Carrie Price

Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis.

BACKGROUND AND OBJECTIVE: Pneumonia is the leading cause of death of children. Diagnostic tools include chest radiography, but guidelines do not currently recommend the use of lung ultrasound (LUS) as a diagnostic method. We conducted a meta-analysis to summarize evidence on the diagnostic accuracy of LUS for childhood pneumonia. METHODS: We performed a systematic search in PubMed, Embase, the Cochrane Library, Scopus, Global Health, World Health Organization–Libraries, and Latin American and Caribbean Health Sciences Literature of studies comparing LUS diagnostic accuracy against a reference standard. We used a combination of controlled key words for age <18 years, pneumonia, and ultrasound. We identified 1475 studies and selected 15 (1%) for further review. Eight studies (765 children) were retrieved for analysis, of which 6 (75%) were conducted in the general pediatric population and 2 (25%) in neonates. Eligible studies provided information to calculate sensitivity, specificity, and positive and negative likelihood ratios. Heterogeneity was assessed by using Q and I2 statistics. RESULTS: Five studies (63%) reported using highly skilled sonographers. Overall methodologic quality was high, but heterogeneity was observed across studies. LUS had a sensitivity of 96% (95% confidence interval [CI]: 94%–97%) and specificity of 93% (95% CI: 90%–96%), and positive and negative likelihood ratios were 15.3 (95% CI: 6.6–35.3) and 0.06 (95% CI: 0.03–0.11), respectively. The area under the receiver operating characteristic curve was 0.98. Limitations included the following: most studies included in our analysis had a low number of patients, and the number of eligible studies was also small. CONCLUSIONS: Current evidence supports LUS as an imaging alternative for the diagnosis of childhood pneumonia. Recommendations to train pediatricians on LUS for diagnosis of pneumonia may have important implications in different clinical settings.

An Integrative Review of Engaging Clinical Nurses in Nursing Research.

PURPOSE To review the literature for best practices for engaging clinical nurses in nursing research. DESIGN Review of the research and nonresearch papers published between 2005 and 2015 that answered the evidence-based practice (EBP) question: what are the best practices for engaging clinical nursing staff in nursing research? METHODS PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Joanna Briggs Institute, and Cochrane were searched using a combination of controlled vocabulary and key words. Nineteen papers that answered the EBP question were selected for review. RESULTS It can be difficult to involve clinical nurses in research. There are multiple factors to consider when nursing leadership looks to engage clinical nurses in nursing research. CONCLUSIONS Nurse leaders can take many approaches to engage clinical nurses in research. Each organization must perform its own assessment to identify areas of opportunity. Nursing leadership can take these areas of opportunity to structure a multifaceted approach to support clinical staff in the conduct and dissemination of nursing research. CLINICAL RELEVANCE The evidence from this review offers EBP recommendations as well as reports on the gaps in the literature related to best practices for engaging clinical nurses in nursing research.

The Economic Impact of Adult Hearing Loss: A Systematic Review

Importance Hearing impairment (HI) is highly prevalent in older adults and has been associated with adverse health outcomes. However, the overall economic impact of HI is not well described. Objective The goal of this review was to summarize available data on all relevant costs associated with HI among adults. Evidence Review A literature search of PubMed, Embase, the Cochrane Library, CINAHL, and Scopus was conducted in August 2015. For this systematic review, data extraction and quality assessment were performed by 2 independent reviewers. Eligibility criteria for included studies were presence of quantitative estimation of economic impact or loss of productivity of patients with HI, full-text English-language access, and publication in an academic, peer-reviewed journal or government report prior to August 2015. This review follows the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. A meta-analysis was not performed owing to the studies’ heterogeneity in outcomes measures, methodology, and study country. Findings The initial literature search yielded 4595 total references. After 2043 duplicates were removed, 2552 publications underwent title and abstract review, yielding 59 articles for full-text review. After full-text review, 25 articles were included. Of the included articles, 8 incorporated measures of disability; 5 included direct estimates of medical expenditures; 8 included other cost estimates; and 7 were related to noise-induced or work-related HI. Estimates of the economic cost of lost productivity varied widely, from

Hearing Loss Treatment in Older Adults With Cognitive Impairment: A Systematic Review

1.8 to

Impact of Hearing Loss on Patient–Provider Communication Among Hospitalized Patients: A Systematic Review:

194 billion in the United States. Excess medical costs resulting from HI ranged from

Tips for Effective Literature Searching

3.3 to

Resources for Grading the Evidence, Appraisal, Writing, and Publishing

12.8 billion in the United States. Conclusions and Relevance Hearing loss is associated with billions of dollars of excess costs in the United States, but significant variance is seen between studies. A rigorous, comprehensive estimate of the economic impact of hearing loss is needed to help guide policy decisions around the management of hearing loss in adults.

Lung ultrasound for the diagnosis of pneumonia in adults: a systematic review and meta-analysis

Purpose The purpose of this systematic review was to assess studies of treating hearing loss in older adults with cognitive impairment. Of interest to this review is identifying clinical adaptations that may be used to tailor hearing loss treatment to older adults with cognitive impairment in order to better serve this vulnerable population. Method A systematic search with controlled vocabulary and key word terms was applied to PubMed, the Cochrane Library, Embase, CINAHL, and PsycINFO. Search concepts included terms related to hearing loss and cognitive impairment. The overall search resulted in 4,945 unique references, 50 of which were eligible for full-text review and 13 of which were included in the final review. Included manuscripts were categorized according to the American Speech-Language-Hearing Associations levels of evidence and the National Institutes of Health Quality Assessment Tools. Results Only 1 study implemented a randomized controlled trial design to assess cognitive function and behavioral symptoms after treatment with hearing aids. Other quasiexperimental studies evaluated dementia-related symptoms and/or auditory function after treating hearing loss in pre/post research designs. Finally, evidence from case studies suggested that hearing loss treatment is feasible, reduces stressful communication for caregivers, and improves dementia-related behavior problems. Conclusion Based on the systematic review, evidence suggests that treating hearing loss in persons with cognitive impairment can have benefits to communication and quality of life. Because of the quasi- and nonexperimental nature of most of the evidence found in this review, further studies are necessary to understand the effect of treatment in the context of a variable and progressive disease.

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Age-related hearing loss is a highly prevalent chronic condition in older adults, but hearing loss is rarely accounted for in patient–provider communication studies. This systematic review synthesizes current evidence on the impact of age-related hearing loss on patient–provider communication in hospitalized older adults. Five databases were queried to identify original research that examined patient–provider communication in older adults with hearing loss in an inpatient setting. Of 1053 studies, 13 were included in the final review. All studies reported an adverse effect of hearing loss on patient–provider communication. Among studies that evaluated an intervention to improve communication in older adults with hearing loss, simple interventions such as low-cost voice amplifiers were found to improve communication. An understanding of the effect of hearing loss on patient–provider communication and strategies to mitigate the impact are needed in order to provide safe, quality, patient-centered care to older adults with hearing loss.

Where in the World Is My Librarian? Creating Cross-Campus Collaborations to Seamlessly Connect with Students When Librarians, Students, and Faculty Are in Different Locations

Literature searching presents challenges for the searcher. It can be difficult to know how to start, which search terms to use, which databases to select, and whether to be comprehensive or very selective. In this chapter, we will explore ways to optimize results for your research purposes. We compare controlled vocabulary in PubMed and Embase and review how to combine controlled vocabulary terms with keywords. We will discuss Boolean operators and how to increase or decrease recall and precision, how to build and combine concepts formulated from a PICO question (PICO = Population or Problem, Intervention, Comparison/Control, Outcomes), and how to exclude unwanted results. We will also see how field tags/field descriptors can change the search and how they aid in finding citations and publications from specific journals or specific authors. We note how to search the reference list or index terms of very relevant articles. We will review how using Advanced Search functions and filters within each database will allow the searcher to limit by date, by language, by publication type, and more. Finally, we will discuss how to save and export relevant results to a bibliographic manager for future use and collaboration with others.