Subject(s)
Critical Care/organization & administration , Education, Nursing, Continuing/organization & administration , Nurse's Role , Nursing Staff, Hospital/education , Budgets , Clinical Competence , Education, Nursing, Continuing/economics , Guidelines as Topic , Humans , Nursing Education Research , Ohio , Organizational Case Studies , Organizational Objectives , Specialties, Nursing , United StatesABSTRACT
In August 2008, the American Association of Critical-Care Nurses' (AACN's) Evidence-Based Practice Resource Work Group met to review current AACN Practice Alerts and to identify new Practice Alerts to be created. The work group was also tasked with reassessment of the grading system used by AACN that evaluates evidence associated with the Practice Alerts and other AACN resources. This article details the effort of this national volunteer work group, specifically highlighting the development of the new AACN evidence-leveling hierarchy system.
Subject(s)
Clinical Nursing Research/methods , Critical Care/standards , Evidence-Based Medicine/standards , Societies, Nursing/organization & administration , Clinical Nursing Research/standards , Evidence-Based Medicine/methods , Humans , Practice Guidelines as Topic , United StatesSubject(s)
Critical Care , Evidence-Based Practice/standards , Nursing Research/standards , Research Design/standards , Societies, Nursing , Specialties, Nursing , Critical Care/standards , Humans , Societies, Nursing/organization & administration , Specialties, Nursing/organization & administration , United StatesABSTRACT
BACKGROUND: Chronic illness burdens some groups more than others. In studies of ethnic/racial groups with chronic illness, some investigators have found differences in health-related quality of life (HRQL), whereas others have not. Few such comparisons have been performed in persons with heart failure. The purpose of this study was to compare HRQL in non-Hispanic white, black, and Hispanic adults with heart failure. METHODS: Data for this longitudinal comparative study were obtained from eight sites in the Southwest, Southeast, Northwest, Northeast, and Midwest United States. Enrollment and 3- and 6-month data on 1212 patients were used in this analysis. Propensity scores were used to adjust for sociodemographic and clinical differences among the ethnic/racial groups. Health-related quality of life was measured using the Minnesota Living with Heart Failure Questionnaire. RESULTS: Significant ethnic/racial effects were demonstrated, with more favorable Minnesota Living with Heart Failure Questionnaire total scores post-baseline for Hispanic patients compared with both black and white patients, even after adjusting for baseline scores, age, gender, education, severity of illness, and care setting (acute vs. chronic), and estimating the treatment effect (intervention vs. usual care). The models based on the physical and emotional subscale scores were similar, with post hoc comparisons indicating more positive outcomes for Hispanic patients than non-Hispanic white patients. CONCLUSION: Cultural differences in the interpretation of and response to chronic illness may explain why HRQL improves more over time in Hispanic patients with heart failure compared with white and black patients.
