Michele Farrington

Worksite Physical Activity Intervention for Ambulatory Clinic Nursing Staff

Health behaviors, including physical activity (PA), of registered nurses (RNs) and medical assistants (MAs) are suboptimal but may improve with worksite programs. Using a repeated-measures crossover design, the authors explored if integrating a 6-month worksite non-exercise activity thermogenesis (NEAT) intervention, with and without personalized health coaching via text messaging into workflow could positively affect sedentary time, PA, and body composition of nursing staff without jeopardizing work productivity. Two ambulatory clinics were randomly assigned to an environmental NEAT intervention plus a mobile text message coaching for either the first 3 months (early texting group, n = 27) or the last 3 months (delayed texting group, n = 13), with baseline 3-month and 6-month measurements. Sedentary and PA levels, fat mass, and weight improved for both groups, significantly only for the early text group. Productivity did not decline for either group. This worksite intervention is feasible and may benefit nursing staff.

Evidence Into Practice: Integration Within an Organizational Infrastructure

OPERATIONALIZING A SHARED GOVERNANCE structure creates important improvements in professional practice. Having a shared governance structure is certainly not new; the University of Iowa Hospitals and Clinics has had nursing shared governance since 1975. Effective governance structures are essential for clinicianled organizational improvements and are key to structural empowerment. Building evidencebased practice (EBP) into a governance structure is one strategy for promoting an organizational culture valuing and expecting evidence-based care.

Oral Care for Head and Neck Cancer Symptom Management

&NA; An evidence-based practice change at a radiation oncology center in a large academic medical center was designed to reduce the severity of oral mucositis in adults receiving radiation treatment for head and neck cancer. In the intervention described, patients were given newly created oral care kits and educational materials to improve their oral hygiene. Evaluations were conducted at three points during the project (before radiation treatment, during week 4 to 5 of treatment, and one month after treatment). At week 4 to 5—when the severity of oral mucositis is expected to peak—patients reported improved oral hygiene practices and reduced oral mucositis severity. The authors conclude that the use of these oral care kits and educational materials lessened the effects of oral mucositis during and after radiation treatment.