Evidence-Based Practice and the Curiosity of Nurses

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

karen eliot/flickr by karen eliot/via flickr

In a series of articles in AJN, evidence-based practice (EBP) is defined as problem solving that “integrates the best evidence from well-designed studies and patient care data, and combines it with patient preferences and values and nurse expertise.”

We recently asked AJN’s Facebook fans to weigh in on the meaning of EBP for them. Some skeptics regarded it as simply the latest buzzword in health care, discussed “only when Joint Commission is in the building.” One comment noted that “evidence” can be misused to justify overtreatment and generate more profits. Another lamented that EBP serves to highlight the disconnect between education and practice—that is, between what we’re taught (usually, based on evidence) and what we do (often the result of limited resources).

There’s probably some truth in these observations. But at baseline, isn’t EBP simply about doing our best for patients by basing our clinical practice on the best evidence we can find? AJN has published some great examples of staff nurses who asked questions, set out to answer them, and ended up changing practice.

Five Steps to Make Writing a Research Paper Less Daunting

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

By DeclanTM, via Flickr. By DeclanTM/Flickr

It takes a certain kind of super strength to be a grad student in springtime. Some days, I’d rather sit on a bench and watch the daffodils sway in the breeze than search for citable references to back up assigned claims. But after three years of graduate study, I’ve found a method that eventually grounds me. A looming deadline helps me hunker down with all necessary objects—iPad, keyboard, headphones, dirty stares for chatty undergrads. Most of my time is spent searching, until I’m finally ready to write. Edits are fairly quick, and my adherence to APA (American Psychological Association) style comes naturally now.

My system for writing a research paper is not new or undocumented. Research papers span all disciplines, but with little structural variation—a research paper is simply that: a paper that discusses research. Once I am able to will myself to focus, my research papers can be written in five basic steps.

Write a Thesis
Writing a research paper (for a school assignment or a work evidence-based practice project) can be intimidating, but fear can be eased by starting with just one sentence. A thesis statement should […]

AJN Collections of Note: From Women’s Health Issues to Assessment Tools for Older Adults

By Jacob Molyneux, senior editor

'Nuff Said by ElektraCute / Elektra Noelani Fisher, via Flickr. Elektra Noelani Fisher/ Flickr

It’s easy to miss, but there’s a tab at the top of the AJN home page that will take you to our collections page. There you can delve more deeply into a wide range of topics—and find many options for obtaining continuing education credits in the process.

For example, you’ll find a collection of recent continuing education (CE) feature articles devoted to women’s health issues, such as menopausal hormone therapy, cardiovascular disease prevention for women, and issues faced by young women who are BRCA positive.

The patient population in the U.S. continues to age. To gain confidence in meeting the needs of these patients, nurses can consult our practical collection of articles and videos devoted to the use of evidence-based geriatric assessment tools and best practices.

For the more creative side of nursing, we have a collection of 20 visual works and poems from our Art of Nursing column.

For those concerned with potential legal issues, it’s a good idea to have a look at the three CE articles from our Legal Clinic column on protecting your nursing license.

For would-be authors and those interested […]

Cochrane Reviews: An Oft-Overlooked Evidence Source for Nurses at the Bedside

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

“Research holding the torch of knowledge” (1896) by Olin Levi Warner. Library of Congress, Thomas Jefferson Building, Washington, D.C./Photo by Carol Highsmith, via Wikipedia

Long ago, in an ICU far away, I picked up the habit of saying, during rounds, “Well, you know, research suggests the practice…” I have trouble remembering who taught me this tactic, but it has always been a highly effective way of advocating for my patients.

The eyes of doctors, never ones to be silenced by a nurse who reads research, usually light up at the challenge.

I’ll admit that, for a while, many of my conversational citations came from ‘clinical pearls’ or tidbits I read from certifying organizations via social media. While my knowledge was based on credible sources, my analysis was topical, at best.

Then I started graduate school. Although my program isn’t a clinical one, the need to seek out evidence for class assignments intensified my practice of trying to apply research evidence at the bedside.

It’s tricky to find and discuss credible research as a bedside nurse. Services like Lexicomp and UpToDate, which most hospitals hold subscriptions to, compile […]

Breathing Training May Ease Depression in Dialysis Patients: Study Findings

By Sylvia Foley, AJN senior editor

It’s estimated that depression afflicts between 25% and 50% of people who have chronic kidney disease. And depression has been associated with numerous adverse outcomes in this population, including poor sleep, reduced quality of life, and higher rates of hospitalization and death. Researchers Siou-Hung Tsai and colleagues wanted to know whether teaching patients a basic relaxation technique—deep, slow breathing—could alleviate depressive symptoms.

To learn more, they developed a four-week intervention and conducted a trial. The intervention included instruction by a dialysis nurse trained in deep breathing techniques, additional audio device–guided instruction, and guided exercises. The authors report on their findings in this month’s CE–Original Research feature, “The Efficacy of a Nurse-Led Breathing Training Program in Reducing Depressive Symptoms in Patients on Hemodialysis.” Here’s a brief summary.

Objectives: The purpose of this randomized controlled trial was to examine the efficacy of a nurse-led, in-center breathing training program in reducing depressive symptoms and improving sleep quality and health-related quality of life in patients on maintenance hemodialysis.
Methods: Fifty-seven patients on hemodialysis were randomly assigned either to an eight-session breathing training group or to a control group. The Beck Depression Inventory II (BDI-II), the Pittsburgh Sleep Quality Index (PSQI), and the Medical Outcome Studies 36-Item Short Form Health Survey (SF-36) were used to assess self-reported depressive symptoms, sleep quality, and health-related quality of life, respectively.
Results: The intervention group exhibited significantly greater decreases in BDI-II scores than did the control group. No significant differences in PSQI change scores were observed between […]

2017-07-27T14:41:22-04:00April 7th, 2015|nursing perspective, nursing research|1 Comment
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