Publications by authors named "Sharon Tucker"

79 Publications

CE: Nurses Are More Exhausted Than Ever: What Should We Do About It?

Am J Nurs 2021 12;121(12):18-28

Alison M. Trinkoff is a professor at the University of Maryland School of Nursing, Baltimore. Carol M. Baldwin is professor emeritus and a Southwest Borderlands Scholar at Arizona State University's Edson College of Nursing and Health Innovation, Phoenix. Eileen R. Chasens is a professor and chair of the Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, where Jacqueline Dunbar-Jacob is dean and a distinguished service professor and Christopher C. Imes is an assistant professor. Now retired, at the time of this writing Jeanne Geiger-Brown was a professor and associate dean for research at the George Washington University School of Nursing, Washington, DC. Carol A. Landis is a professor emeritus at the University of Washington School of Nursing, Seattle. Patricia A. Patrician is a professor and the Rachel Z. Booth Endowed Chair at the University of Alabama at Birmingham School of Nursing, and a retired U.S. Army colonel. Nancy S. Redeker is the Beatrice Renfield Term Professor of Nursing at the Yale University School of Nursing, New Haven, CT. Ann E. Rogers is a professor at the Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta. Linda D. Scott is a professor and dean of the University of Wisconsin-Madison School of Nursing. Catherine M. Todero is dean of the College of Nursing and vice provost of Health Sciences at Creighton University, Omaha, NE, and Phoenix, AZ. Sharon J. Tucker is the Grayce Sills Endowed Professor in Psychiatric-Mental Health Nursing and director of the Translational/Implementation Research Core at the Ohio State University College of Nursing, Columbus. Sharon M. Weinstein is chief executive officer of the Global Education Development Institute, and SMW Group LLC, North Bethesda, MD, and a clinical assistant professor at the College of Nursing, University of Illinois, Chicago. This article was a collaborative effort by the Fatigue Subgroup of the Health Behavior Expert Panel, American Academy of Nursing. The authors acknowledge Claire C. Caruso, PhD, RN, a research health scientist at the National Institute for Occupational Safety and Health, for her help in reviewing the manuscript. Contact author: Alison M. Trinkoff, The authors and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the authors is available at www.ajnonline.com.

Abstract: For nurses, the challenges posed by demanding work environments and schedules often lead to fatigue, and this can be exacerbated during crises like the COVID-19 pandemic. In this article, the authors discuss causes and challenges of nurse fatigue and consider several evidence-based strategies and solutions for individual nurses and organizations. Barriers to implementation, including a negative workplace culture and inadequate staffing, are also described, and several resources are presented.
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http://dx.doi.org/10.1097/01.NAJ.0000802688.16426.8dDOI Listing
December 2021

United States nurses' experiences during the COVID-19 pandemic: A grounded theory.

J Clin Nurs 2021 Sep 15. Epub 2021 Sep 15.

College of Nursing, The Ohio State University, Columbus, Ohio, USA.

Objective: The objective of this study was to explore nurses' experiences and perceptions at selected United States (U.S.) healthcare sites during the COVID-19 pandemic.

Background: The COVID-19 pandemic brought rapid changes to the healthcare community. While a few studies have examined the early pandemic experiences of nurses in China and Europe, nurses' experiences across the United States have remained relatively underexplored.

Design: A qualitative study design was used.

Methods: Using a constructivist grounded theory methodology and methods, we conducted eight focus groups across four hospital sites in the eastern, midwestern and western United States. Registered nurses with a minimum of six months' experience working in all clinical specialties were eligible. Forty-three nurses participated. Data were analysed iteratively using the constant comparative method. The COREQ guidelines supported the work and reporting of this study.

Results: The nurses experiencing a pandemic (NEXPIC) grounded theory emerged positing associations between four interrelated themes: Challenges, Feelings, Coping and Ethics. Nurses reported Challenges associated with changes in the work environment, community and themselves. They expressed more negative than positive feelings. Nurses coped using self-care techniques, and teamwork within the healthcare organisation. Moral dilemmas, moral uncertainty, moral distress, moral injury and moral outrage were ethical issues associated with nurses' Challenges during the pandemic. Moral courage was associated with positive Coping.

Conclusions: Awareness of frontline nurses' complex and interrelated needs may help healthcare organisations protect their human resources. This new theory provides preliminary theoretical support for future research and interventions to address the needs of frontline nurses.

Relevance To Clinical Practice: Nurses face added distress as frontline at-risk caregivers. Interventions to promote nurses' ability to cope with personal and professional challenges from the pandemic and address ethical issues are needed to protect the nursing workforce. This study offers a new substantive theory that may be used to underpin future interventions.
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http://dx.doi.org/10.1111/jocn.16032DOI Listing
September 2021

Critical Care Nurses' Physical and Mental Health, Worksite Wellness Support, and Medical Errors.

Am J Crit Care 2021 05;30(3):176-184

JoEllen Wilbur is associate dean for research, Department of Women, Children and Family Nursing, College of Nursing, Rush University.

Background: Critical care nurses experience higher rates of mental distress and poor health than other nurses, adversely affecting health care quality and safety. It is not known, however, how critical care nurses' overall health affects the occurrence of medical errors.

Objective: To examine the associations among critical care nurses' physical and mental health, perception of workplace wellness support, and self-reported medical errors.

Methods: This survey-based study used a cross-sectional, descriptive correlational design. A random sample of 2500 members of the American Association of Critical-Care Nurses was recruited to participate in the study. The outcomes of interest were level of overall health, symptoms of depression and anxiety, stress, burnout, perceived worksite wellness support, and medical errors.

Results: A total of 771 critical care nurses participated in the study. Nurses in poor physical and mental health reported significantly more medical errors than nurses in better health (odds ratio [95% CI]: 1.31 [0.96-1.78] for physical health, 1.62 [1.17-2.29] for depressive symptoms). Nurses who perceived that their worksite was very supportive of their well-being were twice as likely to have better physical health (odds ratio [95% CI], 2.16 [1.33-3.52]; 55.8%).

Conclusion: Hospital leaders and health care systems need to prioritize the health of their nurses by resolving system issues, building wellness cultures, and providing evidence-based wellness support and programming, which will ultimately increase the quality of patient care and reduce the incidence of preventable medical errors.
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http://dx.doi.org/10.4037/ajcc2021301DOI Listing
May 2021

Caregivers of children with autism spectrum disorder in rural areas: A literature review of mental health and social support.

J Pediatr Nurs 2021 Jun 18;61:229-239. Epub 2021 Jun 18.

College of Nursing, The Ohio State University, USA.

Problem: Caregivers of children with Autism Spectrum Disorder (ASD) report high levels of stress, social isolation, and poor mental health. Social and emotional support may buffer negative effects of stress for caregivers of children with ASD, however, those living in rural areas may be disadvantaged due to social isolation and increased distance from resources. This scoping review examined the literature regarding the mental health and impact of support for rural caregivers of children with ASD.

Eligibility Criteria: Articles were limited to those available in the English language and conducted in a high income country. Articles had to include a population of rural caregivers of children with ASD and focus on caregiver mental health and/or the impact of support on caregiver mental health.

Sample: Searches were conducted with Embase, PubMed, CINAHL, ERIC, and PsycINFO and 22 articles were included.

Results: Study findings indicate overall poor mental health for rural caregivers of children with ASD. Formal and informal support appear to be beneficial in decreasing stress for rural caregivers of children with ASD. However, a few studies indicated that formal support may add stress to rural caregivers.

Conclusion: There is limited information regarding support needs and the impact of support services on the mental health of rural caregivers of children with ASD.

Implications: There is a need to increase access to support resources in rural areas for caregivers of children with ASD. Healthcare professionals, including nurses, can play a fundamental role in supporting, educating, and connecting caregivers to other support services.
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http://dx.doi.org/10.1016/j.pedn.2021.06.009DOI Listing
June 2021

Development and Test of a Text-Messaging Follow-Up Program After Sexual Assault.

Violence Against Women 2021 Sep 15;27(11):2111-2128. Epub 2021 Jun 15.

The Ohio State University College of Nursing, Columbus, USA.

Patients receiving medical forensic examinations following sexual assault often do not receive important follow-up care. To address this gap, we developed and tested a bidirectional text-messaging protocol, Text-SAFE (sexual assault forensic exams). Text-SAFE included automated text messages over 37 days, covering mental health, sexually transmitted infections, medications, and pregnancy. Patients could also send and receive messages. We evaluated feasibility for broader application by examining enrollment rates, patient responses and evaluations, protocol completion and reliability, and nurse compliance with the protocol. A total of 25 patients participated: 24/25 sent at least one text; 21/25 received all messages. Participants found Text-SAFE comfortable and helpful. We identified areas for improvement.
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http://dx.doi.org/10.1177/10778012211014567DOI Listing
September 2021

Mobile Health Applications, Cancer Survivors, and Lifestyle Modification: An Integrative Review.

Comput Inform Nurs 2021 06 2;39(11):755-763. Epub 2021 Jun 2.

Author Affiliations: College of Nursing, The Ohio State University (Drs Kelley, Kue, and Tucker); James Cancer Hospital and Solove Research Institute, The Ohio State University Comprehensive Cancer Center (Brophy); and EngageHealth, Inc (Peabody), Columbus, OH; and Institute for Informatics, Washington University School of Medicine (Drs Foraker and Yen); Department of Internal Medicine, Washington University (Dr Foraker); Department of Medicine, Washington University School of Medicine (Dr Yen); and Goldfarb School of Nursing, Barnes-Jewish College, BJC HealthCare (Dr Yen), St Louis, MO.

Cancer survivors' well-being is threatened by the risk of cancer recurrence and the increased risk of chronic diseases resulting from cancer treatments. Improving lifestyle behaviors attenuates these risks. Traditional approaches to lifestyle modification (ie, counseling) are expensive, require significant human resources, and are difficult to scale. Mobile health interventions offer a novel alternative to traditional approaches. However, to date, systematic reviews have yet to examine the use of mobile health interventions for lifestyle behavior improvement among cancer survivors. The objectives of this integrative review were to synthesize research findings, critically appraise the scientific literature, examine the use of theory in intervention design, and identify survivors' preferences in using mobile health interventions for lifestyle improvement. Nineteen articles met eligibility requirements. Only two studies used quantitative methods. Study quality was low, and only one study reported the use of theory in app design. Unfortunately, the evidence has not yet sufficiently matured, in quality or in rigor, to make recommendations on how to improve health behaviors or outcomes. However, six themes emerged as important considerations for intervention development for cancer survivors (app features/functionality, social relationships/support, provider relationships/support, app content, app acceptability, and barriers to use). These findings underscored the need for rigorous, efficacy studies before the use of mobile health interventions can be safely recommended for cancer survivors.
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http://dx.doi.org/10.1097/CIN.0000000000000781DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578050PMC
June 2021

Evidence-Based Practice in Oncology Nursing: Oncology Nursing Society Survey Results.

Clin J Oncol Nurs 2021 Jun;25(3):282-289

Ohio State University.

Background: Evidence-based practice (EBP) is a clinical decision-making approach that improves quality and outcomes in health care but is not yet standard in clinical settings.

Objectives: The purpose of this study was to determine EBP beliefs, knowledge, implementation strategy self-efficacy, and competencies among a national sample of oncology nurses.

Methods: Oncology nurses completed an online survey of EBP attributes and open-ended questions. Analyses were conducted on data collected from 893 participants from a range of healthcare organizations across a diverse geographic sample of the United States.

Findings: Respondents rated themselves competent to question clinical practice to improve quality care. Oncology nurses reported competency to question clinical practice but deficits in EBP knowledge and skills.

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http://dx.doi.org/10.1188/21.CJON.282-289DOI Listing
June 2021

Advancing Evidence-Based Practice Through Implementation Science: Critical Contributions of Doctor of Nursing Practice- and Doctor of Philosophy-Prepared Nurses.

Worldviews Evid Based Nurs 2021 Apr;18(2):93-101

College of Nursing, Helene Fuld Health Trust National Institute for EBP, The Ohio State University, Columbus, OH, USA.

Purpose: Describe the evolution of implementation science and the roles and potential collaborations of doctorally prepared nurses to advance implementation science in practice settings.

Methods: Review of academic preparation and areas of expertise for doctorally prepared nurses as it relates to implementation science and evidence-based practice (EBP).

Findings: There have been substantial gains in the number of academic programs in healthcare that include content on EBP, resulting in healthcare teams that are motivated to align practices with best evidence. Unfortunately, many EBP initiatives stall during early stages of implementation, resulting in fragmented practices and persistent gaps between evidence and practice. Implementation science aims to bridge this gap and provides a structured, science-based approach to implementation. Few healthcare teams are familiar with implementation science, and many do not incorporate knowledge from the field when implementing EBPs. Doctorally prepared nurses are in a unique position to serve as leaders in EBP implementation due to the breadth and depth of academic preparation and their pivotal roles across practice settings.

Conclusions: Collaboratively aligning existing strengths of PhD and DNP prepared nurses with knowledge of implementation science can advance implementation of EBP across practice settings to effectively incorporate and sustain meaningful change to improve outcomes.

Linking Evidence To Action Section: Doctorally prepared nurses are in a unique position to advance and apply the science of implementation in practice settings. Nurse scientists can generate evidence on effective strategies and outcomes among healthcare teams to successfully integrate evidence based practices into routine care. Nurse leaders and educators can apply these findings and use an implementation science approach when leading clinical teams in evidence-based practice changes.
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http://dx.doi.org/10.1111/wvn.12496DOI Listing
April 2021

Implementation Science: Application of Evidence-Based Practice Models to Improve Healthcare Quality.

Worldviews Evid Based Nurs 2021 Apr 29;18(2):76-84. Epub 2021 Mar 29.

College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.

Background: Translating research into practice is complex for clinicians, yet essential for high quality patient care. The field of implementation science evolved to address this gap by developing theoretical approaches to guide adoption and sustained implementation of practice changes. Clinicians commonly lack knowledge, time, and resources of how evidence-based practice (EBP) models can guide implementation, contributing to the knowledge-to-practice gap.

Aim: This paper aimed to equip clinicians and other healthcare professionals with implementation science knowledge, confidence, and models to facilitate EBP change in their local setting and ultimately improve healthcare quality, safety, and population health outcomes.

Methods: The field of implementation science is introduced, followed by application of three select models. Models are applied to a clinical scenario to emphasize contextual factors, process, implementation strategies, and outcome evaluation. Key attributes, strengths, opportunities, and utilities of each model are presented, along with general resources for selecting and using published criteria to best fit clinical needs. Partnerships between implementation scientists and clinicians are highlighted to facilitate the uptake of evidence into practice.

Linking Evidence To Action: Knowledge of implementation science can help clinicians adopt high-quality evidence into their practices. Application-oriented approaches can guide clinicians through the EBP processes. Clinicians can partner with researchers in advancing implementation science to continue to accelerate the adoption of evidence and reduce the knowledge-to-action gap.
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http://dx.doi.org/10.1111/wvn.12495DOI Listing
April 2021

Evidence-Based Practice Requires Evidence-Based Implementation.

Worldviews Evid Based Nurs 2021 04 18;18(2):74-75. Epub 2021 Mar 18.

Helene Fuld Health Trust National Institute for EBP, College of Nursing, The Ohio State University, Columbus, OH, USA.

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http://dx.doi.org/10.1111/wvn.12494DOI Listing
April 2021

A Scoping Review of Implementation Science in Adult Critical Care Settings.

Crit Care Explor 2020 Dec 16;2(12):e0301. Epub 2020 Dec 16.

College of Nursing, The Ohio State University, Columbus, OH.

Objectives: The purpose of this scoping review is to provide a synthesis of the available literature on implementation science in critical care settings. Specifically, we aimed to identify the evidence-based practices selected for implementation, the frequency and type of implementation strategies used to foster change, and the process and clinical outcomes associated with implementation.

Data Sources: A librarian-assisted search was performed using three electronic databases.

Study Selection: Articles that reported outcomes aimed at disseminating, implementing, or sustaining an evidence-based intervention or practice, used established implementation strategies, and were conducted in a critical care unit were included.

Data Extraction: Two reviewers independently screened titles, abstracts, and full text of articles to determine eligibility. Data extraction was performed using customized fields established a priori within a systematic review software system.

Data Synthesis: Of 1,707 citations, 82 met eligibility criteria. Studies included prospective research investigations, quality improvement projects, and implementation science trials. The most common practices investigated were use of a ventilator-associated pneumonia bundle, nutritional support protocols, and the Awakening and Breathing Coordination, Delirium Monitoring/Management, and Early Exercise/Mobility bundle. A variety of implementation strategies were used to facilitate evidence adoption, most commonly educational meetings, auditing and feedback, developing tools, and use of local opinion leaders. The majority of studies (76/82, 93%) reported using more than one implementation strategy. Few studies specifically used implementation science designs and frameworks to systematically evaluate both implementation and clinical outcomes.

Conclusions: The field of critical care has experienced slow but steady gains in the number of investigations specifically guided by implementation science. However, given the exponential growth of evidence-based practices and guidelines in this same period, much work remains to critically evaluate the most effective mechanisms to integrate and sustain these practices across diverse critical care settings and teams.
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http://dx.doi.org/10.1097/CCE.0000000000000301DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746210PMC
December 2020

Determinants of Fall Prevention Guideline Implementation in the Home- and Community-Based Service Setting.

Gerontologist 2021 08;61(6):942-953

College of Nursing, The Ohio State University, Columbus.

Background And Objectives: Home- and community-based service (HCBS) recipients often possess multiple fall risk factors, suggesting that the implementation of evidence-based fall prevention guidelines may be appropriate for the HCBS setting. The purpose of this exploratory study was to examine the determinants of fall prevention guideline implementation and the potential strategies that can support implementation in HCBS organizations.

Research Design And Methods: Semistructured interview and focus group data were collected from 26 HCBS professionals representing the home-delivered meals, personal care, and wellness programs. Qualitative codes were mapped to the Consolidated Framework for Implementation Research by means of directed content analysis. The Consolidated Criteria for Reporting Qualitative research checklist was used to report the findings of this study.

Results: We identified 7 major determinants of guideline implementation: recipient needs and resources, cosmopolitanism, external policy and incentives, networks and communication, compatibility, available resources, and knowledge/beliefs. Strategies to support guideline implementation included the involvement of recipient and caregiver feedback, building fall prevention networks, and conducting educational meetings for HCBS staff.

Discussion And Implications: Falls and fall-related injuries will continue to plague the older adult community unless innovative approaches to fall prevention are developed and adopted. The implementation of fall prevention guidelines in the HCBS setting can help mitigate fall risk among a highly vulnerable older adult population and may be facilitated through the application of multifaceted implementation strategies.
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http://dx.doi.org/10.1093/geront/gnaa133DOI Listing
August 2021

EBP 2.0: Implementing and Sustaining Change: Implementing Improved Central Line Flushing Practices.

Am J Nurs 2020 08;120(8):66-70

Kirsten Hanrahan is the director of nursing research and evidence-based practice, Jane Utech is a clinical nurse specialist, and Laura Cullen is an evidence-based practice scientist, all in the Department of Nursing Services and Patient Care at University of Iowa Hospitals & Clinics in Iowa City. Sharon J. Tucker is the Grayce Sills Endowed Professor of Psychiatric-Mental Health Nursing, director of the DNP Nurse Executive Program, and director of the Implementation Science Core, and Lynn Gallagher-Ford is senior director, both at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College of Nursing in Columbus. Contact author: Kirsten Hanrahan, The authors have disclosed no potential conflicts of interest, financial or otherwise.

This is the eighth article in a series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.
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http://dx.doi.org/10.1097/01.NAJ.0000694600.82867.24DOI Listing
August 2020

Development and Psychometric Testing of the Implementation Self-efficacy for EBP (ISE4EBP) Scale.

West J Nurs Res 2020 01 31;43(1):45-52. Epub 2020 May 31.

College of Nursing, The Ohio State University, Columbus, OH, USA.

There is inadequate research about nurses' confidence in implementation strategies that foster the application and sustainability of evidence-based practice (EBP). Guided by Bandura's self-efficacy theory, we propose that self-efficacy (confidence) in EBP implementation strategies can accelerate the uptake of evidence into practice to improve health care quality. The purpose of this study was to develop and test the psychometric properties of the Implementation Self-efficacy for EBP (ISE4EBP) scale as a measure for evaluating self-efficacy in using EBP implementation strategies. In a sample of 65 registered nurses, the 29-item ISE4EBP scale demonstrated adequate content validity (via content validity index), internal consistency reliability (Cronbach's alpha = 0.987), and construct validity indicated by associations with organizational readiness for EBP. Clinicians may use the ISE4EBP scale to identify areas for building implementation confidence to accelerate the uptake of evidence to improve quality care.
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http://dx.doi.org/10.1177/0193945920925032DOI Listing
January 2020

Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review.

Am J Health Promot 2020 11 27;34(8):929-941. Epub 2020 Apr 27.

University of Massachusetts Medical School, Worcester, MA, USA.

Objective: This systematic review focused on randomized controlled trials (RCTs) with physicians and nurses that tested interventions designed to improve their mental health, well-being, physical health, and lifestyle behaviors.

Data Source: A systematic search of electronic databases from 2008 to May 2018 included PubMed, CINAHL, PsycINFO, SPORTDiscus, and the Cochrane Library.

Study Inclusion And Exclusion Criteria: Inclusion criteria included an RCT design, samples of physicians and/or nurses, and publication year 2008 or later with outcomes targeting mental health, well-being/resiliency, healthy lifestyle behaviors, and/or physical health. Exclusion criteria included studies with a focus on burnout without measures of mood, resiliency, mindfulness, or stress; primary focus on an area other than health promotion; and non-English papers.

Data Extraction: Quantitative and qualitative data were extracted from each study by 2 independent researchers using a standardized template created in Covidence.

Data Synthesis: Although meta-analytic pooling across all studies was desired, a wide array of outcome measures made quantitative pooling unsuitable. Therefore, effect sizes were calculated and a mini meta-analysis was completed.

Results: Twenty-nine studies (N = 2708 participants) met the inclusion criteria. Results indicated that mindfulness and cognitive-behavioral therapy-based interventions are effective in reducing stress, anxiety, and depression. Brief interventions that incorporate deep breathing and gratitude may be beneficial. Visual triggers, pedometers, and health coaching with texting increased physical activity.

Conclusion: Healthcare systems must promote the health and well-being of physicians and nurses with evidence-based interventions to improve population health and enhance the quality and safety of the care that is delivered.
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http://dx.doi.org/10.1177/0890117120920451DOI Listing
November 2020

A Pancreatic Enzyme Medication Self-Management Initiative.

Am J Nurs 2020 05;120(5):58-62

Lynn Gallagher-Ford is senior director and Sharon J. Tucker is the Grayce Sills Endowed Professor of Psychiatric-Mental Health Nursing and director of the Translational/Implementation Research Core, both at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College of Nursing in Columbus. Margaret Gettis is a nurse scientist in the nursing research and evidence-based practice department, and Betsy Anne Dye is a clinical educator, both at Children's Healthcare of Atlanta's Scottish Rite Hospital. Contact author: Lynn Gallagher-Ford, The authors have disclosed no potential conflicts of interest, financial or otherwise.

This is the seventh article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.
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http://dx.doi.org/10.1097/01.NAJ.0000662828.98696.1dDOI Listing
May 2020

Clinician Mental Health and Well-Being During Global Healthcare Crises: Evidence Learned From Prior Epidemics for COVID-19 Pandemic.

Worldviews Evid Based Nurs 2020 06 22;17(3):182-184. Epub 2020 Apr 22.

Helene Fuld Health Trust National Institute for EBP, Ohio State University, Columbus, OH, USA.

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http://dx.doi.org/10.1111/wvn.12439DOI Listing
June 2020

The Impact of the Electronic Health Record on Moving New Evidence-Based Nursing Practices Forward.

Worldviews Evid Based Nurs 2020 Apr 31;17(2):136-143. Epub 2020 Mar 31.

Helene Fuld Health Trust National Institute for EBP in Nursing and Healthcare, The Ohio State University, Columbus, OH, USA.

Background: Anecdotal reports from across the country highlight the fact that nurses are facing major challenges in moving new evidence-based practice (EBP) initiatives into the electronic health record (EHR).

Purpose: The purpose of this study was to: (a) learn current processes for embedding EBP into EHRs, (b) uncover facilitators and barriers associated with rapid movement of new evidence-based nursing practices into the EHR and (c) identify strategies and processes that have been successfully implemented in healthcare organizations across the nation.

Methods: A qualitative study design was utilized. Purposive sampling was used to recruit nurses from across the country (N = 29). Nine focus group sessions were conducted. Semistructured interview questions were developed. Focus groups were conducted by video and audio conferencing. Using an inductive approach, each transcript was read and initial codes were generated resulting in major themes and subthemes.

Results: Five major themes were identified: (a) barriers to advancing EBP secondary to the EHR, (b) organizational structure and governing processes of the EHR, (c) current processes for prioritization of EHR changes, (d) impact on ability of clinicians to implement EBP and (e) wait times and delays.

Linking Evidence To Action: Delays in moving new EBP practice changes into the EHR are significant. These delays are sources of frustration and job dissatisfaction. Our results underscore the importance of a priori planning for anticipated changes and building expected delays into the timeline for EBP projects. Moreover, nurse executives must advocate for greater representation of nursing within informatics technology governance structures and additional resources to hire nurse informaticians.
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http://dx.doi.org/10.1111/wvn.12435DOI Listing
April 2020

EBP 2.0: Implementing and Sustaining Change: The Evidence-Based Practice and Research Fellowship Program.

Am J Nurs 2020 02;120(2):44-48

Sharon J. Tucker is the Grayce Sills Endowed Professor of Psychiatric-Mental Health Nursing and director of the Translational/Implementation Research Core, and Lynn Gallagher-Ford is senior director, both at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College of Nursing in Columbus. Elisa Jang is a clinical nurse specialist, translational research, in the nursing department of NorthBay Healthcare, Fairfield, CA. Contact author: Sharon J. Tucker, The authors have disclosed no potential conflicts of interest, financial or otherwise.

This is the sixth article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.
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http://dx.doi.org/10.1097/01.NAJ.0000654320.04083.d0DOI Listing
February 2020

EBP 2.0: Implementing and Sustaining Change: The Malnutrition Readmission Prevention Protocol.

Am J Nurs 2019 12;119(12):60-64

Lynn Gallagher-Ford is senior director and Sharon J. Tucker is the Grayce Sills Endowed Professor of Psychiatric-Mental Health Nursing and director of the Translational/Implementation Research Core, both at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College of Nursing in Columbus. Cynthia D. Beckett is director of the EBP Certificate Program and an assistant professor at the Ohio State University College of Nursing. The authors acknowledge Alejandra Figueroa, MA, LSS-GB, and Sheila Walsh, MPH, RD, LSS-BB, for their review of the manuscript. Contact author: Lynn Gallagher-Ford, The authors have disclosed no potential conflicts of interest, financial or otherwise.

This is the fifth article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.
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http://dx.doi.org/10.1097/01.NAJ.0000615816.91858.64DOI Listing
December 2019

The STAND Skin Bundle.

Am J Nurs 2019 10;119(10):45-48

Lynn Gallagher-Ford is senior director and Sharon J. Tucker is the Grayce Sills Endowed Professor of Psychiatric-Mental Health Nursing and director, Translational/Implementation Research Core, both at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College of Nursing in Columbus. Ruth Labardee is the director of Health System Nursing Quality and Evidence-Based Practice, and Julie Rodgers is the manager of Health System Nursing Quality, Ohio State University Wexner Medical Center, also in Columbus. Contact author: Lynn Gallagher-Ford, The authors have disclosed no potential conflicts of interest, financial or otherwise.

This is the fourth article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.
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http://dx.doi.org/10.1097/01.NAJ.0000586180.15960.b3DOI Listing
October 2019

CE: Original Research: Are Milk and Molasses Enemas Safe for Hospitalized Adults? A Retrospective Electronic Health Record Review.

Am J Nurs 2019 Sep;119(9):24-28

Jackline Wangui-Verry is an assistant nurse manager on the clinical research unit at the Institute for Clinical and Translational Science, University of Iowa Hospitals and Clinics, Iowa City. Michele Farrington is a program manager and Grace Matthews is a nursing practice leader in the Department of Nursing Services and Patient Care at the University of Iowa Hospitals and Clinics. Sharon J. Tucker is the Grayce Sills Endowed Professor of Psychiatric-Mental Health Nursing at the Ohio State University College of Nursing, Columbus, as well as director of the Translational/Implementation Research Core at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare. Contact author: Jackline Wangui-Verry, The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

: Background: Constipation in hospitalized patients is common. As a treatment of last resort for unresolved constipation, a milk and molasses enema is often used by nursing staff. But there has been little research investigating the safety and efficacy of this approach.

Purpose: The purpose of this retrospective study was to evaluate the safety of milk and molasses enemas for hospitalized adults with constipation that remained unresolved after standard treatment options were exhausted.

Methods: Data were extracted from the electronic health records (EHRs) of 615 adult patients who had received a milk and molasses enema between July 2009 and July 2013 at a large midwestern academic medical center. Data analysis occurred for a random subset of this group.Participant characteristic variables included age, sex, admitting diagnosis, diet orders, medications, laxatives and enemas administered before the milk and molasses enema, and laboratory values. Serious complication variables included bacteremia, bowel perforation, electrolyte abnormalities, allergic reaction, abdominal compartment syndrome, cardiac arrhythmia, dehydration, and death.

Findings: The final sample of 196 adults had a mean age of 56 years; 61.2% were female and 38.8% were male. Of 105 admitting diagnoses, the most frequent (9.7%) was abdominal pain, unspecified site. Of the 14 discharge dispositions, the most frequent was home or self-care (50.5%). A laxative order was present for 97.4% of patients and a stool softener order was present for 86.2%. Sodium and potassium levels remained within normal limits during hospitalization. For the subset of patients who had these values measured within 48 hours before and after milk and molasses enema administration, no significant changes were found. No cases of nontraumatic abdominal compartment syndrome or other serious adverse enema-related events were documented in the EHR.

Conclusions: No safety concerns were identified from this retrospective EHR review of hospitalized adults who received a milk and molasses enema for constipation relief. The findings indicate that this treatment is safe, although further study examining its efficacy in this population is needed.
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http://dx.doi.org/10.1097/01.NAJ.0000580148.43193.76DOI Listing
September 2019

The Electronic Health Record: A Friend or Foe of Translational Research and Evidence-Based Practice?

Worldviews Evid Based Nurs 2019 Aug;16(4):252-254

The Ohio State University College of Nursing, Columbus, OH, USA.

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http://dx.doi.org/10.1111/wvn.12387DOI Listing
August 2019

Implementing Follow-Along Physical Activity Videos with People Living With Chronic Conditions: A Feasibility Study.

Worldviews Evid Based Nurs 2019 Oct 5;16(5):352-361. Epub 2019 Aug 5.

Iowa State University, Ames, IA, USA.

Background: Compelling evidence supports multiple benefits of physical activity (PA) even in small bursts. Less than 50% of Americans achieve recommended PA levels, lower still for individuals living with chronic illness or disease.

Purpose: The purpose of this study was to develop and evaluate the feasibility and preliminary effects of 3-min follow-along video scenarios to promote brief episodes of low-moderate levels of PA among individuals with chronic diseases.

Methods: Guided by our previous studies and self-efficacy theory, the program (WellMe in 3© for Patients) was modeled after another program developed for healthcare staff. An advisory panel and a health and fitness expert guided the creation of twelve 3-min video scenarios that included two individuals living with chronic illness and a fitness leader who guided the PA scenarios and how to adapt them based on limitations. The 12 scenarios included 3 min of aerobic activities, stretching, or balance. Preliminary pilot effects were measured among 39 patients living with chronic conditions for one month. Standardized instruments were used to measure PA levels, PA self-efficacy (SE), and quality of life (QoL); usability and satisfaction were assessed using researcher-developed tools. Descriptive and inferential statistics were used to evaluate change over time.

Results: Twelve video scenarios were created tailored to persons with chronic illness. Thirty-nine participants piloted the program, reporting an average of two chronic conditions. Baseline QoL scores were lower than normative data, self-efficacy scores were low-to-moderate, and PA levels were very low. Participants averaged using one video per day. 62% of participants provided complete self-reported pre- and post-QoL and SE data and 41% provided pre- and post-PA (accelerometer) data. Significant improvements were found for general health and energy scores, and trends were found for self-efficacy scores. PA levels were highly variable with nonsignificant increases from baseline. Effect sizes were low-moderate for several measures. About 79% of participants rated program "Very good"; all recommended the program.

Linking Evidence To Action: Physical activity has multiple health benefits for all people including those living with chronic conditions. Even short bouts of physical activity have health benefits. A program of 3-min follow-along PA videoclips for individuals living with chronic disease holds promise for clinicians and researchers.
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http://dx.doi.org/10.1111/wvn.12392DOI Listing
October 2019

The future of pediatric nursing science.

Nurs Outlook 2020 Jan - Feb;68(1):73-82. Epub 2019 Jun 27.

Martha S. Pitzer Center for Women, Children, and Youth, The Ohio State University College of Nursing, Columbus, OH.

The provision of safe and effective nursing care to children is dependent upon pediatric nurse scientists creating knowledge that guides and directs day-to-day nursing practice. Current trends demonstrating steady decreases of pediatric nurses and inadequate numbers of PhD-prepared pediatric nurse scientists put the health of our children at risk. The purposes of this paper are to (1) summarize current health care demands in pediatrics, (2) present our concern that the number of pediatric nurse scientists is inadequate to generate foundational knowledge to guide pediatric nursing practice, (3) present our perspectives on factors influencing the number of pediatric nurse scientists, and (4) recommend specific actions for nursing leaders, nursing faculty, and professional nursing organizations to increase the depth and breadth of pediatric nursing science to meet current and future pediatric care needs.
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http://dx.doi.org/10.1016/j.outlook.2019.06.020DOI Listing
May 2020

Data-Driven Precision Implementation Approach.

Am J Nurs 2019 08;119(8):60-63

Laura Cullen is an evidence-based practice scientist and Kirsten Hanrahan is the director of nursing research and evidence-based practice, both in the Department of Nursing Services and Patient Care at the University of Iowa Hospitals and Clinics in Iowa City. Sharon J. Tucker is the Grayce Sills Endowed Professor of Psychiatric-Mental Health Nursing and director, Translational/Implementation Research Core, and Lynn Gallagher-Ford is senior director, both at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College of Nursing in Columbus. The University of Iowa reserves any and all trademark rights to precision implementation approach. The Iowa Model copyright is held by the University of Iowa. Contact author: Laura Cullen, The authors have disclosed no potential conflicts of interest, financial or otherwise.

: This is the third article in a new series about evidence-based practice (EBP) that builds on AJN's awardwinning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series features exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.
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http://dx.doi.org/10.1097/01.NAJ.0000577460.00222.32DOI Listing
August 2019

Promoting Nurse Retention Through Career Development Planning.

Am J Nurs 2019 06;119(6):62-66

Sharon J. Tucker is the Grayce Sills Endowed Professor of Psychiatric-Mental Health Nursing and director, Translational/Implementation Research Core, and Lynn Gallagher-Ford is senior director, both at the Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at the Ohio State University College of Nursing in Columbus. Manisa Baker is a visiting assistant professor, and Beth A. Vottero is an associate professor, both at Purdue University Northwest's College of Nursing in Hammond, IN. Contact author: Sharon J. Tucker, The authors have disclosed no potential conflicts of interest, financial or otherwise.

This is the second article in a new series about evidence-based practice (EBP) that builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step-published between 2009 and 2011 (to access the series, go to http://links.lww.com/AJN/A133). This follow-up series will feature exemplars illustrating the various strategies that can be used to implement EBP changes-one of the most challenging steps in the EBP process.
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http://dx.doi.org/10.1097/01.NAJ.0000559823.73262.d2DOI Listing
June 2019

Patient, Nurse, and Organizational Factors That Influence Evidence-Based Fall Prevention for Hospitalized Oncology Patients: An Exploratory Study.

Worldviews Evid Based Nurs 2019 Apr 27;16(2):111-120. Epub 2019 Mar 27.

Office of Nursing Research and, Evidence-Based Practice, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

Background: Hospital falls remain common despite decades of studies and guidelines to reduce their rate. Research evidence alone is insufficient, and integration of patient values and preferences, clinician expertise and experiences, and organizational culture is needed to ensure sustainable practice changes. Little is known about the best strategies for integrating these constructs to sustain effective fall prevention programs.

Aims: Guided by the Comprehensive Framework for Implementation Research (CFIR), this study aimed to identify patient, nursing staff, and organizational-level factors that influence effective and sustainable fall prevention strategies with the goal of identifying variables amenable to targeted interventions.

Methods: A descriptive research design engaged four oncology units in a Midwestern academic medical center and included patients (N = 39) and nursing staff (N = 70). Questionnaire data were collected from patients with interview assistance, and nursing staff completed a demographic form and two standardized instruments adapted for the study. Data were analyzed using descriptive statistics and narrative summaries.

Results: Findings indicated two-thirds of patients did not see themselves at risk for falling, despite nearly half having a fall history. Nursing staff indicated knowledge gaps related to specific known risks and interventions, and confidence in fall prevention management was lowest for team communication about patient risks and engaging patients and families in preventing falls.

Linking Evidence To Action: Engagement of patients in fall risk assessment and management, clear and routine communication among team members, and creating a culture of true engagement with appropriate leadership and resources can potentially improve the sustainability of successful fall prevention programs. The CFIR can guide the planning of fall prevention and other evidence-based practice changes to become hardwired and sustainable over time even with the ongoing introduction of new initiatives.
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http://dx.doi.org/10.1111/wvn.12353DOI Listing
April 2019
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