMOR-IPAT scoring system. AMOR–IPAT stands for Active Management of Risk in Pregnancy at Term- Upper limit of Optimal Delivery. In their studies utilizing this scoring system (algorithm) assists with finding the ideal gestation for each woman and determines her best delivery date. This scoring system in two studies states that when this scoring system is utilized for induction it reduces the
C-Section rate.</br>
Final answer is the evidence is conflicting and there are many factors that influence the C-section rate. Maternal obesity for instance was not taken into consideration. Awareness and informed consent is imperative when deciding whether or not to induce. Ultimately this is something that should not be taken lightly and should be discussed thoroughly by the patient and her provider.</p>
<p>
References:
Akinsipe, C. D., Villalobos, L. E., & Ridley, R. T. (2012). A
systematic review of implementing an elective labor induction policy. Journal
of Obstetrics and Gynecology and Neonatal Nursing, 41(1) 5-16.
doi:10.1111/j.1552-6909.2011.01320.x</br>
Caughey, A. B., Sundaram, V., Kaimal, A. J. Gienger, A., Cheng, Y. W.,
McDonald, K. M., . . .Bravata, D. M. (2009) Systematic review: Elective
induction of labor versus expectant management of pregnancy. Annals of Internal
Medicine, 151(4) 252-263.</br>
Ehrenthal, D. B., Jiang, X., & Strobino, D. M., (2010) Labor
induction and the risk of cesarean delivery among nulliparous women at term.
Obstetrics & Gynecology, 116(1) 35-42.</br>
Glantz, J. G. (2010) Term labor induction compared with expectant
management. Obstetrics & Gynecology, 115(1).</br>
Nicholson, J. M., Cronholm, P., Kellar, L. C., Stenson, M. H., & Macones, G. A. (2009). The
association between increased use of labor induction and reduced rate of
cesarean delivery. Journal of Women’s Health, 18(11) 1747-1758.</br>
Wilson, B. L., Effken, J., & Butler, R. J.
(2010) The relationship between cesarean section and labor induction. Journal
of Nursing Scholarship, 42(2) 130-138. doi:10.1111/j.1547-5069.2010.01346.xDanielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-51713538772082236312015-08-06T14:31:00.002-07:002015-08-06T14:31:56.933-07:00St. Joseph Hospital Nurses Publish Article<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Congratulations to Mary Gonzales, RN, MSN & </span></span><span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Dana Rutledge, RN, PhD</span></span> for their newly published article on pain and anxiety during IR procedures. SJO
employees have access to the full article through <a href="http://www.burlewmedicallibrary.org/" target="_blank">Burlew Medical Library</a>. Contact <a href="mailto:burlewmedicallibrary@stjoe.org" target="_blank">library staff</a> for more details.</span></span><br />
<br />
<b><span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Pain and Anxiety During Less Invasive Interventional Radiology Procedures</span></span></b><br />
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Mary Gonzales, MSN, RN</span></span><br />
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Dana N. Rutledge, PhD, RN</span></span><br />
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">Journal of Radiology Nursing</span></span><br />
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">June 2015; 34(2) 88-93</span></span><br />
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<span style="font-size: x-small;">Abstract</span></div>
<span style="font-size: x-small;">
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
The purpose of this study was to describe patient-reported pre-,
intra-, and postprocedure pain and anxiety levels for adults undergoing less
invasive interventional radiology procedures. Most of the 53 outpatients were
males, English speakers (91%), aged between 40 and 70 years, and having a chest
port or arm port insertion procedure. Pain levels greater than 4 (0-10 scale)
were experienced by a minority of participants (before, n = 1; during, n = 7;
and after, n = 3). Many patients undergoing arm port and chest port insertions
(22-68%) experienced some level of preprocedural anxiety. This is the first
study to document the presence of pain and anxiety levels of outpatients
receiving dialysis arteriovenous graft fistulogram or declotting procedures,
chest port or arm port insertions, or tunneled dialysis catheter placements.
Radiology nurses need to be aware of the pain and anxiety experiences of these
patients and should be assessing and managing these in collaboration with their
medical colleagues.</div>
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<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></span>Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-57693494470350130692015-04-10T14:01:00.001-07:002015-04-10T14:01:38.486-07:00Clinical Inquiry Series<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5sDbplGa0-qRbcNXU68sp-xpwL2Z1Cq7HuRBrAJuxtj7Lp6mREcvpRnbAsZCxXzvoQnVM2lsClS0WEcN-3W9Bkt07zFvU5KgoiTCr4KG1gE-kj0Uhho0Ll4WAIKScRxw77UTT/s1600/evidence+cow.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5sDbplGa0-qRbcNXU68sp-xpwL2Z1Cq7HuRBrAJuxtj7Lp6mREcvpRnbAsZCxXzvoQnVM2lsClS0WEcN-3W9Bkt07zFvU5KgoiTCr4KG1gE-kj0Uhho0Ll4WAIKScRxw77UTT/s1600/evidence+cow.jpg" height="200" width="179" /></a></div>
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;"><span><span style="text-transform: none;">The RNs at St. Joseph Hospital are curious and inquisitive when it comes
to best nursing practice. Our nurses are encouraged to submit their
clinical practice questions to our Research Department for review of the
best evidence to guide patient care. Here is another in our series
entitled "Clinical Inquiry". </span></span></span></span><br />
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;"><span><span style="text-transform: none;"><br /></span></span></span></span>
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;"><span><span style="text-transform: none;">Q: What laboring positions are most effective in turning a posterior baby anterior? We currently use far left or lateral, upper LE on over bed table, and "frog" position. I have also seen hands on knees used.</span></span></span></span><br />
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;"><span><span style="text-transform: none;"><br /></span></span></span></span>
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;"><span><span style="text-transform: none;">A: What does the evidence say?</span></span></span></span><br />
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;"><span><span style="text-transform: none;">There are many beliefs regarding the best way to position a laboring woman to turn an OP baby to the occiput anterior (OA) position. A review of the literature notes conflicting evidence for the hands and knees position (Kariminia et al., 2004) (Stremler et al., 2005). There is not enough evidence at this time to confirm if all other positions (left lateral, right lateral or frog position) assist with rotating the baby from OP to OA position (Simkin, 2010). The evidence does show that the hands and knees position reduces back pain during labor (Hunter et al., 2007). None of the aforementioned positions have been shown to be harmful. At this time, the evidence in conflicting or there is not enough evidence to say one position is better than another to rotate an OP baby.</span></span></span></span><br />
<br />
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;"><span><span style="text-transform: none;">References</span></span></span></span><br />
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<br />
<div align="left" class="MsoTitle" style="text-align: left;">
<span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: x-small;"><span style="text-transform: none;">The RNs at St. Joseph Hospital are curious and inquisitive when it comes
to best nursing practice. Our nurses are encouraged to submit their
clinical practice questions to our Research Department for review of the
best evidence to guide patient care. Here is the first of our series
entitled "Clinical Inquiry". </span></span></span></div>
<div align="left" class="MsoTitle" style="text-align: left;">
<br /></div>
<div align="left" class="MsoTitle" style="text-align: left;">
<span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: x-small;"><span style="text-transform: none;">Question</span><span style="text-transform: none;">: Why
does St. Joseph RTs and RNs still lavage ET tubes with normal saline when
evidence-based practice research shows this is not helpful and potentially
harmful? </span></span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><div align="left" class="MsoTitle" style="text-align: left;">
<br /></div>
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><div align="left" class="MsoTitle" style="text-align: left;">
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;"><span>Answer:</span><b><span> </span></b><span style="text-transform: none;">According to Lippincott’s Nursing
Procedures, the use of normal saline is not included in the guidelines for
suctioning. Current research is not clear. A recent study indicates that
not using normal saline before endotracheal suction decreases the incidence of
ventilator-associated pneumonia and associated medical costs (Mei-Yu,
Shu-Hua, & Yi-Hui, 2012). This is contradicted by findings from
another recent study which found that instillation of normal saline decreased
incidence of pneumonia in intubated and ventilated patients (Caruso, Denari,
Ruiz, Demarzo, & Deheinzelin, 2009). One possible explanation for the
discrepancy in results is from variations in the administration of the normal
saline, time to suctioning, patient position, and dosages of saline. </span></span></span></div>
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span><div align="left" class="MsoTitle" style="text-align: left;">
<br /></div>
<span style="font-size: x-small;"><span style="font-family: Arial,Helvetica,sans-serif;">
</span></span><span style="font-family: Arial,Helvetica,sans-serif;">
</span><div align="left" class="MsoTitle" style="text-align: left;">
<span style="font-size: 12pt;"></span><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: 7.5pt; text-transform: none;">Response written by
Kathleen Pentecost, SRN CBU, BA Sociology & Carla I. Morales, SRN CBU, BS
Psychobiology</span>
</span></div>
<div align="left" class="MsoTitle" style="text-align: left;">
<br /></div>
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><div align="left" class="MsoTitle" style="text-align: left;">
<span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: 7.5pt; text-transform: none;">Caruso,P. Denari,s.,
Ruiz, S. A. L., Demarzo, S. E., Deheinzelin, D. (2009). Instillation of normal
saline before suctioning reduces the incidence of pneumonia in intubated and
ventilated adults. <i>Critical Care Medicine, 37</i>, 32-38.</span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><div align="left" class="MsoTitle" style="text-align: left;">
<span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: 7.5pt; text-transform: none;">Lippincott Williams
& Wilkins. (2009). Lippincott's nursing procedures. Philadelphia:
Lippincott </span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><div align="left" class="MsoTitle" style="text-align: left;">
<span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: 7.5pt; text-transform: none;">Williams & Wilkins. </span></span></div>
<span style="font-family: Arial,Helvetica,sans-serif;">
</span><div align="left" class="MsoTitle" style="text-align: left;">
<span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: 7.5pt; text-transform: none;">Mei-Yu, L., Shu-Hua, C.,
& Yi-Hui, S. (2012). Reducing Ventilator-Associated Pneumonia (VAP) by not
using instillation saline before suctioning [Chinese]. Journal of Nursing &
Healthcare Research, 8(4), 325-331.</span></span></div>
Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-28939308811500481012015-02-11T13:59:00.003-08:002015-02-11T13:59:48.279-08:00Danielle's Picks from the Literature - February 2015<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHqnp4h_5NqSF5FTbNPeZFhXR9kwrLpwBjIgKw1GyVv1_efZwZK-PQDCAzSdJcIAXaopI76BqViandSuzBfBMU-Oq2u_pzvAsxUKqMd2CABHyf7y_1I0iyQAl3hNzFhwt8xkdb/s1600/hearts.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHqnp4h_5NqSF5FTbNPeZFhXR9kwrLpwBjIgKw1GyVv1_efZwZK-PQDCAzSdJcIAXaopI76BqViandSuzBfBMU-Oq2u_pzvAsxUKqMd2CABHyf7y_1I0iyQAl3hNzFhwt8xkdb/s1600/hearts.png" /></a></div>
Here are my picks from the nursing literature for February. SJO and CHOC staff have access to the articles by contacting <a href="http://www.burlewmedicallibrary.org/" target="_blank">Burlew Medical Library</a>.<br />
<br />
<br />
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<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>What are the factors of organisational culture in health care settings
that act as barriers to the implementation of evidence-based practice? A
scoping review.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Williams, Brett; Perillo, Samuel; Brown, Ted;</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Nurse Education Today, 2015 Feb; 35 (2): e34-41. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Abstract: Summary Background The responsibility to implement
evidence-based practice (EBP) in a health care workplace does not fall solely
on the individual health care professional. Organisational barriers relate to
the workplace setting, administrational support, infrastructure, and facilities
available for the retrieval, critique, summation, utilisation, and integration
of research findings in health care practices and settings. Objective Using a
scoping review approach, the organisational barriers to the implementation of
EBP in health care settings were sought. Method This scoping review used the
first five of the six stage methodology developed by Levac et al. (2010). The
five stages used are: 1) Identify the research question; 2) identify relevant
studies; 3) study selection; 4) charting the data; and 5) collating,
summarising and reporting the results. The following databases were searched
from January 2004 until February 2014: Medline, EMBASE, EBM Reviews, Google
Scholar, The Cochrane Library and CINAHL. Results Of the 49 articles included
in this study, there were 29 cross-sectional surveys, six descriptions of
specific interventions, seven literature reviews, four narrative reviews, nine
qualitative studies, one ethnographic study and one systematic review. The
articles were analysed and five broad organisational barriers were identified.
Conclusions This scoping review sought to map the breadth of information
available on the organisational barriers to the use of EBP in health care
settings. Even for a health care professional who is motivated and competent in
the use of EBP; all of these barriers will impact on their ability to increase
and maintain their use of EBP in the workplace.</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Back to Basics: Implementing Evidence-Based Practice.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Spruce, Lisa; </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
AORN Journal, 2015; 101 (1): 106-12. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Abstract: As health care transitions from volume-based care to
value-based care, it is imperative that perioperative nurses implement
evidence-based practices that support effective care. Implementing
evidence-based practice is a challenge but improves patient outcomes,
standardizes care, and decreases patient care costs. Understanding how care
interventions work and how to implement them is important to compete in today's
health care market. This "Back to Basics" article discusses how to
identify, review, and appraise research; make recommendations to implement new
practices; evaluate the outcomes of the implementations; and make necessary
changes to facilitate evidence-based practice.</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Development of Evidence-Based Remote Telemetry Policy Guidelines for a
Multifacility Hospital System.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
George, Karen J.; Walsh-Irwin, Colleen; Queen, Caleb; Vander Heuvel,
Kimberly; Hawkins, Carrie; Roberts, Susan; </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Dimensions of Critical Care Nursing, 2015 Jan-Feb; 34 (1): 10-8. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Abstract: Over 10 years ago, the standards for cardiac monitoring were
set forth by the Councils on Cardiovascular Nursing, Clinical Cardiology, and
Cardiovascular Disease in the Young. The standards were endorsed by the
International Society of Computerized Electrocardiology and the American
Association of Critical-Care Nurses. The American Heart Association printed the
standards as an American Heart Association Scientific Statement. The standards
provided direction related to remote telemetry monitoring to acute care
hospitals. Since the standards were published, remote monitoring of cardiac
patients has increased dramatically prompting research and literature related
to appropriate utilization. Appropriate and safe telemetry monitoring requires
clearly written evidence-based facility policies. This article describes the
process whereby a team of Veterans Hospital Administration nurses from across
the country reviewed 70 remote telemetry policies representing 75 Veterans
Hospital Administration hospitals for clarity, consistency, and congruency to
existing levels of evidence found in the literature. This article describes the
processes, successes, and challenges of compiling an evidence-based remote
telemetry policy guideline.</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Evidence-Based Practice to Improve Outcomes for Late Preterm Infants.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Baker, Brenda; </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing, 2015
Jan; 44 (1): 127-34 <span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Abstract: Infants born between 34 weeks 0 days to 36 weeks 6 days
gestation have been identified as late preterm infants (LPIs) and account for
70% of preterm births and 9% of all births. The rise in elective deliveries in
the past decade is believed to have contributed to the number of late preterm
births. An interprofessional team including labor and delivery, neonatal
intensive care, and postpartum care providers collaborated to address this
issue at an urban academic medical center.</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Evidence-based nursing. Harnessing technology to promote
patient-centered care.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Fisher, Cheryl A.; Feigenbaum, Kathryn; </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Nursing Management, 2015 Jan; 46 (1): 14-5. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Implementing evidence-based care for patients with obstructive sleep
apnea.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Bourdon, Leslie;</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
AORN Journal, 2014; 100 (6): C5-7. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Nursing Journal Clubs: A Literature Review on the Effective Teaching
Strategy for Continuing Education and Evidence-Based Practice.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Lachance, Carly;</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Journal of Continuing Education in Nursing, 2014 Dec; 45 (12): 559-65. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Abstract: Background: This literature review on nursing journal clubs
evaluates the efficacy of the teaching strategy within the clinical setting.
Method: Peer-reviewed articles were retrieved using an online journal database.
Inclusion criteria incorporated information on efficacy of the teaching
strategy, evidence-based practices, and continuing education as they related to
nursing journal club initiatives. Results: The literature cited numerous
benefits and proved to be in favor of nursing journal clubs. The most common
benefits found were nurses remaining abreast of current research, skill
development in reading and critically appraising research, and incorporation of
evidence-based practices to patient care. Due to the self-motivated and
voluntary nature of this teaching strategy, a limitation commonly identified
was lack of participation, and further research on this limitation often was
suggested. Conclusion: Nursing journal clubs proved to be an effective teaching
strategy, a finding that remains consistent with the medical pioneers of the
movement. J Contin Educ Nurs. 2014;45(12):559-565.</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Evidence Synthesis and Its Role in Evidence-Based Health Care.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Pearson, Alan; </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Nursing Clinics of North America, 2014 Dec; 49 (4): 453-60. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Promoting patient safety with evidence-based management.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Hastings, Clare; </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Nursing Management, 2014 Dec; 45 (12): 11-3. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Implementing Evidence-Based Medication Safety Interventions on a
Progressive Care Unit.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Williams, Tyeasha; King, Melissa W.; Thompson, Julie A.; Champagne,
Mary T.; </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
American Journal of Nursing, 2014 Nov; 114 (11): 53-62. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Abstract: While preparing medications in complex health care
environments, nurses are frequently distracted or interrupted, which can lead
to medication errors that may adversely affect patient outcomes. This pilot
quality improvement project, which took place in a 32-bed surgical progressive
care unit in an academic medical center, implemented five medication safety
interventions designed to decrease distractions and interruptions during
medication preparation: nursing staff education, use o f a medication safety
vest, delineation of a no-interruption zone, signage, and a card instructing
nurses how to respond to interruptions. Four types of distractions and
interruptions decreased significantly between the two-month preimplementation
and two-month postimplementation periods: those caused by a physician, NR o r
physician assistant; those caused by other personnel; phone calls and pages
placed or received by the nurse during medication administration; and
conversation unrelated to medication administration that involved the nurse or
loud nearby conversation that distracted the nurse. The total number of
reported adverse drug events also decreased from 10 to four, or by 60%. Thus,
medication safety interventions may help decrease distractions and
interruptions in high-acuity settings.</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Improving the Culture of Evidence-Based Practice at a Magnet® Hospital.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Kaplan, Louise; Zeller, Edna; Damitio, Diane; Culbert, Sarah; Bayley,
K. Bruce; </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Journal for Nurses in Professional Development, 2014 Nov-Dec; 30 (6):
274-80. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Role of the Acute Care Nurse in Managing Patients With Heart Failure
Using Evidence-Based Care.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Paul, Sara; Hice, Amber; </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Critical Care Nursing Quarterly, 2014 Oct-Dec; 37 (4): 357-76. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Abstract: Acute heart failure is a major US public health problem,
accounting for more than 1 million hospitalizations each year. As part of the
health care team, nurses play an important role in the evaluation and
management of patients presenting to the emergency department with acute
decompensated heart failure. Once acute decompensation is controlled, nurses
also play a critical role in preparing patients for hospital discharge and
educating patients and caregivers about strategies to improve long-term
outcomes and prevent future decompensation and rehospitalization. Nurses’
assessment skills and comprehensive knowledge of acute and chronic heart
failure are important to optimize patient care and improve outcomes from
initial emergency department presentation through discharge and follow-up. This
review presents an overview of current heart failure guidelines, with the goal
of providing acute care cardiac nurses with information that will allow them to
better use their knowledge of heart failure to facilitate diagnosis,
management, and education of patients with acute heart failure.</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Preventing Ventilator-Associated Events: Complying With Evidence-Based Practice.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Munaco, Sandra S.; Dumas, Bonnie; Edlund, Barbara J.;</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Critical Care Nursing Quarterly, 2014 Oct-Dec; 37 (4): 384-92. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Abstract: The leading cause of death due to health care-associated
infections is ventilator-associated pneumonia (VAP). The lack of clarity in the
definition of VAP has made it difficult to execute and evaluate the
effectiveness of prevention strategies. Beginning in 2013, hospitals were
expected to implement a new surveillance definition algorithm to identify
ventilator-associated events (VAEs). The Institute for Healthcare Improvement
recommended the use of the Ventilator Care Bundle as part of an initiative to
decrease the incidence of VAP. This article outlines the results of a quality
improvement project that was conducted to address this recommendation, improve
current staff knowledge, identify gaps in practice, and determine the rate of
compliance with prevention strategies. The major findings of this project also
exposed limitations of the electronic medical record system, and suggested
enhancements, which would promote the VAP Bundle initiatives, facilitate
documentation, and permit straightforward data collection.</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>Systematic review of instruments for measuring nurses' knowledge,
skills and attitudes for evidence-based practice.</b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Leung, Kat; Trevena, Lyndal; Waters, Donna; </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Journal of Advanced Nursing, 2014 Oct; 70 (10): 2181-95. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Abstract: Aim To identify, appraise and describe the characteristics of
instruments for measuring evidence-based knowledge, skills and/or attitudes in
nursing practice. Background Evidence-based practice has been proposed for
optimal patient care for more than three decades, yet competence in
evidence-based practice knowledge and skills among nurse clinicians remains
difficult to measure. There is a need to identify well-validated and reliable
instruments for assessing competence for evidence-based practice in nursing.
Design Psychometric systematic review. Data Sources The MEDLINE, EMBASE,
CINAHL, ERIC, CDSR, All EBM reviews and PsycInfo databases were searched from
1960-April 2013; with no language restrictions applied. Review Methods Using
pre-determined inclusion criteria, three reviewers independently identified
studies for full-text review, extracting data and grading instrument validity
using a Psychometric Grading Framework. Results Of 91 studies identified for
full-text review, 59 met the inclusion criteria representing 24 different
instruments. The Psychometric Grading Framework determined that only two
instruments had adequate validity - the Evidence Based Practice Questionnaire
measuring knowledge, skills and attitudes and another un-named instrument
measuring only EBP knowledge and attitudes. Instruments used in another nine
studies were graded as having 'weak' validity and instruments in the remaining
24 studies were graded as 'very weak'. Conclusion The Evidence Based Practice
Questionnaire was assessed as having the highest validity and was the most practical
instrument to use. However, the Evidence Based Practice Questionnaire relies
totally on self-report rather than direct measurement of competence suggesting
a need for a performance-based instrument for measuring evidence-based
knowledge, skills and attitudes in nursing.</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
<b>$trategies for Searching and Managing Evidence-Based Practice
Resources. </b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Robb, Meigan; Shellenbarger, Teresa;</div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Journal of Continuing Education in Nursing, 2014 Oct; 45 (10): 461-6. </div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;">
Abstract: Evidence-based nursing practice requires the use of effective
search strategies to locate relevant resources to guide practice change.
Continuing education and staff development professionals can assist nurses to
conduct effective literature searches. This article provides suggestions for
strategies to aid in identifying search terms. Strategies also are recommended
for refining searches by using controlled vocabulary, truncation, Boolean
operators, PICOT (Population/Patient Problem, Intervention. Comparison,
Outcome, Time) searching, and search limits. Suggestions for methods of
managing resources also are identified. Using these approaches will assist in
more effective literature searches and may help evidence-based practice
decisions. </div>
Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com1tag:blogger.com,1999:blog-23245819.post-21180960455648343012014-08-06T11:53:00.000-07:002014-08-06T11:53:08.261-07:00Clinical Inquiry - first of a series<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRAjU-ucU7r3h5Si-CENGyd8ucpu-BiercxfaoxzzjOXQicXrY5RkyUDHOsjP-7FIKvBqzYLNQMndOWSqBla764i76T86Z4pC1QUdP0SLnGuf82R76YFmE3tsJUJj6xrYdFrI-/s1600/evidence+cow.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRAjU-ucU7r3h5Si-CENGyd8ucpu-BiercxfaoxzzjOXQicXrY5RkyUDHOsjP-7FIKvBqzYLNQMndOWSqBla764i76T86Z4pC1QUdP0SLnGuf82R76YFmE3tsJUJj6xrYdFrI-/s1600/evidence+cow.jpg" height="200" width="179" /></a></div>
The RNs at St. Joseph Hospital are curious and inquisitive when it comes to best nursing practice. Our nurses are encouraged to submit their clinical practice questions to our Research Department for review of the best evidence to guide patient care. Here is the first of our series entitled "Clinical Inquiry".<br />
<br />
Q: Why do we use sterile water to flush NG tubes? Why can't we use bottled or tap water?<br />
A: Bottled or tap water is only indicated for hydration in healthy patients who are not immunocompromised. Acutely ill patients or those with chronic conditions that have any alterations to the GI tract are vulnerable to nosocomial infections from non-sterile products including water. This also holds true for patients who are immunocompromised but not acutely ill. Because tap water contains metals, medications should only be diluted in sterile water to prevent reduction of bioavailability. Tap water also has the potential to be a source of contamination when reconstituting formula. Filtration of water may be beneficial but still poses a risk for contamination. Sterile water is solute-free and free of chemical or microbial contaminants; therefore, it is the only type of water that should be used to flush NG tubes, dilute medications and reconstitute formula.<br />
<br />
<span style="font-size: x-small;">response written by Kathleen Pentecost, SRN CBU, BA Sociology & Carla I. Morales, SRN CBU, BS Psychobiology</span><br />
<br />
<span style="font-size: x-small;">Bankhead, R., Boullata, B.S., Corkins, M., Guenter, P., Krenitsky, J., Lyman, B., et al. (2009) A.S.P.E.N. Enteral nutrition practice recommendations. <i>Journal of Enteral and Parenteral Nutrition, 33</i>, 122-69. </span>Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-54430415422277808242014-08-04T10:21:00.000-07:002014-08-04T10:21:16.970-07:00St. Joseph Hospital Staff Publishes ArticleCongratulations to the following St. Joseph Hospital staff
for their newly published article on blood culture accuracy: Beth Winokur, RN, PhD, CEN, Debra Pai, RN, BSN, CEN, Dana Rutledge, RN, PhD, Kate Vogel, MA, CLS, MT, Sadeeka Al-Majid, RN, PhD, Christine Marshall, RN, MSN, CEN, CPEN and Paul Sheikewitz, MD! SJO
employees have access to the full article through <a href="http://www.burlewmedicallibrary.org/" target="_blank">Burlew Medical Library</a>. Contact <a href="mailto:burlewmedicallibrary@stjoe.org" target="_blank">library staff</a> for more details.<br />
<br />
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J Emerg Nurs. 2014 Jul;40(4):323-9. doi:
10.1016/j.jen.2013.04.007. Epub 2013 Jun 29.</div>
<div class="MsoNormal">
<b>Blood culture accuracy: discards from central venous
catheters in pediatric oncology patients in the emergency department.</b></div>
<div class="MsoNormal">
Winokur EJ1, Pai D2, Rutledge DN2, Vogel K2, Al-Majid S2,
Marshall C2, Sheikewitz P2.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Abstract</div>
<div class="MsoNormal">
INTRODUCTION:</div>
<div class="MsoNormal">
Lack of specific guidelines regarding collection of blood
for culture from central venous catheters (CVCs) has led to inconsistencies in
policies among hospitals. Currently, no specific professional or regulatory
recommendations exist in relation to using, reinfusing, or discarding blood
drawn from CVCs before drawing blood for a culture. Repeated wasting of blood
may harm immunocompromised pediatric oncology patients. The purpose of this
comparative study was to determine whether differences exist between blood
cultures obtained from the first 5 mL of blood drawn from a CVC line when
compared with the second 5 mL drawn.</div>
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METHODS:</div>
<div class="MsoNormal">
During 2009-2011, 62 pediatric oncology patients with CVCs
and orders for blood cultures to determine potential sepsis were enrolled
during ED visits. Trained study nurses aseptically drew blood and injected the
normally discarded first 5 mL and the second specimen (usual care) into
separate culture bottles. Specimens were processed in the microbiology
laboratory per hospital policy.</div>
<div class="MsoNormal">
RESULTS:</div>
<div class="MsoNormal">
Positive cultures were evaluated to assess agreement between
specimen results and to determine that the identified pathogen was not a
contaminant. Out of 186 blood culture pairs, 4.8% demonstrated positive
results. In all positive-positive matches, the normal discard specimen
contained the same organism as the usual care specimen. In 4 matches, the
normally discarded specimen demonstrated notably earlier time to positivity (4
to 31 hours) compared with the usual care specimen, which resulted in earlier
initiation of definitive antibiotics.</div>
<div class="MsoNormal">
DISCUSSION:</div>
<div class="MsoNormal">
These findings support the accuracy of the specimen that is
normally discarded and suggest the need to reconsider its use for blood culture
testing.</div>
<br />
<br />Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-92183359085036509602014-07-14T15:39:00.003-07:002014-07-14T15:39:40.782-07:00St. Joseph Hospital Nurse Publishes ArticleCongratulations to St. Joseph Hospital RN Lupe Ramos, MSN, NP-C, ACNP for her newly published article on cardiac diagnostic testing! SJO employees have access to the full article through <a href="http://www.burlewmedicallibrary.org/" target="_blank">Burlew Medical Library</a>. Contact <a href="mailto:burlewmedicallibrary@stjoe.org" target="_blank">library staff</a> for more details.<br />
<br />
Critical Care Nurse.<br />
2014 Jun;34(3):16-27; quiz 28. doi: 10.4037/ccn2014361.<br />
Cardiac diagnostic testing: what bedside nurses need to know.<br />
Ramos LM.<br />
Abstract:
Coronary artery disease affects more than 385000 persons annually and continues to be a leading cause of death in the United States. Recently, the number of available noninvasive cardiac diagnostic tests has increased substantially. Nurses should be knowledgeable about available noninvasive cardiac diagnostic testing. The common noninvasive cardiac diagnostic testing procedures used to diagnose coronary heart disease are transthoracic echocardiography, stress testing (exercise, pharmacological, and nuclear), multidetector computed tomography, coronary artery calcium scoring (with electron beam computed tomography or computed tomographic angiography), and cardiac magnetic resonance imaging. Objectives include (1) describing available methods for noninvasive assessment of coronary artery disease, (2) identifying which populations each test is most appropriate for, (3) discussing advantages and limitations of each method of testing, (4) identifying nursing considerations when caring for patients undergoing various methods of testing, and (5) describing outcome findings of various methods. <br />
<br />Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-27454026994969217242014-04-02T09:56:00.002-07:002014-04-02T09:56:21.657-07:00Danielle's Picks from the Literature - April 2014<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS151whC-u1d3wdlq_iWSZT4z_dom2rIOREkXHToQbn4BnzJ37WwdvRyYQ9oeu8tWyYxDboMuCQdyiff3_5wkyXRk9UCCHqcUaC6FR0hlc1lWxTjq6JjrAlp_l3aeUfe8MH5kr/s1600/carrot.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS151whC-u1d3wdlq_iWSZT4z_dom2rIOREkXHToQbn4BnzJ37WwdvRyYQ9oeu8tWyYxDboMuCQdyiff3_5wkyXRk9UCCHqcUaC6FR0hlc1lWxTjq6JjrAlp_l3aeUfe8MH5kr/s1600/carrot.jpg" /></a></div>
Here are my picks from the nursing literature for April. SJO and CHOC staff have access to the articles by contacting <a href="http://www.burlewmedicallibrary.org/" target="_blank">Burlew Medical Library</a>.<br />
<br />
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<b>1. Ruptured thought: rupture as a critical attitude to
nursing research.</b></div>
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Beedholm, Kirsten; Lomborg, Kirsten;
Frederiksen, Kirsten; </div>
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Nursing Philosophy, 2014 Apr; 15 (2): 102-11. </div>
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Abstract: In this paper, we introduce the notion of
'rupture' from the French philosopher Michel Foucault, whose studies of
discourse and governmentality have become prominent within nursing research
during the last 25 years. We argue that a rupture perspective can be helpful
for identifying and maintaining a critical potential within nursing research.
The paper begins by introducing rupture as an inheritance from the French
epistemological tradition. It then describes how rupture appears in Foucault's
works, as both an overall philosophical approach and as an analytic tool in
his historical studies. Two examples of analytical applications of rupture
are elaborated. In the first example, rupture has inspired us to make an
effort to seek alternatives to mainstream conceptions of the phenomenon under
study. In the second example, inspired by Foucault's work on discontinuity,
we construct a framework for historical epochs in nursing history. The paper
concludes by discussing the potential of the notion of rupture as a response
to the methodological concerns regarding the use of Foucault-inspired
discourse analysis within nursing research. We agree with the critique of
Cheek that the critical potential of discourse analysis is at risk of being
undermined by research that tends to convert the approach into a fixed
method.</div>
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<b>2. Pursuing a career in nursing research.</b> </div>
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Fawcett, Tonks (Josephine) Nicola; McCulloch, Corrienne; </div>
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Nursing Standard,
2014 Mar 12; 28 (28): 54-8. </div>
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Abstract: Nursing is an evidence-based profession that
uses the latest and best research to improve nursing practice and patient
outcomes. Nursing research is needed to generate knowledge and develop
nursing care. Despite this, the role of the research nurse is poorly understood
and appreciated. This article discusses the importance of the nurses' role in
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<b>3. </b><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><b>Analysis and Use of
Different Research Review Approaches in Nursing</b>.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Cope, Diane
G.; </span></span></div>
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<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Oncology Nursing Forum, 2014 Mar; 41 (2): 207-8. </span></span></div>
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<![endif]--><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Abstract:
Asignificant increase in nursing research is being conducted as the nursing
profession shifts from "ritual" clinical decisions to practice based
on research evidence. Evidence-based practice is now an accepted, essential
foundation for high-quality patient care. Initially, best practice was based on
a few randomized, controlled trials that reflected similar clinical problems.
However, with the plethora of nursing research to date, evidence-based nursing
practice currently is grounded in summaries of research or research reviews,
resulting in robust findings used in the development of clinical guidelines.
Several terms exist for reviews, such as literature, integrative, systematic,
meta-analysis, and metasynthesis. Similarities can be noted among the types of
reviews; however, the objectives and goals of each method differ and the terms
should not be used synonymously. This article will define each of the
literature and research reviews and discuss methodologic procedures for
conducting each method.</span></span> </span></div>
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<![endif]--><span style="font-family: "Times New Roman","serif";">5. <b>The Iowa Model of
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<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Brown, Carlton G.; </span></span></span></div>
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<![endif]--><span style="font-family: "Times New Roman","serif";">6. <b>Evidence to Change
Practice: Creating a Restful Hospital Environment for Nurses and
Patients.</b></span></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Hinkulow, Maricel B.; </span></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Archives of Psychiatric Nursing, 2014 Feb; 28
(1): 74-5. </span> </span></span></div>
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<![endif]--><span style="font-family: "Times New Roman","serif";">8. <b>The Establishment of
Evidence-Based Practice Competencies for Practicing Registered Nurses and
Advanced Practice Nurses in Real-World Clinical Settings: Proficiencies to
Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs.<span style="font-size: small;"> </span></b></span></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Melnyk, Bernadette Mazurek; Gallagher-Ford, Lynn; Long, Lisa English;
Fineout-Overholt, Ellen; </span></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Worldviews on Evidence-Based Nursing, 2014; 11 (1):
1st Quarter: 5-15. </span> </span></span></div>
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<![endif]--><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Abstract: Background Although it is widely known that evidence-based practice (EBP)
improves healthcare quality, reliability, and patient outcomes as well as
reduces variations in care and costs, it is still not the standard of care
delivered by practicing clinicians across the globe. Adoption of specific EBP
competencies for nurses and advanced practice nurses (APNs) who practice in
real-world healthcare settings can assist institutions in achieving high-value,
low-cost evidence-based health care. Aim The aim of this study was to develop a
set of clear EBP competencies for both practicing registered nurses and APNs in
clinical settings that can be used by healthcare institutions in their quest to
achieve high performing systems that consistently implement and sustain EBP.
Methods Seven national EBP leaders developed an initial set of competencies for
practicing registered nurses and APNs through a consensus building process. Next,
a Delphi survey was conducted with 80 EBP mentors across the United States to
determine consensus and clarity around the competencies. Findings Two rounds of
the Delphi survey resulted in total consensus by the EBP mentors, resulting in
a final set of 13 competencies for practicing registered nurses and 11
additional competencies for APNs. Linking Evidence to Action Incorporation of
these competencies into healthcare system expectations, orientations, job
descriptions, performance appraisals, and clinical ladder promotion processes
could drive higher quality, reliability, and consistency of healthcare as well
as reduce costs. Research is now needed to develop valid and reliable tools for
assessing these competencies as well as linking them to clinician and patient
outcomes.</span></span></span></span></div>
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<![endif]--><span style="font-family: "Times New Roman","serif";">9. <b>Advancing advanced
practice — Clarifying the conceptual confusion<span style="font-size: small;">.</span></b></span></span></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Stasa,
Helen; Cashin, Andrew; Buckley, Thomas; Donoghue, Judith; </span></span></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Nurse Education
Today, 2014 Mar; 34 (3): 356-61. </span> </span></span></span></div>
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<![endif]--><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Abstract: Summary:
Background: In recent years, there has been a substantial increase in the
number of nurses holding advanced practice nursing positions. However, the lack
of clarity regarding key terms such as ‘advanced practice nursing’, ‘advanced
nursing practice’, ‘scope of practice’ and ‘extended practice’, and
international variability in how these terms are used has created significant
confusion. This lack of clarity is problematic for nurses, other health
professionals, health service consumers, educators and policy makers,
particularly given the global mobility of the nursing workforce. Objectives: 1)
To highlight the significant international variability in how advanced practice
nursing, and associated terms such as extended and expanded practice, are
defined and regulated across a variety of different English speaking countries,
including the US, UK, New Zealand, Canada and Australia. 2) To propose
innovative formulations for how the nursing profession may attempt to ensure
greater precision and agreement around advanced practice terminology. Design:
Discursive paper. Results: It was found that there is a considerable lack of
clarity regarding the precise definitions of key terms surrounding the
discussion of advanced practice. Additionally, there are large disparities in
how the five chosen countries regulate advanced practice nursing, and roles
such as that of the nurse practitioner. Conclusions: It is suggested that the
confusion regarding advanced practice terminology can be reduced definitionally
by minimising the use of the term ‘expanded practice’; defining advanced
practice nursing to refer to the type of practice in defined and regulated
advanced practice nursing scopes; and defining advanced nursing practice as
expert practice within a regulated nursing scope.</span></span> </span></span> </span></span></div>
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<![endif]--><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">10. <b>Understanding the
Role of the Professional Practice Environment on Quality of Care in Magnet® and
Non-Magnet Hospitals.</b></span></span></div>
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<![endif]--><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Abstract: OBJECTIVE:
The aim of this study was to explore the relationship between Magnet
Recognition® and nurse-reported quality of care. BACKGROUND: Magnet® hospitals
are recognized for nursing excellence and quality patient outcomes; however,
few studies have explored contributing fac-tors for these superior outcomes.
METHODS: This was a secondary analysis of linked nurse survey data, hospital administrative
data, and a listing of American Nurses Credentialing Center Magnet hospitals.
Multivariate regressions were modeled before and after propensity score
matching to assess the relationship between Magnet status and quality of care.
A mediation model assessed the indirect effect of the professional practice
environ-ment on quality of care. RESULTS: Nurse-reported quality of care was
sig-nificantly associated with Magnet Recognition after matching. The
professional practice environment me-diates the relationship between Magnet
status and quality of care. CONCLUSION: A prominent feature of Magnet
hospitals, a professional practice environment that is supportive of nursing,
plays a role in explaining why Magnet hospitals have better nurse-reported quality
of care.</span></span></div>
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Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0tag:blogger.com,1999:blog-23245819.post-41212227670325551312014-02-13T09:41:00.002-08:002014-02-13T09:41:52.176-08:00Danielle's Picks from the Literature - February 2014<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlYNCp7hu-Pt5L3CvYzXJlMWXIhwjPzY8DfIPMDdEoz5qwVfuAl4jm8EF5Ml1d-R_ZwkNuFj-hVLgza1SZPEFMF5ZOwuhUv78j5NCxhw-dzYwj6ddpTuv7VgHcgT3W3O0uY98s/s1600/carrot.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlYNCp7hu-Pt5L3CvYzXJlMWXIhwjPzY8DfIPMDdEoz5qwVfuAl4jm8EF5Ml1d-R_ZwkNuFj-hVLgza1SZPEFMF5ZOwuhUv78j5NCxhw-dzYwj6ddpTuv7VgHcgT3W3O0uY98s/s1600/carrot.jpg" /></a></div>
Here are my picks from the nursing literature for February. SJO and CHOC staff have access to the articles by contacting <a href="http://www.burlewmedicallibrary.org/" target="_blank">Burlew Medical Library</a>.<br />
<br />
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New Model for Evidence Rating.</span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">SPRUCE, LISA; VAN WICKLIN, SHARON A.; HICKS,
RODNEY W.; CONNER, RAMONA; DUNN, DEBRA; AORN Journal, 2014; 99 (2): 243-255.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">2. </span></span><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><!--[if gte mso 9]><xml>
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Workers: Is There Evidence of Knowledge in Patient Handoffs?</span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Matney, Susan A.;
Maddox, Lory J.; Staggers, Nancy; </span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Western Journal of Nursing Research, 2014
Feb; 36 (2): 171-90. </span> </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">3. </span></span><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><!--[if gte mso 9]><xml>
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Prevention of Pressure Ulcers in the Intensive Care Unit.</span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Cooper, Karen L.; </span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Critical Care Nurse, 2013 Dec; 33 (6): 57-67.</span> </span></span><br />
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<![endif]--><span style="font-family: "Times New Roman","serif";">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.</span> </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">4. </span></span><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><!--[if gte mso 9]><xml>
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</xml><![endif]--></span><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Twitter and nursing
research: how diffusion of innovation theory can help uptake.</span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Archibald, Mandy
M.; Clark, Alexander M.; </span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Journal of Advanced Nursing, 2014 Mar; 70 (3): e3-5. </span> </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">5. </span></span><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><!--[if gte mso 9]><xml>
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</xml><![endif]--></span><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">RESEARCH CORNER.
What's the impact of quality bundles at the bedside?</span></span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Welchel, Catherine; Berg, Lisa; Brown, Annette; Hurd, Debra; Koepping, Dianne;
Stroud, Shalan; </span></span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Nursing, 2013 Dec; 43 (12): 18-21. </span></span> </span></span><br />
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<![endif]--><span style="font-family: "Times New Roman","serif";">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.</span> </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">6. </span></span><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><!--[if gte mso 9]><xml>
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</xml><![endif]--></span><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Evidence-based
nursing. Transforming care through leadership and research alignment.</span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Sellars,
Bridgett B.; Mayo, Ann; </span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Nursing Management, 2013 Dec; 44 (12): 12-5.</span> </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">7. </span></span><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"></span><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"> </span>How DNP and PhD
nurses can collaborate to maximize patient care.</span></span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Moore, Kate; </span></span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">American Nurse
Today, 2014 Jan; 9 (1): 48-9. </span></span></span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">8. </span></span></span></span><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><!--[if gte mso 9]><xml>
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to EBP.</span></span></span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Walter, Monica R.; Aucoin, Julia; Brown, Rosemary; Thompson, Julie A.;
Taylor Sullivan, Dori; </span></span></span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Nursing Management, 2014 Jan; 45 (1): 14-7. </span> </span></span></span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">9. </span></span></span></span><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><!--[if gte mso 9]><xml>
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</xml><![endif]--></span><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Interventions to
minimise the initial use of indwelling urinary catheters in acute care: A
systematic review.</span></span></span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">Murphy, Catherine; Fader, Mandy; Prieto,
Jacqui; </span></span></span></span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-family: "Times New Roman","serif";">International Journal of Nursing Studies, 2014; 51 (1): 4-13. </span> </span></span></span></span><br />
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<![endif]--><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">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.</span></span> </span></span></span></span><br />
<br />
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</xml><![endif]--><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">10. </span></span>Embracing a culture
in conducting research requires more than nurses' enthusiasm.</span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Loke, Jennifer C.F.; Laurenson, Mary C.; Lee, Kah Wai; </span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">Nurse
Education Today, 2014 Jan; 34 (1): 132-7. </span></span><br />
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<![endif]--><span style="font-size: small;"><span style="font-family: "Times New Roman","serif";">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.</span></span> </span></span><br />
<span style="font-size: small;"><span style="font-family: "Times New Roman","serif";"> </span></span> Danielle Linden, MLIS, AHIPhttp://www.blogger.com/profile/13605094710935228614noreply@blogger.com0