Joanne Profetto-McGrath

Sources of Practice Knowledge Among Nurses

Several studies have been published listing sources of practice knowledge used by nurses. However, the authors located no studies that asked clinicians to describe comprehensively and categorize the kinds of knowledge needed to practice or in which the researchers attempted to understand how clinicians privilege various knowledge sources. In this article, the authors report findings from two large ethnographic case studies in which sources of practice knowledge was a subsidiary theme. They draw on data from individual and card sort interviews, as well as participant observations, to identify nurses’ sources of practice knowledge. Their findings demonstrate that nurses categorize their sources of practice knowledge into four broad groupings: social interactions, experiential knowledge, documents, and a priori knowledge. The insights gained add new understanding about sources of knowledge used by nurses and challenge the disproportionate weight that proponents of the evidence-based movement ascribe to research knowledge.

Emotional intelligence and nursing: An integrative literature review

AIM The purpose of this paper is to present findings of an integrative literature review related to emotional intelligence (EI) and nursing. BACKGROUND A large body of knowledge related to EI exists outside nursing. EI theory and research within nursing is a more recent phenomenon. A broad understanding of the nature and direction of theory and research related to EI is crucial to building knowledge within this field of inquiry. METHOD A broad search of computerized databases focusing on articles published in English during 1995-2007 was completed. Extensive screening sought to determine current literature themes and empirical research evidence completed in nursing focused specifically on emotional intelligence. RESULTS 39 articles are included in this integrative literature review (theoretical, n=21; editorial, n=5; opinion, n=4 and empirical, n=9). The literature focuses on EI and nursing education, EI and nursing practice, EI and clinical decision-making, and EI and clinical leadership. Research that links EI and nursing are mostly correlation designs using small sample sizes. CONCLUSION This literature reveals widespread support of EI concepts in nursing. Theoretical and editorial literature confirms EI concepts are central to nursing practice. EI needs to be explicit within nursing education as EI might impact the quality of student learning, ethical decision-making, critical thinking, evidence and knowledge use in practice. Emotionally intelligent leaders influence employee retention, quality of patient care and patient outcomes. EI research in nursing requires development and careful consideration of criticisms related to EI outside nursing is recommended.

The intellectual structure and substance of the knowledge utilization field: A longitudinal author co-citation analysis, 1945 to 2004

BackgroundIt has been argued that science and society are in the midst of a far-reaching renegotiation of the social contract between science and society, with society becoming a far more active partner in the creation of knowledge. On the one hand, new forms of knowledge production are emerging, and on the other, both science and society are experiencing a rapid acceleration in new forms of knowledge utilization. Concomitantly since the Second World War, the science underpinning the knowledge utilization field has had exponential growth. Few in-depth examinations of this field exist, and no comprehensive analyses have used bibliometric methods.MethodsUsing bibliometric analysis, specifically first author co-citation analysis, our group undertook a domain analysis of the knowledge utilization field, tracing its historical development between 1945 and 2004. Our purposes were to map the historical development of knowledge utilization as a field, and to identify the changing intellectual structure of its scientific domains. We analyzed more than 5,000 articles using citation data drawn from the Web of Science®. Search terms were combinations of knowledge, research, evidence, guidelines, ideas, science, innovation, technology, information theory and use, utilization, and uptake.ResultsWe provide an overview of the intellectual structure and how it changed over six decades. The field does not become large enough to represent with a co-citation map until the mid-1960s. Our findings demonstrate vigorous growth from the mid-1960s through 2004, as well as the emergence of specialized domains reflecting distinct collectives of intellectual activity and thought. Until the mid-1980s, the major domains were focused on innovation diffusion, technology transfer, and knowledge utilization. Beginning slowly in the mid-1980s and then growing rapidly, a fourth scientific domain, evidence-based medicine, emerged. The field is dominated in all decades by one individual, Everett Rogers, and by one paradigm, innovation diffusion.ConclusionWe conclude that the received view that social science disciplines are in a state where no accepted set of principles or theories guide research (i.e., that they are pre-paradigmatic) could not be supported for this field. Second, we document the emergence of a new domain within the knowledge utilization field, evidence-based medicine. Third, we conclude that Everett Rogers was the dominant figure in the field and, until the emergence of evidence-based medicine, his representation of the general diffusion model was the dominant paradigm in the field.

Increasing retention of new graduate nurses: a systematic review of interventions by healthcare organizations.

With the nursing shortage and the high incidence of turnover among new graduate nurses (NGNs) within the first year of employment, there is an increased need to investigate the effectiveness of retention strategies aimed at retraining NGNs. The purpose of this articled was to determine which organizational strategies increase the retention rates of NGNs. A systematic review of the research literature was conducted to examine published studies that focused on a retention strategy implemented to influence NGNs to stay in their place of employment. Data were extracted, and the quality of each study was assessed. Sixteen published studies were included in this review. Of these, 13 did not use true experimental study designs. Based on the studies with the strongest designs, the highest retention rates were associated with retention strategies that used a preceptor program model that focused on the NGN as well as a program length of 3 to 6 months. Evidence for the effectiveness of implementation strategies is limited; however, it is apparent from all the studies reviewed that implementing a retention strategy is effective for increasing retention rates of NGNs.

A Study of Critical Thinking and Research Utilization Among Nurses

Previous studies have suggested that critical thinking influences research utilization; however, empirical support for the link between critical thinking dispositions and research utilization is nonexistent. In this article, critical thinking dispositions and research utilization habits are detailed, and the relationship of critical thinking dispositions to research utilization in a sample of 141 nurses working on two acute surgical units and five pediatric units in four tertiary care hospitals are examined. Results indicate a significant positive correlation between the total critical thinking disposition score and overall research utilization. Overall critical thinking disposition correlates significantly with all forms of research utilization, with the exception of symbolic research utilization. These findings indicate a need to foster critical thinking in both nursing education and the work environment.

Defining the fundamentals of care.

Kitson A, Conroy T, Wengstrom Y, Profetto-McGrath J, Robertson-Malt S. International Journal of Nursing Practice 2010; 16: 423–434 Defining the fundamentals of care A three-stage process is being undertaken to investigate the fundamentals of care. Stage One (reported here) involves the use of a met a-narrative review methodology to undertake a thematic analysis, categorization and synthesis of selected contents extracted from seminal texts relating to nursing practice. Stage Two will involve a search for evidence to inform the fundamentals of care and a refinement of the review method. Stage Three will extend the reviews of the elements defined as fundamentals of care. This introductory paper covers the following aspects: the conceptual basis upon which nursing care is delivered; how the fundamentals of care have been defined in the literature and in practice; an argument that physiological aspects of care, self-care elements and aspects of the environment of care are central to the conceptual refinement of the term fundamentals of care; and that efforts to systematize such information will enhance overall care delivery through improvements in patient safety and quality initiatives in health systems.A three-stage process is being undertaken to investigate the fundamentals of care. Stage One (reported here) involves the use of a met a-narrative review methodology to undertake a thematic analysis, categorization and synthesis of selected contents extracted from seminal texts relating to nursing practice. Stage Two will involve a search for evidence to inform the fundamentals of care and a refinement of the review method. Stage Three will extend the reviews of the elements defined as fundamentals of care. This introductory paper covers the following aspects: the conceptual basis upon which nursing care is delivered; how the fundamentals of care have been defined in the literature and in practice; an argument that physiological aspects of care, self-care elements and aspects of the environment of care are central to the conceptual refinement of the term fundamentals of care; and that efforts to systematize such information will enhance overall care delivery through improvements in patient safety and quality initiatives in health systems.

An Inventory of Nursing Education Research

Purpose: To describe nursing education research literature in terms of quality, content areas under investigation, geographic location of the research, research designs utilized, sample sizes, instruments used to collect data, and funding sources.Design and Methods: Quantitative and qualitative research literature published between January 1991 and December 2000 were identified and classified using an author-generated Relevance Tool.Findings: 1286 articles were accepted and entered into the inventory, and an additional 22 were retained as references as they were either literature reviews or meta-analyses. Not surprisingly, 90% of nursing education research was generated in North America and Europe, the industrialised parts of the world. Of the total number of articles accepted into the inventory, 61% were quantitative research based. The bulk of the research was conducted within the confines of a course or within a program, with more than half based in educational settings. Sample sizes of the research conducted were diverse, with a bare majority using a sample between 50 and 99 participants. More than half of the studies used questionnaires to obtain data. Surprising, 80% of the research represented in these articles was not funded. The number of publications of nursing education research generated yearly stabilised at approximately 120 per year.Conclusion: Research programs on teaching and learning environments and practice in nursing education need to be developed. Lobbying is needed to increase funding for this type of research at national and international levels.

Clinical Nurse Specialists' Approaches in Selecting and Using Evidence to Improve Practice

UNLABELLED ABSTRACT Background: Evidence-based practice (EBP) has become the desired standard within all health disciplines because the integration of the best evidence into clinical practice is fundamental to optimizing patient outcomes. The valuing of research and research-based knowledge as the basis for decision making is explicit in current discourse in the health sciences. Despite the desires of proponents of EBP for use of evidence derived through research, nurses prefer to use knowledge derived from experience and social interactions. The clinical nurse specialist (CNS) is in the ideal position to act as a link between evidence and practice; however, a paucity of knowledge exists on how CNSs select and use evidence in their daily practice. PURPOSE The purpose of this descriptive, cross-sectional study was to examine the approaches used by CNSs to select and use evidence in their daily practice. METHOD A telephone survey, developed for this study from a pilot study conducted by the principal investigator (PI), was used to elicit responses from a purposive sample of CNSs living in a western Canadian province who were willing to be contacted for research, and who had practiced clinically as CNSs within the past year. A response rate of 75% (n = 94) was achieved. Descriptive statistics were used to describe and compare the variables of interest. RESULTS Literature tailored to particular specialties and personal experiences were reported as the most frequently accessed sources of evidence. This evidence was most often used to facilitate improvements in patient care, and least often used to develop further research proposals. CONCLUSION This study indicates that although CNSs select and use evidence from a wide variety of sources, further development of their capacity to retrieve and transfer knowledge may increase the uptake of research findings in nursing practice.

Interventions that promote retention of experienced registered nurses in health care settings: a systematic review

AIM The aim of this review was to report the effectiveness of strategies for retaining experienced Registered Nurses. BACKGROUND Nursing researchers have noted that the projected nursing shortage, if not rectified, is expected to affect healthcare cost, job satisfaction and quality patient care. Retaining experienced nurses would help to mitigate the shortage, facilitate the transfer of knowledge and provision of quality care to patients. EVALUATION A systematic review of studies on interventions that promote the retention of experienced Registered Nurses in health care settings. KEY ISSUES Twelve studies were included in the final analysis. Most studies reported improved retention as a result of the intervention. Team work and individually targeted strategies including mentoring, leadership interest and in-depth orientation increased job satisfaction and produced higher retention results. CONCLUSIONS Few published studies have examined interventions that promote the retention of experienced Registered Nurses in healthcare. Retention was highest when multiple interventions were used. Further research is needed to inform nurse leaders of ways to retain nurses and to maintain quality care in health care settings. IMPLICATIONS FOR NURSING MANAGEMENT AND LEADERSHIP Programmes targeting the retention of experienced nurses need to be considered when implementing measures to decrease the nursing shortage and its effects on quality care.

Mapping the Knowledge Utilization Field in Nursing from 1945 to 2004: A Bibliometric Analysis

BACKGROUND The field of knowledge utilization has been hampered by several issues including: the synonymous use of multiple terms with little attempt at definition precision; an overexamination of knowledge utilization as product, rather than a process; and a lack of progress to cross disciplinary boundaries to advance knowledge development. In order to address the challenges and current knowledge gaps in the knowledge utilization field in nursing, a comprehensive picture of the current state of the field is required. METHODS Bibliometric analyses were used to map knowledge utilization literature in nursing as an international field of study, and to identify the structure of its scientific community. FINDINGS Analyses of bibliographic data for 433 articles from the period 1945-2004 demonstrated three trends: (1) there has been significant recent growth and interest in this field, (2) the structure of the scientific knowledge utilization community is evolving, and (3) the Web of Science does not index the majority of journals where this literature is published. CONCLUSIONS In order to enhance the accessibility and profile of this literature, and nursings scientific literature at large, we encourage the International Academy of Nursing Editors to work collaboratively to increase the number of journals indexed in the Web of Science.