Nursing research
-
Establishing system-wide evidence-based nursing practice requires the support of senior leadership as well as adherence to a model that is sensitive to the challenges of practice change. ⋯ A successful EBP program requires (a) consistent long-term vision and support from senior leadership; (b) resources such as trained personnel, finances, and time; and (c) structured approach to create an environment that facilitates the process. However, the success of an EBP program relies heavily on each nurse's commitment to change designed to improve nursing care for patients.
-
The efficacy of oral sucrose in the reduction of single episodes of acute procedural pain in newborn infants has been demonstrated in a large number of well-conducted randomized controlled trials. However, there are few studies that have examined the effectiveness of repeated doses of sucrose and there are no studies of prolonged sucrose use in sick infants over an entire period of hospitalization. ⋯ The predominantly low behavioral responses to heel lancing and the lack of increase in behavioral pain outcomes suggest the ongoing effectiveness of oral sucrose during painful procedures throughout the infants' hospitalization. Further studies are recommended to ascertain the influence of factors such as adjunct analgesics, sedatives, and severity of illness.
-
In randomized controlled trials (RCTs), the intention-to-treat (ITT) principle, which involves maintaining study participants in the treatment groups to which they were randomized regardless of postrandomization withdrawal, is the recommended analytic approach for preserving the integrity of randomization, yet little is known about the use of ITT in nursing RCTs. ⋯ Nurse researchers conducting RCTs should be more diligent in following the Consolidated Standards of Reporting Trials guidelines about ITT, documenting ITT use in their reports, clarifying their definition of ITT, and presenting flowcharts that describe subject flow. Readers of nursing reports, in evaluating evidence from RCTs, should not rely on stated use of ITT but should examine how analyses were conducted.
-
For health organizations (private and public) to advance their care-management programs, to use resources effectively and efficiently, and to improve patient outcomes, it is germane to isolate and quantify care-management activities and to identify overarching domains. ⋯ Applying a systematic method to a large set of care-management activities can identify a parsimonious number of higher order categories of variables and factors to guide the understanding of dementia care-management processes. Further application of this methodology in outcome analyses and to other data sets is necessary to test its practicality.
-
Oral care is proposed as key to preventing ventilator-associated pneumonia, yet little work has been done to measure reliably current oral care practices nationwide. Five critical care oral care surveys are described in the literature; however, their usefulness is diminished because of insufficient validity or reliability measures and sampling limitations that limit generalizability. ⋯ This survey, tested for validity and reliability, can be used in future critical care settings as an audit tool for oral care practices performed by nurses.