Worldviews on evidence-based nursing
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Worldviews Evid Based Nurs · Aug 2012
Recognizing and responding to uncertainty: a grounded theory of nurses' uncertainty.
There has been little research to date exploring nurses' uncertainty in their practice. Understanding nurses' uncertainty is important because it has potential implications for how care is delivered. ⋯ This theory advances the nursing perspective of uncertainty in clinical practice. The theory is relevant to nurses who are faced with uncertainty and complex clinical decisions, to managers who support nurses in their clinical decision-making, and to researchers who investigate ways to improve decision-making and care delivery.
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Worldviews Evid Based Nurs · Apr 2012
ReviewUsing clinical pathways to aid in the diagnosis of necrotizing soft tissue infections synthesis of evidence.
Necrotizing soft tissue infections (NSTIs) are rare, rapidly spreading infections that occur in the soft tissue compartments. The mortality rate is high and has been found to decrease if patients are treated early and aggressively with surgical debridement and broad-spectrum antibiotics. Unfortunately these infections present similarly to other types of skin and soft tissue infections (SSTIs) making diagnosis difficult. ⋯ Educating ED providers about the signs, symptoms, and laboratory findings associated with NSTIs will lead to earlier diagnosis and treatment and decreased morbidity and mortality.
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Worldviews Evid Based Nurs · Apr 2012
Multicenter StudyEffect of online journal club on evidence-based practice knowledge, intent, and utilization in school nurses.
In the United States, an estimated 73,697 school nurses provide leadership in the provision of health care in the school setting. School nurses face challenges, such as providing quality health care in an educational setting and working in isolation. Journal clubs are one strategy to help incorporate evidence into practice. ⋯ A school nurse online journal club is one strategy to bring evidence to practitioners. Technology exists for nurses experiencing practice isolation to connect through online avenues. Nursing researchers, educators, and administrators seeking to disseminate research to school nurses or other clinical specialties could replicate or expand this project. Expanding online journal clubs would allow busy clinicians to connect with colleagues and researchers to integrate evidence into practice.
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Worldviews Evid Based Nurs · Feb 2012
Outcomes and challenges in implementing hourly rounds to reduce falls in orthopedic units.
Patient falls remain a common adverse event in acute care facilities. Findings from research into structured nursing rounds interventions (SNRIs) indicate promise as a fall prevention practice. Translating, adapting, and sustaining SNRI in real world clinical practices is an important next step. ⋯ Findings illuminate the multiple challenges in translational research. SNRI appeared to reduce fall rates initially, but fidelity to the SNRI implementation and documentation was variable and fall reduction gains appeared lost 1 year later. Nurses expressed the importance of balancing intervention fidelity and individualizing patient interventions.
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Worldviews Evid Based Nurs · Feb 2012
Redesigning the ICU nursing discharge process: a quality improvement study.
To evaluate the impact of a redesigned intensive care unit (ICU) nursing discharge process on ICU discharge delay, hospital mortality, and ICU readmission within 72 hours. ⋯ Involving both ward and ICU staff in the redesign process may have contributed to a shared situational awareness of the problems, which led to more timely and effective ICU discharge processes. The use of a change agent, whose ongoing role involved follow-up of patients discharged from ICU, may have helped to embed the new process into practice.