Role of nurse practitioners in cardiology

You can run a PubMed search by cutting and pasting the following into the PubMed search field:

(((“Women’s Health”[Mesh] OR (cardiology OR cardiac))) AND “Nurse Practitioners”[Majr]) AND “Nurse’s Role”[Mesh]

Selected resources:

The evolution of specialists in women’s health care across the lifespan: women’s health nurse practitioners

The past, present, and future of the advanced practice role in women’s healthcare.

Literature review of the impact of nurse practitioners in critical care services.

Optimal management of outpatients with heart failure using advanced practice nurses in a hospital-based heart failure center.

Patients with heart failure in primary health care: effects of a nurse-led intervention on health-related quality of life and depression.

Marketing new policies and procedures to nurses

Landrum, B J. “Marketing innovations to nurses, Part 2: Marketing’s role in the adoption of innovations.” Journal of wound, ostomy, and continence nursing 25.5 (1998):227-32.
“This article is the second in a two-part series concerning marketing techniques to enhance nurses’ adoption of innovations. Introducing and getting staff to implement new policies and procedures constitute an important part of the WOC nurse’s role. The application of Rogers’ Diffusion of innovation Theory provides WOC nurses with a framework to introduce innovations into the clinical setting and to change subsequent practice patterns. This article introduces the WOC nurse to marketing principles needed to successfully introduce a practice innovation to nurse colleagues; it also builds upon Rogers’ Diffusion of Innovation Theory and presents a sample marketing plan as a template for marketing innovations in the clinical setting.”

Landrum, B J. “Marketing innovations to nurses, Part 1: How people adopt innovations.” Journal of wound, ostomy, and continence nursing 25.4 (1998):194-9.
“This article is the first in a two-part series that explores marketing techniques to enhance nurse’s adoption of innovations in practice. Introducing new policies and procedures and persuading colleagues to implement them constitute an important part of the WOC nurse role. Nursing research reveals a lag of 8 to 30 years between the time new ideas are generated and nurses use them in practice. This article presents a theoretic grounding based on the Everett Rogers Diffusion of innovation Theory and uses the author’s experiences introducing a research-based practice innovation to illustrate concrete and practice-relevant examples of innovation adoption theory and marketing principles in action.”

Hospital discharge planning decision tools and algorithms.

To run the search, copy/paste this into PubMed: 

(((“patient discharge” OR “patient discharge”[MeSH] and (decision making OR “Decision Support Techniques”[Mesh])))) AND (“Outcome and Process Assessment (Health Care)”[Mesh] OR length of stay)

Selected articles include:

Coudeyre, E, et al. “Transcultural validation of the Risk Assessment and Predictor Tool (RAPT) to predict discharge outcomes after total hip replacement.” Annals of physical and rehabilitation medicine 57.3 (2014):169-84.

Hansen, Viktor J, et al. “Does the Risk Assessment and Prediction Tool predict discharge disposition after joint replacement?.” Clinical orthopaedics and related research 473.2 (2015):597-601.

Holland, Diane E, et al. “Developing and testing a discharge planning decision support tool for hospitalized pediatric patients.” Journal for specialists in pediatric nursing 19.2 (2014):149-61.

What evidence is there for using sterile saline/water instead of tap water for enteral/tube feeding flushes and/or free water for enterally fed patients?

CINAHL search with the following terms:

(enteral feeding OR tube feeding OR enteral nutrition OR feeding tube) AND (sterile OR saline OR water) AND (irrigation OR flush OR flushing)

Allen S. As a Flushing Agent for Enteral Nutrition, Does Sterile Water Compared to Tap Water Affect the Associated Risk of Infection in Critically Ill Patients?. Alabama Nurse [serial online]. March 2015;42(1):5-6. Available from: CINAHL, Ipswich, MA. Accessed June 1, 2015.

ASPEN Enteral Nutrition Practice Recommendations.” JPEN, Journal of Parenteral and Enteral Nutrition 33.2 (2009):122.

Enteral tube flushing.” American journal of nursing 105.3 (2005):58.

 

Standardization of nursing documentation and its effects on patient outcomes

Here is a search strategy that finds 13 articles in PubMed. Go here, click on PubMed, and run this search. Then you can click the Find It at Emory button within an article’s entry to see if Emory has full-text access for an article.

24885821[uid] OR 24313025[uid] OR 21517280[uid] OR 19998628[uid] OR 19181202[uid] OR 18840217[uid] OR 18165723[uid] OR 17430533[uid] OR 16183359[uid] OR 14767231[uid] OR 19207524[uid] OR 8648420[uid] OR 8987274[uid]

Here are three articles that state that standardized documentation improves patient outcomes. The others seem to only briefly mention that standardizing documentation may improve patient outcomes. However, they may give you ideas on how to best standardize documentation.

Huffman, Melinda H, and Jennie ACowan. “Redefine care delivery and documentation.” Nursing Management 35.2 (2004):34-8.

Müller Staub, Maria, et al. “Improved quality of nursing documentation: results of a nursing diagnoses, interventions, and outcomes implementation study.” International Journal of Nursing Terminologies and Classifications 18.1 (2007):5-17.

Müller Staub, Maria. “Evaluation of the implementation of nursing diagnoses, interventions, and outcomes.” International Journal of Nursing Terminologies and Classifications 20.1 (2009):9-15.

Use of Neutral Zone in the operating room

Recent publications support the use of the Hands-Free Technique, or Neutral Zone, for reducing surgical injuries, most of the evidence for this support comes from studies older than your 5-6 year window of interest.

For example DiGirolamo KM, Courtemanche DJ, Hill WD, Kennedy A, Skarsgard ED,’s “Use of safety scalpels and other safety practices to reduce sharps injury in the operating room: what is the evidence?” Can J Surg. 2013 Aug; 56(4):263-269. PMID 23883497 examines 5 articles reporting effects of hands-free technique. Four showed significant reduction in incidents, the fifth showed no change. However, the studies themselves were published in 1992, 2000, 2002, and 2009. Only the last meets your request for articles from the past 5-6 years.

• The 2009 study, Stringer et al.’s “Hands-free technique in the operating room: reduction of body fluid exposure and the value of a training video.” Public Health Rep. 2009 Ju-Aug;124 Suppl 1:169-79. PMID 19618819, found a 35% reduction in incidents (defined as percutaneous injury, glove tear, and contamination).

Similarly, Walijee JF, Malay S, and Chung KC. “Sharps Injuries: The Risks and Relevance to Plastic Surgeons” Plast Reconstr Surg. 2013 Apr;131(4): 784-91. PMID 23542251, claim an up to 60% reduction in incidents when using a neutral zone, but base this claim on the previously reported study done in 2002.

Another study, Jagger et al. “Increase in sharps injuries in surgical settings versus nonsurgical settings after passage of national needlestick legislation” J Am Coll Surg. 2010 Apr;210(4):496-502. PMID 20347743 shows data on the percentage of surgical incidents that occur during “passing/between steps” but does not comment on specific intervention reductions.

In short, with the one exception of Stringer et al.’s 2009 article studies on the efficacy of the Hands-Free Technique, or Neutral Zone, appear to be 10-15 years old. Such older studies include:
• Berguer R, Heller PJ. “Preventing sharps injuries in the operating room.” J Am Coll Surg. 2004 Sep;199(3):462-7. PMID 15325617 Review of available evidence, often cited as offers summary of 2000 and 2002 data.
• Stringer B, Infante-Rivard C, Hanley JA. “Effectiveness of the hands-free technique in reducing operating theatre injuries.” Occup Environ Med. 2002;59(10):703-707. Reports 59% reduction.
• Folin A, Nyberg B, Nordström G. “Reducing blood exposures during orthopedic surgical procedures.” AORN J. 2000 Mar; 71(3):573-6, 579, 581-2. Small sample size, reported significant reduction for “scrub people” not for “first assistants” or “surgeons.”