Wednesday, December 22, 2010

Danielle's Picks from the Literature - December 2010

Here are my picks from the nursing literature published over the last few months. Staff at St. Joseph Hospital or Children's Hospital of Orange County may be able to access some of the full text articles through the Burlew Medical Library.

1. Translating Infant Safe Sleep Evidence Into Nursing Practice.
Shaefer SJM; Herman SE; Frank SJ; Adkins M; Terhaar M;
JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing, 2010 Nov-Dec; 39 (6): 618-26 CINAHL AN: 2010847501

2. Improving diabetes patient outcomes: Framing research into the chronic care model.
Dancer S; Courtney M;
Journal of the American Academy of Nurse Practitioners, 2010 Nov; 22 (11): 580-5 CINAHL AN: 2010851492

3. Conceptual models of evidence-based practice: part II of a four-part series on evidence-based practice.
Bondmass M; Nevada RNformation, 2010 Nov; 19 (4): 6, 22 CINAHL AN: 2010855071

4. Recognizing the evidence and changing practice on injection sites.
Cocoman A; Murray J;
British Journal of Nursing (BJN), 2010 Oct 14; 19 (18): 1170-4 CINAHL AN: 2010831580

5. Evidence and the Executive. Instruments to Assess Organizational Readiness for Evidence-Based Practice.
Newhouse RP;
Journal of Nursing Administration, 2010 Oct; 40 (10): 404-7 CINAHL AN: 2010851305

6. Culturally competent psychiatric nursing care.
Wilson DW;
Journal of Psychiatric & Mental Health Nursing, 2010 Oct; 17 (8): 715-24 CINAHL AN: 2010777605

7. Good practice in management of patients with urethral catheters.
Pratt R; Pellowe C;
Nursing Older People, 2010 Oct; 22 (8): 25-9 CINAHL AN: 2010826639

8. Evidence-based practice, step by step. Critical appraisal of the evidence: Part II: Digging deeper--examining the "keeper" studies... sixth article in a series.
Fineout-Overholt E; Melnyk BM; Stillwell SB; Williamson KM;
American Journal of Nursing, 2010 Sep; 110 (9): 41-8 CINAHL AN: 2010829193

9. Preoperative fasting doesn't mean nothing after midnight: staff nurses can encourage the adoption of evidence-based practices.
Sendelbach S;
American Journal of Nursing, 2010 Sep; 110 (9): 64-5 CINAHL AN: 2010829198

10. Sustaining excellence: clinical nurse specialist practice and magnet designation.
Muller AC; Hujcs M; Dubendorf P; Harrington PT; Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 2010 Sep-Oct; 24 (5): 252-9 CINAHL AN: 2010771289

11. Health facility design. Evaluating the evidence in evidence-based design.
Stichler JF;
Journal of Nursing Administration, 2010 Sep; 40 (9): 348-51 CINAHL AN: 2010802322

12. WOCN update on evidence-based guideline for pressure ulcers.
Ratliff CR; Tomaselli N;
Journal of Wound, Ostomy & Continence Nursing, 2010 Sep-Oct; 37 (5): 459-60 CINAHL AN: 2010802053

13. Journal clubs on the night shift: a staff nurse initiative.
Stewart C; Snyder K; Sullivan SC; MEDSURG Nursing, 2010 Sep-Oct; 19 (5): 305-6 CINAHL AN: 2010804977

Thursday, November 18, 2010

Danielle's picks from the literature November 2010


Here are my picks from the nursing literature published over the last few months. Staff at St. Joseph Hospital or Children's Hospital of Orange County may be able to access some of the full text articles through the Burlew Medical Library.

1. Translating Infant Safe Sleep Evidence Into Nursing Practice. Shaefer SJM; Herman SE; Frank SJ; Adkins M; Terhaar M; JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing, 2010 Nov-Dec; 39 (6): 618-26
Abstract: The authors describe a 4-year demonstration project (2004-2007) to reduce infant deaths related to sleep environments by changing attitudes and practices among nurses who work with African American parents and caregivers in urban Michigan hospitals. An approach was developed for creating sustainable change in nursing practice by implementing nursing practice policies that could be monitored through quality improvement processes already established within the hospital organization. Following the policy change effort, nurses changed their behavior and placed infants on the back to sleep.

2. Critical care: does profusion of evidence lead to confusion in practice? McKenna H; Nursing in Critical Care, 2010 Nov-Dec; 15 (6): 285-90
Abstract: There have been a plethora of articles on evidence-based practice or its many derivative terms (evidence-based nursing, evidence-based medicine, evidence-based health care, etc.). However, the word 'based' implies an almost unquestioning belief in evidence. I will argue that the term 'Evidence Informed Practice' is probably more accurate. This argument will be underpinned by Archie Cochrane's 'road to Damascus' questioning of the value of soft over hard interventions and challenge what is held up as gold-standard evidence. The differences in definitions of evidence-based practice will also be discussed. Carper's identification of ethical, aesthetic and personal knowing will be used to debunk the myth that empirical evidence is always the gold standard for care and treatment. It will be argued that empirical evidence can be ignored when it clashes with other types of evidence. Finally, the tension between certainty and agreement with evidence will be explored.

3. Marketing evidence-based practice: what a CROC™!. Boyington AR; Ferrall SM; Sylvanus T; Clinical Journal of Oncology Nursing, 2010 Oct; 14 (5): 653-5
Abstract: Nurses should be engaged in evidence-based practice (EBP) to ensure that nursing care is efficient and effective. This article describes one cancer center's use of the Marketing Mix framework to educate staff nurses with the CROC™: Clinging Rigidly to Outdated Care campaign. As a result of the campaign, five EBP projects have been initiated in the cancer center.

4. Evidence-based practice guidelines: a survey of subcutaneous dexamethasone administration. Walker J; Lane P; McKenzie C; International Journal of Palliative Nursing, 2010 Oct; 16 (10): 494-8
Abstract: Searching for good evidence to develop clinical practice guidelines can be challenging, as research may not be published or available. A simple question set the authors on a journey to find evidence related to the nursing administration of subcutaneous dexamethasone in the palliative setting. This article outlines the search for evidence and discusses the survey results to gather expert opinion about the nursing administration of dexamethasone. Survey results indicated that only 39% of community services gave dexamethasone via a bolus injection and 88% gave it via a continuous infusion, mainly for site preservation. The diluents used were water for injection or normal saline. Many procedural aspects were supported by current guidelines, with several services using the New Zealand Waitemata District Health Board's (2008) clinical guidelines. Developing and implementing procedural recommendations for nurses to administer this subcutaneous medication will form the next stage of the project.

5. Evidence supporting technology-based interventions for people with early-stage alzheimer's disease. Buettner LL; Yu F; Burgener SC; Journal of Gerontological Nursing, 2010 Oct; 36 (10): 15-9
Abstract: Innovative uses of technology offer many exciting possibilities for better care and improved quality of life for people with Alzheimer's disease and their families. This article provides empirical evidence through a systematic review of 10 studies involving technological advances. Although the studies reported have a small number of participants, the early results are positive. We believe the use of technology has the potential to save health care costs, ease caregiver stress, and help people with dementia live better, safer, and more fulfilling lives.

6. Rating the level, quality, and strength of the research evidence. Jones KR; Journal of Nursing Care Quality, 2010 Oct-Dec; 25 (4): 304-12
Abstract: Improving patient safety and quality requires more consistent application of best practices based on the strongest scientific evidence available. Although evidence-based practice initiatives are increasingly being implemented in healthcare settings, clinicians may not have had the necessary preparation to accurately determine the overall strength of evidence supporting specific practice change recommendations. A particular issue is lack of clarity in use of the terms level of evidence, quality of evidence, and strength of evidence. This article clarifies the important differences among these terms.

7. Implementing Evidence-Based Practices: Considerations for the Hospice Setting.
Sanders S; Mackin ML; Reyes J; Herr K; Titler M; Fine P; Forcucci C; American Journal of Hospice & Palliative Medicine, 2010 Sep; 27 (6): 369-76

8. Cultivating quality: an evidence-based approach to taking charge. Flynn JP; Prufeta PA; Minghillo-Lipari L; American Journal of Nursing, 2010 Sep; 110 (9): 58-63

9. Evidence-based practice and the magnet journey. Krugman M; Journal for Nurses in Staff Development, 2010 Sep-Oct; 26 (5): 239-

10. Cannabis use in palliative care – an examination of the evidence and the implications for nurses. Green AJ; De-Vries K; Journal of Clinical Nursing, 2010 Sep; 19 (17/18): 2454-62
Abstract: Aim and objective. Examine the pharmaceutical qualities of cannabis including a historical overview of cannabis use. Discuss the use of cannabis as a clinical intervention for people experiencing palliative care, including those with life-threatening chronic illness such as multiple sclerosis and motor neurone disease [amyotrophic lateral sclerosis] in the UK. Background. The non-medicinal use of cannabis has been well documented in the media. There is a growing scientific literature on the benefits of cannabis in symptom management in cancer care. Service users, nurses and carers need to be aware of the implications for care and treatment if cannabis is being used medicinally. Design. A comprehensive literature review. Method. Literature searches were made of databases from 1996 using the term cannabis and the combination terms of cannabis and palliative care; symptom management; cancer; oncology; chronic illness; motor neurone disease/amyotrophic lateral sclerosis; and multiple sclerosis. Internet material provided for service users searching for information about the medicinal use of cannabis was also examined. Results. The literature on the use of cannabis in health care repeatedly refers to changes for users that may be equated with improvement in quality of life as an outcome of its use. This has led to increased use of cannabis by these service users. However, the cannabis used is usually obtained illegally and can have consequences for those who choose to use it for its therapeutic value and for nurses who are providing care. Relevance to clinical practice. Questions and dilemmas are raised concerning the role of the nurse when caring and supporting a person making therapeutic use of cannabis.

11. Evidence-based practice. Fluconazole to prevent systemic fungal infections in infants: reviewing the evidence. Wilkerson J; McPherson C; Donze A; Neonatal Network, 2010 Sep-Oct; 29 (5): 323-33
Abstract: IN NEONATOLOGY, EVIDENCE-BASED practice (EBP) relies on well-designed, adequately powered trials to guide practitioners. Several large randomized controlled trials (RCTs) have been conducted to explore the use of fluconazole for fungal prophylaxis in premature infants. Despite the findings of these studies, practice varies among units. In a recent survey of members of the American Academy of Pediatrics (AAP), 34 percent of clinicians indicated that they have used antifungal prophylaxis and only 11 percent of clinicians indicated that a written protocol was in place in their NICU. Intravenous (IV) fluconazole (66 percent), oral nystatin (59 percent), and IV amphotericin (21 percent) were the three most commonly used agents among the respondents.

12. Describing the problem for an evidence-based practice improvement project: a missing ingredient. Burke RE; Levin RF; Research & Theory for Nursing Practice, 2010; 24 (3): 155-8

Tuesday, November 09, 2010

Clinical Experts Update

View my guestbook
Welcome to Vickie’s Research Corner. Over the past several years the Office of Nursing Research at St. Joseph Hospital has been holding annual classes for Clinical III/IVs called the Clinical Nurse Experts in Evidence-Based Practice (EBP). This class is designed for the Clinical Nurse III or IV who have an interest in learning more about EBP. Currently we have had twenty-five RNs who have graduated in the past 3 years.
I would like to introduce you to Larisa (Kozuki) Taraborrelli a graduate from our Summer 2009 class. Larisa is currently a Clinical Nurse III who has worked in the Emergency Department (ED) for the past 5 years. This year she will be applying for her Clinical Nurse IV. When asked why she wanted to become a Clinical Expert, Larisa responded that she was going to be involved in the Pediatric Blood culture Study in the ED and wanted to understand EBP and research better.
Larisa currently sits on the Policy & Procedure Committee (P&P) and feels as a result of the class she has a much better understanding of why incorporating evidence into policies and procedures is important for practice- Evidence-Based Practice is best practice! Currently the P&P Committee has been working on incorporating current evidence into new and renewing policies and she is now an integral part of making those changes as a committee member.
Over the past several months Larisa has been working on updating the Burn Policy for the ED and is looking for current research related to burn treatments. She also stated that since taking the class she has a much better comprehension of how EBP impacts her own practice. She is now able to look up information and answer the question why!
EBP is so important for our practice as nurses and as you can see our Clinical Experts are becoming quite the specialist in the world of EBP. If you are a St. Joseph RN and interested in becoming a Clinical Expert of EBP and you are a Clinical Nurse III/IV look for the next opportunity in May 2011 to apply! If you are a Clinical Nurse II then find out who is that expert on your unit, if you don’t have one may be one day it will be you!

Thursday, October 14, 2010

Danielle's picks from the literature October 2010


Here are my picks from the nursing literature published over the last few months. Staff at St. Joseph Hospital or Children's Hospital of Orange County may be able to access some of the full text articles through the Burlew Medical Library.

1. An evidence-based practice primer for infusion nurses. Bays CL; Hermann CP; Journal of Infusion Nursing, 2010 Jul-Aug; 33 (4): 220-5. Abstract: Evidence-based practice (EBP) is the process of using current, best evidence to guide nursing care and improve patient outcomes. This article discusses the differences between research and EBP, reviews the process of EBP, and applies EBP guidelines to central catheter infections, a clinical problem relevant to infusion nursing.

2. Involving students in the real world of evidence-based practice. Putnam JM; Journal of Nursing Education, 2010 Jul; 49 (7): 423-4.

3. Promoting evidence-based practice and translational research. Barnsteiner JH; Reeder VC; Palma WH; Preston AM; Walton MK; Nursing Administration Quarterly, 2010 Jul-Sep; 34 (3): 217-25. Abstract: Evidence-based practice (EBP) is an evolutionary step in the nursing model of excellence in professional practice at the Hospital of the University of Pennsylvania. A healthcare culture focused on excellence and world-class patient care requires that nursing research and EBP are integrated into the professional practice model and nursing care delivery. To achieve this, it requires the development of staff expertise, time allocation for staff to participate in scholarly activities, resources that support EBP and research, and expert consultants in EBP and nursing translational research. This article describes the systems and structures in place to provide staff with resources in order to translate research and deliver EBP and the multiple initiatives in disseminating evidence to the point of care.

4. Engaged nurses lead way to improved outcomes via technology. Simpson RL; Nursing Administration Quarterly, 2010 Jul-Sep; 34 (3): 268-73. Abstract: Coupling evidence-based practice with technology enables nursing leaders and their staffs to engage with new vigor and passion as they integrate better practices from the nursing literature into what happens at the patient bedside. The degree to which nurses and their leaders engage positively, or negatively, affects organization's health-from the unit to the boardroom. Nurse executives now have available to them the tools needed to measure, improve, and sustain a culture of engagement in their organizations.

5. Meeting Magnet® Research and Evidence-Based Practice Expectations Through Hospital-Based Research Centers. Ingersoll GL; Witzel PA; Berry C; Qualls B; Nursing Economic$, 2010 Jul-Aug; 28 (4): 226-36.

6. Responding to agitation in people with dementia. Dewing J; Nursing Older People, 2010 Jul; 22 (6): 18-25. Abstract: Although medication and physical restraint have traditionally been used to treat agitated behaviours, there is growing evidence that holistic approaches can be beneficial, says Jan Dewing.

7. The limitations of evidenced-based practice.Baumann SL; Nursing Science Quarterly, 2010 Jul; 23 (3): 226-30.

8. Building research capacity in the nursing workforce: the design and evaluation of the nurse researcher role. Chan R; Gardner G; Webster J; Geary A; Australian Journal of Advanced Nursing, 2010 Jun-Aug; 27 (4): 62-9. Abstract: Objectives The Nurse Researcher Project (NRP) was initiated to support development of a nursing research and evidence based practice culture in Cancer Care Services (CCS) in a large tertiary hospital in Australia. The position was established and evaluated to inform future directions in the organisation. Background The demand for quality cancer care has been expanding over the past decades. Nurses are well placed to make an impact on improving health outcomes of people affected by cancer. At the same time, there is a robust body of literature documenting the barriers to undertaking and utilising research by and for nurses and nursing. A number of strategies have been implemented to address these barriers including a range of staff researcher positions but there is scant attention to evaluating the outcomes of these strategies. The role of nurse researcher has been documented in the literature with the aim to provide support to nurses in the clinical setting. There is, to date, little information in relation to the design, implementation and evaluation of this role. Design The Donabedian's model of program evaluation was used to implement and evaluate this initiative. Methods The 'NRP' outlined the steps needed to implement the nurse researcher role in a clinical setting. The steps involved the design of the role, planning for the support system for the role, and evaluation of outcomes of the role over two years. Discussion This paper proposes an innovative and feasible model to support clinical nursing research which would be relevant to a range of service areas. Conclusion Nurse researchers are able to play a crucial role in advancing nursing knowledge and facilitating evidence based practice, especially when placed to support a specialised team of nurses at a service level. This role can be implemented through appropriate planning of the position, building a support system and incorporating an evaluation plan. Database:

9. Critical appraisal of the evidence: Part II digging deeper--examining the "keeper" studies. Fineout-Overholt E; Melnyk BM; Stillwell SB; Williamson KM; American Journal of Nursing, 2010 Sep; 110 (9): 41-8.

10. An Evidence-based Clinical Guideline for Initial Management of Behavioral Emergencies. White A; JEN: Journal of Emergency Nursing, 2010 Sep; 36 (5): 450-4.

11. New evidence-based clinical practice guidelines for neonatal pain. Advances in Neonatal Care, 2010 Aug; 10 (4): 171.

12. Hypothyroidism: an evidence-based approach to a complex disorder. Kapustin JF; Nurse Practitioner, 2010 Aug; 35 (8): 44-53 Abstract: Approximately 11 million people are affected with hypothyroidism every year in the United States. Because signs and symptoms of hypothyroidism often mimic other comorbid conditions, making an accurate diagnosis can be difficult.

Friday, October 01, 2010

The Nurse Angels of St. Joseph Hospital


Another St. Joseph Hospital nurse is recognized in the press for a job well done! Critical Care Manager Gemma Seidl, MSN, MPH, RN, PHN is featured in the latest issue of Advance for Nurses, discussing her innovative ICU Angel program to recognize staff nurses who go above and beyond the call of duty.

“The ICU Angel recognizes ICU team members who receive positive written feedback from patients and their families,” says Seidl, “[we] get the sickest of the sick, just hearing ‘thank you’ makes a difference. Morale is definitely up here.” Read more about Gemma Seidl and the ICU nurses at St. Joseph Hospital here.

Tuesday, September 28, 2010

For Nurses: Conducting an Advanced Literature Search


The latest issue of AORN Journal includes a really great article for nurses on advanced literature searching in PubMed. The author details the advantages of using PubMed’s advanced search features such as Medical Subject Headings (MeSH), search fields, and limits. The article also includes techniques for building an effective search by combining terms with AND, OR, & NOT.

Effectively conducting an advanced literature search.
Brusco JM.
AORN J. 2010 Sep;92(3):264-71.

Access to this article is available online or by request to all St. Joseph Hospital and CHOC employees through the Burlew Library Website.

Improving literature search skills is a good strategy for all nurses, but the process can be daunting. Staff at the Burlew Medical Library are available to help – whether you need training or prefer we provide you with a professional mediated literature search. St. Joseph Hospital and CHOC employees can contact us through the Burlew Library Website for more information.

Friday, September 03, 2010

New article published by Bogert, Ferrell, & Rutledge: St. Joseph Hospital, Orange


Congratulations to St. Joseph Hospital authors Soudi Bogert, Carmen Ferrell & Dana Rutledge for their new article published in the July/August 2010 edition of MEDSURG Nursing!

Experience with Family Activation of Rapid Response Teams
Soudi Bogert, Carmen Ferrell, and Dana N. Rutledge
MEDSURG Nursing: The Journal of Adult Health, 2010 July/August; 19 (4): 215-22.

Condition H allows family activation of a rapid response team in a hospital setting. Systematic implementation of Condition H at a 500-bed Magnet® community hospital led to varied types of calls, all of which met the policy criteria. Many communication issues were discovered through this process.

This article is so new it is yet to hit the pages of PubMed or CINAHL, but staff at St. Joseph Hospital, Orange & CHOC may access the full text of this article by making a request through the Burlew Medical Library.

Tuesday, August 24, 2010

Abstract and Commentary - Heart Failure and Cognition

Research Abstract and Commentary
Cognitive Deficits in Chronic Heart Failure (authors’ abstract)

BACKGROUND: Patients with heart failure (HF) have been found to have cognitive deficits, but it remains unclear whether these deficits are associated with HF or with aging or comorbid conditions common in HF.
OBJECTIVES: The purpose of this study was (a) to determine the types, the frequency, and the severity of cognitive deficits among patients with chronic HF compared with age- and education-matched healthy participants and participants with major medical conditions other than HF, and (b) to evaluate the relationships between HF severity, age, and comorbidities and cognitive deficits.
METHODS: A sample of 414 participants completed the study (249 HF patients, 63 healthy and 102 medical participants). The HF patients completed measures of HF severity, comorbidity (multiple comorbidity, depressive symptoms), and neuropsychological functioning. Blood pressure and oxygen saturation were assessed at interview; clinical variables were abstracted from records. Participants in the comparison groups completed the same measures as the HF patients except those specific to HF.
RESULTS: Compared with the healthy and medical participants, HF patients had poorer memory, psychomotor speed, and executive function. Significantly more HF patients (24%) had deficits in three or more domains. Higher (worse) HF severity was associated with more cognitive deficits; HF severity interacted with age to explain deficits in executive function. Surprisingly, men with HF had poorer memory, psychomotor speed, and visuospatial recall ability than women. Multiple comorbidity, hypertension, depressive symptoms, and medications were not associated with cognitive deficits in this sample.
DISCUSSION: HF results in losses in memory, psychomotor speed, and executive function in almost one fourth of patients. Patients with more severe HF are at risk for cognitive deficits. Older patients with more severe HF may have more problems in executive function, and men with HF may be at increased risk for cognitive deficits. Studies are urgently needed to identify the mechanisms for the cognitive deficits in HF and to test innovative interventions to prevent cognitive loss and decline.

Pressler, S. J., Subramanian, U., Kareken, D., Perkins, S. M., Gradus-Pizlo, I., SauvĂ©, M. J., … Shaw, R. M. (2010). Cognitive deficits in chronic heart failure. Nursing Research, 59, 127-39.



Commentary by Dana Rutledge

In this carefully done comparative study, HF patients were compared with healthy (although a bit younger) and medical (current diagnosis of a major chronic disorder other than HF) patients on a battery of cognitive performance measures. HF diagnosis was documented by a test such as echocardiography, nuclear imaging, or cardiac catheterization within a 2-year window; patients had a left ventricular ejection fraction of 40% or less. HF patients came from seven sites in one Midwestern city; healthy and medical participants came from one medical practice, family members of HF participants, and volunteers. Measures selected were valid (measured what they are supposed to measure) and reliable in the populations of interest (accurate, sensitive, replicable). Procedures for testing were carefully laid out.

Study findings support previous work showing that HF patients have poorer performance compared with healthy/medical patients in memory, psychomotor speed, and executive functioning. Deficits found in HF patients show that the systematic damage from HF includes cerebral damage, and lead to cerebral hypoperfusion. Memory deficits were the most common problems identified in HF patients, followed by psychomotor slowing, and decreased executive function (thinking). These deficits are more severe in persons with greater HF severity and executive function was especially problematic in older patients with more severe HF. A unique finding was that deficits were worse in men.

What do these results say to nurses caring for patients with HF? Cognitive deficits occurred in almost 25% of patients!! Can these persons handle new information? When you try to teach them something, can they learn? Can they care for themselves? These are important considerations. All nurses should be evaluating the potential learning capacity or incapacity of these patients to determine what home care needs they have, and what deficits need to be addressed, and potentially managed by others. Home care may be necessary for many of these persons.

Thursday, August 12, 2010

Danielle's picks from the literature August 2010


As it is such a popular feature, I will be continuing the tradition of sharing the latest nursing research/EBN articles. Here are my picks from the nursing literature published over the last few months. Staff at St. Joseph Hospital or Children's Hospital of Orange County may be able to access some of the full text articles through the Burlew Medical Library.

1. Autonomy, evidence and intuition: nurses and decision-making. Traynor M; Boland M; Buus N; Journal of Advanced Nursing, 2010 Jul; 66 (7): 1584-91 CINAHL AN: 2010682934
Database: CINAHL Plus with Full Text

2. The Connected Learning Model for disseminating evidence-based care practices in clinical settings. Lekan D; Hendrix CC; McConnell ES; White H; Nurse Education in Practice, 2010 Jul; 10 (4): 243-8 CINAHL AN: 2010677329
Database: CINAHL Plus with Full Text

3. Central line-associated bloodstream infections: evidence for practice. DePalma JA; Home Health Care Management & Practice, 2010 Jun; 22 (4): 294-6 CINAHL AN: 2010660479
Database: CINAHL Plus with Full Text

4. General pain assessment among patients with cancer in an acute care setting: a best practice implementation project. Ang E; Chow YL; International Journal of Evidence-Based Healthcare, 2010; 8 (2): 90-6 CINAHL AN: 2010671536
Database: CINAHL Plus with Full Text

5. What do nurses need to know about the quality enterprise? Farquhar M; Kurtzman ET; Thomas KA; Journal of Continuing Education in Nursing, 2010 Jun; 41 (6): 256-8 CINAHL AN: 2010690925
Database: CINAHL Plus with Full Text

6. Translating evidence from systematic reviews for policy makers. Nannini A; Houde SC; Journal of Gerontological Nursing, 2010 Jun; 36 (6): 22-6 CINAHL AN: 2010688735
Database: CINAHL Plus with Full Text

7. What is evidence-based practice? Cullen L; Adams S; Journal of PeriAnesthesia Nursing, 2010 Jun; 25 (3): 171-3 CINAHL AN: 2010690732
Database: CINAHL Plus with Full Text

8. Development of an Evidence-Based Pressure Ulcer Program at the National Naval Medical Center: Nurses' Role in Risk Factor Assessment, Prevention, and Intervention Among Young Service Members Returning from OIF/OEF. Crumbley DR; Kane MA; Nursing Clinics of North America, 2010 Jun; 45 (2): 153-68 CINAHL AN: 2010674841
Database: CINAHL Plus with Full Text

9. Engage nurses in EBP with the nursing clinical question process. Pangarakis S; Graner T; Nursing Management, 2010 Jun; 41 (6): 15-7 CINAHL AN: 2010684003
Database: CINAHL Plus with Full Text

10. Evidence-based practice: pushback from a holistic perspective. Jackson C; Holistic Nursing Practice, 2010 May-Jun; 24 (3): 120-4 CINAHL AN: 2010655126
Database: CINAHL Plus with Full Text

11. Outcomes and evidence-based practice: moving forward. Stumbo NJ; Pegg S; Annual in Therapeutic Recreation, 2010; 18: 12-23 CINAHL AN: 2010459609
Database: CINAHL Plus with Full Text

12. "Inside looking in" or "inside looking out"? How leaders shape cultures equipped for evidence-based practice. Halm MA; American Journal of Critical Care, 2010 Jul; 19 (4): 375-8 CINAHL AN: 2010708170
Database: CINAHL Plus with Full Text

13. Evidence-based nursing. Using incident reports as a teaching tool. Besmer M; Bressler T; Barrell C; Nursing Management, 2010 Jul; 41 (7): 16-8 CINAHL AN: 2010713313
Database: CINAHL Plus with Full Text

14. Merging silos: collaborating for information literacy. Miller LC; Jones BB; Graves RS; Sievert MC; Journal of Continuing Education in Nursing, 2010 Jun; 41 (6): 267-72 CINAHL AN: 2010692418
Database: CINAHL Plus with Full Text

15. Using theory and frameworks to facilitate the implementation of evidence into practice. Worldviews on Evidence-Based Nursing, 2010 2nd Quarter; 7 (2): 57-8 CINAHL AN: 2010691792
Database: CINAHL Plus with Full Text

16. Translating an evidence-based protocol for nurse-to-nurse shift handoffs. Dufault M; Duquette CE; Ehmann J; Hehl R; Lavin M; Martin V; Moore MA; Sargent S; Stout P; Willey C; Worldviews on Evidence-Based Nursing, 2010 2nd Quarter; 7 (2): 59-75 CINAHL AN: 2010691793
Database: CINAHL Plus with Full Text

Tuesday, July 27, 2010

SJO nurses present ANCC 2010 Magnet Conference "virtual posters"

We are proud to announce St. Joseph Hospital of Orange nurses presenting two of the 25 "virtual posters" accepted at the 2010 ANCC Magnet Conference.

Transformational Leadership: Building Leadership Competency with Blended Learning by Vivian Norman, RN, MSN, CCRN and Factors Associated with Nurses' Discussions of Hospice by Denise Boyd, RN, BSN, OCN; Kristen Merkh, RN, BSN, OCN; Dana N. Rutledge, RN, PhD; and Victoria Randall, RN.

Their posters are now available for viewing at the ANCC 2010 National Magnet Conference Virtual Poster Session via Virtual World and will remain on view until the end of the October conference.

To access Virtual World please follow the steps below (note, the software required for entry into the Virtual World is not compatible with Mac).

  1. View this training video with step by step instructions (Windows Media Player 9 or later & speakers/headphones are required), or view the written instructions.
  2. Register and DOWNLOAD the Virtual World software which must be installed on your computer.
  3. You may need to work with your Information Systems department in order to be able to download the software at your desktop computer (if accessing Virtual World from work).
  4. Technical support for actual technical difficulties is available, call 1-800-679-3646 from 9 a.m. to 5 p.m. Eastern Time and ask for “virtual technical support.” You may also email virtual technical support at support@virtualbeginnings.com. Please, carefully review the instructions above before asking for technical support.

Tuesday, July 20, 2010

Blog Leadership change: Introducing Danielle Linden, new Library Manager

I would like to share that it has been a tremendous privilege and joy for me to have been involved in beginning the world's first blog devoted to nursing research and evidenced based nursing some 3+ years ago.
An enormous thank you to our entire blog team for their dedication to the continued improvement in the quality of our blog is in order. Nursing Research: Show me the Evidence! is truly a team effort . I will miss our entire team and wish everyone in the wider world of nursing research the best of everything. I will be retiring on August 6 after 31 years in my position as Library Manager of Burlew Medical Library, St. Joseph Hospital in Orange, California. My husband and I will be pursuing our twin loves of travel and all things "ballroom dancing". We, of course, also relish the thought of spending more time with our families, our garden, our cameras and our BOOKS!! We will also serve as volunteer couriers for the National Bone Marrow Association and I hope to involve myself in literacy training.

Please allow me to introduce Danielle Linden, MLS, AHIP as both our new Library Manager and the new administrator for our nursing research blog. Danielle received her BA in Anthropology from UCLA and her Master of Library and Information Science Degree from San Jose State University. Professionally certified by the Medical Library Association’s Academy of Health Information Professionals (AHIP) at the senior member level, Danielle has been actively involved in both the Medical Library Group of Southern California and Arizona as well as the Medical Library Association. Danielle’s experience includes working as a medical librarian in both academic and hospital environments. She is an experienced searcher and instructor in a wide variety of databases. She has a special interest in library services and resources for nurses and notably has presented a poster entitled “Incorporating Library Resources into an Undergraduate Nursing Program Wiki.” Danielle runs marathons for fun and has an outgoing, engaging personality.

Wednesday, June 30, 2010

Magnet Maggie at St. Joseph Hospital in Orange featured in Advance for Nurses



A June 2010 issue of Advance for Nurses features a great article on Magnet Maggie and her adventures at St. Joseph Hospital in Orange, California. Not only can you follow Magnet Maggie as she tours throughout the hospital but you can also see how much fun she has had accompanying nurses to conferences and even graduations. Thank you to feature writer Candy Goulette!!

Tuesday, June 29, 2010

Julie's picks from the literature May 2010


Here are my picks from the nursing literature for May dealing with nursing research articles or articles about nursing research/EBN. Staff at St. Joseph Hospital or Children's Hospital of Orange County may be able to access some of the full text articles through the library website

1. Nursing students' and clinical instructors' perceptions on the
    implementation of a best practice guideline.(includes abstract);
    Ritchie L; Evans MK; Matthews J;  Journal of Nursing Education, 2010
    Apr; 49 (4): 223-7 (journal article - research) ISSN: 0148-4834 PMID:
    20055324 CINAHL AN: 2010617920

2. Partnering with your library to strengthen nursing research.(includes
    abstract); Hallyburton A; St John B;  Journal of Nursing Education,
    2010 Mar; 49 (3): 164-7 (journal article - research) ISSN: 0148-4834
    PMID: 19954132 CINAHL AN: 2010602293
3. Integration of spirituality in nursing practice: a literature
    review.(includes abstract); Tiew LH; Creedy DK;  Singapore Nursing
    Journal, 2010 Jan-Mar; 37 (1): 15-20, 22 (journal article - research,
    systematic review) ISSN: 0218-0995 CINAHL AN: 2010621331
4. Evidence-based nursing. 6 steps for transforming organizational EBP
    culture.Ogiehor-Enoma G; Taqueban L; Anosike A;  Nursing Management,
    2010 May; 41 (5): 14-7 (journal article) ISSN: 0744-6314 PMID: 20418746
    CINAHL AN: 2010647956
5. Rapid response team - a proactive strategy in managing
    haemodynamically unstable adult patients in the acute care hospitals
    [corrected] [published erratum appears in SINGAPORE NURS J 2010
    Jan-Mar;37(1):4].Choo CL; Heng D; Ching AC; Kang J; Wentao Z; 
    Singapore Nursing Journal, 2009 Oct-Dec; 36 (4): 17-22, 24-8 (journal
    article - tables/charts) ISSN: 0218-0995 CINAHL AN: 2010489902
6. Information literacy for evidence-based practice in perianesthesia
    nurses: readiness for evidence-based practice.Ross J;  Journal of
    PeriAnesthesia Nursing, 2010 Apr; 25 (2): 64-70 (journal article -
    research, tables/charts) ISSN: 1089-9472 PMID: 20359640 CINAHL AN:
    2010635535
7. A meta-study of the essentials of quality nursing
    documentation.(includes abstract); Jefferies D; Johnson M; Griffiths R;
     International Journal of NursingPractice, 2010 Apr; 16 (2): 112-24
    (journal article - research, systematic review, tables/charts) ISSN:
    1322-7114 PMID: 20487056 CINAHL AN: 2010605897
8. Perceived facilitators and inhibitors for the use of personal
    digital assistants by nurses: a systematic review.Gyi AA;  Journal of
    Advanced Nursing, 2010 May; 66 (5): 964-6 (journal article - abstract)
    ISSN: 0309-2402 PMID: 20423356 CINAHL AN: 2010647106
9. Rounding for outcomes: an evidence-based tool to improve nurse
    retention, patient safety, and quality of care.Baker SJ; McGowan N; 
    JEN: Journal of Emergency Nursing, 2010 Mar; 36 (2): 162-4 (journal
    article - pictorial) ISSN: 0099-1767 PMID: 20211412 CINAHL AN:
    2010621739
10. Team-based care interventions involving nurses and primary care or
    community pharmacists improve hypertension control.Khan EU; 
    Evidence-Based Nursing, 2010 Apr; 13 (2): 47-8 (journal article) ISSN:
    1367-6539 PMID: 20436147 CINAHL AN: 2010668595
11. Nurse-led postpartum discharge education programme including
    information on postnatal depression reduces risk of high depression
    scores at 3-month follow-up.Morrell CJ;  Evidence-Based Nursing, 2010
    Apr; 13 (2): 48-9 (journal article) ISSN: 1367-6539 PMID: 20436148
    CINAHL AN: 2010668596

12. Evidence-based practice improvement: merging 2 paradigms.(includes
    abstract); Levin RF; Keefer JM; Marren J; Vetter M; Lauder B;
    Sobolewski S;  Journal of Nursing Care Quality, 2010 Apr-Jun; 25 (2):
    117-26 (journal article - tables/charts) ISSN: 1057-3631 PMID: 19680149
    CINAHL AN: 2010617873
13. Accreditation and certification for evidence-based design.(includes
    abstract); Stichler JF;  Journal of Nursing Administration, 2010 Apr;
    40 (4): 158-61 (journal article) ISSN: 0002-0443 PMID: 20305460 CINAHL
    AN: 2010629098
14. Knowledge translation: summarizing and synthesizing the evidence for
    WOC best practices.Kelechi TJ; Naccarato MK;  Journal of Wound, Ostomy
    & Continence Nursing, 2010 Mar-Apr; 37 (2): 132-6 (journal article -
    tables/charts) ISSN: 1071-5754 PMID: 20228652 CINAHL AN: 2010604492
15.     Discover a better way to care: exploring uncharted territory,
    researchers are blazing a path to better nursing practice.Brown G; 
    Johns Hopkins Nursing, 2010 Spring; 8 (1): 28-33 (journal article -
    pictorial) CINAHL AN: 2010631192
16. Telephone behavioural intervention delivered by nurses combined with
    home blood pressure monitoring improves long-term hypertensive
    management compared with usual care.Hill MN;  Evidence-BasedNursing,
    2010 Apr; 13 (2): 46 (journal article) ISSN: 1367-6539 PMID: 20436146
    CINAHL AN: 2010668594
17. How professional nurses working in hospital environments experience
    moral distress: a systematic review.McArthur A;  Journal of Advanced
    Nursing, 2010 May; 66 (5): 962-3 (journal article - abstract) ISSN:
    0309-2402 PMID: 20423356 CINAHL AN: 2010620396

18. The journey to Magnet®: establishing a research
    infrastructure.(includes abstract); Steele-Moses SK;  Clinical Journal
    of Oncology Nursing, 2010 Apr; 14 (2): 237-9

19. Preoperative skin cleansing with chlorhexidine-alcohol reduces
    surgical site infection after clean-contaminated surgery compared with
    povidone-iodine.Mimoz O;  Evidence-Based Nursing, 2010 Apr; 13 (2):
    36-7 (journal article) ISSN: 1367-6539 PMID: 20436136 CINAHL AN:
    2010668584
20. Nicotine patch plus lozenge gives greatest increases in abstinence
    from smoking at 6 months compared with placebo; smaller effects seen
    with nicotine patch alone, bupropion or nicotine lozenges alone or
    combined.Buchanan L;  Evidence-Based Nursing, 2010 Apr; 13 (2): 50-1
    (journal article) ISSN: 1367-6539 PMID: 20436150 CINAHL AN: 2010668598
21. Cohort study finds nine times increased overdose risk (fatal plus
    non-fatal) in patients receiving 100 mg/day for 90 days compared with
    1-20 mg/day opioids for chronic non-cancer pain, but wide CI and
    possibility of unmeasured confounders.Hochman JS; Pergolizzi J; 
    Evidence-Based Nursing, 2010 Apr; 13 (2): 55-6 (journal article) ISSN:
    1367-6539 PMID: 20436154 CINAHL AN: 2010668602
22. Telephone-delivered collaborative care for post-CABG depression is
    more effective than usual care for improving quality of life related to
    mental health.Gallagher R;  Evidence-BasedNursing, 2010 Apr; 13 (2): 37
    (journal article) ISSN: 1367-6539 PMID: 20436137 CINAHL AN: 2010668585
23. Systematic review finds no difference in effect between home and
    centre-based cardiac rehabilitation on mortality, morbidity and
    modifiable risk factors in patients with CHD.Parry M; 
    Evidence-BasedNursing, 2010 Apr; 13 (2): 38 (journal article) ISSN:
    1367-6539 PMID: 20436138 CINAHL AN: 2010668586
24. Ginger reduces severity of nausea in early pregnancy compared with
    vitamin B6, and the two treatments are similarly effective for reducing
    number of vomiting episodes.Smith C;  Evidence-BasedNursing, 2010 Apr;
    13 (2): 40 (journal article) ISSN: 1367-6539 PMID: 20436140 CINAHL AN:
    2010668588
25. Hand hygiene and facemask use within 36 hours of index patient
    symptom onset reduces flu transmission to household contacts.Gould D; 
    Evidence-BasedNursing, 2010 Apr; 13 (2): 44 (journal article) ISSN:
    1367-6539 PMID: 20436144 CINAHL AN: 2010668592
26. Low specificity and high false-positive rates limit the usefulness
    of the STRATIFY tool and clinical judgement in predicting falls in
    older patients in an acute hospital setting.Healey F; 
    Evidence-BasedNursing, 2010 Apr; 13 (2): 54 (journal article) ISSN:
    1367-6539 PMID: 20436153 CINAHL AN: 2010668601
27. Where to find help when you need it: EIDM resources.Dobbins M; 
    Reflections on Nursing Leadership, 2010 1st Quarter; 36 (1). (2p)
    (journal article) ISSN: 1527-6538 CINAHL AN: 2010641747

Wednesday, June 16, 2010

SlideWorld: a portal for medically oriented powerpoints




Are you looking for downloadable PowerPoints that you can use for patient teaching/nursing instruction? Slideworld  may be just what you're looking for.
For instance,  there is a slide show on Asthma Pathophysiology which is both 5 star rated and has received
over 3800 hits.

SlideWorld is a powerful resource for PowerPoint Slide Presentations.
It is a web resource designed to facilitate the educational process of
medical professionals. As you know, slide presentations have become
one of the key ways of facilitating education and a way of
communicating new scientific developments. Academic faculties and
clinicians in practice from worldwide have contributed to the web
portal.


Take the Quick Tour of SlideWorld .

More than 5 million ppt presentations are searchable by both broad categories and textword searches. Slideworld employs web 2.0 technologies allowing you to rate presentations as well as incorporate them into
your tweets and other social networking tools. Registration is both free and easy. Medically orientated
PowerPoint templates are also available for purchase for a small fee. Upload your own presentations  to share information and receive a wider viewership.
Enjoy!!

Wednesday, May 26, 2010

New article published by Loucks, Rutledge, Hatch and Morrison: St. Joseph Hospital, Orange

Congrats to  Jeanine Loucks, Dana Rutledge, Beverly Hatch and Victoria Morrison  for their newly published article. The article is so new it hasn't yet ( as of 5/26/10) been picked up PubMed or CINAHL.

Rapid Response Team for Behavioral Emergencies

Jeannine Loucks St. Joseph Hospital, Orange, CA, USA, jeannine.loucks@stjoe.org
Dana N. Rutledge
St. Joseph Hospital, Orange, CA, USA, California State University Fullerton, Fullerton, CA, USA
Beverly Hatch
St. Joseph Hospital, Orange, CA, USA
Victoria Morrison
St. Joseph Hospital, Orange, CA, USA
Behaviors of patients with psychiatric illness who are hospitalized on nonbehavioral health units can be difficult to address by staff members. Instituting a rapid response team to proactively de-escalate potential volatile situations on nonpsychiatric units in a hospital allows earlier treatment of behavioral issues with these patients. The behavioral emergency response team (BERT) consists of staff members (registered nurses, social workers) from behavioral health services who have experience in caring for patients with acute psychiatric disorders as well as competence in management of assaultive behavior. BERT services were trialed on a medical pulmonary unit; gradual housewide implementation occurred over 2 years. Tools developed for BERT include an activation algorithm, educational cue cards for staff, and a staff survey. Results of a performance improvement survey reveal that staff nurses have had positive experiences with BERT but that many nurses are still not comfortable caring for psychiatric patients on their units.

Key Words: rapid response team • psychiatric emergencies • behavioral health • psychiatric nursing • de-escalation • Iowa Model of Evidence-Based Practice  

Journal of the American Psychiatric Nurses Association, Vol. 16, No. 2, 93-100 (2010)
DOI: 10.1177/1078390310363023

Monday, May 24, 2010

MedlinePlus Redesign Preview

MedlinePlus Redesign Preview

Medline Plus and Medline Plus Espanol are receiving a major overhaul and redesign in the summer of 2010. If you are not already familiar with Medline Plus, it is the #1 most authoritative and reliable source of lay information for the health consumer. All topics are available in both English and Spanish and many topics are available in a multitude of other languages. In many cases, you will also have a video or tutorial available on your topic. Amomg other improvements, the redesigned Medline Plus will incorporate new web 2.0 technologies as well.

Medline Plus encourages comments and suggestions regarding this redesign.

Check it out!!

Friday, May 21, 2010

Julie's picks from the literature: April 2010

Check out these new articles either on the topic of evidence based nursing or key nursing research articles. Staff at St. Joseph Hospital in Orange or Children's Hospital of Orange County may be able to access some of the full text through the medical library's website .

1. Evidence-based nursing. Stop "knowledge creep".Pape T; Richards B; Nursing Management, 2010 Feb; 41 (2): 8-11 (journal article -
 tables/charts) ISSN: 0744-6314 PMID: 20142671 CINAHL AN: 2010582834

2. Evidence-based guideline: wandering [corrected] [published erratum
    appears in J GERONTOL NURS 2010 Mar;36(3):1p].Futrell M; Melillo KD;
    Remington R; Schoenfelder DP;  Journal of Gerontological Nursing, 2010
    Feb; 36 (2): 6-16 (journal article - glossary, questionnaire/scale)
    ISSN: 0098-9134 PMID: 20151627 CINAHL AN: 2010552782

3. Utilizing a mock trial to demonstrate evidence-based nursing
    practice: a staff development process.(includes abstract); Staffileno
    BA; McKinney C;  Journal for Nurses in Staff Development, 2010 Mar-Apr;
    26 (2): 73-6 (journal article) ISSN: 1098-7886 PMID: 20354408 CINAHL
    AN: 2010620225

4. A unique collaborative nursing evidence-based practice initiative
    using the Iowa model: a clinical nurse specialist, a health science
    librarian, and a staff nurse's success story.(includes abstract); Krom
    ZR; Batten J; Bautista C;  Clinical Nurse Specialist: The Journal for
    Advanced NursingPractice, 2010 Mar-Apr; 24 (2): 54-9 (journal article -
    tables/charts) ISSN: 0887-6274 PMID: 20168139 CINAHL AN: 2010583113

5. Use of research by nurses during their first two years after
    graduating.(includes abstract); Forsman H; Rudman A; Gustavsson P;
    Ehrenberg A; Wallin L;  Journal of Advanced Nursing, 2010 Apr; 66 (4):
    878-90 (journal article - research, tables/charts) ISSN: 0309-2402
    PMID: 20423375 CINAHL AN: 2010587577

6. The role of the clinical nurse specialist in facilitating
    evidence-based practice within a university setting.(includes
    abstract); Tuite PK; George EL;  Critical Care Nursing Quarterly, 2010
    Apr-Jun; 33 (2): 117-25 (journal article - algorithm, tables/charts)
    ISSN: 0887-9303 PMID: 20234200 CINAHL AN: 2010612060

7. Nursing handoffs: a systematic review of the literature:
    surprisingly little is known about what constitutes best
    practice.(includes abstract); Riesenberg LA; Leitzsch J; Cunningham JM;
     American Journal of Nursing, 2010 Apr; 110 (4): 24-36 (journal article
    - CEU, exam questions, research, systematic review, tables/charts)
    ISSN: 0002-936X PMID: 20335686 CINAHL AN: 2010612001

8. NNN language and evidence-based practice guidelines for acute
    cardiac care: retaining the essence of nursing.(includes abstract); Van
    Horn ER; Kautz DD;  Dimensions of Critical Care Nursing, 2010 Mar-Apr;
    29 (2): 69-72 (journal article - tables/charts) ISSN: 0730-4625 PMID:
    20160543 CINAHL AN: 2010598180

9. What makes a phenomenological study phenomenological? An analysis of
    peer-reviewed empirical nursing studies.Norlyk A; Harder I; 
    Qualitative Health Research, 2010 Mar; 20 (3): 420-31 (journal article
    - research, tables/charts) ISSN: 1049-7323 PMID: 20068190 CINAHL AN:
    2010568773

10. Othering: difference understood??: A 10-year analysis and critique
    of the nursing literature.(includes abstract); Canales MK;  Advances in
    Nursing Science, 2010 Jan-Mar; 33 (1): 15-34 (journal article -
    research, systematic review, tables/charts) ISSN: 0161-9268 PMID:
    20010068 CINAHL AN: 2010598159

11. Documenting an EBP project: guidelines for what to include and
    why.(includes abstract); Worral PS; Levin RF; Arsenault DC;  Journal of
    the New York State Nurses Association, 2009 Fall-2010 Winter; 40 (2):
    12-9 (journal article - tables/charts) ISSN: 0028-7644 PMID: 20415269
    CINAHL AN: 2010608331

12. Putting evidence-based practice into your practice: a CE activity.
    Journal of the New York State Nurses Association, 2009 Fall-2010
    Winter; 40 (2): 28-31 (journal article - CEU, exam questions) ISSN:
    0028-7644 CINAHL AN: 2010608360

13. How much time do you spend reviewing research per week?Mourfield NM;
    Medcalfe S;  Nursing Management, 2009 Dec; 40 (12): 13-4, 16, 18
    (journal article - research, tables/charts) ISSN: 0744-6314 PMID:
    19966545 CINAHL AN: 2010589640

14. Inspiring change. Using PICO and the brief report to answer clinical
    questions.Elkins MY;  Nursing, 2010 Apr; 40 (4): 59-60 (journal
    article) ISSN: 0360-4039 PMID: 20234276 CINAHL AN: 2010612406

Thursday, May 20, 2010

2010 Nursing Web Awards: nominations end May 23!! Polls open May 25 and end May 31

OnlineCollegeGuru.com has asked us to announce their first award categories for best Nursing Web sites. Please note that there is a category for Best Nursing Blog-- if you feel inclined to nominate our blog, Nursing Research: Show me the Evidence! we would be most appreciative.

2010 Nursing Web Awards


Sponsored by OnlineCollegeGuru.com

17 May 2010 Nursing Web Awards Begins!

Noticing that there is a web award for practically every category except nursing, I’ve decided to create this award to honor all the great nursing websites/blogs!
How this will work

Nomination
Visit each of the following categories and leave an comment with the your nomination for that section. Include why you are nominating the website/app. You are allowed to nominate your own website.

Here's a link to the awards website http://onlinecollegeguru.com/awards/nursing/2010/2010-nursing-web-awards-begins/

•Best Nursing Blog of 2010

•Best New Nursing blog of 2010

•Best/Influential Post of 2009-2010

•Top Nursing Twitterer of 2010

•Most Useful Nursing Website of 2010

•Most Useful Web/Mobile Tool for Nurses of 2010

Nominations will end 00:00 GMT on Sunday May 23rd 2010.

Each user are allowed to vote once, your IP will be recorded to prevent vote fraud.

The Polls will open: Tuesday May 25th 00:00 GMT.


The Polls will end: Monday May 31st 00:00 GMT.

Round 2 Voting – Final Nominees

The polls will be tallied, nominees that received the most votes for each category will be chosen for round 2 of polls.

Round 2 Polls opening TBA.

Winners – Prizes!

The winners will be chosen based on number of votes and prizes will be awarded (if applicable).

Prizes will be in Kiva Gift Certificates – you can either cash it or lend it to the poor.


•Winners for Best Nursing Blog, New Nursing Blog, and Influential Posts will receive $150 Kiva gift certificates each.

•1st Runners up for Best Nursing Blog, New Nursing Blog, and Influential Posts will receive $75 Kiva gift certificates each.

•2nd Runner up for Best Nursing Blog, New Nursing Blog, and Influential Posts will receive $25 Kiva gift certificates each.

I don’t have any monetary prizes for the following categories, except a sweet badge you can use on your website and bragging rights.

•Top Nursing Twitterer of 2010

•Most Useful Nursing Websites of 2010

•Most Useful Web/Mobile Tool for Nurses of 2010










2010 Awards Categories

Best Nursing Blog of 2010



Best New Nursing blog of 2010



Best/Influential Post of 2009-2010



Top Nursing Twitterer of 2010



Most Useful Nursing Website of 2010



Most Useful Iphone App for Nurses of 2010







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Wednesday, April 14, 2010

Julie's picks from the literature: March


Here are my picks from the most recent nursing articles dealing with nursing research and evidence based nursing. Staff at St. Joseph Hospital in Orange and Children's Hospital of Orange County may be able to access some of these articles via the library's website.

1. A nursing clinical decision support system and potential predictors
of head-of-bed position for patients receiving mechanical
ventilation.(includes abstract); Lyerla F; LeRouge C; Cooke DA; Turpin
D; Wilson L; American Journal of Critical Care, 2010 Jan; 19 (1): 39-47 (journal article - research) ISSN: 1062-3264 PMID: 20045847 CINAHL AN: 2010530899

2. Breast cancer screening behaviors of African American women: a comprehensive review, analysis, and critique of nursing research.(includes abstract); Conway-Phillips R; Millon-Underwood S;
ABNF Journal, 2009 Fall; 20 (4): 97-101 (journal article - research, systematic review) ISSN: 1046-7041 PMID: 19927894 CINAHL AN: 2010522060

3. Do calculation errors by nurses cause medication errors in clinical practice? A literature review.(includes abstract); Wright K; Nurse Education Today, 2010 Jan; 30 (1): 85-97 (journal article - research,
systematic review, tables/charts) ISSN: 0260-6917 PMID: 19666199 CINAHL AN: 2010543404

4. Evidence-based practice: step by step. Igniting a spirit of inquiry: an essential foundation for evidence-based practice: how nurses can build the knowledge and skills they need to implement ERP.(includes
abstract); Melnyk BM; Fineout-Overholt E; Stillwell SB; Williamson KM; American Journal of Nursing, 2009 Nov; 109 (11): 49-52 (journal article - tables/charts) ISSN: 0002-936X PMID: 19858857 CINAHL AN: 2010536578

5. Cultivating quality. Shared governance supports evidence-based practice: the experience of perioperative nurses at Children's Hospital Boston can serve as a model for others.(includes abstract); Waddell
AWG; American Journal of Nursing, 2009 Nov; 109 (11): 53-7 (journal article - pictorial) ISSN: 0002-936X PMID: 19858858 CINAHL AN: 2010536579

6. Generalizability and transferability of meta-synthesis research findings.(includes abstract); Finfgeld-Connett D; Journal of Advanced Nursing, 2010 Feb; 66 (2): 246-54 (journal article - research) ISSN: 0309-2402 CINAHL AN: 2010539481
7.Walk the walk to reduce catheter-related bloodstream infections.(includes abstract); Hatler C; Hebden J; Kaler W; Zack J; American Nurse Today, 2010 Jan; 5 (1): 26-31 (journal article - CEU,
exam questions, pictorial) ISSN: 1930-5583 CINAHL AN: 2010546030

8.Leadership: the critical success factor in the rise or fall of useful research activity.(includes abstract); Henderson A; Winch S; Holzhauser K; Journal of Nursing Management, 2009 Dec; 17 (8): 942-6
(journal article) ISSN: 0966-0429 PMID: 19941567 CINAHL AN: 2010485576

9. Controlling bias in complex nursing intervention studies: a checklist.(includes abstract); Campbell-Yeo M; Ranger M; Johnston C; Fergusson D; Canadian Journal of Nursing Research, 2009 Dec; 41 (4):
32-50 (journal article - questionnaire/scale) ISSN: 0844-5621 PMID: 20191712 CINAHL AN: 2010529009

10. Applying the Stetler Model of Research Utilization in staff development: revitalizing a preceptor program.(includes abstract); Romp CR; Kiehl E; Journal for Nurses in Staff Development, 2009 Nov-Dec; 25
(6): 278-86 (journal article - CEU, exam questions, research,
tables/charts) ISSN: 1098-7886 PMID: 19955975 CINAHL AN: 2010506957

11. Writing an appropriate methods section for a research article: procedure, instruments/measurements and analysis.Lambert VA; Lambert CE; Thai Journal of Nursing Research, 2009 Oct-Dec; 13 (4): 245-8
(journal article) ISSN: 0859-7685 CINAHL AN: 2010545155

12. Review summaries: evidence for nursing practice. Blood donor skin preparation with alcohol vs. alcohol plus any antiseptic for preventing bacteraemia or contamination of blood for transfusion.Jayasekara R;
Journal of Advanced Nursing, 2010 Feb; 66 (2): 257-8 (journal article - abstract) ISSN: 0309-2402 CINAHL AN: 2010555036

13. Review summaries: evidence for nursing practice. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery.Jayasekara R; Journal of Advanced Nursing,
2010 Feb; 66 (2): 258-9 (journal article - abstract) ISSN: 0309-2402
CINAHL AN: 2010555037

14. Opportunities and challenges: wound and skin alterations of obesity.Zuelzer HB; Bariatric Nursing & Surgical Patient Care, 2009 Dec; 4 (4): 283 (journal article - abstract) ISSN: 1557-1459 CINAHL AN: 2010554679

Web based course on Health Literacy-- CNE for Nurses

Health Literacy has become such an important topic that some are now referring to it as the "Fifth Vital Sign"-(new health literacy screening tool-- the Fifth Vital Sign). The CDC has developed a web based tutorial titled "Health Literacy for Public Health Professionals". Although this is geared to public health professionals, it will also be of great interest to nurses and comes with 1 CNE. You will need to register for the course and complete an evaluation in order to earn the CNE.

For more resources on Health Literacy, visit:

AHRQ
National Library of Medicine resources on Health Literacy
USDHS-- plain language thesaurus
California Health Literacy Initiative

Monday, March 22, 2010

Mammogram Advice a Health Threat

The recent announcement by the U.S. Preventive Services Task Force, a national panel of medical officials tasked with reviewing clinical data and making recommendations about preventive care, has generated considerable confusion about the role of mammography and threatens to undo years of beneficial public and physician education and behavior adaptation.

Since the news broke about the recommendation last month, our team of breast cancer specialists has been inundated by questions, concerns and comments from women.
Until 1990, the breast cancer death rate in the United States had remained unchanged for 50 years. With the introduction of screening mammography, there was an abrupt and sustained decrease in the breast cancer death rate by 30 percent over the past 20years. The new USPSTF guidelines threaten to reverse the significant progress that has been made over the past two decades.

The task force recommends against routine screening mammography for women ages 40-49. However, there is ample scientific evidence that women in their forties can expect an equivalent decrease in breast cancer mortality due to screening mammography as compared to women 50 and older. Population studies in Sweden have shown a 40 percent decrease in breast cancer mortality in women ages 40-49 who underwent screening.

The incidence of breast cancer rises steadily with age, but there is no dramatic increase at age 50. The probability of being diagnosed with breast cancer among women in their forties is 1.44 percent as compared with 2.63 percent among women in their fifties. Meanwhile it has been estimated that 40 percent of the years of life saved by screening can be attributed to women diagnosed under the age of 50.

The task force advises only those women in their forties who are at high risk to undergo screening. However, it should be emphasized that only 10 percent to 25 percent of breast cancers occur in women at high risk. The majority of breast cancers arise in women with no special risk factors.

Yearly screening may be especially important for younger women because they tend to have faster growing cancers. Lengthening the screening interval to two years will diminish the survival benefit for all women and ultimately contribute to more treatment related toxicity because more cancers will be diagnosed at a later stage.
Physical exam, whether practiced by a woman herself or her doctor, will always be complementary to any breast-imaging technique.

Women should remember to bring any changes to their doctor's attention regardless of how soon after a negative mammogram they occur. We can each cite many personal instances where a woman's self exam led her to a doctor for follow up, sometimes with life-saving consequences.

In conclusion, the breast specialists at the Center for Cancer Prevention and Treatment at St. Joseph Hospital do not support the revised screening mammography guidelines recently issued by the Task Force and strongly urge women 40 and older to continue annual screening mammography. Better yet, talk to your own doctor about your risk factors and make a decision together about your breast health. It could save your life.

Wednesday, March 17, 2010

Research Abstract and Commentary: Aromatherapy Massage

Effectiveness of Aromatherapy Massage in the Management of Anxiety and Depression in Patients with Cancer: A Multicenter Randomized Controlled Trial

Wilkinson SM, Love SB, Westcombe AM, Gambles MA, Burgess CC, Cargill A, Young T, Maher EJ, Ramirez AJ. Journal of Clinical Oncology, 25, 532-538.

PURPOSE: To test the effectiveness of supplementing usual supportive care with aromatherapy massage in the management of anxiety and depression in cancer patients through a pragmatic two-arm randomized controlled trial in four United Kingdom cancer centers and a hospice.
PATIENTS AND METHODS: 288 cancer patients, referred to complementary therapy services with clinical anxiety and/or depression, were allocated randomly to a course of aromatherapy massage or usual supportive care alone.
RESULTS: Patients who received aromatherapy massage had no significant improvement in clinical anxiety and/or depression compared with those receiving usual care at 10 weeks postrandomization (odds ratio [OR], 1.3; 95% CI, 0.9 to 1.7; P = .1), but did at 6 weeks postrandomization (OR, 1.4; 95% CI, 1.1 to 1.9; P = .01). Patients receiving aromatherapy massage also described greater improvement in self-reported anxiety at both 6 and 10 weeks postrandomization (OR, 3.4; 95% CI, 0.2 to 6.7; P = .04 and OR, 3.4; 95% CI, 0.2 to 6.6; P = .04), respectively.
CONCLUSION: Aromatherapy massage does not appear to confer benefit on cancer patients' anxiety and/or depression in the long-term, but is associated with clinically important benefit up to 2 weeks after the intervention.


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

This randomized controlled trial contributes to the body of evidence about the effectiveness of complementary therapies in cancer, specifically the use of aromatherapy massage (AM). There have been complaints that the “evidence” about complementary therapies is weak or nonexistent. This gives little credence to providers who wish to use these therapies. This study gives strong evidence that in the short-term (two weeks after AM was completed) cancer patients who received AM had less anxiety than patients who did not receive AM. They did not have less depression or other symptoms (e.g., pain, fatigue, nausea and vomiting, global quality of life).

The study intervention was massage with essential oils delivered by massage therapists over 1 hour weekly for 4 weeks. Patients in the treatment group received at least one treatment. Patients in the control group received access to psychological support as part of their cancer care. Patients recruited to the study had been referred to complementary therapy services by a cancer health professional.

Of interest to hospital nurses is that in a pilot study of 57 patients receiving AM, patients showed significantly decreased average anxiety levels immediately after the treatment. This endpoint was not of interest to the researchers, but would be to hospital nurses. This means that immediately following a 1-hour massage with essential oils, patients had less anxiety – on average. No adverse effects from the AM were reported.

Wednesday, March 03, 2010

Julie's picks from the Feb 2010 literature

Here are my picks from the recent literature on Nursing research and evidence based nursing. Staff at St. Joseph Hospital in Orange or CHOC may be able to access some of the full text via the library website.  Staff may also request that Burlew Medical Library provide them with the full text.
1. Nursing pedagogy and the intergenerational discourse.(includesabstract); Earle V; Myrick F; Journal of Nursing Education, 2009 Nov; 48 (11): 624-30 (journal article) ISSN: 0148-4834 CINAHL AN: 2010467042

2. Smoking cessation interventions in cancer care: opportunities for oncology nurses and nurse scientists.(includes abstract); Cooley ME; Lundin R; Murray L; Annual Review of Nursing Research, 2009; 27:
243-72 (journal article - research, systematic review, tables/charts) ISSN: 0739-6686 CINAHL AN: 2010521100

3. Theories used in nursing research on smoking cessation.(includes abstract); O'Connell KA; Annual Review of Nursing Research, 2009; 27: 33-62 (journal article - research, systematic review, tables/charts)
ISSN: 0739-6686 CINAHL AN: 2010521092

4. Nurses' use of qualitative research approaches to investigate tobacco use and control.(includes abstract); Schultz ASH; Bottorff JL; McKeown SB; Annual Review of Nursing Research, 2009; 27: 115-44
(journal article - research, systematic review, tables/charts) ISSN: 0739-6686 CINAHL AN: 2010521095

5. Nursing interventions in tobacco-dependent patients with cardiovascular diseases.(includes abstract); Shishani K; Sohn M; Okada A; Froelicher ES; Annual Review of Nursing Research, 2009; 27: 221-42
(journal article) ISSN: 0739-6686 CINAHL AN: 2010521099

6. A review of research by nurses regarding tobacco dependence and mental health.(includes abstract); Sharp DL; Blaakman SW; Annual Review of Nursing Research, 2009; 27: 297-318 (journal article -
research, systematic review, tables/charts) ISSN: 0739-6686 CINAHL AN: 2010521102

7. Nursing research in tobacco use and special populations.(includes abstract); Browning KK; Baker CJ; McNally GA; Wewers ME; Annual Review of Nursing Research, 2009; 27: 319-42 (journal article - research, systematic review, tables/charts) ISSN: 0739-6686 CINAHL AN: 2010521103

8. Simulation-based learning in nurse education: systematic review.(includes abstract); Cant RP; Cooper SJ; Journal of Advanced Nursing, 2010 Jan; 66 (1): 3-15 (journal article - research, systematic review, tables/charts) ISSN: 0309-2402 CINAHL AN: 2010503799

9. Cultivating quality. Implementing surgical smoke evacuation in the operating room: a nurse-led initiative changes policy to provide health care workers and patients more protection.(includes abstract); Waddell
AWG; American Journal of Nursing, 2010 Jan; 110 (1): 54-8 (journal article - pictorial, review, tables/charts) ISSN: 0002-936X PMID: 20032670 CINAHL AN: 2010518193

10. Use of three evidence-based postoperative pain assessment practices by registered nurses.(includes abstract); Carlson CL; Pain Management Nursing, 2009 Dec; 10 (4): 174-87 (journal article - research,
tables/charts) ISSN: 1524-9042 PMID: 19944373 CINAHL AN: 2010508818

11. Music as a nursing intervention for postoperative pain: a systematic review.Engwall M; Duppils GS; Journal of PeriAnesthesia Nursing, 2009 Dec; 24 (6): 370-83 (journal article - research, systematic review,
tables/charts) ISSN: 1089-9472 PMID: 19962104 CINAHL AN: 2010513653

12. A literature review: factors that impact on nurses' effective use of the Medical Emergency Team (MET).(includes abstract); Jones L; King L; Wilson C; Journal of Clinical Nursing, 2009 Dec; 18 (24): 3379-90
(journal article - research, systematic review, tables/charts, teaching materials) ISSN: 0962-1067 CINAHL AN: 2010472833

13. A collaborative protocol on oxytocin administration: bringing nurses, midwives and physicians together.Mandel D; Pirko C; Grant K; Kauffman T; Williams L; Schneider J; Nursing for Women's Health, 2009 Dec-2010 Jan; 13 (6): 480-5 (journal article - tables/charts) ISSN:
1751-4851 PMID: 20017777 CINAHL AN: 2010499698

14. Is nurse-managed blood glucose control in critical care as safe and effective as the traditional sliding scale method?(includes abstract); Adams G; Hunter J; Langley J; Intensive & Critical Care Nursing, 2009
Dec; 25 (6): 294-305 (journal article - research, systematic review, tables/charts) ISSN: 0964-3397 PMID: 19850481 CINAHL AN: 2010516840

15. Development and implementation of an oral care protocol for patients with cancer.(includes abstract); Sieracki RL; Voelz LM; Johannik TM; Kopaczewski DM; Hubert K; Steele-Moses SK; Clinical Journal of
Oncology Nursing, 2009 Dec; 13 (6): 718-22 (journal article - pictorial) ISSN: 1092-1095 PMID: 19948471 CINAHL AN: 2010497856

16. The effect on infected wound of topical silver and silver dressing: a view of evidence-based nursing PC6-37.Shiao C; Liu H; World Council of Enterostomal Therapists Journal, 2009 Oct-Dec; 29 (4): 29-30
(journal article - abstract, research, systematic review) ISSN: 0819-4610 CINAHL AN: 2010543560

17. Collaborating across services to advance evidence-based nursing practice.(includes abstract); Kenny DJ; Richard ML; Ceniceros X; Blaize K; Nursing Research, 2010 Jan-Feb; 59 (1): Supplement: S11-21 (journal article - tables/charts) ISSN: 0029-6562 PMID: 20010273 CINAHL AN:
2010518133

18. Design and validation of an instrument to measure nursing research culture: the Nursing Research Questionnaire (NRQ).(includes abstract); Corchon S; Watson R; Arantzamendi M; SaracĂ­bar M; Journal of Clinical Nursing, 2010 Jan; 19 (1-2): 217-26 (journal article - research, tables/charts) ISSN: 0962-1067 CINAHL AN: 2010510245

19. The role of the CNS in achieving and maintaining Magnet® status.(includes abstract); Walker JA; Urden LD; Moody R; Journal of Nursing Administration, 2009 Dec; 39 (12): 515-23 (journal article -
research, tables/charts) ISSN: 0002-0443 PMID: 19955965 CINAHL AN: 2010503484

20. Registered nurses' application of evidence-based practice: a national survey.(includes abstract); Boström A; Ehrenberg A; Gustavsson JP; Wallin L; Journal of Evaluation in Clinical Practice, 2009 Dec; 15
(6): 1159-63 (journal article - research, tables/charts) ISSN: 1356-1294 CINAHL AN: 2010522845

21. Seeing through the clouds in evidence-based practice.(includes abstract); Russell-Babin K; Nursing Management, 2009 Nov; 40 (11): 26-33 (journal article - CEU, exam questions, pictorial, tables/charts)
ISSN: 0744-6314 PMID: 19901753 CINAHL AN: 2010497587

22. Evidence-based practice: step by step. The seven steps of evidence-based practice: following this progressive, sequential approach will lead to improved health care and patient outcomes.(includes abstract); Melnyk BM; Fineout-Overholt E; Stillwell SB; Williamson KM; American Journal of Nursing, 2010 Jan; 110 (1): 51-3 (journal article) ISSN: 0002-936X PMID: 20032669 CINAHL AN: 2010518192

23. Creating quality evidence summaries on a clinician's schedule.McGee S; Clark E; Journal of Nursing Administration, 2010 Jan; 40 (1): 7-9 (journal article - tables/charts) ISSN: 0002-0443 PMID: 20010371 CINAHL AN: 2010519062

Wednesday, February 24, 2010

H1N1 Vaccination Keeps You and Your Patients Safe

Oncology nurses are aware of the need to prevent infection in neutrapenic patients. But what about preventing your own infections? Although the number of H1N1 cases in oncology nurses has not been measured, the illness poses a risk from two fronts: We may be seeing infected patients in our daily practice and we also run the risk of giving the virus to uninfected patients and co-workers.

Immunocompromised patients may not benefit from vaccination because they are not always able to mount an adequate immune response. thus preventing nurses from developing the infection and passing it along to those patients becomes a high priority. Unfortunately, limited sick leave, staffing issues and peer pressure may promote some nurses with mild symptoms to come to work, risking coworkers and patients.

According to the Centers for Disease Control and Prevention (CDC, 2009), nurses in any treatment setting should receive the vaccine. Although the Joint Commissions suggests optional vaccination with a provision to opt out for religious or medical reasons. However, attempting to force vaccination for hospital nurses has resulted in pending legal action. In 2009, less than half of hospital healthcare workers were vaccinated against the flu (CDC, 2009).

The CDC (2009) indicated that H1N1 treatment should not wait for laboratory confirmation. In addition, a negative rapid test does not rule out influenza. The antiviral medications oseltamivir (Tamiflu) and zanamivir (Relenza)can reduce the severity and duration of and complications from H1N1 and are recommended for individuals with suspected or confirmed influenza requiring hospitalization.

Centers for Disease Control and Prevention. (2009). Seasonal influenza vaccination
resources for healthcare professionals. Retrieved December 22, 2009, from http://www.cdc.gov/flu/professionals/vaccination/index.htm

Thursday, February 18, 2010

Dark Chocolate is Good for the Heart!

Do you have a box of Valentine chocolates that you aren't sure you should eat? Well if they are dark chocolate then you are in luck! According to a literature review published earlier this month on complimentary medicine in cardiology- dark chocolate is a champion for heart health.
(Posted: 02/05/2010; Pharmacotherapy. 2010;30(1):109 © 2010 Pharmacotherapy Publications).
The literature review shows strong evidence that dark chocolate can prevent cardiovascular disease by decreasing CRP (C reactive protien) levels which is associated with inflammation and coronary artery disease. It has also been found to dcrease platelet reactivity and in one study lowered LDL-C by 6% and raised HDL-C by 9% over only a week of daily dark chocolate consumption!
It can help mitigate the endothelial inflammatory effects of smoking as well.
In one study of 22 heart transplant patients - significant coronary vasodilitation, decreased platelet adhesion, and improved coronary vascular function was seen only 2 hours after consumption of a Nestle Intense(70% cocoa content) Bar. A study of 44 adults with prehypertension found that daily dark chocolate consumptionr reduced both systolic and diastolic blood pressures. It was also found to increase levels of S-nitrosoglutathione- a vasodilative nitric oxide.
While we know that dark chocolate has other health benefits- during Women's Heart Health month it is encouraging to see the evidence that a daily indulgence of dark chocolate is good for us! So enjoy your chocolate knowing that you are doing something good for your heart.

References:
Di Giuseppe R, Di Castelnuovo A, Centritto F, et al. Regular Consumption of Dark Chocolate Is Associated with Low Serum Concentrations of C-Reactive Protein in a Healthy Italian Population. J Nutr. 2008;138:1939–1945.
Allen RR, Carson L, Kwik-Uribe C, Evans EM, Erdman JW. Daily Consumption of a Dark Chocolate Containing Flavanols and Added Sterol Esters Affects Cardiovascular Risk Factors in a Normotensive Population with Elevated Cholesterol. J. Nutr. 2008;138:725–731.
Hamed MS, Gambert S, Bliden KP, et al. Dark Chocolate Effect on Platelet Activity, C-reactive Protein, and lipid profile: A pilot Study. South Med J 2008;12(101):1203–1208.
Hermann F, Spieker LE, Ruschitzka F, et al. Dark chocolate improves endothelial and platelet function. Heart 2006;92:119–120.
Flammer AJ, Hermann F, Sundano I, et al. Dark Chocolate Improves Coronary Vasomotion and Reduces Platelet Reactivity. Circulation. 2007;116:2376–2382.
Taubert D, Roesen R, Lehmann C, et al. Effects of Low Habitual Cocoa Intake on Blood Pressure and Bioactive Nitric Oxide. A Randomized Controlled Trial. JAMA. 2007;298(1):49–60.