New Nursing Research Toolkit available from the ANA

The American Nurses Association has a new Research Toolkit available free of charge. The Toolkit was developed to help nurses provide evidence-based care and promotes quality health outcomes. It includes a section on introduction to research and evidence-based practice. Access to resources that help the nurse translate evidence into practice and to support nurse researchers are available. While the Tool is free, ANA members only can log in with their username and password to gain access to a research repository containing reviews of research articles. Richard Barry, the librarian at ANA says, "this toolkit will change over time and add new resources to meet your needs." Check out this great new resource to add to your Evidence Based Practice tool belt!

Danielle's Picks from the Literature - August 2011

Here are my picks from the nursing literature over the past few months. SJO and CHOC employees have access to the full text of many of these articles through the Burlew Medical Library.

1. Children's nursing research: toward development, drudgery or demise?
Long, Tony;
British Journal of Nursing (BJN), 2011 Sep 8; 20 (14): 873-7
Abstract: This paper, based on a presentation to the UK Association of Chief Children's Nurses, is the author's personal reflection on the nature and future of children's nursing research. Key constitutive elements of this concept are considered to arrive at the conclusion that children's nursing research is research undertaken by children's nurses into questions of relevance to children's nursing practice and services, or wider issues in which children's nursing has a vital role. Three possible futures are presented, of which only the last is positive and desirable: development in line with the reality of practice and population needs. An integrated approach is necessary, with responsibilities both for those in positions of authority in the service and for researchers themselves. In particular, this partnership is essential for children's nursing to evidence the impact of research and for children and young people to reap the greatest benefit from evidence-based practice.

2. Grading recommendations in clinical practice guidelines: randomised experimental evaluation of four different systems.
García CA; Alvarado KP; Gaxiola GP;
Archives of Disease in Childhood, 2011 Aug; 96 (8): 723-8
Abstract: Objective To evaluate the effect of presenting a recommendation in a clinical practice guideline using different grading systems to determine to what extent the system used changes the clinician's eventual response to a particular clinical question. Design Randomised experimental study. Setting Clinician offices and academic settings. Participants Paediatricians and paediatric residents in private and public practice in Mexico. Intervention Case notes of a child with diarrhoea and a question about clinician preference for using racecadotril. The same evidence was provided in a clinical recommendation but with different presentations according to the following grading systems: NICE (National Institute for Health and Clinical Excellence), SIGN (Scottish Intercollegiate Guideline Network), GRADE (Grading of Recommendations Assessment, Development and Evaluation) and CEBM (Centre for Evidence-Based Medicine, Oxford). Main outcome measure Mean change in direction from baseline response (measured on a 10 cm visual scale and a Likert scale) and among groups. Results 216 subjects agreed to participate. Most participants changed their decision after reading the clinical recommendations (mean difference 0.7 cm, 95% CI 0.29 to 1.0; p<0.001). By groups, mean change (95% CI) from baseline was 0.04 (-0.68 to 0.77) for NICE, 0.31 (-0.41 to 1.05) for SIGN, 2.18 (1.48 to 2.88) for GRADE and 0.08 (-0.52 to 0.69) for CEBM (p=0.007 between groups). In a final survey, a small difference was noted regarding the clarity of the results presented with the GRADE system. Conclusion The clinician's decision to use a therapy was influenced most by the GRADE system. Trial registration number NCT00940290.

3. Implementing evidence-based nutrition guidelines: the critical care experience.
Cahill, Naomi E;
Clinical Nutrition Insight, 2011 Aug; 37 (8): 1-5

4. Immunological Methods for Nursing Research: From Cells to Systems.
Morrison, Helena W.; Downs, Charles A.;
Biological Research for Nursing, 2011 Jul; 13 (3): 227-34

5. Spit: Saliva in Nursing Research, Uses and Methodological Considerations in Older Adults.
Woods, Diana Lynn; Mentes, Janet C.;
Biological Research for Nursing, 2011 Jul; 13 (3): 320-7

6. Why and when should we conduct collaborative international oncology nursing research?
Hinds, Pamela S;
Cancer Nursing, 2011 Jul-Aug; 34 (4): 253-4

7. Innovation in engaging hospital staff and university faculty in research.
Zinn, Jennifer; Reinert, Jean; Bigelow, Andrea; Ellis, Waqiah; French, Amanda F; Milner, Frostenia; Letvak, Susan;
Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 2011 Jul-Aug; 25 (4): 193-7
Abstract: PURPOSE: : The purpose of this article was to describe an innovative faculty-staff engagement dinner that was conducted to enhance collaboration between university faculty and hospital staff. Specific steps used to develop the dinner, as well as outcomes gained, are discussed. BACKGROUND/RATIONALE: : Collaborative relationships between academic and clinical nurses may promote nursing research and strengthen mutual interest. Unique stressors and demands of clinical and academic nursing often lead to isolated practice roles. Nursing may require new ways of facilitating collaboration between groups. DESCRIPTION OF THE PROJECT:: A dinner supported by a health system was planned for nursing staff interested in conducting research. Faculty at 2 local universities interested in collaborating with nursing staff were invited. Forty participants attended, including 8 faculty from 2 universities, 17 staff nurses, and 16 nurse leaders. Seven collaborative research projects were initiated following the dinner meeting. INTERPRETATION/CONCLUSION: : Faculty and nursing staff partnerships were established and led to research projects that focused on themes of improving quality. Faculty and nursing staff expressed enthusiasm for the opportunity to connect over shared research ideas. IMPLICATIONS: : Mechanisms for enhancing staff nurse and nurse faculty collaborative relationships are needed to promote nursing research that ensures evidence-based bedside practices. A dinner event was an innovative method to partner nurses at the bedside with faculty with expertise in research methods.

8. Facebook: A Tool for Nursing Education Research.
Amerson, Roxanne;
Journal of Nursing Education, 2011 Jul; 50 (7): 414-6
Abstract: Facebook is an online social networking Web site that allows users to connect with other users. Nurse educators can use this technology to advance nursing research. Social networks provide new opportunities for locating potential research participants and maintaining contact during the research process. The purpose of this article is to explain how the researcher used Facebook to locate previous nursing students to ask them to participate in a qualitative study. Between 2006 and 2008, 22 nursing students had participated in international trips over a 3-year period. Because the students had graduated and moved to other geographical areas, the researcher had little or no contact information to use to follow-up with them. The researcher used Facebook to locate 18 of the 22 nursing graduates and invite them to participate in a qualitative research study. A discussion of the process and the potential ethical issues are provided.

9. Demystifying nursing research terminology. Part 1.
Welford, Claire; Murphy, Kathy; Casey, Dympna;
Nurse Researcher, 2011; 18 (4): 38-43
Abstract: Aim This article aims to provide clear explanations of the research approaches available for nursing research. Background There are numerous research approaches available to the nurse researcher. There is also some ambiguity in the literature in relation to research terminology and this often leads to confusion about which approach to adopt. Data sources A review of the available and most up-to-date literature. Discussion The most commonly adopted approaches in nursing research are described and discussed. Conclusion This article explains the research paradigms and the rationales for choosing particular paradigms while part two will provide an explanation of the methodological options available to the researcher. A table is included that summarises the key information related to each paradigm. Implications for practice/research These articles will be particularly useful for the novice researcher or for the doctoral student.

10. Obstacles and Drawbacks to Avoid in Qualitative Nursing Research.
Windle, Pamela;
Journal of PeriAnesthesia Nursing, 2011 Jun; 26 (3): 173-5

11. Magnet status-does it promote holistic health care?
Jackson, Christina;
Holistic Nursing Practice, 2011 Jul-Aug; 25 (4): 175-83

12. Introducing evidence into nursing practice: using the IOWA model.
Doody, Catriona M.; Doody, Owen;
British Journal of Nursing (BJN), 2011 Jul 14; 20 (11): 661-4
Abstract: Evidence-based practice has gained increasing popularity in all healthcare settings. Nurses are urged to use up-to-date research evidence to ensure better patient outcomes and inform decisions, actions and interactions with patients, to deliver the best possible care. Within the practice setting, there is an increasing challenge to provide clearly measurable care of the highest quality, which is evidence-based. In order for nurses to operate from an evidence-based perspective, they need to be aware of how to introduce, develop and evaluate evidence-based practice. This article presents how evidence may be introduced into practice using the Iowa model, offering practical advice and explanation of the issues concerning nurses in practice.

13. What is a systematic review?
Clarke, Jane;
Evidence Based Nursing, 2011 Jul; 14 (3): 64

14. Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers.
Majid, Shaheen; Foo, Schubert; Luyt, Brendan; Xue Zhang; Yin-Leng Theng; Yun-Ke Chang; Mokhtar, Intan A.;
Journal of the Medical Library Association, 2011 Jul; 99 (3): 229-36
Abstract: Objective: Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population. The objective of this study was to explore nurses' awareness of, knowledge of, and attitude toward EBP and factors likely to encourage or create barriers to adoption. In addition, information sources used by nurses and their literature searching skills were also investigated. Method: A total of 2,100 copies of the questionnaire were distributed to registered nurses in 2 public hospitals in Singapore, and 1,486 completed forms were returned, resulting in a response rate of 70.8%. Results: More than 64% of the nurses expressed a positive attitude toward EBP. However, they pointed out that due to heavy workload, they cannot keep up to date with new evidence. Regarding self-efficacy of EBP-related abilities, the nurses perceived themselves to possess moderate levels of skills. The nurses also felt that EBP training, time availability, and mentoring by nurses with EBP experience would encourage them to implement EBP. The top three barriers to adopting EBP were lack of time, inability to understand statistical terms, and inadequate understanding of the jargon used in research articles. For literature searching, nurses were using basic search features and less than one-quarter of them were familiar with Boolean and proximity operators. Conclusion: Although nurses showed a positive attitude toward EBP, certain barriers were hindering their smooth adoption. It is, therefore, desirable that hospital management in Southeast Asia, particularly in Singapore, develop a comprehensive strategy for building EBP competencies through proper training. Moreover, hospital libraries should also play an active role in developing adequate information literacy skills among the nurses.

15. Nurturing the Novice Nurse Researcher: Strategies for Librarians.
Nursing & Allied Health Resources Section (NAHRS) Newsletter, 2011 Jul; 31 (3): 8-10

16. Spirituality in nursing: a systematic review of the literature from 2006-10. Pike, Joanne;
British Journal of Nursing (BJN), 2011 Jun 24; 20 (12): 743-9
Abstract: Spirituality in nursing care has been discussed for many years in the nursing press. There has been no literature review that explores only UK literature, and this article updates a literature review carried out in 2006 (Ross, 2006). Aim: The review was designed to investigate the current nursing evidence underpinning the concept of spirituality and its application. Method: A systematic review of the literature was undertaken and a thematic analysis performed following a search for literature using defined dates, databases and search terms. Results: Four major themes emerged from the literature: concept clarification; spiritual care-giving; religion and spirituality; and nurse education. Conclusion: Definitions of spiritual care vary, and the concept of spirituality in nursing is still under development. However, until a common language of spirituality is developed, models of spiritual care developed through research involving mainly nursing staff will be difficult for nurses to apply.

17. Nursing work environment and nurse caring: relationship among motivational factors.
Burtson PL; Stichler JF;
Journal of Advanced Nursing, 2010 Aug; 66 (8): 1819-31
Abstract: Aim. This paper is a report of a study of the relationships among compassion satisfaction, nurse job satisfaction, stress, burnout and compassion fatigue to nurse caring. Background. Nurse caring is the most influential dimension of patient advocation and is predictive of patient satisfaction. Qualitative studies have indicated that nurse caring is a key motivational factor impacting recruitment and retention. Methods. A correlational study of nurses ( N = 126) was conducted in 2008 at a single, academic medical center. The six variables of interest were operationalized using four valid and reliable research instruments: (1) the Mueller McCloskey Satisfaction Scale, (2) the Professional Quality of Life Scale, (3) the Stress in General Scale and (4) the Caring Behaviors Inventory. Results. Pearson Product-moment correlations showed statistically significant relationships between nurse caring and compassion satisfaction ( r = 0DT51, P < 0DT001), nurse job satisfaction subscales ( r = 0DT16-0DT28, P < 0DT05), stress ( r = -0DT21, P < 0DT05), and burnout ( r = -0DT22, P < 0DT01). A statistically significant relationship was found between the nurse caring subscale of knowledge and skill and compassion fatigue ( r = -0DT22, P < 0DT01). Hierarchical multiple regression analysis demonstrated that compassion satisfaction ( R² = 0DT287, [beta] = 0DT536, P = 0DT000) and nurse satisfaction with social interaction opportunities related to work ([beta] = 0DT223, P = 0DT032) explained variability in nurse caring. Conclusion. Fostering compassion satisfaction and social interaction opportunities among nurses may improve nurse caring, potentially sustaining long-term improvements in patient.

18. Quality caring in nursing: applying theory to clinical practice, education, and leadership.
Gottesfeld IB;
Nursing Education Perspectives, 2010 Jul-Aug; 31 (4): 260