Janene Batten

This Blog has moved to new address

2006-03-21T13:06:00.000-05:00

My blog has moved ... a technical glitch was periodically affecting this blog -- whenever I posted a new blog, the posting would not show up.

So look up the new blog YSN Library for the latest in items of nursing interest.

Statistics

2006-02-13T06:08:00.000-05:00

Looking for statistics? Try the National Center for Health Statistics sponsored by the CDC.

Look for:

Fast Stats A-Z for quick reference alphbetically
State and territorial data
Search for stats on the topic you need

YSN Library February 13 - February 17

2006-02-10T09:41:00.000-05:00

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 2/13
11:00 - 5:00

Tuesday 2/14
Call Medical Library for assistance - 737-4065
Class: 10:00-11:00 PubMed Basics (TCC - Med Library)

Wednesday 2/15
Call Medical Library for assistance - 737-4065
Class: 5:00-6:00 RefWorks Basics (TCC - Med Library)

Thursday 2/16
Call Medical Library for assistance - 737-4065
Class: 4:00-5:00 Advanced Searching Techniques (TCC - Med Library)

Friday 2/17
8:30 - 12:00
Class: 12:30-1:30 Ovid Refresher (TCC - Med Library)
Class: 1:45-2:45 RefWorks Basics (TCC - Med Library)

All Library Classes

Is the Professional Code Still the Cornerstone of Clinical Nursing Practice?

2006-02-10T06:25:00.000-05:00

"Although codes of practice for those concerned with the health care of others have always been inherent in the structure of societies, they have been institutionalized within the nursing discipline since the end of the last century. Up until the early 1970s they promulgated subservience to the medical discipline. As a result of the processes of emancipation and professionalization, the philosophy of the nurse has come to contain concepts of autonomy, accountability and patient-advocacy, based on a personal and individualized care system. Research in recent years has shown that nurses are making morally sound and ethically acceptable choices based on their own decision-making abilities, whilst having little or no active knowledge of the existing professional codes. Based on the literature, the author discusses ethical codes in relation to their perception by nurses in the clinical situation. The influence of the code in the areas of moral decision-making, administration and management, and education are likewise discussed and the conclusion is reached that codes remain the cornerstone of nursing practice."

To read the full article:
Esterhuizen, P. (2006) Is the professional code still the cornerstone of clinical nursing practice?*. J Adv Nurs. 2006 Jan;53(1):104-10. PMID: 16422701

Spirituality and family nursing

2006-02-09T06:09:00.000-05:00

"The majority of published guidelines on spiritual assessment and interventions are designed predominantly for individuals. They fail to differentiate between individual and family spirituality or offer only brief discussions on family spirituality. Such guidelines are potentially problematic. They may lead nurses to focus only on individual spirituality and neglect to discern family unit spirituality or recognize the presence of conflicts in spiritual perspectives within the family."

"The aim of this paper is to propose a guideline for spiritual assessment and interventions explicitly for families, while considering each family member's unique spirituality.
Background. Spirituality's positive effect is."

To read the full paper:
Ruth A. Tanyi Spirituality and family nursing: spiritual assessment and interventions for families. J Adv Nurs. 2006 Feb;53(3):287-94.

Why is Nursing Research Not Implemented into Practice

2006-02-08T06:26:00.000-05:00

"This paper discusses a number of different levels at which the implementation of nursing research findings needs to be addressed and identifies 10 areas of potential difficulty:

the complexity of the change process
the genesis of research programmes
the formulation of research questions
differences in theoretical approaches
timescales and planning cycles
information overload
credibility
applicability
response to change
the management of change.

"An attempt is made to shift the nature of the discourse from the personal to the organizational and from a diffusionist perspective to that of change management. It is suggested that it is simplistic to regard the apparent lack of take-up of research-based practice findings as a failure on the part of individual nurses to respond rationally to the production of new information. The integration of research and practice has to be addressed at all levels within an organization; from policy statements to procedure manuals and from managers, educators and clinicians to support workers within the framework of the management of change. The potential of action research and quality circles in this context is touched on."

To read the full article:
Macguire JM. Putting nursing research findings into practice: research utilization as an aspect of the management of change*. 2006 Jan;53(1):65-71.

Critically Appraising Qualitative Research Evidence

2006-02-07T06:11:00.000-05:00

"As you review the Evidence-Based Practice (EBP) literature, you note the increasing number of qualitative research studies being published. Since you do not know as much about this methodology and how to critically evaluate it, you decide to find out what information is available to help you become more knowledgeable about this research method and how to critically appraise qualitative research reports."

This article by ME Duffy (Resources for critically appraising qualitative research evidence for nursing practice clinical question. Clin Nurse Spec. 2005 Nov-Dec;19(6):288-90) gives guidance on how to critically appraise the qualitative literature.

The article also cites a number of tools that can assist in the appraisal, including Critical Appraisal Checklist for an Article on Qualitative Research from the Department of General Practice, University of Glasgow Web site. The link in the refernence list does not work, so try this one instead ... Critical appraisal checklist for an article on qualitative research.

Another tool cited is also incorrectly linked ... so use this link instead. Giacomini M, Cook D. A User's Guide to Qualitative Research in Health Care. Centre for Health Evidence, University of Alberta; 2004.

Despite it's rocky citations, this article is a great start for discovering how to critically appriase qualitative literature.

For those of you that want to investigate the concpet of critically appraising qualitative literature look into this website The Qualitative Report for more details.

Failure To Thrive

2006-02-06T06:41:00.000-05:00

"Explaining failure to thrive (FTT) in dichotomous terms--organic versus non-organic --no longer applies in the context of modern pediatric nursing. FTT has turned out to be much more multifaceted. One infant's story illustrates the complexities and long-term ramifications of a pediatric feeding disorder and the challenges faced by health care professionals and families in their care. The story illustrates how physiologic, sensorimotor, and behavioral issues can all impact a child's inability to gain weight as expected. With greater understanding, pediatric nurses can appreciate their role as members of a multidisciplinary pediatric feeding disorder team. "

Locklin, M. (2005). The Redefinition of Failure To Thrive from a Case Study Perspective. Pediatric Nursing, Vol. 31 Issue 6, p474.

YSN Library February 6 - February 10

2006-02-03T13:13:00.000-05:00

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 2/6
8:30 - 5:00

Tuesday 2/7
Call Medical Library for assistance - 737-4065

Wednesday 2/8
10:30 - 5:00
C lass: 7:00-8:00 PowerPoint Basics (TCC - Med Library)

Thursday 2/9
Call Medical Library for assistance - 737-4065
C lass: 4:00-5:00 EndNote Basics (TCC - Med Library)

Friday 2/10
8:30 - 5:00

All Library Classes

Female Fetus More Likely to Cause Asthma Symptoms in Moms

2006-02-03T13:06:00.000-05:00

A study in the February American Journal of Epidemiology finds that pregnant women who are carrying a female fetus are more likely than those carrying a male fetus to experience more severe asthma symptoms.

Researchers from Yale University evaluated 702 pregnant women with asthma and measured lung function for 10 days at “selected points in their pregnancy.” The researchers found that throughout their pregnancies, women carrying male fetuses had 10% better lung function than women carrying female fetuses. Although the researchers are unsure why the sex of the fetus affects asthma and say more research is necessary, they speculate that testosterone secreted by male fetuses “may relax the mother’s airway tissue”.

Read the full article:

Helen L. Kwon, Kathleen Belanger, Theodore R. Holford, and Michael B. Bracken (2006)
Effect of Fetal Sex on Airway Lability in Pregnant Women with Asthma. American Journal of Epidemiology 163: 217-221.

Guideline Updates

2006-02-02T06:49:00.000-05:00

Here are some of the latest updates from the Institute for Clinical Systems Improvement

Assessment and management of chronic pain
Diagnosis and treatment of chest pain and acute coronary syndrome (ACS).(This updates a previously published guideline summary.)
Diagnosis of breast disease (This updates a previously published guideline summary.)
Prevention and management of obesity (mature adolescents and adults). (This updates a previously published guideline summary.)

State of the Union Address - 2006

2006-02-01T08:45:00.000-05:00

Here are some links to the President's State of the Union address given last night. Amongst other things of interest to the American public are his propsals for healthcare.

Official Whitehouse release of the Address
NPR has the Address broken down into excerpts with commentary about each section

See previous State of the Union addresses by G.W. Bush, W.J. Clinton, and G.H.W. Bush.

Each website has the opportunity to either listen and/or watch the Presenident's address.

American Diabetes Association (ADA) 2006 Clinical Practice Guidelines

2006-01-31T06:17:00.000-05:00

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:

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

2006 Childhood Immunization Schedule Update - AAP

2006-01-30T06:53:00.000-05:00

Updated as of January 2006:

Recommended childhood and adolescent immunization schedule

AAP/AAFP/CDC

YSN Library January 30 - February 3January 27

2006-01-27T19:49:00.000-05:00

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
C lass: 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

2006-01-27T06:09:00.000-05:00

"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

2006-01-26T06:37:00.000-05:00

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:

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

SIDS (cot death) prevention guideline - AAP

2006-01-25T09:03:00.000-05:00

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

2006-01-24T06:48:00.000-05:00

"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

2006-01-23T06:37:00.000-05:00

"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

2006-01-20T08:46:00.000-05:00

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
C lass: 3:00-4:00 Library 101 (TCC - Med Library)

Wednesday 1/25
10:00 - 5:00
C lass: 5:00-6:00 RSS and Blogging (TCC - Med Library)
C lass: 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

2006-01-20T06:28:00.000-05:00

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

2006-01-19T06:27:00.000-05:00

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

2006-01-18T06:28:00.000-05:00

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

2006-01-17T16:34:00.000-05:00

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

2006-01-17T06:12:00.000-05:00

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

2006-01-13T11:33:00.000-05:00

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

2006-01-09T06:02:00.000-05:00

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

YSN Library January 9 - January 13

2006-01-06T12:26:00.000-05:00

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

2006-01-06T06:14:00.000-05:00

"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)

2006-01-05T06:17:00.000-05:00

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

2006-01-04T06:02:00.000-05:00

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

2006-01-03T05:50:00.000-05:00

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

YSN Library January 2 - January 6

2005-12-23T13:28:00.000-05:00

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 1/2
University Recess - HAPPY HOLIDAYS

Tuesday 1/3
Call Medical Library for assistance - 737-4065

Wednesday 1/4
Call Medical Library for assistance - 737-4065

Thursday 1/5
Call Medical Library for assistance - 737-4065

Friday 1/6
8:30 - 4:30

Library Classes

AHRQ - Comparative Effectiveness Review

2005-12-22T07:34:00.000-05:00

Drugs can be as effective as surgery for management of gastroesophageal reflux disease (GERD), according to a new AHRQ report, "Comparative Effectiveness of Management Strategies for Gastroesophageal Reflux Disease."

The report is the first Comparative Effectiveness Review from AHRQ's new Effective Health Care Program that synthesizes and then compares alternative treatments for health conditions. GERD, one of the most common health conditions among older Americans, results in $10 billion annually in direct health care costs. The study compares treatment approaches for chronic uncomplicated GERD, where the condition is likely to require life-long management but does not involve more serious disease of the esophagus.

Read the AHRQ press release and the report.
Also see other Effective Health care topics in progress, as well as reports in draft form

Conscientious objection

2005-12-21T08:36:00.000-05:00

Do nurses have the right to refuse health care on the basis on conscience? Renece Waller-Wise give an interesting commentary about the ethics, legalities and standards, as well as the responsibilities of nurses and their employers in concientious objection.

To read the article:
Waller-Wise, R. Conscientious objection. Do nurses have the right to refuse to provide care?AWHONN Lifelines. 2005 Aug-Sep;9(4):283-6.

Antiperspirant Use and Breast Cancer

2005-12-20T07:57:00.000-05:00

The FDA is aware of concerns that antiperspirant use -- in conjunction with underarm shaving -- may be associated with increased risk of developing breast cancer. FDA continues to search scientific literature for studies examining this possible adverse drug effect. Unfortunately, there are many publications that discuss the issue but very few studies in which data have been collected and analyzed. Overall, the studies that contain data are inconclusive in determining whether antiperspirants, in any way, contribute to the development of breast cancer. FDA hopes that definitive studies exploring breast cancer incidence and antiperspirant use will be conducted in the near future.

For more information, go to http://www.fda.gov/oc/opacom/hottopics/antiperspirant.html.

Next Steps After a Diagnosis - Web Video

2005-12-19T15:36:00.000-05:00

AHRQ just released a short Web video called Next Steps After a Diagnosis, which features information from the recently released AHRQ publication of the same name to help patients who have been diagnosed with an illness to learn more about their condition and treatment options. It aims to help patients not only find information and resources but also deal with the various physical and emotional aspects of a diagnosis. The video provides individuals with important questions they should ask their doctor when they receive a diagnosis and information to help them understand their disease or condition, how it might be treated, and what they need to know before making treatment decisions.

The video is a great resource to share with those patients who may have difficulty reading English, or who prefer information delivered visually. The printed document that the video is based on is available in both English and Spanish.

YSN Library December 19 - December 23

2005-12-16T10:34:00.000-05:00

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

Monday 12/19
Call Medical Library for assistance - 737-4065

Tuesday 12/20
Call Medical Library for assistance - 737-4065

Wednesday 12/21
10:30 - 5:00

Thursday 12/22
8:30 - 4:30

Friday 12/16
University Recess - HAPPY HOLIDAYS

Library Classes

Happy Holiday Tips

2005-12-16T06:39:00.000-05:00

From the American Academy of Family Physicians:
Choosing Safe Toys

From the Centers for Disease Control and Prevention
Holidays the Healthy Way

From the Food and Drug Administration (FDA)
Tips to Prevent Foodborne Illness This Holiday Season

From the National Mental Health Association
Holiday Depression & Stress

From the National Safety Council
Holiday Season Safety

Courtesy of the AHRQ. For more from this agency ...

Look for evidence-based clinical practice guidelines in AHRQ's National Guideline Clearinghouse (NGC) (http://www.guideline.gov).
Look for practical, ready-to-use tools for measuring and improving the quality of health care in the Agency for Healthcare Research and Quality's (AHRQ's) QualityTools Web site (http://www.qualitytools.ahrq.gov).
or subscribe to AHRQ's Electronic Newsletter. Issued periodically as news warrants, AHRQ's Electronic Newsletter describes the results of AHRQ-funded studies, announces new print and electronic resources, updates the status of current funding opportunities, and much more. Subscribe (http://www.ahrq.gov/research/mar00/0300ra35.htm) to this free service.

FDA Patient Safety News Video - Online

2005-12-15T08:47:00.000-05:00

The FDA posts monthly editions of Patient Safety News. These are a Web-based video news programs aimed primarily at health professionals. There is a "search" tab that allows you to search for a particular video. If you want to see the entire list, just leave the field blank, and all previous topics will display. Alternatively, if you click the "view broadcasts" tab the entire list of topics is displayed.

Topics go as far back as 2002. The December program features information on new drugs, biologics, and medical devices, as well as FDA safety notifications and product recalls. Topics covered include the risk of suicidal thinking in children treated with the attention-deficit drug Strattera.

It's a great way to get information, in a creative way. Have fun!

Randomized Controlled Trials, Statistics and other Baffling Research Terminology Explained

2005-12-14T06:26:00.000-05:00

Linda Shields and Alison Twycross have put together a series of articles that simplify research terminology. The articles have been published over the past few years in Paediatric Nurse. Each article is a quick read explaining the concepts. They are worth the effort for initial concept understanding, as well as memory refreshers.

The articles include:

Personal and Electronic Health Records - Podcast

2005-12-13T15:22:00.000-05:00

AHRQ has released a two-part Newscast Special Report with AHRQ Director Carolyn M. Clancy, M.D., discussing personal and electronic health records. In the first part, released November 22, Dr. Clancy explains what personal health records include, how they differ from electronic health records, and how those records can help you in an emergency. In the second part, released November 29, she discusses the technology and how electronic health records can, and will, impact the quality of our health care. Select to listen to Part 1 and Part 2 of this audio newscast. You can hear them from your computer's speakers, or you can download them to any portable digital player.

Podcasting is a way of making a radio-type broadcast available on demand. Podcasts typically are downloaded from Web sites and played on your computer or on a portable media player such as an iPod®. More information about podcasting is available through the following Web sites: Wikipedia; Yahoo® Podcasts. If you are unable to listen to the Podcast, there is a link to allow you to view and print the transcript.

Reporting Clinical Trial Results

2005-12-13T09:50:00.000-05:00

Hayward RA, Kent DM, Vijan S, Hofer TP. Reporting clinical trial results to inform providers, payers, and consumers. Health Affairs (Millwood). 2005 Nov-Dec;24(6):1571-81.

This article gives a candid account of how the "the conventional approachto reporting clinical trials has fundamental flaws that canresult in overlooking identifiable subgroups harmed by a treatmentwhile underestimating benefits to others."

The reporting of some clinical studies can be biased in a number of ways: the perception of the researchers; and professional, political, and financial incentives. This report discusses the bias of "the desire to promote a beneficial treatment for use inas many people as possible".

The authors recommend that the evidence reported in the study can be greatly enhanced by ensuring that "whenever a multivariableprediction tool is available, the observed relative and absoluterisk reduction for subjects with higher versus lower predictednet benefit should be reported using risk-stratified analysis.

This discussion is a reminder that all research that reports clinical trials should be carefully analyzed for accuracy.

YSN Library December 12 - December 16

2005-12-12T10:03:00.000-05:00

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 12/12
Call Medical Library for assistance - 737-4065

Tuesday 12/13
Call Medical Library for assistance - 737-4065

Wednesday 12/14
1:30 - 5:00
Class: 5:00-6:00pm Scopus Features (TCC Medical Library)

Thursday 12/15
Call Medical Library for assistance - 737-4065

Friday 12/16
8:30 - 4:00

Other Library Classes

YSN Library November 7 - November 11

2005-11-04T15:38:00.000-05:00

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 11/7
8:30 - 2:00

Tuesday 11/8
Call Medical Library for assistance - 737-4065

Wednesday 11/9
10:00 - 2:00
Class: 2:00-3:00pm Refworks Basics (TCC Medical Library)

Thursday 11/10
Call Medical Library for assistance - 737-4065

Friday 11/11
12:00 - 5:00

Other Library Classes

Cancer Patients - Complementary and Alternative Therapies

2005-11-02T06:30:00.000-05:00

A recent edition of Seminars in Oncology Nursing (Vol21, Issue3) devoted it's content to complementary and alternative therapies for cancer patients.

The National Center for Complementary and Alternative Medicine (NCCAM) has developed a framework entitled “Major Domains of CAM” (complementary and alternative medicine*) which assists clinician and consumers in finding information. The NCCAM groups complementary and alternative medicine into four domains: biologically based practices, mind-body medicine, energy medicine, and manipulative and body-based practices. This issue of Seminars in Oncology Nursing includes information on each of these as well as articles focusing on education of nurses, future research, and resources for patients and clinicians including centers of excellence funded by NCCAM.

NCCAM is one of the centers that make up the National Institute of Health. It is dedicated to exploring complementary and alternative healing practices in the context of rigorous science, training complementary and alternative (CAM) researchers, and disseminating authoritative information to the public and professionals.

*A complementary therapy is an adjunct and support to a conventional medical intervention, and an alternative therapies is a replacement.

Disaster Planning

2005-11-01T09:55:00.000-05:00

The September issue of Nursing Clinics of North Americ a is devoted to disaster planning. This timely issue addresses concerns that are confronting us in our day to day lives. Topics discussed include:

Emergency preparedness: Concept development for nursing practice
The impact of disaster on culture, self, and identity: Increases awareness by health care professionals is needed
Disaster competency development and integration into nursing education
The role of the Nurse Practitioner in disaster planning and response
other articles

This issue provides a variety of articles that discuss many aspects of disaster health care. As the editor says " the professional nurse needs to be a driving force in better preparing the nation, one patient, organization, and community at a time."

YSN Library October 31 - November 4

2005-10-28T15:10:00.000-04:00

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 10/31
8:30 - 5:00

Tuesday 11/1
Call Medical Library for assistance - 737-4065

Wednesday 11/2
Call Medical Library for assistance - 737-4065
Class: 7:00-8:00pm PowerPoint Basics (TCC Medical Library)

Thursday 11/3
Call Medical Library for assistance - 737-4065
Class: 11:30-12:30pm RefWorks (TCC Medical Library)

Friday 11/4
8:30 - 5:00

Other Library Classes

Guideline Synthesis: Obesity in Children

2005-10-24T08:37:00.000-04:00

This synthesis entitled Overweight and obesity in children and adolescents: Assessment, prevention, and management took the guidelines proposed by:

American Academy of Pediatrics
American Heart Association
Registered Nurses Association of Ontario
Scottish Intercollegiate Guidelines Network
Singapore Ministry of Health, and
U.S. Preventive Services Task Force

and directly compared each of them for:

objectives and scope
target population
guideline's intended users
interventions and practices considered

The report then goes on the compare recommendations for:

assessment and classification of overweight/obesity
assessment of other risk factors
strategies for prevention of obesity
Management of Overweight and Obesity

The third table compares the benefits and harms from each guideline, and the last table explains the levels of evidence used for each guideline.

The National Guideline Clearinghouse regularly performs and posts Guideline Syntheses to its website. Other topics that might be of interest include Screening for Breast Cancer; Tobacco Use Cessation and Prevention; and Pharyngitis/Sore Throat.
The site also allow you to do your own guideline comparison.

YSN Library October 24 - October 28

2005-10-21T06:12:00.000-04:00

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 10/24
8:30 - 5:00
Class: 4:00-5:00pm EndNote Advanced (TCC Medical Library)

Tuesday 10/25
Call Medical Library for assistance - 737-4065

Wednesday 10/26
Call Medical Library for assistance - 737-4065
Class: 7:00-8:00pm PowerPoint Basics (TCC Medical Library)

Thursday 10/27
Call Medical Library for assistance - 737-4065

Friday 10/28
8:30 - 5:00
Class: 12:00-1:00pm RSS and Blogs (TCC Medical Library)

Other Library Classes

Summary of policy recommendations for periodic health examinations

2005-10-21T05:25:00.000-04:00

Link to these summaries of policy recommendations for periodic health examinations (by the American Academy of Family Physicians) listed on the National Guidelines Clearinghouse website. Included are summaries for:

Breast Cancer
Breastfeeding
Cardiac Disease
Coronary Heart Disease
Depression
Diabetes, Type 2
Family Violence and Intimate Partner Violence
Genital Herpes Simplex Virus Infection
Healthy Diet
HIV Infection
Hormone Replacement Therapy
Idiopathic Scoliosis in Adolescents
Lead Poisoning
Neural Tube Defects
Obesity
Pneumococcal Disease
Second Hand Smoke
Tobacco Use

Each of these recommendations, and many others listed at the website give a brief statement about the strengths of recommendation about screening for each condition.

Role of nurse administrators in the clinical setting

2005-10-20T08:00:00.000-04:00

This article discusses the role of the nurse administrator in the clinical setting.

Maintenance of professional standards
Evaluation of nursing practice
Selection of courses of action that promote professional growth and yet still ensure accountability to patients and the community.

"Nurse administrators are in ideal positions to address [the questions of professional standards, self-regulation, and self-discipline] and to create a moral climate that will affect positively the actual practice of the profession, its future, and its ethics."

Curtin, L.L., Arnold, L. (2005) A framework for analysis, part II. Nurs Adm Q. 2005 Jul-Sep;29(3):288-91.

EBP - The Magnet Pathway

2005-09-12T06:13:00.000-04:00

Kathleen Hudson, in her article From research to practice on the magnet pathway describes how develop a structure within the hospital environment that uses evidence-based practice (EBP) to establish best practices. She describes the four components:

EBP steering committee
EBP committee and specialty focus teams
nursing policy and procedure committee
nursing research committee

With each of these in place, the organization is most likely to foster an environment of ongoing staff development and ultimately attract high quality nurses to this professional environment. To fully embrace this requires "supportive leadership, facilitative library and literature resources, paid time away from the bedside seeking new research, and supported implementation of findings into practice through local change agents."

Hudson, K (2005). From research to practice on the Magnet pathway. Nurs Manage. 2005 Mar;36(3):33-7.

YSN Library September 12 - September 16

2005-09-09T06:50:00.000-04:00

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 9/12
8:30 - 5:00
Class: 5:00-6:00pm RSS and Blogs (TCC Medical Library)

Tuesday 9/13
Call Medical Library for assistance - 737-4065

Wednesday 9/14
Call Medical Library for assistance - 737-4065

Thursday 9/15
Call Medical Library for assistance - 737-4065
Class: 11:00-12:00pm RefWorks Basics (TCC Medical Library)
Class: 12:15-1:15pm Ovid Refresher (TCC Medical Library)

Friday 9/16
8:30 - 5:00
Class: 10:00-11:00pm RefWorks Basics (TCC Medical Library)
Class: 11:15-12:15pm Ovid Refresher (TCC Medical Library)

Other Library Classes

Are US Nurses Ready for EBP?

2005-09-07T06:45:00.000-04:00

Evidence-based practice is not just the domain of physicians, but a very important part of the role of nurses.

A study recently published in AJN exmines nurses' perceptions about their skill level in accessing the tools available for EBP as well as their access to these tools.

Study findings concluded that nurses acknowldege that they need information for effective practice but:

they are not prepared to use information resources available to them
have little or no training in how to use resources
did not understand the value of research
are generally unprepared for a practice built on evidence

Some of this can be attributed to technological changes, as well as nursing program's failure to prepare students for an evidence based practice, and the principals that are involved in EBP.

The article concludes that RNs in the United States are not prepared for EBP. The authors call for a paradigm change in nursing education programs. They also recommend that nursing administrators lobby within their organizations for resources, time, and training to support and integrate evidence based research into practice.

Pravikoff D.S. et al. Readiness of U.S. Nurses for Evidence-Based Practice: Many don't understand or value research and have had little or no training to help them find evidence on which to base their practice. Am J Nurs. 2005 Sep;105(9):40-51.

Evidence Based Practice

2005-09-06T06:28:00.000-04:00

"Evidencebased medicine (EBM) is a systematic approach to clinical problemsolving which allows the integration of the best available researchevidence with clinical expertise and patient values."

The use of EBM has become the tenet of practitioners in all areas of medicine.

This recent journal article series gives a clear and concise overview of the principles of EBM. Discussion centers on:

the 5-step EBP model
understanding randomised controlled trials
understanding systematic reviews and meta-analysis
evidence in practice

Akobend A.K. Principles of evidence based medicine. Arch Dis Child. 2005 Aug;90(8):837-40.

YSN Library September 6 - September 9

2005-09-02T06:43:00.000-04:00

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 9/6
University Holiday

Tuesday 9/7
2:30 - 5:00

Wednesday 9/8
8:30 - 5:00
Class: 4:00-5:00pm RefWorks Basics (TCC Medical Library)

Thursday 9/9
Call Medical Library for assistance - 737-4065
Class: 1:00-2:00pm EndNote Basics (TCC Medical Library)

Friday 9/10
Call Medical Library for assistance - 737-4065

Other Library Classes

Web-based Clinician Education

2005-09-01T06:46:00.000-04:00

It seems that if you're not offering it in web-based format, your just not cutting edge!

The AHRQ, National Safety Foundation, and the Medical College of Wisconsin have created patient safety materials that are accessed via the web. Materials are focused on the different constituents including physicians, nurses, and patients, each with their own website.

The nursing topics include:

an ethical imperitive
changing the system and the culture
breaking down barriers
impact of a close call reporting system
learning from error
resporting error and follow-up
the proactive approach to error
health literacy
technology and the nurse
implications of the patient safety movement
staffing
geriatric nursing
home healthcare

We may have seen it before, but this is a very creative format. Well worth clicking through!

For other National Patient Safety Organisation information see their Patient Safety Resources web page.

Getting down to business

2005-08-31T06:26:00.000-04:00

You've sat through the orientation, you've heard what's expected of you, and you're ready to go.

Here are some tips that may help you make the most of your study time.

Collegeboard.com recommends that you come up with a plan to study when you are not in class. Don't leave it to chance. It's also good to develop study habits early.

College Study Tutor Guide has a 5-step plan that might interest you: survey; motivation; reading; recall; review.

The Dartmouth Academic Skills Center have a Where to Study/How to Study webpage with some great links. And here's some Study Skills Self Help from Virginia Tech.

Most of all I really liked the advice from Woman Student Online: "Everyone works best with positive reinforcements, so make sure you reward yourself for your accomplishments."

Take the advice you suits you most, then find a the nearest coffee shop, or wherever you feel comfortable, and relax. You're on the road to success!

Salary Survey

2005-08-30T06:10:00.000-04:00

Salary Survey 2005 was published in the July issue of Nursing Management. This is the seventh annual salary survey and includes data submitted by educators, case managers and nurse managers.

Most of the respondents had their BSN, but 22% had their MSN, 11% had a masters degree in another field, and 2% have their doctoral degree. Finding show that those with their doctoral degree continue to earn the top salaries (just under $100,000). Worthy of note is that people with their nonnursing masters earn more than colleagues, about $85,000. And it does seem that those who work a 60+ hour work week will be rewarded with the higher salaries.

This is a very interesting report, and well worth reviewing.

Hader R. (2005) Salary survey 2005. Nurs Manage. 2005 Jul;36(7):18-27.

Welcome

2005-08-29T06:22:00.000-04:00

Greetings to new students, and welcome back to returning students.

It seems that you are not alone as you end your summer and return to school. Apparently there are 16.7 million of you. And over 37% are over 25 years of age. According to this Back-To-School facts report, the rewards will be worth it. Congratulations on a good decision!

According to the Bureau of Labor Statistics, your profession has one of the highest future job growths. Congratulations again! Now I know it says registered nurses, but I am not sure the Bureau knows that you are here now and will be a driving force in the profession.

We know that you are here because you want to make a difference. If there is anything that the Library staff can do to help make it easier for you, please ask.

From the Medical Library staff, we wish you a great year.

YSN Library August 1 - August 5

2005-07-29T15:34:00.000-04:00

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

Monday 8/1
8:30 - 4:00

Tuesday 8/2
Call Medical Library for assistance - 737-4065
Class: 3:30 - 4:30 EndNote Basics (TCC - Med Library)

Wednesday 8/3
8:30 - 1:30

Thursday 8/4
Call Medical Library for assistance - 737-4065

Friday 8/5
8:30 - 5:00

For all other Classes go to Library Classes

Antimalarial Agents in Africa

2005-07-27T08:43:00.000-04:00

Another great audio interview in the NEJM this week.

Arrow KJ, Gelband H, Jamison DT. Making Antimalarial Agents Available in Africa. N Engl J Med. 2005 Jul 6

The Africa Malaria Report 2003 prepared by UNICEF shows that Africa's population carries the largest burden of malaria cases in the world, and the barrier to treating those that have the disease is cost. It's no wonder, with Africa being home to come of the poorest of poor in the world. And now, across Africa, malaria has become resistant to chloroquine - the cheaper antimalarial. The alternative - artemisinins which are widely used in Asia, and very expesive by comparison.

The solution propoes by the Institute of Medicine is to "allow subsidies to enter at a high internationallevel — at the top of the distribution chain. ... The drugs would then flow down to the endusers through the same pathways as chloroquine now does, withthe requisite profit margins being taken where the private sectornow operates. If these drugs start at a very low price whenthey enter the supply chain and if their supply is adequate,the price to consumers should be about the same as the currentprice of chloroquine."

Read the story, or listen to the interview, it's heartbreaking.

National Guidelines Clearinghouse - Updated Guidelines

2005-07-26T15:41:00.000-04:00

The following new/updated information was posted to the NGC Web site the week of July 25, 2005.

National Collaborating Centre for Nursing and Supportive Care
Infection control. Prevention of healthcare-associated infection in primary and community care.

Veterans Health Administration
VHA/DoD clinical practice guideline for the diagnosis and management of hypertension in the primary care setting. (This updates a previously published guideline summary.)

Guideline Synthesis
The Overweight and Obesity in Children and Adolescents  (has been updated to include recommendations from the Registered Nurses Association of Ontario)

More Guidelines in Progress

Tour de Lance

2005-07-25T08:26:00.000-04:00

"Sunday July 24 is Lance Armstrong Day. It marks the end of an era. His achievements can never be repeated. " Lance Armstrong has defied the odds and won his 7th Tour de France in as many years.

You've seen the action, you've watched the brilliance, you've cheered the champion. Now read about how he does it. Dr. Edward Coyle published an article in the June issue of Journal of Applied Physiology describing how Lance's ability to win is as a result of an 8% improvement in muscular efficiency when cycling, as well as large reductions in body weight and body fat during the months before the race. The article is the result of a seven-year study conducted at the University of Texas's Human Performance Laboratory.

And the proof is in the riding ...
Tour de France 2005
Fact: During the first eight days over 1,300km were raced at over 47km/h (29.20 mph)!
Fact: [Lance] set a record for a time trial, completing the opening stage at 54.676km/h (33.974 mph) – the fastest ever in the Tour.
Fact: Armstrong and his colleagues established another record: the quickest team time trial ever – 67.5km (41.88miles) at 57.324km/h (35.619 mph).
Lance lives strong.

Coyle, EF. Improved muscular effi ciency displayed as Tour de France champion matures.J Appl Physiol. 2005 Jun;98(6):2191-6. Epub 2005 Mar 17.

YSN Library July 25 - July 29

2005-07-22T06:25:00.000-04:00

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

Monday 7/25
8:30 - 4:00

Tuesday 7/26
Call Medical Library for assistance - 737-4065
Class: 1:00-2:00 RefWorks Basics (TCC - Med Library)
Class: 4:00 - 5:00 EndNote Advanced (TCC - Med Library)

Wednesday 7/27
8:30 - 5:00
Class: 5:00 - 6:00 RSS and Blogs (TCC - Med Library)

Thursday 7/28
Call Medical Library for assistance - 737-4065

Friday 7/29
8:30 - 5:00

For all other Classes go to Library Classes

AHRQ - Quality Tools Update

2005-07-19T10:01:00.000-04:00

The QualityTools Web site, sponsored by the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services.  Listed below are some updates.  For a complete list of the tools go to Quality Tools.

Early Child Development in Social Context: A Chartbook http://www.qualitytools.ahrq.gov/summary/summary.aspx?view_id=1&doc_id=7219 This chartbook contains more than thirty key indicators of development and health for children ages zero to six along with social factors in the family and neighborhood that affect these outcomes.
Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes. Summary, Evidence Report/Technology Assessment http://www.qualitytools.ahrq.gov/summary/summary.aspx?view_id=1&doc_id=7291 To address gaps in knowledge about perinatal depression, the Agency for Healthcare Research and Quality (AHRQ), in collaboration with the Safe Motherhood Group (SMG), commissioned this evidence report from the RTI International-University of North Carolina's (RTI-UNC's) Evidence-based Practice Center (EPC) for a systematic review of the evidence on three questions related to perinatal depression. These questions address the prevalence and incidence of perinatal depression, the accuracy of screening instruments for perinatal depression, and the effectiveness of interventions for women screened as high risk for developing perinatal depression.
Learn the Signs. Act Early. Interactive Tool for Parents: Milestones Chart http://www.qualitytools.ahrq.gov/summary/summary.aspx?view_id=1&doc_id=7322 This interactive tool allows parents and caregivers to view how a developmental milestone category (social and emotional, cognitive, or language) changes as a child grows.

YSN Library July 18 - July 22

2005-07-15T13:10:00.000-04:00

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

Monday 7/18
2:00 - 4:00

Tuesday 7/19
Call Medical Library for assistance - 737-4065
Class: 5:00-6:00pm Advanced Searching (TCC Medical Library)

Wednesday 7/20
11:30 - 5:00
Class: 4:30-5:30pm PowerPoint Basics (TCC Medical Library)

Thursday 7/21
Call Medical Library for assistance - 737-4065
Class: 1:00-2:00pm EndNote Basics (TCC Medical Library)

Friday 7/22
8:30 - 10:00

Other Library Classes

HIV Screening Recommendations

2005-07-15T06:58:00.000-04:00

The U.S. Preventive Services Task Force released new recommendation s on HIV screening. The Task Force recommends that all pregnant women, not just those considered at high risk, be screened for the virus that causes AIDS because testing has proven so successful at helping prevent the spread of the disease to babies.

Scientific advances in treating HIV have changed the 1996 recommendations that screening all pregnant women was of no benefit. More accurate HIV testing during pregnancy and new treatments for HIV have been shown to be safe and effective for mothers and infants and may reduce the number of infants born with the disease.

In addition to its recommendations about pregnant women, the Task Force also reaffirmed its recommendation that adolescents and adults at increased risk for HIV be tested. The Task Force broadened its definition of high risk to include those getting care at homeless shelters or clinics specializing in the care of sexually transmitted diseases.

The recommendations were published in the July 5 Annals of Internal Medicine. Select to read the AHRQ press release.

Lack of Evidence for Screening for Childhood Obesity

2005-07-14T06:54:00.000-04:00

The U.S. Preventive Services Task Force is urging pediatricians not to focus only on height and weight in determining whether a child is overweight.

In a new recommendation, the Task Force found insufficient evidence that screening children for overweight provides any benefit. Leading groups of family doctors and pediatricians endorse routine screening using the height-weight ratio of the Body Mass Index. But there's no evidence that all children with high BMIs need to lose weight to be healthy-and there's no evidence that pediatricians' weight counseling results in weight loss and better health. BMI can be fairly effective at identifying children who have weight problems, said Task Force member Virginia Moyer, M.D. But it can't determine if body mass is mostly fat or lean tissue, and not all children with high BMIs need to lose weight, said Moyer, a pediatrics professor at the University of Texas Health Science Center in Houston. Dr. Moyer recommends that doctors investigate rapid increases in weight that are not accompanied by increases in height.

Select to read the recommendation.

The recommendation is published in the July issue of Pediatrics.

AHRQ - 2005 Guide to Clinical Preventive Services

2005-07-13T15:47:00.000-04:00

AHRQ released the Guide to Clinical Preventive Services 2005, which highlights current recommendations from the U.S. Preventive Services Task Force.

These evidence-based recommendations for clinicians address preventive services, which include screening tests, counseling, and preventive medications for adults and children in the primary care setting. The guide contains recommendations that have been adapted for a pocket-size book, making it easier for clinicians to consult the recommendations in their daily practice. THe Guide can also be viewed, and printed, at the AHRQ website. Recommendations are presented in an indexed, easy-to-use format, with at-a-glance charts. Recommendation statements and supporting statements from the Task Force are available on the AHRQ Web site.

Read the press release and select to download a copy of the guide.
A print copy of the guide is available by sending an e-mail to ahrqpubs@ahrq.gov.

Becoming an Advanced Practitioner in Neonatal Nursing

2005-06-21T06:51:00.000-04:00

This recently published article discusses the results of a study of the relationship between educational preparation and role development of neonatal nurses.

The aims of this research were to identify

the educational and working experiences and
subsequent training needs of graduates of one ANNP course in the UK

The objectives were

to assess the medium to long-term impact of the training programme on the professional development of the respondents;
identify potential areas of excellence and
areas for improvement in this and other training programmes for ANNPs

The results were:

attention needs to be paid to ongoing professional development particularly the management of professional role relationships among all nurses and between nurses and doctors
training need to be relevance to clinical practice
focus on professional role relationships and more effective communication in the clinical setting would be of benefit to all members of multi-disciplinary teams
greater level of day-to-day support is required for ANNPs, other neonatal nurses and junior doctors if this is to be achieved, especially in clinical settings where there are few ANNPs or the addition of these clinical specialists is relatively new.

Read the full report:
Nicolson P, Burr J, Powell J. Becoming an advanced practitioner in neonatal nursing: a psycho-social study of the relationship between educational preparation and role development.
J Clin Nurs. 2005 Jul;14(6):727-38.

Conscience and Refusing to Deliver Care

2005-06-20T06:17:00.000-04:00

Dr. Charo discusses the challenge that clinicians face when torn between their professional obligation to deliver care, and the conflict of that professionalism with her or his own moral inclinations.

Read this perspective
R.A. Charo The Celestial Fire of Conscience — Refusing to Deliver Medical Care N Engl J Med. 2005 Jun 16;352(24):2471-3.

And listen to Dr. Charo's commentary:
An Audio Interview with Professor R. Alta Charo

YSN Library June 20 - June 24

2005-06-17T05:49:00.000-04:00

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

Monday 6/20
8:30 - 5:00
Class: 1:00-2:00pm EndNote Basics (TCC Medical Library)

Tuesday 6/21
Call Medical Library for assistance - 737-4065

Wednesday 6/22
8:30 - 5:00
Class: 5:00-6:00pm RefWorks Basics (TCC Medical Library)

Thursday 6/23
Call Medical Library for assistance - 737-4065

Friday 6/24
Call Medical Library for assistance - 737-4065

JCAHO Releases 2006 Patient Safety Goals

2005-06-17T05:02:00.000-04:00

JCAHO recently announced its 2006 National Patient Safety Goals, retaining the same six goals from 2005 while adding three new requirements and removing three others.

Additions include

"New Requirement in all of the programs that "hand-offs" of patients between caregivers be standardized, with particular attention to assuring the opportunity for asking and responding to questions"
"New Requirement for all types of accredited organizations which provide surgical or other invasive services, specifies that all medications, medication containers and other solutions used in perioperative settings are to be labeled"
New Goals in other selected programs address the prevention of pressure ulcers and encourage the active involvement of patients and their families in the patient's care as a patient safety strategy

"The following requirements will be retired for all applicable accrediation programs in 2006:

Elimination of the Requirement to remove concentrated electrolytes (including but not limited to potassium chloride, potassium phosphate, sodium chloride greater than 0.9 percent) from patient care units. This Requirement will continue to exist in relevant accreditation manuals.
Retirement of a Requirement to ensure free-flow protection on all general-use and patient-controlled analgesia intravenous infusion pumps used in an organization. Compliance with this Requirement has been greater than 99 percent, and equipment manufacturing and availability issues for all health care setting have been satisfactorily resolved."

Full text of the 2006 Goals and Requirements can be found at the JCAHO site.

Oral Bacteria Can Cause Premature Deliveries

2005-06-16T05:58:00.000-04:00

A recent study published in the Journal of Clinical Periodontology finds that there is a link between oral bacteria and pre-term deliveries and low birth weight.

The study was conducted with 297 low-income and predominantly African-American women in Alabama who were pregnant for the first time and found that those with high levels of certain oral bacteria had an increased risk of delivering prematurely and having babies with low birth weights. While such bacteria has been previously linked to pneumonia, heart disease, and diabetes, scientists say the new link between gum disease and pre-term delivery is the “strongest” to date. The study’s lead researcher says pregnant women should be encouraged to regularly visit a dentist and maintain good oral hygiene

To find out more, read the study:
Moreu, Gerardo, Téllez, Luís & González-Jaranay, Maximino (2005) Relationship between maternal periodontal disease and low-birth-weight pre-term infants. Journal Of Clinical Periodontology 32 (6), 622-627.

NIH Public Access Policy

2005-06-15T06:15:00.000-04:00

As of May 2, 2005, the National Institutes of Health issued its “Policy on Enhancing Public Access to Archived Publications Resulting from NIH-Funded Research” (known as the NIH Public Access Policy). The policy requests that all NIH-funded investigators submit to PubMed Central (PMC) an electronic version of the author’s final manuscript, upon acceptance for publication. This policy applies to any journal articles resulting from research supported in whole or in part with direct costs from NIH. The manuscript is defined as the final version accepted for journal publication and includes all modifications from the publishing peer review process.

The NIH sees this policy as a mechanism to help them not only monitor and archive the output of research funded by NIH, but also ensure the availability of research results for the benefit of the public, health care providers, educators, and scientists.

To assist in understanding this policy the Medical Library has created a web page with information about the Public Access Policy and guides to help you through the process.

Portable Patient Medical Information Storage

2005-06-14T06:02:00.000-04:00

Portable USB devices can now be used to store personal medical information. There are several versions including MedicAlert, Med-Info Chip and MedicTag that store general medical information, such as personal identification data, emergency contacts, and even photos. They also store information about prior and present medical conditions, allergies, immunizations, and prostheses. In addition, documents can be scanned into the UBS device, such as EKG results, birth certificates, and X-rays.

The devices are literally a thumb drive that can be plugged into any computer in order to access the medical information. The chip currently is not password-protected, but one developer from Boston University, is working on a dual password system that would allow clinicians to access the information in an emergency but prevent changes from being made. It is thought that having the device password protected would hinder doctors accessing the information in times of emergency.

The device developed in Boston comes in "garish yellow", can hang on your key chain, and sells for around $70 for a single user version, and $100 for a double-user version. The device is perfect for medical emergencies where clinicians can plug it in and retrieve data otherwise unknown about the patient.

The military have employed an Electronic Information Carrier (EIC) that give medics in the field fast access to a patient's history, and do not have the luxury of paper copies of records. Unlike the device developed in Boston, the military use a wireless device that is read by a handheld. In the event that there is no wireless signal, the EIC can be plugged in to the handheld just as the USB device can.

YSN Library June 13 - June 17

2005-06-10T08:51:00.000-04:00

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

Monday 6/13
8:30 - 5:00
Class: 5:00-6:00 RefWorks Basics (TCC - Med Library)

Tuesday 6/14
Call Medical Library for assistance - 737-4065
Class: 12:00-1:00 Library 101 Basics of Library Use (TCC - Med Library)

Wednesday 6/15
Call Medical Library for assistance - 737-4065

Thursday 6/16
8:30 - 5:00

Friday 6/17
8:30 - 5:00

Managing Conflict at the End of Life

2005-06-09T08:45:00.000-04:00

Great audio article in theis week's NEJM.

M. Gregg Bloche, M.D., J.D., Managing Conflict at the End of Life. N Engl J Med 2005;352(23):2371-3

Read the perspective and listen to the audio.

Dr. Bloche is a professor of law at Georgetown University and a guest scholar at the Brookings Institution, both in Washington, D.C., and an adjunct professor at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore.

YSN Library June 6 - June 10

2005-06-03T06:16:00.000-04:00

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

Monday 6/6
8:30 - 3:00

Tuesday 6/7
Call Medical Library for assistance - 737-4065
Class: 5:00-6:00 EndNote Basics (TCC - Med Library)

Wednesday 6/8
8:30 - 5:00

Thursday 6/9
Call Medical Library for assistance - 737-4065

Friday 6/10
8:30 - 5:00

Combined Tetanus, Diphtheria, and 5-Component Pertussis Vaccine

2005-06-02T06:04:00.000-04:00

Increasing reports of pertussis among US adolescents, adults, and their infant contacts have stimulated vaccine development for older age groups. A intramuscular 0.5 ml dose of either Tdap or tetanus-diphtheria vaccine (Td) was given to adolescents and adults aged 11 - 64 years.

Conclusions "This Tdap vaccine elicited robust immune responses in adolescents and adults to pertussis, tetanus, and diphtheria antigens, while exhibiting an overall safety profile similar to that of a licensed Td vaccine. These data support the potential routine use of this Tdap vaccine in adolescents and adults."

This is an early release article found in JAMA.
Read the entire article:
Pichichero, Michael E. et al. Combined Tetanus, Diphtheria, and 5-Component Pertussis Vaccine for Use in Adolescents and Adults JAMA published 2 June 2005

The Emotional State and The MRI: What's Love Got To Do With It?

2005-05-31T13:39:00.000-04:00

A news item in todays New York Times reports that researchers studying brain patterns of people who are newly in love, have seen "the neural activity associated with romantic love alters slightly, and in some cases primes areas deep in the primitive brain that are involved in long-term attachment".

"In the study, a computer-generated map of particularly active areas showed hot spots deep in the brain, below conscious awareness, in areas called the caudate nucleus and the ventral tegmental area, which communicate with each other as part of a circuit." It is in the caudate nucleus that was particularly active in people who measured highly in a questionnaire measuring passionate love. What is interesting is that this part of the brain is on the opposite side that registers physical attractiveness. It does appear to be involved "in longing, desire and the unexplainable tug that people feel toward one person, among many attractive alternative partners."

Read the article:
Arthur Aron, Helen E Fisher, Debra J Mashek, Greg Strong, Hai-fang Li, and Lucy L Brown Reward, Motivation and Emotion Systems Associated with Early-Stage Intense Romantic Love J Neurophysiol, May 2005; 10.1152

Informatics Competencies

2005-05-25T10:47:00.000-04:00

I came across the following article in my readings the other day that made me sit up and think.

Curren, C. Informatics competencies for nurse practitioners. AACN Clin Issues. 2003 Aug;14(3):320-30.

It discusses the informatics competencies that are essential for advanced level nurse education and practice. It is a landmark document, authored by a faculty member at Columbia University School of Nursing. She, along with two nurse informaticists and six nurse practitioners developed the proposed competencies. Prior to its publication, competencies in this area had not been defined and validated. They had been defined for general levels of nursing practice, but not for the level of students that we see here at YSN.

This is the earlier article defining competencies for general levels of nursing practice:
Staggers N. etal. A Delphi study to determine informatics competencies for nurses at four levels of practice. Nurs Res. 2002 Nov-Dec;51(6):383-90.

One of the most interesting aspects of the Curren article is that the panel had omited some of the earlier competenices because they are assumed as clinicians progress in their career. Those competencies added relate to Evidence Based Practice. Going forward these competencies need to be addressed at the level of education of the clinicians who are taking on advanced level nursing roles. This is because currently nurse managers in hospitals are playing catch-up, eager to understand the principals that were not part of their education, anxious because of the implications if they don't.

It is great food for thought.
It is easy to read.
The tables enable a quick glance at the competencies.

YSN Library May 23 - May 27

2005-05-20T04:40:00.000-04:00

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

Monday 5/23
Call Medical Library for assistance - 737-4065

Tuesday 5/24
Call Medical Library for assistance - 737-4065

Wednesday 5/25
8:30 - 5:00

Thursday 5/26
Call Medical Library for assistance - 737-4065

Friday 5/27
8:30 - 5:00

Statistics - H-CUPnet

2005-05-19T06:41:00.000-04:00

Need to get some statistics? Browse around the AHRQ's statistics tool where you can design your own criteria for the statistic set that you need.

What is HCUP?
The Healthcare Cost and Utilization Project (HCUP, pronounced "H-cup") is a family of health care databases and related tools that can assist you to synthesize the data. It is based on statewide data collected by individual data organizations across the United States and provided to AHRQ.

It includes the largest collection of longitudinal hospital care data in the United States, encompassing all-payer, discharge-level information.

Databases that can be found include:

Nationwide Inpatient Sample (NIS)
State Inpatient Databases (SID)
State Ambulatory Surgery Databases (SASD)
State Emergency Department Databases (SEDD)
Kids' Inpatient Database (KID)

The website includes reports, news and events, and even has a link for technical assistance (my kind of page!).

Here is the link to the page if you haven't already linked to it: http://hcup.ahrq.gov/HCUPnet.asp

Guidelines and Standards Update

2005-05-18T05:10:00.000-04:00

Updates and new Guidelines: National Guideline Clearinghouse
For a full list, go to the National Guidelines Clearinghouse "What's New This Week"

Special treatment situations: pediatric migraine. Standards of care for headache diagnosis and treatment.  (National Headache Foundation)

Treatment of primary headache: patient education. Standards of care for headache diagnosis and treatment.  (National Headache Foundation)

Nasotracheal suctioning - 2004 revision & update.(This updates a previously published guideline summary.)(American Association for Respiratory Care)

Metabolic measurement using indirect calorimetry during mechanical
ventilation - 2004 revision & update. (This updates a previously published guideline summary.)

Guidelines for the management of chronic kidney disease in HIV-infected patients (Infectious Diseases Society of America (IDSA))

Pediatric Medication Errors

2005-05-17T06:08:00.000-04:00

Medication errors in children can be far more harmful that errors in adults. According to a recent article children that are most at risk for medication errors include those:

who are younger than two years.
who are in ICUs, especially neonatal ICUs
who are in EDs, especially if seriously ill, between the hours of 4 AM and 8 AM or on weekends
who are receiving chemotherapy
who are receiving IV medication
whose weight hasn’t been documented

This article includes information about calculating the right dosage for children using weight based method, body surface area, status of prematurity, and dilution. It also give indepth commentary on how to avoid medication errors including knowing the medication that is to be administered, confirming that the right patient is receiving the medication, double checking orders, minimizing distractions when administering medications, and communicating with parents/caregivers throughout the child's care.

Even if this topic is very familiar to you, this article is well worth reviewing.

Hughes RG, Edgerton EA. Reducing Pediatric Medication Errors: Children are especially at risk for medication errors. Am J Nurs. 2005 May;105(5):79-84

Unique Value of Highly Educated Nurses

2005-05-16T05:36:00.000-04:00

American Organization of Nurse Executives (AONE) is promoting the issue of having a more highly educated workforce. They believe that "that education has a direct impact on the skills and competencies of a nurse clinician." Evidence is also becoming available "which underscores the importance of baccalaureate nursing education to safe patient care and quality outcomes." This is a position that is has been long advocated by the AACN.

Read the American Association of Colleges of Nursing (AACN) Postion Statement: The Baccalaureate Degree in Nursing as Minimal Preparation for Professional Practice

American Association of Colleges of Nursing (AACN) Fact Sheet: The Impact of Education on Nursing Practice

American Association of Colleges of Nursing (AACN) Press Release: AACN Applauds New Study that Confirms Link Between Nursing Education and Patient Mortality Rates

YSN Library May 16 - May 20

2005-05-13T15:18:00.000-04:00

I will be away at a conference this week. Please contact the reference desk with any questions 737-4065, or email the reference desk by going to this web page.
http://www.med.yale.edu/library/ref/ask.html

Monday 5/16
Call Medical Library for assistance - 737-4065

Tuesday 5/17
Call Medical Library for assistance - 737-4065

Wednesday 5/18
Call Medical Library for assistance - 737-4065

Thursday 5/19
Call Medical Library for assistance - 737-4065

Friday 5/20
Call Medical Library for assistance - 737-4065

Support for first time mothers

2005-05-12T08:09:00.000-04:00

The results of a study about the support that first-time mothers received and how it related to their confidence in care fo their infant.

"This paper reports a study whose primary aim was to explore the relationship between social support for first-time mothers and their confidence in infant care practices. A secondary aim was to identify their sources of support in the postnatal period."

Results of the study showed that new mothers that received "appraisal support" had a statistically significant moderate relationship with confidence in infant care practices. Those mothers that received "nformational support" had a weaker but statistically significant relationship.

Primarily, "appraisal support" came from partners and their own mothers, while "informational support" came from public health nurses and mothers.

The study concluded that "first time mothers' husbands/partners need to become active participants in antenatal and postnatal care. Interdisciplinary educational programmes need to be developed so that public health nurses and midwives work collaboratively in facilitating social support for first-time mothers in caring for their infants. Curricula for public health nurses and midwives need to be evidenced-based with respect to social support."

Leahy, Warren P. First-time mothers: social support and confidence in infant care. J Adv Nurs. 2005 Jun;50(5):479-88.

QuickStats: Primary Contraceptive Methods Among Women

2005-05-11T07:25:00.000-04:00

Here are some statistics from the National Center for Health Statistics.

Primary Contraceptive Methods Among Women Aged 15-44 Years - United States, 2002

QuickStats: Primary Contraceptive Methods Among Women Aged 15-44 Years--United States, 2002: JAMA 2005;293 2208.

Merits of Personalized Discharge Teaching

2005-05-10T06:06:00.000-04:00

A study published in Circulation adds to the increasing body of literature showing that focused predischarge education given to individuals improves patient outcomes. Patients who received this attention, in the form of one-hour predischarge education required fewer hospital readmissions, conducted better self-care and incurred lower health care costs than patients who received routine discharge instructions.

In this study, discharge education included the nurse educator delivering a 60-minute, one-on-one teaching session. The nurse educator gave a Power Point presentation developed by the study’s authors that addresses 50 heart failure topics, ranging from causes to symptom management. Amongst other things, patients had their individual questions answered, and also received a copy of CHF treatment guidelines “written in layman’s terms”.

Ultimately, the authors note, the costs of medical care are significantly reduced for the patient when the time is taken to do this additional discharge care.

Todd M. Koelling, Monica L. Johnson, Robert J. Cody, and Keith D. Aaronson. Discharge Education Improves Clinical Outcomes in Patients With Chronic Heart Failure. Circulation, Jan 2005; 111: 179 - 185.

APN Nursing Roles

2005-05-09T06:10:00.000-04:00

Despite the growing demand for advanced practice nurses, there is limited published information to guide the successful implementation and optimal utilization of these staff.

This paper provides a participatory, evidence-based, patient-focused process, for guiding the development, implementation, and evaluation of advanced practice nursing (APN) roles. It is well worth the read.

Bryant-Lukosius, Denise & DiCenso, Alba (2004). A framework for the introduction and evaluation of advanced practice nursing roles. Journal of Advanced Nursing 48 (5), 530-540.

YSN Library - May 9 - May 13

2005-05-06T08:29:00.000-04:00

Here is the schedule for when I will be at YSN for this week. Questions, comments, concerns? .... please email me janene.batten@yale.edu

Monday 5/2
8:30-12:30
Class: 1:00-2:00 RefWorks (TCC - Med Library)

Tuesday 5/3
Call Medical Library for assistance - 737-4065

Wednesday 5/4
8:30-5:00

Thursday 5/5
Call Medical Library for assistance - 737-4065

Friday 5/6
8:30-5:00

Preparing for an Influenza Pandemic

2005-05-05T07:40:00.000-04:00

This commentary in today's New England Journal of Medicine is using the science of the Internet to it's fullest!

Listen to an audiocast of an interview from Dr. Michael Osterman about preparing for an influenza pandemic. This is courtesy of NEJM and is a supplement to the article Osterholm MT. Preparing for the Next Pandemic. N Engl J Med 2005;352(18):1839-42. When you are finished listening, NEJM give also gives you the opportunity to view an interactive figure showing the proposed mechanism of the cytokine storm evoked by the influenza virus.

Isn't this the best use of internet technology? You have to be just slightly impressed! If I had copyright clearance I could download it to my palmOne (or iPod) and listen to it there. The technology is there, we just have to use it!

Dr. Osterholm is the director of the Center for Infectious Disease Research and Policy, the associate director of the National Center for Food Protection and Defense, and a professor of public health at the University of Minnesota, Minneapolis. Rachel Gotbaum, the interviewer, is an independent producer based in Boston.

Barriers to Patient Centered Care

2005-05-05T06:30:00.000-04:00

Hospitals have developed tools that allow patients to give feedback about the standards of care during their hospital stay. When patients give negative evaluations it is sometimes difficult for hospital administrators to know how to respond.

The authors of the study Overcoming the barriers to patient centered care believe that nursing staff are acutely aware of the deficits in standards of care that are reported by patients. The authors believe that nursing staff can provide the hospital with information about the organization, management, and resourcing of care that can be used to improve patients' experiences.

The study is well worth the read.

West, E., Barron, D. N., & Reeves, R. (2005). Overcoming the barriers to patient-centred care: Time, tools and training. Journal of Clinical Nursing, 14(4), 435-443.

RefWorks - New Direct Export From Ovid

2005-05-04T09:16:00.000-04:00

Ovid has streamlined the process for getting your citations from any of its databases into Refworks.

After selecting the records you would like in in your RefWorks database, use the Direct Export option in the Results Manager. Then press save. If your RefWorks account is already open the citations will be directly imported in. If RefWorks is not open, the window will open, just sign in and then the citations will automatically be imported in.

Need more help? Just let me know.

JAMA and NEJM this week

2005-05-04T08:42:00.000-04:00

There are a number of articles that might be of interest to you in this weeks issue of JAMA (April 28, 2005).

And an image in NEJM that might be of interest

Image of the Week: Painless Loss of Vision after Vomiting in a 24 year-old who was 30 weeks pregnant

For full table of contents for click journal names of each.