research

Free Stuff for Nurses this Week

by Nursetopia on May 7, 2013

freeNurses Week is full of freebies and giveaways to spread the love among the largest healthcare profession in the U.S. Here’s a smattering of some of the FREE stuff this week:

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Predictors of Survival in Patients with Non-Small Cell Lung Cancer [Article A Week]

by Nursetopia on March 1, 2013

The Article: Luo, J., Chen, Y., Narsavage, G. L., and Ducatman, A. (2012). Predictors of survival in patients with non-small cell lung cancer. Oncology Nursing Forum, 39(6): 609-616.

Big Idea: Lung cancer remains the leading cause of cancer deaths both in the U.S. and worldwide. Non-small cell lung cancer (NSCLC) makes up 80%-85% of lung cancers. Patients typically present with advanced stages, and the median survival time is 4 to 15 months. Chemotherapy slightly increases five-year survival rates. The authors retrospectively studied several factors of 110 rural-Appalachian hospitalized NSCLC patients’ charts to determine one-year overall survival outcomes.

Survey Says!: The researchers found several significant predictive factors of NSCLC one-year survival including: low BMI, elevated neutrophil counts, elevated platelet counts, and advanced cancer stage.

Quotable: “The current study confirmed that cancer staging and low BMI are powerful predictive factors of survival” (p. 613).

“As with elevated neutrophil counts, elevated platelets also may have inflammatory significance; whether inflammation relates directly to prognosis or is merely associated warrants further exploration” (p. 614).

“The study findings were limited to investigating short-term (one year) lung cancer survival rather than long-term survival outcomes. However, in predicting short-term lung cancer survival, the study results demonstrated significant clinical prognostic factors that could be meaningful in clinical trial research with survival outcomes, clinical care, and related areas for treatment” (p. 614).

So What?: This article is fascinating to me. I learned a lot about already extensively-studied predictors of NCSLC survival as well as about the Charlson Comorbidity Index, or CCI, a validated comorbidity tool that helps weigh the impact of comorbidities on mortality.

NSCLC is a common cancer diagnosis with a relatively poor prognosis. It’s important for oncology professionals to understand predictors of survival – common parameters – in order to create early interventions impacting those predictors.

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From Toyota to the Bedside: Nurses Can Lead the Lean Way in Health Care Reform

by Nursetopia on February 16, 2013

Screen Shot 2013-02-16 at 4.33.05 PMThe Article: Johnson, J.E., Mastro, K.A., & Smith, A.L. (2012). From Toyota to the bedside: Nurses can lead the lean way in health care reform. Nursing Administration Quarterly, 36(3), 234-42.

Big Idea: The Toyota Production System of the 1960′s produced a new quality and efficiency method called Lean, which focuses on standardization and reducing waste. With healthcare systems required to “do more with less,” Lean initiatives are appropriate options. Nurses can help lead the way with Lean ideas and programs. The authors discuss the overall concept of Lean, how it can impact health care, two case studies of how nurse-led Lean initiatives are changing care within the operating room and the emergency department, and lessons learned from the Lean change processes.

Survey Says!: The two nurse-led initiatives streamlined supply/inventory processes, improved OR turnaround time, reduced overtime, aligned staffing with demand, and reduced ED length-of-stay by 47 minutes. All of these efforts led to increased revenue.

Quotable: “Since 2005, Lean has been used tactically for discrete, departmental problems in hospitals [ref]. Lean techniques have been used to increase the performance of hospital administration, specialty clinics in dermatology and gastroenterology, health plans and medical practices [ref]; heart and vascular centers [ref]; oncology clinics [ref]; radiology [ref]; emergency departments [refs]; and entire hospital systems [ref]. Increasingly, Lean has been used as a system-wide operating framework within health care systems that have emerged as early adopters of Lean as a major innovation in health care” (p. 235).

“As Senge [ref] suggested more than 20 years ago, the systems perspective is badly needed in a world overwhelmed by rapid technologic change, changing demographics, shifting borders, and increasing complexity” (p. 238).

“Leading a complex Lean transformation of a large hospital department is a natural role for nurses, who have experience leading multi-disciplinary teams, are trained in assessment, and are system thinkers. Nurses also bring added advantages to the role of Lean leader – an uncompromising commitment to patient care and the natural ability to view hospital systems through the lens of the patient” (p. 238).

So What?: With the Affordable Care Act fully implemented in 2019, it is essential for hospitals to work at maximum efficiency. Lean initiatives can help streamline care and processes, and nurses are ideal Lean leaders. If you are interested in systems, processes, quality improvement, or improving your healthcare organization’s bottom line, you should definitely read this article and engage your nurses and other healthcare leadership.

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New, Free Journal Dedicated to Healthcare Clinical Innovation “Coming Soon”

by Nursetopia on February 12, 2013

Healthcare: The Journal of Delivery Science and Innovation will being quarterly publishing in June 2013. The journal, touted as the first of its kind to offer research on direct clinical care innovation, or the “how” of healthcare, will be free online for the first year. Hooray! My only qualm with the new journal – as many may guess – is the pantheon of healthcare leadership and innovation editorial board lacks nurse involvement other than the amazing Maureen Bisognano.

Really? “Delivery science and innovation” scream nursing to me. What do you think? Will you add this new journal to your reading?

 

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Teach Me what You’re Learning

by Nursetopia on February 11, 2013

Screen Shot 2013-02-10 at 7.49.22 PMRob Fraser, MN, RN, over at NursingIdeas is fanning the nursing learning-sharing-learning cycle flames through his Nursing Research Challenge.

I’m absolutely recommitting my passion for The Challenge. I hope you do the same. I want to learn from you!

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Male AYA Cancer Survivor Participants Needed for ‘Family After Cancer’ Study

by Nursetopia on February 6, 2013

Researchers at Northwestern University would like to talk with adolescent and young adult (AYA) cancer survivors about their experiences with thinking about whether or how to have a family.

Cancer survivors eligible include those:

  • Diagnosed after age 16
  • Who have ever been open to having or adopting children after diagnosis (regardless of whether or not they have children now)
  • Who are male and of all sexual orientations including straight, gay, bisexual, transgender, queer or other.

This is a one-time phone interview, and is expected to last about 45 minutes to an hour. After the interview, participants will receive a $20 gift card as a small token of appreciation. Please see the complete recruitment flyer for all details, including study contact information.

Please share this information to help researchers and the cancer community at-large understand the impact of treatment on family planning among young men surviving cancer!

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The Teaching Worked; Now Look at Me

by Nursetopia on January 15, 2013

My professors preached “research” all through graduate school. I went into grad school revolting any idea of doing research and especially the thought that it was expected of me as a masters-prepared nurse. Still, my professors sang the same song – first in melodies, then in harmonies – of research.

And, as I neared graduation, I became much more comfortable with research. Today, it’s a common thought in my nursing practice…What does the evidence say about this? I bet there’s already a validated tool for this. Let’s take this through the IRB; it will make an excellent paper. This is so interesting; I wonder if…

Yep. Research is a daily part of my nursing practice, which I actually enjoy.

And all my nursing professors smirk.

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Ethical Reasoning and Online Social Media

by Nursetopia on December 18, 2012

The Article: Englund, H., Chappy, S., & Jambunathan, J. (2012). Ethical reasoning and online social media. Nurse Educator, 37(6): 242-247.

Big Idea: While nurses and nursing students frequently utilize social media, little research has been done to understand nursing students’ own understanding of the ANA’s Principles for Social Networking or their accountability for their social media posts and how they relate to the ANA Code of Ethics. After experiencing an increase in students’ unprofessional use of social media, researchers at the University of Wisconsin Oshkosh surveyed their first semester and last semester undergraduate nursing students using a 21-item survey corresponding to the nine provisions within the Code of Ethics.

Survey Says!: 124 nursing students completed the surveys. Mean ages of the two semester groups were young – 22.4 and 24.4 years of age. The convenience sample was predominantly female, and the two groups – first semester and last semester students – had significant differences in their understanding of ethical decisions to not post certain information. Be sure to view the original article for the specifics of all the t tests.

Quotable: “The increasing use of social media sites by nursing students has opened a ‘‘Pandora’s box’’ of issues related to ethicality and nursing professionalism in a cyber world” (p. 243).

“Although the CON [College of Nursing] has a policy in place, unfortunately, results of this study indicated that 27.5% of the sophomore 2 students and 30.4% of the senior 2 students were either unaware or unsure if the CON had such a policy. Clearly, more effective methods are needed to ensure that students are aware of the CON’s social media policy” (p. 247).

So What?: The stories of nurses and nursing students (and other healthcare professionals/students) misusing social media are everywhere. This study indicates nursing students have varying levels of understanding of ethical boundaries while using social media and that it is a learned skill. Perhaps nursing schools and programs should more heavily focus on this skill early in the curriculum to circumvent future issues.

This study could be easily replicable in any nursing school in the world. In fact, the authors encourage others to use their tool to further validate the survey. Every nurse should reach out to his alma mater to make it aware of this study and the tool as it just might shed some light on this highly unstudied yet incredibly needed area of research.

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Estimates of the Annual Direct Medical Costs of the Prevention and Treatment of Disease Associated with HPV in the U.S.

by Nursetopia on September 7, 2012

The Article: Chesson, H.W., Ekwueme, D.U., Watson, M., Lowy, D.R., Markowitza, L.E. (2012). Estimates of the annual direct medical costs of the prevention and treatment of disease associated with human papillomavirus in the United States. Vaccine,  http://dx.doi.org/10.1016/j.vaccine.2012.07.056.

Big Idea: Human papillomavirus, or HPV, infection is linked to numerous diseases, both benign and malignant. Cancers linked with various HPV strains include cervical, vaginal, penile, anal, and certain head and neck cancers. Two HPV vaccines are currently available within the U.S. and could potentially reduce the incidence of the benign and malignant HPV-related diseases. The study authors updated the direct medical costs of HPV-associated diseases to stress the overall health and economic benefits of HPV vaccination.

Survey Says!: After all the computing, the researchers reported the direct cost of HPV-related diseases in the U.S. is $8 billion, most of which is attributed to the burden of cervical cancer.

Quotable: “Cervical cancer screening and follow-up together account for about $6.5 billion of the $8 billion total, or a little over 80% of the total estimated costs. This observation is consistent with findings from numerous studies that the cost-effectiveness of HPV vaccination could be enhanced greatly if vaccination is combined with reductions in routine cervical cancer screening costs through a delayed age of onset of screening or less frequent screening, or both [references]. Further, vaccination can help to reduce the follow-up costs of cervical cancer screening, such as costs associated with cervical intraepithelial neoplasia (p. 3).

So What?: $8 billion is quite a number. This is only direct costs, and does not include indirect costs such as loss of work, etc. for those living with HPV-related illnesses. It is clear the economic burden of HPV-related cancers is high. This article is helpful as leverage to increase HPV vaccination. I found that I was lacking comparison, though, to help me think through the study. What is the economic burden of other cancers? Preventable cancers? Virus-linked cancers? With the current cost of HPV vaccination and FDA vaccination guidelines/recommendations, what is the estimated financial impact on the estimated annual direct medical costs if vaccination increased? Overall, this is an interesting and useful article, and it left me wanting and wondering more.

 

 

 

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Free, Full-Text Nursing Articles Right to Your Inbox

by Nursetopia on July 31, 2012

I enjoy nursing research articles. Gasp. Yes, I said it. No, I didn’t always feel this way. I post about nursing research as well as research resources from time to time so others can locate their own free, full-text nursing articles. These posts remain some of my most frequently searched posts, and I can typically identify trends in nursing paper due dates via the spikes in those blog posts. Okay, not quite, but you get my drift.

Well, why search-out free nursing research articles when you can get them directly in your inbox throughout the year? One of my go-to (or shall I say “come-to”) resources is the Lippincott, Williams, & Wilkins publishing site. They have nursing journals the likes of the  American Journal of Nursing, Nurse Educator, and Nursing Administration Quarterly. If you register on the LWW website, you get all sorts of news and goodies, including assortments of free, full-text nursing articles every once in a while right to your inbox. Oh, yeah. Jackpot.

What? A girl can’t love her some nursing research?

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