Revisiting Evidence-Based Practice, and ‘Making Change Stick’

Do you ever wonder why nurses engage in practices that aren’t supported by evidence, while not implementing practices substantiated by a lot of evidence? In the past, nurses changed hospitalized patients’ IV dressings daily, even though no solid evidence supported this practice. When clinical trials finally explored how often to change IV dressings, results indicated that daily changes led to higher rates of phlebitis than did less frequent changes.

That’s the beginning of the first article in our first “step by step” series, Evidence-Based Practice, Step by Step, launched in November 2009. It won the Nursing Print Media Award for Nursing Excellence from Sigma Theta Tau International; the 12 articles in the series continue to be among the most highly viewed of any AJN articles online.

Nurses know about EBP, but changing practice is another thing.

The continued popularity of the articles made us wonder if the tenets of EBP were still not adequately known by nurses. So we asked the experts, and the result is our new series, EBP 2.0: Implementing and Sustaining Change.

Sharon Tucker, PhD, RN, FAAN, and Lynn Gallagher-Ford, PhD, RN, NE-BC, DPFNAP, FAAN, both  at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College […]

2019-04-17T08:43:00-04:00April 17th, 2019|Nursing, nursing research|1 Comment
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April Issue: IV Patient-Controlled Analgesia Errors, Implementing EBP, Nurses and Climate Action, More

“Think about your own workplace: do you take pride in what you do, feel that you and your work are valued, and enjoy the team you work with? Do the good days outweigh the bad days?”—AJN editor-in-chief Shawn Kennedy in her April editorial

The April issue of AJN is now live. Here are some highlights.

CE: Original Research: Errors in Postoperative Administration of Intravenous Patient-Controlled Analgesia: A Retrospective Study

The authors describe and analyze the errors associated with the use of IV patient-controlled analgesia at a large medical center in South Korea.

CE: A Historical Review of Nurse–Physician Bedside Rounding

How has the nurse’s role in bedside rounding evolved since the 19th century? This article discusses the challenges of nurse participation in bedside rounding from 1873 to 1973.

Sustaining Nursing Grand Rounds Through Interdisciplinary Teamwork and Interorganizational Partnership

The authors present the implementation of a grand rounds program at their naval hospital, and demonstrate how nursing grand rounds can support professional growth and strengthen partnerships.

New Series: EBP 2.0: Implementing and Sustaining Change: From Strategy to Implementation

Our follow-up to the popular Evidence-Based Practice, Step by Step series (which appeared in AJN from 2009 to 2011) is focused on the most challenging of the seven EBP steps—implementation.

Environments and […]

2019-03-25T09:53:59-04:00March 25th, 2019|Nursing, nursing history|0 Comments
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May Issue: Transfusion Therapy, Sustaining Fall Prevention Programs, Nurses’ Role in Assisted Suicide, More

“Nursing students are the future of nursing. Treating them with anything less than respect, support, and nurturing is unacceptable and unprofessional.” —John Burkley, MSN, RN, author of this month’s Viewpoint

The May issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: Original Research: Exploring Clinicians’ Perceptions About Sustaining an Evidence-Based Fall Prevention Program

Although hospitals have made extensive efforts to reduce patient falls through evidence-based fall prevention programs, sustaining such programs has proven challenging. This qualitative study addresses the knowledge gap between implementing and sustaining evidence-based fall prevention practices for hospitalized patients.

CE: A Review of Current Practice in Transfusion Therapy

The authors review the blood products that are commonly transfused, discuss the potential complications of transfusion—including TACO, TRALI, and TRIM—and outline current recommendations for transfusion therapy.

Special Feature: Assisted Suicide/Aid in Dying: What Is the Nurse’s Role?

This article presents the panel discussion that occurred during a policy dialogue on aid in dying (AID) at the American Academy of Nursing’s annual conference in 2016. The discussion explored the arguments for and against the growing state expansion of AID legislation, and the role of nurses in assisting patients who request AID.

2018-04-27T09:18:27-04:00April 27th, 2018|Nursing|0 Comments
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The Ten Most-Viewed AJN articles in 2017

What AJN Readers Read

nurse typing on keyboardIt’s always interesting (at least to me) to look back over the year and see what articles were the most popular. While we can’t be sure what people who read AJN in print actually viewed, we can get a good idea from those who read online. From those who accessed AJN articles either through the Ovid institutional subscription service or through our own website, www.ajnonline.com (but not counting those who read AJN articles on the iPad or via the company nursing portal, www.nursingcenter.com), here’s what we know readers viewed the most. Some of the content was new in 2017; some of it was not.

  1. AJN’s award-winning series “Evidence-Based Practice, Step-by-Step.” – This series of 11 articles by Melnyk, Fineout-Overholt, and colleagues ran every other month from November 2009 through July 2011 and took readers through the steps of searching and appraising the literature and implementing change.
  2. “Nursing’s Evolving Role in Patient Safety,” by Sonya Kowalski and Maureen Anthony (February 2017). This content analysis of AJN articles from 1900 to 2015 explored the nurse’s role in promoting patient safety. (I have to admit, as a history buff, this is one of my personal favorites.)
  3. “Interprofessional Collaboration and Education,” by Mary Sullivan et al (March 2015). This article describes the tenets of interprofessional collaboration […]
2018-01-02T14:46:41-05:00January 2nd, 2018|Nursing|0 Comments
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How Should We Measure Temperature in Young Children?

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

Photo courtesy of Exergen Corporation. Photo courtesy of Exergen Corporation.

Do you dread taking rectal temperatures in pediatric patients, knowing that your action will leave you with a screaming, distrustful child as well as a distressed parent? Rectal temperature measurements have long been considered the “gold standard” for accuracy. But are they essential in very young children, especially when infection is not suspected?

“Improving Pediatric Temperature Measurement in the ED” in our September issue relates how a group of ED nurses explored possible alternatives to routine rectal temperature measurements during triage. Their ED protocol had been to use this method in all children under the age of five. However, this practice extended the time needed for triage, was often upsetting to parents, and seemed potentially unnecessary when the reason for the ED visit did not suggest infection (where there would be a need for more careful fever assessment).

An existing emergency services committee made up of ED staff nurses from the hospital’s two campuses set out to explore their options. The committee’s first move was to clearly define the practice problem:

Using PICOT format (Patient population, Intervention of interest, Comparison intervention, Outcome, Time frame), the committee initially formulated the following clinical question: For pediatric patients younger than five years of age (P) who require temperature […]

2016-11-21T13:02:01-05:00September 10th, 2015|Nursing, Patients|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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