Julie's picks from the nursing literature:April 09

1. Evidence-based nursing: clarifying the concepts for nurses in practice.(includes abstract); Scott K; McSherry R; Journal of Clinical Nursing, 2009 Apr; 18 (8): 1085-95

2. Evaluating nursing documentation -- research designs and methods: systematic review.(includes abstract); Saranto K; Kinnunen U; Journal of Advanced Nursing, 2009 Mar; 65 (3): 464-76

3. Evidence-based nursing. The SCIP core measures: A dizzying array of issues.Booth J; Nursing Management, 2009 Mar; 40 (3): 10, 12, 14

4. Developing clinical research projects: novice to expert.Siegel JH; Korniewicz DM; Perioperative Nursing Clinics, 2009 Mar; 4 (1): 23-9

5. The latest evidence to guide obesity prevention, policy, and clinical practice with overweight children and adolescents.Melnyk BM; Worldviews on Evidence-Based Nursing, 2009 1st Quarter; 6 (1): 44-8

6. Pain assessment and management in surgical nursing: a literature review.(includes abstract); Bell L; Duffy A; British Journal of Nursing (BJN), 2009 Feb 12; 18 (3): 153-6 (journal article - pictorial, research, systematic review) ISSN: 0966-0461 PMID: 19223798 CINAHL AN: 2010196749

7. PUTTING EVIDENCE INTO PRACTICE: evidence-based interventions to prevent and manage anorexia.(includes abstract); Adams LA; Shepard N; Caruso RA; Norling MJ; Belansky H; Cunningham RS; Clinical Journal of Oncology Nursing, 2009 Feb; 13 (1): 95-102 (journal article - research, systematic review, tables/charts) ISSN: 1092-1095 PMID: 19193554 CINAHL AN: 2010190247

8. Systematic review of the effectiveness of primary care nursing.(includes abstract); Keleher H; Parker R; Abdulwadud O; Francis K; International Journal of Nursing Practice, 2009 Feb; 15 (1): 16-24 (journal article - research, systematic review, tables/charts) ISSN: 1322-7114 PMID: 19187165 CINAHL AN: 2010171910

9. Review summaries: evidence for nursing practice.Stern C; Journal of Advanced Nursing, 2009 Feb; 65 (2): 279-84 (journal article - abstract, tables/charts) ISSN: 0309-2402 CINAHL AN: 2010177689

10. How evidence-based is venous leg ulcer care? A survey in community settings.(includes abstract); Van Hecke A; Grypdonck M; Beele H; De Bacquer D; Defloor T; Journal of Advanced Nursing, 2009 Feb; 65 (2): 337-47 (journal article - research, tables/charts) ISSN: 0309-2402 PMID: 19016923 CINAHL AN: 20101776

11. Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center.(includes abstract); Brown CE; Wickline MA; Ecoff L; Glaser D; Journal of Advanced Nursing, 2009 Feb; 65 (2): 371-81 (journal article - research, tables/charts) ISSN: 0309-2402 PMID: 19040688 CINAHL AN: 2010177698

12. Organizational readiness for evidence-based practice.(includes abstract); Gale BV; Schaffer MA; Journal of Nursing Administration, 2009 Feb; 39 (2): 91-7 (journal article - research, tables/charts) ISSN: 0002-0443 PMID: 19190426 CINAHL AN: 2010194939

13. Pediatric perspectives. Pediatric evidence-based practice: using the best available evidence to improve pediatric outcomes.Jones SKB; Pate MFD; AACN Advanced Critical Care, 2009 Jan; 20 (1): 19-25 (journal article - tables/charts) ISSN: 1559-7768 PMID: 19174633 CINAHL AN: 2010190119

14. Perceived effects of specialty nurse certification: a review of the literature.(includes abstract); Wade CH; AORN Journal, 2009 Jan; 89 (1): 183-8, 190-2 (journal article - research, systematic review, tables/charts) ISSN: 0001-2092 PMID: 19121422 CINAHL AN: 2010153499

15. Promoting evidence-based practice through a traveling journal club.(includes abstract); Campbell-Fleming J; Catania K; Courtney L; Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 2009 Jan-Feb; 23 (1): 16-20 (journal article) ISSN: 0887-6274 PMID: 19098510 CINAHL AN: 2010147816

16. Graduated compression stocking and intermittent pneumatic compression device length selection.(includes abstract); Hilleren-Listerud AE; Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 2009 Jan-Feb; 23 (1): 21-4 (journal article - review) ISSN: 0887-6274 PMID: 19098511 CINAHL AN: 2010147817

Book Review: Real Stories of Nursing Research

New book in Burlew Library (WY 20.5 R2877 2010 NSG)
McLaughlin, M. M. K., & Bulla, S. A. (Eds). (2009). Real stories of nursing research: The quest for Magnet recognition. Sudbury MA: Jones & Bartlett.
In Real Stories of Nursing Research: The Quest for Magnet Recognition, real stories and brief research abstracts show that direct care nurses really can do research. We know this at St. Joseph, but it is fun to read these stories, as they come from nurses in Magnet-designated hospitals located in all types of settings. This text includes helpful hints from experts like librarians, statisticians, and IRB reviewers who discuss how to make the research journey smoother. Real Stories of Nursing Research addresses overcoming fears of research and is a fun read.

Did you ever think bath basins might be a reservoir for infection?

Research Abstract with Commentary

Patients’ Bath Basins as Potential Sources of Infection: A Multicenter Sampling Study

Background. Nosocomial infections are a marked burden on the US health care system and are linked to a high number of patient deaths.
Objective. To identify and quantify bacteria in patients' bath basins and evaluate the basins as a possible reservoir for bacterial colonization and a risk factor for subsequent hospital-acquired infection.
Methods. In a prospective study at 3 acute care hospitals, 92 bath basins, including basins from 3 intensive care units, were evaluated. Sterile culture sponges were used to obtain samples from the basins. The culture sponges were sent to an outside laboratory, and qualitative and quantitative microbial tests were conducted and the results reported.
Results. Some form of bacteria grew in 98% of the samples (90 sponges), either by plating or on enrichment (95% confidence interval, 92%-99.7%). The organisms with the highest positive rates of growth on enrichment were enterococci (54%), gram-negative organisms (32%), Staphylococcus aureus (23%), vancomycin-resistant enterococci (13%), methicillin-resistant S aureus (8%), Pseudomonas aeruginosa (5%), Candida albicans (3%), and Escherichia coli (2%). Mean plate counts, in colony-forming units, were 10 187 for gram-negative organisms, 99 for E coli, 30 for P aeruginosa, 86 for S aureus, 207 for enterococci, and 31 for vancomycin-resistant enterococci.
Conclusions. Bath basins are a reservoir for bacteria and may be a source of transmission of hospital-acquired infections. Increased awareness of bath basins as a possible source of transmission of hospital-acquired infections is needed, particularly for high-risk patients.

Johnson, D., Lineweaver, L., & Maze, L. M. (2009). Patients’ bath basins as potential sources of infection: A multicenter sampling study. American Journal of Critical Care, 18, 31-40.

Commentary by Dana N. Rutledge, RN, PhD, Nursing Research Facilitator

In this eye-opening study, researchers address an area of common concern to nursing: infection control. They break the myth that a “dry” bath basin cannot harbor bacteria. New knowledge has shown that the development of biofilm (multiple colonies of microorganisms attached to a surface) can be present on multiple surfaces (including contaminated items or unwashed hands).

Johnson and colleagues (2009) sampled bath basins used at least twice for whole-body bathing of patients hospitalized for 48+ hours that had not been “cleaned” with any substance (probably just rinsed out with the washcloth). All basins were disposable and were found in the upright position, many times with articles in them (e.g., incontinence supplies). They were swabbed (cultured) at least 2 hours after patient bathing.

Findings showed that age, gender, and length of stay did not affect the findings of bacterial presence in the 98% of bath basins. Of concern is that 8% harbored methicillin-resistant Staphylococcus aureas (MRSA) and 13% harbored vancomycin-resistant enterococci (VRE), both of which are difficult organisms to eradicate, and the subject of much infection control work. The patients from which the 92 basins were taken all had been screened on admission for MRSA and VRE, and had been found to be negative indicating their presence in the hospital environment.

Study authors discuss how bathing can release skin flora into bath water, and how this water can be a potential contaminant to patients, particularly for mucosal introduction. Nurses should consider bath basins as a potential source of bacterial spread. Potential methods to decrease the likelihood that bath basins will be reservoirs are listed here:
Use disposable bath packages and products
Use disposable cleansing cloths to eliminate reuse of a washcloth to cover all parts of the body
Potential benefits include prevention of urinary tract infections and less skin damage from drying soap and water baths.

Assessing the Impact of Research

Assessing the Impact of Research Check out this link by the Bernard Becker Medical Library from Washington University School of Medicine. They offer a model that can be used for assessing the impact of your research. Whether it's nursing or medical research, this model can assist you in quantifying the true impact of your research. Has anyone used aspects of this model?