Karin T. Kirchhoff

Using the journal club as a component of the research utilization process

Although journal clubs are recommended for research utilization, the various ways in which journal clubs are conducted do not always lead to research utilization. Major institutional changes in practice must be preceded by a comprehensive literature search and a complete review. An example is provided of how a series of journal clubs using the comprehensive search approach led to research utilization.

Research activities of clinical nurse researchers

A nationwide telephone survey was carried out on 34 nurses employed as researchers in clinical settings (CNRs). CNRs reported current involvement in over 200 projects with a range from 1 to 29 projects. Projects were categorized into the following types: clinical practice, nursing administration, evaluation, education, or methodology. Almost half (47%) of the projects were in clinical practice. Type of involvement in research was used as a basis for conceptualizing the CNRs role as traditional scientist, associate, or facilitator. Results are discussed regarding the variations found in how the CNR role is enacted across settings and the focus of the research in which CNRs are engaged.

Clinical nurse researchers: strategies for success.

One response to nursings growing commitment to grounding practice in a research base has been the development of clinical nurse researcher positions in hospitals throughout the country. Drawing on data from a nationwide survey, the authors describe goals and strategies that clinical nurse researchers and their chief nurse executives identify as contributing to successfully carrying out the clinical nurse researcher role.

Evaluation of scheduled J-pouch irrigations on decreasing stool frequency after ileoanal pull-through and ileostomy closure

This study was intended to determine whether J-pouch irrigations through the efferent limb of the protective ileostomy stoma after ileoanal pull-through are effective in decreasing high stool frequency after ileostomy closure. Patients undergoing ileoanal pull-through may have high stool frequency after ileostomy closure. J-pouch irrigations through the efferent ileostomy stoma may decrease stool frequency by increasing J-pouch volume, improving storage capacity. The study used a randomized, prospective design in a university hospital outpatient setting. Participants (N = 58) were randomly assigned to control and experimental groups. Effectiveness of irrigation was determined by stool frequency. Both groups were taught Kegel exercises (anal muscle strengthening exercises). The experimental group was taught how and when to irrigate the J-pouch daily; the control group was not. Forty-seven subjects, 25 men and 22 women ranging in age from 15 to 65 years, completed the study. Results of MANOVA indicated no significant between-group difference in the average number of times that subjects performed Kegel exercises; however, there was a significant decrease during the 4-week study period (p < 0.001). There was no significant difference between groups in stool frequency, which decreased with time. There also was no significant effect on nocturnal leakage or satisfaction with surgical outcome. Additional clinical variables that were measured but had no significant effect included eating late, pouch size, and intake of sugar, fiber, bulk-forming products, and antidiarrheal agents. The study did not support the effectiveness of J-pouch irrigation in decreasing stool frequency after ileostomy closure. The cost, time commitment, and burden of performing daily irrigations are not warranted in this patient group.

Productivity of nurse researchers employed in clinical settings.

With limited resources, there is increased scrutiny of the contributions of leadership staff, such as nurse researchers employed in the clinical setting (NRECS). The authors describe activities that pertain to research, presentations, publications, and procurement of funds for studies. Major obstacles that impede NRECS from achieving their goals, job performance evaluation and indices (staff, organization, and personal) that NRECS use to determine success in enacting their role also are presented.

Fixed-interval v as-needed analgesics in cancer outpatients

Abstract Many health professionals advocate medicating cancer patients in pain with fixed-interval analgesic schedules, but there is little research to support this approach. A pilot study in cancer outpatients was conducted to test the hypothesis that patients randomized to fixed-interval schedules of oral narcotic analgesics would report lower pain intensity than patients randomized to as-needed schedules. Twelve patients were randomized to fixed-interval and eight to as-needed schedules. They were followed for five consecutive days, recording amount and time they took analgesics, and rating pain intensity three times daily on a 10 cm visual analogue scale. A one-way repeated measures analysis of variance revealed no differences between the two groups of patients. Possible explanations for the findings include small sample size, unreliable measures of pain intensity, inadequate analgesic doses or intervals, or individual characteristics of the pain experience. Further research must address methodologic and measurement problems involved in the study of pain and its management to clarify the issue of analgesic scheduling in cancer outpatients.

Financial Management Series: A Comprehensive Charge System for Unit Supplies

Various methods of capturing charges for supplies stocked on nursing units have been devised, such as stickers and charge slips attached to the items. Effectiveness and efficiency were not maximized through these methods. A new system customized for each unit showing daily patient charges per patient provides for an audit of inventory and for lost charges. Items from both pharmacy and central supply are included. Charge capture is maximized with relative ease for the nursing staff.