American Diabetes Association (ADA) 2006 Clinical Practice Guidelines

The American Diabetes Association recently published the 2006 standards in medical care for diabetes. They have been published in an entire supplement of Diabetes Care 29(1)

Evidence support the statements has been graded according to quality of scientific evidence supporting it. The grades range from A: clear evidence supported by RCTs, through E: expert consensus or clinical experience.

The supplement contains ADA’s "Standards of Medical Care in Diabetes," which is it's major position statement, and which contains all or key recommendations. In addition, they have published selected position statements on certain topics not adequately covered in the "Standards." These include:

• Standards of medical care in diabetes - 2006
• Diagnosis and classification of diabetes mellitus
• Diabetes care in the school and day care setting
• Diabetes care in correctional institutions

For the complete issue, go to Diabetes Care Volume 29 Supplement 1

2006 Childhood Immunization Schedule Update - AAP

Updated as of January 2006:

Recommended childhood and adolescent immunization schedule

AAP/AAFP/CDC

YSN Library January 30 - February 3January 27

These are the hours that I will be in the Nursing Library this week.
Questions, comments, concerns, please email me: janene.batten@yale.edu

Monday 1/30
8:30 - 5:00

Tuesday 1/31
Call Medical Library for assistance - 737-4065

Wednesday 2/1
1:30 - 5:00

Thursday 2/2
Call Medical Library for assistance - 737-4065
Class: 12:00-1:00 RefWorks Basics (TCC - Med Library)

Friday 2/3
9:30 - 5:00

All Library Classes

Contribution of qualitative research to evidence-based practice

"Applying the findings of qualitative research to practice is far from straightforward. This difficulty is often overlooked in the literature on the role of qualitative research in evidence-based practice. In this EBN notebook, [it is argued] that current attempts to provide guidance for clinicians do not accurately capture the specific and unique contribution of qualitative approaches. We will clarify the type of clinical questions for which qualitative research may provide appropriate answers and consider what the application of qualitative research findings to practice might mean. This analysis will result in guidance on the application of qualitative research findings to practice."

Newman, M., Thompson, C., & Roberts, A. P. (2006). Helping practitioners understand the contribution of qualitative research to evidence-based practice. Evid Based Nurs, 9(1), 4-7.

AHRQ's M&M Reports

The AHRQ publishes Morbidity & Mortality Rounds on the web. While reviewing these I noticed that the web page includes a Did You Know section. The DYK are represented by some form of graph. Some of the DYK include:

• Top seven barriers to implementing patient safety system
• Most common prescribing errors in long-term care facilities
• Physicians and nurses disagree on which clinical information technology would benefit patient safety.
• The vast majority of doctors and nurses believe that decision support technology will change medical practice in the next 5 years, but few actually use it now.
• Many adverse events attributed to inadequate nurse staffing.

Each DYK has a reference attached should you wish to read the original report.

SIDS (cot death) prevention guideline - AAP

New guidelines produced by the Task Force on Sudden Infant Death Syndrome say that in addition to "back to sleep," the American Academy of Pediatrics recommends eight other measures for minimizing risk of sudden infant death syndrome (SIDS, or cot death), joining the Netherlands and Germany in recommending pacifier (dummy) use.

The other measures are:

• Infants should sleep on their backs, not on their sides or stomach.
• The sleep surface should be a firm crib mattress, without other padding.
• Keep all loose bedding and soft objects out of the crib.
• Do not smoke during pregnancy.
• Infants should sleep in the same room, but not the same bed, as the mother. Bed sharing is not recommended.
• Consider offering a pacifier at nap time and bedtime. Avoid a pacifier in the first month of breastfeeding. Do not force a pacifier if the infant does not want it.
  
• Avoid overbundling and overheating.
• Avoid devices to prevent SIDS risk, since none have been tested for safety or effectiveness.
• Do not use home monitors (respiratory or cardiac), since they have not been shown to be effective at reducing risk of SIDS or identifying infants at high risk.

(Courtesy of Daily InfoPOEMS)

For the full article:
American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. The changing concept of sudden infant death syndrome: Diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics 2005; 116:1245-55.

After Schiavo: next issue for nursing ethics

"The purpose of this article is to anticipate the ethical issues for nurses in the care of patients who are not dying, and who have refused artificial hydration and nutrition through a living will."

Hall, JK. (2005). After Schiavo: next issue for nursing ethics. JONAS Healthc Law Ethics Regul. 2005 Jul-Sep;7(3):94-8.

HIV and Adolescent Girls

"The article presents an analysis of human immunodeficiency virus (HIV) risk behaviours and testing rates in adolescent girls. There are around eleven million cases worldwide with HIV infection, and the number of adolescents are the fastest growing group of persons newly diagnosed with HIV. The most recent epidemiological data from the U.S. Centers for Disease Control and Prevention indicate that 89% of all recent adolescent heterosexually acquired HIV infections through girls. The data also points out that the prevalence and incidence of HIV is disproportionately higher in Blacks than in Whites."

Morrison-Beedy, D., Nelson, L.E., Volpe, E. HIV Risk Behaviors and Testing Rates in Adolescent Girls: Evidence to Guide Clinical Practice. Pediatric Nursing, Nov/Dec2005, Vol. 31 Issue 6, p508.

YSN Library January 23 - January 27

These are the hours that I will be in the Nursing Library this week.
Questions, comments, concerns, please email me: janene.batten@yale.edu

Monday 1/23
8:30 - 5:00

Tuesday 1/24
Call Medical Library for assistance - 737-4065
Class: 3:00-4:00 Library 101 (TCC - Med Library)

Wednesday 1/25
10:00 - 5:00
Class: 5:00-6:00 RSS and Blogging (TCC - Med Library)
Class: 7:00-8:00 PowerPoint Basics (TCC - Med Library)

Thursday 1/26
Call Medical Library for assistance - 737-4065

Friday 1/27
8:30 - 4:30

All Library Classes

Database of Health Organizations - NIH/NLM

The Directory of Health Organizations (DIRLINE) is a directory of sources to go to when looking for information about a particular health and biomedicine condition.

The resources fall into many categories including federal, state, and local government agencies; information and referral centers; professional societies; self-help groups and voluntary associations; academic and research institutions and their programs; information systems; and research facilities.

Topics include HIV/AIDS, maternal and child health, most diseases and conditions including genetic and other rare diseases, health services research and technology assessment.

DIRLINE is maintained by the National Institutes of Health, and is one of their Specialized Information Services.

Avian Influenza - CDC information

The Centers for Disease Control and Prevention (CDC) has issued fact sheets about Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus

Also see the CDC's question and answer page about Avian Influenza.

Updated dietary recommendations: children and adolescents

The American Heart Association has published a consensus statement recommending dietary guidelines for children and adolescents. The basic premise of the recommendations is that the "diet that primarily relies on fruits and vegetables, whole grains, low-fat and nonfat dairy products, beans, fish, and lean meat".

A summary of the guideline can be found in the National Guidelines Clearinghouse.

To view the complete guideline:
Gidding SS, et al. Dietary recommendations for children and adolescents: a guide for practitioners: consensus statement from the American Heart Association. Circulation 2005 Sep 27;112(13):2061-75.

Annual Legislative Issues Update

In this month's issue of Nurse Practitioner is the annual update on legislative issues affecting advanced practice registered nurses (APRNs) across the country.

It is a highly regarded report for the nurse practitioner profession, as well as for regulatory agencies, state nurse practitioner associations, healthcare administrations, and state legislators.

See the full report:
Phillips, SJ (2006) Eighteenth Annual Legislative Update: A comprehensive look at the legislative issues affecting advanced nursing practice. Nurse Pract. Jan;31(1):6-11.

National Healthcare Disparities Report - 2005

The AHRQ has released the 2005 National Healthcare Disparities Report.

According to the recent AHRQ press report (1/9/06) the latest National Healthcare Disparities Report "finds that many of the largest disparities in measures of quality and access are observed for low-income people regardless of race or ethnicity, with some signs of improvement. Overall, more racial disparities in quality of care were narrowing than were widening, and most racial disparities in access to care were narrowing (affecting blacks, Asians and American Indians/Alaska Natives). But for Hispanics, the majority of disparities for both quality and access were growing wider."

NHDR Full Report

YSN Library January 16 - January 20

These are the hours that I will be in the Nursing Library this week.
Questions, comments, concerns, please email me: janene.batten@yale.edu

Monday 1/16
MLK Day

Tuesday 1/17
8:30 - 11:30

Wednesday 1/18
Call Medical Library for assistance - 737-4065

Thursday 1/19
1:00-4:00
Class: 11:30-12:30 PubMed Basics (TCC - Med Library)

Friday 1/20
8:30 - 4:30
Class: 1:00-2:00 RefWorks Basics (TCC - Med Library)

Library Classes

CDC Immunization Schedules

The CDC continually updates immunization schedules for people of all ages:

• Recommended adult immunization schedule
• Childhood and adolescent immunization schedule
• Childhood and adolescent catchup immunization schedule
  

YSN Library January 9 - January 13

These are the hours that I will be in the Nursing Library this week.
Questions, comments, concerns, please email me: janene.batten@yale.edu

Monday 1/9
9:30-11:30

Tuesday 1/10
Call Medical Library for assistance - 737-4065
Class: 4:00-5:00 EndNote Basics (TCC - Med Library)

Wednesday 1/11
Call Medical Library for assistance - 737-4065
Class: 5:00-6:00 RefWorks Basics (TCC - Med Library)

Thursday 1/12
12:30-4:30
Class: 3:00-4:00 EndNote Advanced (TCC - Med Library)

Friday 1/13
8:30 - 4:30

Library Classes

Meditation, Spirituality and the Elderly

"Recently, increased attention has been given to meditation-relaxation strategies to improve physical health, reduce pain, enhance immune response, improve emotional well-being, and foster spiritual growth. This article reviews research conducted in the last 25 years about meditation and spirituality, in particular as it relates to the health of the elderly. This review supports the hypothesis that meditation can be taught to the elderly, even those with dementia. The results also support the hypothesis that meditation and spiritual practices could promote significant social and emotional benefits for those in social isolation. Specific treatment plan interventions for nursing homes are discussed. Future research should investigate the effectiveness of various types of meditative and spiritual practices to nursing home residents."

To read the full article:
Lindberg DA. Integrative review of research related to meditation, spirituality, and the elderly.
Geriatr Nurs. 2005 Nov-Dec;26(6):372-7.

Executive walk rounds (EWRs)

Executive walk rounds (EWRs) are a widely used to improve safety culture in hospitals. This study measured the EWRs for 23 clinical units in a tertiary care teaching hospital in order to measure the impact of EWRs on one important part of safety culture.

The result of the study showed that EWRs have a positive effect on the safety climate attitudes of nurses who participate in the walk rounds sessions. EWRs are a promising tool to improve safety climate and the broader construct of safety culture.

To read the entire article:
Thomas EJ, Sexton JB, Neilands TB, Frankel A, Helmreich RL.The effect of executive walk rounds on nurse safety climate attitudes: a randomized trial of clinical units [corrected] BMC Health Serv Res. 2005 Apr 11;5(1):28. Erratum in: BMC Health Serv Res. 2005 Jun 8;5(1):4.

Nursing students' knowledge transfer to clinical situations

In a recent study by Tsai and Tsai, seventeen critical success factors were found to impact nursing students when transferring nursing knowledge during nursing clinical practise.
"This paper identified the CSFs that nursing students feel a nurse should have when transferring nursing knowledge in the practical training. Although they may have different perspectives towards each success factor, they agreed on the top 20-items that were regarded as success factors that influence the transformation of nursing knowledge. The most important factor for two groups was a deep respect for life."

Five of the factors are:

• Nursing students are cautious and respect for life
• Hospitals require nursing students to qualify with nursing knowledge
• Clinical instructors arrange reading reports
• Nursing students ask questions without hesitation
• Hospitals provide many nursing skills for nursing students to learn

The study explored the critical success factors in transferring nursing knowledge, as well as the impact of prior knowledge when evaluating the success factors for transferring nursing knowledge. To read the full article:

Tsai MT, Tsai LL. The critical success factors and impact of prior knowledge to nursing students when transferring nursing knowledge during nursing clinical practise. J Nurs Manag. 2005 Nov;13(6):459-66.

Latest National Healthcare Quality Report

The 2005 National Healthcare Quality Report (NHQR) is now available
(http://www.ahrq.gov/qual/nhqr05/nhqr05.htm)

"The 2005 NHQR includes 179 performance measures that can be used to
monitor the Nation's progress toward improved health care quality for
all Americans. This year's report focuses on a group of 46 "core"
measures representing the most important and scientifically sound
measures of quality."

 NHQR Full Report