Resources page
Policy report Registered Nurses' Association of Ontario (RNAO), Mind the Safety Gap in Health System Transformation: Reclaiming the Role of the RN. http://rnao.ca/sites/rnao-ca/files/HR_REPORT_May11.pdf RNAO announced to its members at the May 2015 annual general meeting last year that we would undertake a major study to analyse Ontario's nursing human resources to ensure the public has access to appropriate nursing care. It was in response to our members, who voiced their concerns over a negative trend in the health system, that was robbing Ontarians of the rich knowledge and skills of registered nurses. RNAO has diligent...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Noble, H. Tags: Resources Source Type: research

Simulated patient deterioration situations reveals taxonomy of the decisions made by nursing students
This study provides a taxonomy of the decisions made by nursing students in patient deterioration simulations that can clarify the expected outcomes of decision-making education. The results highlight the influence of knowledge and non-technical skills on student's decision-making in a team-based context. Further research is needed to examine the generalisability of this taxonomy and evaluate the effectiveness of different approaches to teaching decision-making. Context Simulation is increasingly used to prepare nursing students to recognise and respond to patient deterioration and research suggests its effectiveness to im...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Lavoie, P. Tags: Nurse education Source Type: research

More research needed on animal-assisted interventions in dementia
Commentary on: Olsen C, Pedersen I, Bergland A, et al.. Effect of animal-assisted interventions on depression, agitation and quality of life in nursing home residents suffering from cognitive impairment or dementia: a cluster randomized controlled trial. Int J Geriatr Psychiatry 2016;31:1312–21. Implications for practice and research Animal-assisted interventions may support quality of life and decrease the degree of depressivity in patients with dementia in nursing homes. Larger definitive trials are needed to confirm effectiveness of animal-assisted interventions in people suffering from dementia. Context There is ...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Rapp, M. A. Tags: Care of the older person Source Type: research

Supportive care model could be used to inform interventions and service development to improve quality of care for older people
Commentary on: Nicholson C, Morrow EM, Hicks A, et al.. Supportive care for older people with frailty in hospital: an integrative review. Int J Nurs Stud 2016;66:60–71. Implications for practice and research The model presented joins together theory and evidence of supportive care to inform interventions and service development for older people with frailty in hospital. The model suggests a framework for evaluation of such interventions and services for managers and researchers. This paper highlights that future research is needed in relation to assessment of needs; the impact of supportive care on patient outcomes; ...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Brown, J., Conroy, S. Tags: Care of the older person Source Type: research

Spouses with partners with dementia living in institutional care develop visiting routines that help to maintain the spousal relationship
This study by Førsund et al explored the experiences of 15 spouses in Norway whose partners had dementia and were living in institutional care settings. The couples had relationship histories... (Source: Evidence-Based Nursing)
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Holman, C. Tags: Care of the older person Source Type: research

Mindfulness training can reduce depression and anxiety among nurses
Commentary on: Guillaumie L, Boiral O, Champagne J. A mixed-methods systematic review of the effects of mindfulness on nurses. J Adv Nurs 2016. Published Online First. http://dx.doi.org/10.1111/jan.13176 Implications for practice and research Mindfulness can help relieve symptoms of depression and anxiety among nurses and may improve patient care. There is a need for future quantitative studies to measure the nurse-perceived benefits of mindfulness identified in qualitative research. Mixed-methods reviews can help develop a more complete and clinically relevant understanding of a given topic. Context Work-related stress is...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Hunter, L. Tags: Editor's choice Nursing issues Source Type: research

Greater nurse autonomy associated with lower mortality and failure to rescue rates
This study by Rao et al is the first study... (Source: Evidence-Based Nursing)
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: van Oostveen, C., Vermeulen, H. Tags: Editor's choice, Nursing issues Source Type: research

Task-based weight management programme delivered in primary care promotes better long-term weight loss among women from lower socioeconomic groups than usual practice
Commentary on: McRobbie H, Hajek P, Peerbux S, et al.. Tackling obesity in areas of high social deprivation: clinical effectiveness and cost-effectiveness of a task-based weight management group programme—a randomised controlled trial and economic evaluation. Health Technol Assess 2016;20:1–150. Implications for practice and research The study is important in demonstrating that a task-based weight management programme can potentially be effective in reducing obesity among lower socioeconomic groups. The role of nurses in delivering such weight loss interventions should be evaluated. Context Obesity is recognise...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Bambra, C. Tags: Health promotion and public health Source Type: research

Brief motivational intervention delivered in the emergency department can reduce hazardous drinking and risky sexual behaviour
Commentary on: Monti PM, Mastroleo NR, Barnett NP, et al.. Brief motivational intervention to reduce alcohol and HIV/sexual risk behavior in emergency department patients: a randomized controlled trial. J Consult Clin Psychol 2016;84:580–91. Implications for practice and research In an emergency department (ED) setting, a 1-hour motivational interviewing session involving personalised risk feedback can yield meaningful reductions in hazardous alcohol use and risky sexual behaviour. Research is needed to evaluate this intervention with racial, ethnic and sexual minority patients and test its effectiveness when deliver...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Dermen, K. Tags: Health promotion and public health Source Type: research

Cognitive-behavioural therapy may reduce high rates of service use among frequent primary care attenders
This study adds to the growing literature showing that frequent attendance and high usage of primary care services may be modifiable behaviours. Larger scale, controlled trials are needed. Context High users or FAs of healthcare clinics place significant organisational and financial strain on healthcare systems. It has been estimated that the top 3% of users account for 15% of primary care visits.1 Short-term frequent attendance may be related to acute causes, but long-term frequent attendance has been found to be associated with high... (Source: Evidence-Based Nursing)
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Goodwin, C. L., Weisberg, R. B. Tags: Health promotion and public health Source Type: research

Physical activity as a core component of the nursing curriculum
Commentary on: Blake H, Stanulewicz N, Mcgill F, et al.. Predictors of physical activity and barriers to exercise in nursing and medical students. J Adv Nurs 2016. http://dx.doi.org/10.1111/jan.13181. [Epub ahead of print] Implications for practice and research Nursing students are not meeting the minimum recommended level of physical activity (PA). The PA behaviour of nursing students has the potential to influence their delivery of health promotion education. The development of PA within nursing curricular will potentially facilitate strategies to balance the demands of study and personal commitments and PA. Further rese...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Dwyer, T. Tags: Health promotion and public health Source Type: research

Body mass index in adolescence may influence the risk of cardiovascular disease later in life
Commentary on: Twig G, Yaniv G, Levine H, et al. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med 2016;374:2430–40. Implications for practice and research Adolescents who are considered to be in the normal body mass index (BMI) range had an increased risk of cardiovascular disease and all-cause mortality at 10–40 years follow-up, which continuously increased with a higher BMI. Future research is needed to establish the optimal threshold for a healthy BMI during adolescence. Context The prevention and treatment of cardiovascular disease (CVD) has improved over r...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Hulsegge, G. Tags: Health promotion and public health Source Type: research

Parents require more information on how to manage their child's postoperative pain at home
Commentary on: Longard J, Twycross A, Williams AM, et al.. Parents' experiences of managing their child's postoperative pain at home: an exploratory qualitative study. J Clin Nurs 2016;25:2619–28. Implications for practice and research Parents use various strategies to manage their children's postoperative pain, but they also face challenges and want support from health professionals. More effective and family-informed interventions are needed to improve children's pain management at home. Interventions would require evaluating to establish their effectiveness. Context Previous studies have described children's exper...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: He, H.-G. Tags: Child health Source Type: research

Palliative care improves quality of life and reduces symptom burden in adults with life-limiting illness
Commentary on: Kavalieratos D, Corbelli J, Zhang D, et al.. Association between palliative care and patient and caregiver outcomes: a systematic review and meta-analysis. JAMA 2016;316:2104–14. Implications for practice and research Palliative care (PC) improves patients' quality of life and symptom burden. There is also some evidence that it increases care satisfaction and reduces healthcare usage. The impact of PC on caregiver outcomes needs more attention in future research. PC needs a standardised outcome measurement framework to be able to fully demonstrate its impact. Further development of integrated PC models...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Anagnostou, D. Tags: Adult nursing Source Type: research

Increased physical activity in women following myocardial infarction improves health-related quality of life
Commentary on: Lovlien M, Mundal L, Hall-Lord ML, et al.. Health-related quality of life, sense of coherence and leisure-time physical activity in women after myocardial infarction. J Clin Nurs 2016. http://dx.doi.org/10.1111/jocn.13411. Implications for practice and research Strategies are needed to improve the uptake of secondary prevention programmes among women. Further research into female illness perception and value placed on physical activity postmyocardial infarction (MI). Context In recent years, there is growing realisation that women have poorer outcomes following MI compared with men, for example, an increased...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Fitzsimons, D., Hill, L. Tags: Adult nursing Source Type: research

Impact of spousal bereavement for carers of people with dementia
Commentary on: Shah SM, Carey IM, Harris T, et al.. The mental health and mortality impact of death of a partner with dementia. Int J Geriatr Psychiatry 2016;31:929–37. Implications for practice and research This paper improves our understanding of spousal bereavement in dementia and highlights the need for both pre-bereavement and post-bereavement support for family carers. It provides good-quality evidence that in the year preceding bereavement, spousal carers of people with dementia are at increased risk of psychological distress. This research highlights the need for better support for family carers of people wit...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Brede, J., Orgeta, V. Tags: Mental health Source Type: research

Alcohol consumption during pregnancy and breast feeding in Canada is prevalent and not strongly associated with mental health status
Commentary on: Lang S, Quere M, Shield K, et al.. Alcohol use and self-perceived mental health status among pregnant and breastfeeding women in Canada: a secondary data analysis. BJOG 2016;123:900–9. Implications for practice and research Healthcare practitioners need to be aware that women who stop drinking alcohol during pregnancy may resume drinking while breast feeding. Breastfeeding women should be informed about the potential effect of ethanol on the baby. Longitudinal studies are needed to describe the trajectory and patterns of alcohol use in women of reproductive age from preconception through pregnancy and ...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Smith, L. Tags: Women ' s health and midwifery Source Type: research

Pregnancy in women with sickle cell disease is associated with risk of maternal and perinatal mortality and severe morbidity
Commentary on: Boafor TK, Olayemi E, Galadanci N, et al.. Pregnancy outcomes in women with sickle-cell disease in low and high income countries: a systematic review and meta-analysis. BJOG 2016;123:691–8. Implication for practice Pregnancy in patients with sickle cell disease (SCD) is associated with the risk of maternal and perinatal mortality and severe morbidity. Findings provide important estimates on associated mortality and morbidity for policymakers, clinicians and researchers to work together to improve on these adverse outcomes. There is a need for multidisciplinary care in order to manage the multisystem na...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Oteng-Ntim, E. Tags: Women ' s health and midwifery Source Type: research

Caesarean section increases risk of preterm birth in subsequent pregnancy
Commentary on: Wong LF, Wilkes J, Korgenski K, et al.. Risk factors associated with preterm birth after a prior term delivery. BJOG 2016;123:1772–8. Implications for practice and research Caesarean section was identified as a risk factor for preterm birth in a subsequent pregnancy, however it is not known if the relationship between caesarean section and preterm birth is causal. Large observational studies might provide additional information regarding the relationship between caesarean section and the increased risk on preterm birth. Context The aetiology of spontaneous preterm birth remains, despite many publicatio...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Visser, L., de Boer, M. A., Mol, B. W. Tags: Women ' s health and midwifery Source Type: research

Undertaking research with children and young people
In the previous edition of Evidence-Based Nursing, ‘the ethical context of nursing research’, the role of the nurse researcher in respecting and ensuring the welfare of participants was highlighted.1 Historically, children and young people (CYP) have been excluded from participating in research because of tensions between developing a sound knowledge base for interventions, care and service delivery and the need to protect them.2 Involving CYP in the planning, participation and dissemination of research will ensure that the research undertaken is relevant to their needs and considers their overall well-being. W...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Twycross, A., Smith, J. Tags: Editor's choice, Research made simple Source Type: research

Correction
Heale R, Noble H. Advance care planning and palliative care. Evidence-Based Nursing 2017;20:5–6. The second affiliation is incorrect and should state: School of Nursing and Midwifery, Queens University Belfast, Belfast, UK (Source: Evidence-Based Nursing)
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Tags: Correction Source Type: research

Care of the older person
In this series, commentaries in evidence-based nursing from the past 2 years from a specific nursing theme are brought together and highlights are discussed. The topic for this edition is care of the older person. From January 2015 to the January 2017 edition, 19 commentaries were published on the chosen topic. Three commentaries in this category related to advance care planning or palliative care were removed because they were addressed in EBN Perspectives in January 2017. Key themes were extrapolated from these commentaries and the implications for practice and future research were explored. Key themes The 19 commen...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Noble, H., Heale, R. Tags: EBN perspective Source Type: research

Fields of nursing: do we need them, what should they be and when should nurses choose theirs?
This month’s Opinion relates to an EBN twitter chat that explored the value of fields of nursing and their future within the United Kingdom (http://blogs.bmj.com/ebn/2016/11/10/fields-of-nursing-do-we-need-them-what-should-they-be-and-when-should-nurses-choose-theirs/). Background In the UK, preregistration nurse education provides a route into one of the four ‘nursing fields’—Adult, Child, Learning Disabilities and Mental Health. Student nurses select their chosen field at the time of application to University, and then complete a degree (or higher) level programme of study focused on that field (a...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Barrett, D. Tags: EBN Opinion Source Type: research

Second thoughts about palliative sedation
‘When I use a word,’ Humpty Dumpty said, ‘it means just what I choose it to mean—neither more nor less’. ‘The question is,’ said Alice, ‘whether you can make words mean so many different things’. (Carroll L 1872. Alice through the looking glass) Palliative sedation is a term used to describe the use of sedative drugs in dying patients to induce a state of decreased or absent awareness (unconsciousness) in order to relieve intolerable suffering from refractory symptoms.1 2 Perhaps, for many of us, this conjures up an image of an agitated patient who is rendered unconscio...
Source: Evidence-Based Nursing - March 22, 2017 Category: Nursing Authors: Twycross, R. Tags: Editorials Source Type: research

Have you seen the Evidence-Based Nursing blog? Evidence-Based Nursing blogs: highlighting contemporary issues in nursing
The survey undertaken here at EBN last year suggested that our online and print readerships were different. Many of our readers who subscribe to the print edition of the journal do not access our online content. One of our most successful online features, not available in the print edition, is our weekly blogs. The blogs are written by a wide range of professionals with diverse interests. Bloggers comment on their concerns and challenges of delivering health in an increasingly complex world; they all have a passion for nursing and health. In this special edition, we are featuring some of our blog content within the journal...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Twycross, A., Smith, J. Tags: Miscellaneous Source Type: research

Meaningful use of Twitter in nursing education may improve student learning and should be considered as a viable educational tool to assist in the development of digital professionalism
This study by Jones and colleagues delved into the practicalities of deploying Twitter... (Source: Evidence-Based Nursing)
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Booth, R., O'Connor, S. Tags: Editor's choice Nurse education Source Type: research

Self-management programme for people with dementia and their spouses demonstrates some benefits, but the model has limitations
Commentary on: Laakkonen ML, Kautiainen H, Hölttä E, et al.. Effects of self-management groups for people with dementia and their spouses—randomized controlled trial. J Am Geriatr Soc 2016;64:752–60. Implications for practice and research Promotion of self-management is important following dementia diagnosis, but questions remain regarding the level of disease severity which renders self-management unachievable. Group-based self-management interventions are valued by those who participate but ability to tailor to individual needs is important. Researchers must work with people with dementia to coproduce and...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Mountain, G. Tags: Health policy, Dementia, Memory disorders (psychiatry), Health service research Care of the older person Source Type: research

DemDel, a nursing-led practice-based delirium intervention, improves certain outcomes for older cognitively impaired inpatients
Commentary on: Hasemann W, Tolson D, Godwin JA, et al.. A before and after study of a nurse led comprehensive delirium management programme (DemDel) for older acute care inpatients with cognitive impairment. Int J Nurs Stud 2016;53:27–38. Implications for practice and research Delirium prevention and management require nurse-led identification of those at risk, cognitive screening and management of triggers and risk factors. Educational approaches can improve delirium practice, but more studies are needed to explore the impact of nursing education on patient outcomes. Context Older people with cognitive impairment ar...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Wand, A. P. F., Teodorczuk, A. Tags: Long term care, Care of the older person, Case management, Delirium, Drugs: psychiatry, Memory disorders (psychiatry), Psychotic disorders (incl schizophrenia), Drugs: musculoskeletal and joint diseases, Screening (public health) Source Type: research

Nursing home residents prefer fewer interventions and the nursing home instead of hospital for place of death
Commentary on: Ng CW, Cheong SK, Govinda Raj A, et al.. End-of-life care preferences of nursing home residents: results of a cross-sectional study. Palliat Med 2016;30:843–53. Implications for practice and research End-of-life care preferences of residents in nursing homes confirm the importance of developing practice to ensure high-quality end-of-life is delivered. The role and competencies required of nurses working in nursing homes in supporting the end-of-life preferences of residents requires more research. Context The importance of nursing homes as places where people die, and the need to support nursing homes ...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Watson, J. Tags: Health policy, End of life decisions (geriatric medicine), Long term care, Care of the older person, Interventional cardiology, End of life decisions (palliative care), Hospice, Memory disorders (psychiatry), End of life decisions (ethics) Source Type: research

High proportion of elderly patients who are admitted to hospital are entering the last year of their lives
Commentary on: Pocock LV, Ives A, Pring A, et al.. Factors associated with hospital deaths in the oldest old: a cross-sectional study. Age Ageing 2016;45:372–6. Implications for practice and research This paper supports the view that a high proportion of elderly patients who are admitted to hospital are entering the last year of their lives. Clinicians might make more use of the opportunity provided by such hospital admission to discuss end-of-life care. Future research might focus on the associations between cause of death, comorbidity, deprivation and place of death in those who do not require hospital admission wi...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Isles, C. Tags: End of life decisions (geriatric medicine), Long term care, Care of the older person, Dementia, End of life decisions (palliative care), Hospice, Memory disorders (psychiatry), End of life decisions (ethics) Source Type: research

Physical activity can successfully be promoted to older adults within a primary care setting by trained nurses
Commentary on: Harris T, Kerry SM, Victor CR, et al.. A primary care nurse-delivered walking intervention in older adults: PACE (Pedometer Accelerometer Consultation Evaluation)-Lift cluster randomised controlled trial. PLoS Med 2015;12:e1001783. Implications for practice and research General practitioners (GPs) should consider using nurses to promote physical activity. Evidence suggests that most older adults need help and support to increase daily walking and gain health benefits. Support can be provided by trained practice nurses and minimal additional resources. Further research is needed on how best to attract the int...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Nanette, M., Baker, G. Tags: General practice / family medicine, Care of the older person, Pain (neurology) Source Type: research

Link between length of hospital stay and mortality among hip fracture patients varies across healthcare systems
Commentary on: Nikkel LE, Kates SL, Schreck M, et al.. Length of hospital stay after hip fracture and risk of early mortality after discharge in New York State: retrospective cohort study. BMJ 2015;351:h6246. Implications for practice and research The link between length of stay and mortality is complex and appears to differ across healthcare settings. More insight into the potential causal mechanisms linking length of stay and mortality is needed. Context Hip fracture is the most serious complication related to osteoporosis both from a patient and societal perspective due to the high case-fatality rate and healthcare cost...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Johnsen, S. P., Kristensen, P. K. Tags: Health policy, Care of the older person, Osteoporosis, Trauma, Health service research, Injury Source Type: research

Earplugs could be an effective sleep hygiene strategy to reduce delirium in the ICU
Commentary on: Litton E, Carnegie V, Elliott R, et al.. The efficacy of earplugs as a sleep hygiene strategy for reducing delirium in the ICU: a systematic review and meta-analysis. Crit Care Med 2016;44:992–9. Implications for practice and research Simple sleep hygiene strategies, such as earplugs, can be implemented at the bedside in the intensive care unit (ICU), can reduce the risk of delirium and increase patients' total sleep time. Future research should be conducted to delineate the actual reduction in length of stay (LOS), delirium, mortality and costs associated with these strategies. Context Delirium is a s...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Hill, L. Tags: Other rehabilitative therapies, Nursing issues, Delirium, Memory disorders (psychiatry), Sleep disorders, Sleep disorders (respiratory medicine), Internet, Medical error/ patient safety, Medical humanities Source Type: research

Staffing and nurse-perceived quality of care
Commentary on: Cho E, Lee NJ, Kim EY, et al.. Nurse staffing level and overtime associated with patient safety, quality of care, and care left undone in hospitals: a cross-sectional study. Int J Nurs Stud 2016;60:263–71. Implications for practice and research Nursing staff and administrators should be aware of the extensive evidence supporting the association of staffing and work hours on patient safety. Researchers should evaluate existing staffing policy legislations nationally and internationally to determine strengths and weaknesses of these approaches. Context For well over a decade, research examining the effec...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: de Cordova, P. B. Tags: Editor's choice, Nursing issues, Medical error/ patient safety, Quality improvement Source Type: research

Telemonitoring improves diabetes control, but more work is needed
Commentary on: Wild SH, Hanley J, Lewis SC, et al.. Supported telemonitoring and glycemic control in people with type 2 diabetes: the Telescot diabetes pragmatic multicenter randomized controlled trial. PLoS Med 2016;13:e1002098. Implications for practice and research Large-scale acceptance of telemonitoring of patient self-administered tests (eg, glucose, blood pressure) will require attention to how additional workload will be integrated into the workflow of the clinic. Additional research is required to fine tune telemonitoring interventions, including content, intervention dose, intervention length and appropriate targ...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Wakefield, B. Tags: Community and primary care nursing Source Type: research

Patients who self-monitor or self-manage can improve the quality of their oral anticoagulation therapy
Commentary on: Heneghan CJ, Garcia-Alamino JM, Spencer EA, et al.. Self-monitoring and self-management of oral anticoagulation. Cochrane Database Syst Rev 2016;7:CD003839. Implications for practice and research For suitable patients self-monitoring or self-managing enhances the quality of oral anticoagulation therapy. Self-monitoring and self-managing patients experience greater time in therapeutic range with the associated decrease in thromboembolic events. Future research should focus on establishing the factors affecting the uptake of self-monitoring and self-managing of oral anticoagulation. Context There are 950 ...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Kennedy, M. Tags: Immunology (including allergy), Drugs: cardiovascular system, Stroke, Internet, Diabetes, Arrhythmias, Metabolic disorders Community and primary care nursing Source Type: research

Early warning tools may assist in the identification of clinical deterioration in the new-born nursery
Commentary on: Paliwoda M, New K, Bogossian K. Neonatal Early Warning Tools for recognizing and responding to clinical deterioration in neonates cared for in the maternity setting: a retrospective case–control study. Int J Nurs Stud 2016;61:125–35. Implications for practice and research Prospective identification of new-born infants in maternity wards who are clinically deteriorating may be assisted with the use of early identification tools. Differences in physiological norms between late preterm, early-term and post-term new-born infants may limit the performance ‘one size fits all’ neonatal early...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Parshuram, C., Dryden-Palmer, K. Tags: Child health, Medical error/ patient safety Source Type: research

Application of heat prior to intravenous catheter insertion to improve comfort and safety for patients requires further research
Commentary on: Biyik Bayram S, Caliskan N. Effects of local heat application before intravenous catheter insertion in chemotherapy patients. J Clin Nurs 2016;25:1740–7. Implications for practice and research Improving comfort and safety for patients by simply applying heat prior to cannulation warrants practice consideration. The application of heat prior to cannulation/catheterisation is not a new technique, though this research has provided evidence to promote change and review of current practices. Context Intravenous (IV) catheter insertion is performed on ~80% of patients who present to hospital and is the commo...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Robinson-Reilly, M. Tags: Adult nursing Source Type: research

Newer drugs to treat prostate symptoms are associated with increased risk of falls
Commentary on: Welk B, McArthur E, Fraser LA, et al.. The risk of fall and fracture with the initiation of a prostate-selective α antagonist: a population based cohort study. BMJ 2015;351:h5398. Implications for practice and research Prostate-selective α-antagonists are associated with a small increased risk of falls and fall-related fractures. Healthcare practitioners should consider counselling patients on the increased risk for falls prior to starting prostate-selective α-antagonists. Future studies should evaluate strategies to reduce the risk of falls in men prescribed α-antagonists. Context Lo...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Tan, M. P., Abdul Razack, A. H. Tags: Long term care, Adult nursing, Osteoporosis, Trauma, Injury Source Type: research

Consumption of artificially sweetened beverages during pregnancy is associated with a twofold higher risk of infant being overweight at 1 year
Commentary on: Azad MB, Sharma AK, de Souza RJ, et al.. Association between artificially sweetened beverage consumption during pregnancy and infant body mass index. JAMA Pediatr 2016;170(7):662–70. Implications for practice and research The impact of nutrition on body weight should not be studied using single food items but instead dietary patterns and associated lifestyle behaviours. Recommendations for a healthy lifestyle should not be limited to one food or beverage. Context Artificially sweetened beverage (ASB) consumption is increasing among adults. The consequences of this consumption during pregnancy on the we...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Mullie, P., Clarys, P. Tags: Women ' s health and midwifery Source Type: research

Pregnancy-specific telephone support helps reduce maternal smoking
Commentary on: Cummins SE, Tedeschi GJ, Anderson CM, et al.. Telephone intervention for pregnant smokers: a randomized controlled trial. Am J Prev Med 2016;51:318–26. Implications for practice and research Proactive, pregnancy-specific telephone counselling added to an ongoing tobacco quitline can help prenatal smoking cessation and prevent relapse. Research should examine the factors that influence marginalised women to quit smoking during pregnancy and maintain long-term abstinence. Research should determine whether intervention effectiveness varies with cigarette dependence and motivation to quit. Context Tobacco ...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Koren, I. Tags: Open access, Pregnancy, Reproductive medicine, Health education, Smoking, Smoking cessation, Tobacco use Women ' s health and midwifery Source Type: research

Persistent long-term urinary incontinence post parturition
This study follows on from the authors' previous work, which identified and examined a high incidence of urinary incontinence as late as 6 years after... (Source: Evidence-Based Nursing)
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Walsh, I. K. Tags: Obesity (nutrition), Incontinence, Pregnancy, Reproductive medicine, Medical humanities, Health education, Obesity (public health) Women ' s health and midwifery Source Type: research

Ethical context of nursing research
Nursing research is held to the same ethical standards as all other research involving human participants. Nurses need to understand and apply ethical principles to their own research, as well as to the reading and review of research. The Declaration of Helsinki in 1964 is a statement about ethical principles, initially applied to medical research, but which now guides all types of research. Of the three core principles, the most important is ‘respect of persons’ where the participants' welfare takes precedence over interests of the researchers, society or science. Safeguards to participants are paramount and i...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Heale, R., Shorten, A. Tags: Sexual transmitted infections (bacterial), Editor's choice, Research made simple Source Type: research

Meeting the needs of families: facilitating access to credible healthcare information
EBN engages readers through a range of online social media activities to debate issues important to nurses and nursing. EBN Opinion papers highlight and expand on these debates. Background Following an increase in the use of the internet in everyday life, research has identified that individuals are increasingly turning to the internet as a means for identifying information about healthcare conditions.1 One study identified that 98% of parents surveyed used the internet to search for information about their child's condition.2 While the use of the internet as an information seeking source is not problematic in itself, a su...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Jordan, A., Chambers, C. Tags: EBN Opinion, Child health Source Type: research

Vital role of school nursing
Cuts in public health funding risk widening child health inequalities. A recent review by the Health Service Journal highlights children and young people are bearing the brunt of the cuts in local authority budgets,1 with school nursing services as a result being significantly reduced in many parts of the country. School nursing is a universally accessible service that is non-stigmatising, with school nurses having a key role in promoting the health and well-being of children and young people. Essentially, the school nurse functions as health promoter and health educator, working in collaboration with families, teachers, y...
Source: Evidence-Based Nursing - December 13, 2016 Category: Nursing Authors: Smith, F. Tags: Health policy, Immunology (including allergy), Epilepsy and seizures, Adolescent health, Child and adolescent psychiatry (paedatrics), Child health, Child and adolescent psychiatry, Asthma, Dermatology, Health service research Editorials Source Type: research

Nursing home staff should ensure that advance treatment decisions are discussed with residents and relatives
Commentary on: Bollig B, Gjengedal E, Rosland JH. They know!-Do they? A qualitative study of residents and relatives views on advance care planning, end-of-life care, and decision-making in nursing homes. Palliat Med 2016;30:456–70. Implications for practice and research Organisational policies for advance treatment decisions should be established. It is important to engage in advance treatment discussions within nursing homes. Communication arenas should be explored to promote advance treatment discussions. Study findings should be tested in other countries. Context The aim of this paper was to study the views of co...
Source: Evidence-Based Nursing - September 21, 2016 Category: Nursing Authors: Rietze, L. Tags: End of life decisions (geriatric medicine), Care of the older person, Pain (neurology), End of life decisions (palliative care), Hospice, End of life decisions (ethics) Source Type: research

Hypovitaminosis D predicts more rapid and severe cognitive deterioration in ethnically diverse older adults with and without dementia
Commentary on: Miller JW, Harvey DJ, Beckett LA, et al.. Vitamin D status and rates of cognitive decline in a multiethnic cohort of older adults. JAMA Neurol 2015;72:1295–303. Implications for practice and research Hypovitaminosis D precedes and predicts incident declines in episodic memory and executive function in older adults with and without baseline dementia. This finding encourages testing the efficacy of vitamin D supplementation to slow down, prevent or even improve cognitive decline. These findings should encourage clinicians to correct hypovitaminosis D in elderly patients. Context Hypovitaminosis D is a ru...
Source: Evidence-Based Nursing - September 21, 2016 Category: Nursing Authors: Noublanche, F., Annweiler, C. Tags: Care of the older person, Dementia, Stroke, Malnutrition, Memory disorders (psychiatry), Drugs: musculoskeletal and joint diseases Source Type: research

Subclavian site should be preferred for central venous access
Commentary on: Parienti JJ, Mongardon N, Mégarbane B, et al.., 3SITES Study Group. Intravascular Complications of Central Venous Catheterization by Insertion Site. N Engl J Med 2015;373:1220–9. Implications for practice and research Subclavian site should be preferred for central venous access (CVA) with a low risk of pneumothorax. Excluding patients before randomisation represents a selection bias. Post hoc sensitivity analysis may reduce the bias without fully balancing it. An adjudication committee, unaware of study-group assignments, may compensate for the absence of feasible blindness. Context Infection, ...
Source: Evidence-Based Nursing - September 21, 2016 Category: Nursing Authors: Mourvillier, B., Radjou, A., Timsit, J.-F. Tags: Health policy, Nursing issues, Drugs: infectious diseases, Drugs: cardiovascular system, Stroke, Ophthalmology, Venous thromboembolism, Health service research Source Type: research

Information gaps in medication communication during clinical handover calls for a different approach
This study by Braaf et al addresses the link between 2 of the 10 patient safety issues given prominence in the National Safety and Quality Health Service Standards1 introduced into the Australian health system in 2011: medication safety and clinical handover. ... (Source: Evidence-Based Nursing)
Source: Evidence-Based Nursing - September 21, 2016 Category: Nursing Authors: Redley, B. Tags: Nursing issues, Medical error/ patient safety Source Type: research

It is unclear if combined motivational interviewing and cognitive behavioural therapy improve medication adherence
Commentary on: Spoelstra SL, Schueller M, Hilton M, et al.. Interventions combining motivational interviewing and cognitive behaviour to promote medication adherence: a literature review. J Clin Nurs 2015;24:1163–73. Implications for practice and research Interventions in motivational interviewing (MI) and cognitive behavioural therapy (CBT) to enhance self-care and healthy behaviours, including the appropriate use of medication, should be implemented in practice. Future research should separately consider MI and CBT and their effect on medication adherence, ensuring the utilisation of a skilled cognitive behavioural...
Source: Evidence-Based Nursing - September 21, 2016 Category: Nursing Authors: Roles, S., Smith, H. Tags: Editor's choice, Nursing issues, Internet Source Type: research