Evaluation of an Evidence-Based Practice Tutorial for Nurses: A Useful Tool and Some Lessons Learned.

Although evidence-based practice (EBP) and research is important to hospitals and nursing staff interested in achieving Magnet status, a more important purpose is the improvement of patient care. As the nursing staff of UConn Health and its John Dempsey Hospital began its initial assessment prior to embarking on the journey for Magnet status, staff nurses were found to lack skills in searching vetted sources of EBP literature and appraising the results of a search. To address this need, a librarian at UConn Health, in collaboration with the hospital's Nursing Research steering committee, developed an online, self-paced EBP tutorial. The EBP tutorial used the iterative (Analysis, Design, Development, Implementation, and Evaluation) model of instructional design in development and assessment. This article describes the development and implementation of the tutorial, its evaluation, and lessons learned. J Contin Educ Nurs. 2016;47(6):266-271.

Responding to increasing RN demand: diversity and retention trends through an accelerated LVN-to-BSN curriculum.

By providing accelerated licensed vocational nurses (LVN)-to-BSN academic mobility, our university addresses the nationwide nursing shortage, as well as concerns for retention, diversity, and career advancement. LVNs are committed to health care, are likely to remain working as nurses, and represent ethnic and racial minorities. However, LVNs differ from generic students and benefit from tailored curricula and educational strategies. Disadvantaged personal and academic backgrounds, lower grade point averages, cultural diversity, language challenges, age, life responsibilities, and learned LVN behaviors are considered in the development and implementation of this baccalaureate nursing (BSN) degree program. Strategies to build professional identity, reading comprehension, verbal and written articulation, critical thinking, and leadership skills are addressed. A combination of teaching strategies are used to address adult learner needs, including online and face-to-face projects and case studies. Mixing LVN-to-BSN and RN-to-BSN students benefits both and increases efficiency.

Exploring the effects of walking the labyrinth.

PURPOSE: This pilot study examines the effects of walking a labyrinth. METHOD: A convenience sample of 25 community members participated in a four-group, repeated measures study to gather information about vital signs and affect before and after labyrinth walks. Because of the small sample size, results were inspected for effect size (ES) differences in pre-to postcomparisons. Mean postwalk scores were also compared to control group scores. FINDINGS: Systolic and diastolic blood pressures showed essentially no ES differences pre to postwalk. The remaining ES comparisons showed .14 ES for pulse differences, .37 ES for respirations, and .22 and .56 ES differences for positive and negative affect measures, respectively. CONCLUSIONS: Comparisons of postwalk scores for walkers to nonwalkers showed mixed results in significance of differences. IMPLICATIONS: This pilot study shows the feasibility of the procedures for assessing the effects of labyrinth walking on basic parameters of health.

Why carve up your continuous data?

Continuous data are commonplace in social, biophysical, and health research. For various reasons, researchers often carve up data into ordered chunks. Such data carving results in less information being carried by the data, a reduction or spurious increase in statistical power, and resultant Type I or Type II errors. We give examples of data carving in selected nursing literature, and illustrate how unnecessary categorization can produce erroneous statistical results. Finally, we propose credible alternatives to data carving.

Randomized study of stability and change in patients' advance directives.

Little is known about ethnic differences in understanding or using advance directives (ADs). Although health practitioners may presume AD intentions are durable over time, there is no supporting evidence. This randomized study intended to (a) examine differences between hospitalized Hispanic and non-Hispanic patients' AD preferences, (b) assess AD stability, and (c) discover if the Life Support Preferences Questionnaire (LSPQ) influences AD preferences. Hispanics and non-Hispanics showed no difference in AD preferences. However, non-Hispanics were more likely to change AD preferences. The LSPQ itself prompted change in AD preferences, delivering an educational effect with no specific educational intent. Change seen in patients' ADs, even over a brief interval, suggests revisiting AD preferences with patients and their families after hospitalization.

Acculturation level and postpartum depression in Hispanic mothers.

PURPOSE: Perinatal health outcomes for Hispanic women are associated with acculturation. The purpose of this study was to explore the relationship between acculturation levels and postpartum depressive symptomatology and diagnosed postpartum depression among Hispanic subgroups. STUDY DESIGN AND METHODS: The Postpartum Depression Screening Scale and the Short Acculturation Scale were used in the two phases of data collection. Phase 1 and 2 samples consisted of 377 and 150 Hispanic mothers, respectively. Puerto Rican mothers showed higher levels of acculturation than Mexican and other Hispanic women. A DSM-IV diagnostic interview (SCID) was used to establish a diagnosis of depression. Hierarchical regression analyses were used to study the unique relationships between ethnicity, depressive symptomatology, diagnosed depression, and acculturation. RESULTS: There was no consistent relationship between acculturation and postpartum depression. Significant predictors of elevated postpartum depressive symptoms in Hispanic mothers were Puerto Rican ethnicity and cesarean delivery. Single marital status was a significant risk factor for postpartum depression. A limitation of the study was use of language as the sole criterion measure for acculturation. Acculturation is a complex construct with problematic measurement that needs greater refinement to facilitate research in which it is used as a variable. CLINICAL IMPLICATIONS: Hispanic mothers are a heterogeneous group and should not be treated as a homogeneous group. Subgroups of Hispanic mothers may not have the same level of acculturation or the same level of postpartum depressive symptomatology.

Validation of measures of middle schoolers' self-efficacy for physical and emotional health, and academic tasks.

The development and psychometric study of a measure of middle schoolers' perceptions of self-efficacy for physical, emotional, and academic behaviors appropriate to their age and developmental tasks are described. The validation of the Middle School Self-Efficacy Questionnaire (MISSE) included the adaptation of existing items and the generation of new ones. Items were subjected to judges' review by two expert panels and were tested with a large, geographically diverse sample of youngsters aged 11-14. Statistical analyses included factor analysis, internal consistency estimations, t tests, and analyses of variance for hypothesis testing related to construct validity. Results showed support for the expected factors and provided evidence of the validity of the MISSE.

Evaluation of an educational intervention on breastfeeding for NICU nurses.

The effect of breastfeeding education on breastfeeding knowledge and attitudes of nurses in a neonatal intensive care unit (NICU) was evaluated. NICU nurses (intervention) and pediatric nurses (untreated control) working at a northeastern US children's hospital participated in the pretest/posttest design study. Both groups answered the same breastfeeding questionnaire on 2 occasions. NICU nurses completed the questionnaire the second time after attending the education session. Outcome measures evaluated by questionnaire items were (1) breastfeeding knowledge, (2) pro-breastfeeding attitudes, (3) baby-focused care attitudes, and (4) nurse-focused care attitudes. Comparison groups were similar at pretest on demographic variables and remained so despite attrition between pretesting and posttesting. A significant increase (P < .001) occurred in NICU nurses' breastfeeding knowledge after the education session. Findings suggest that an educational intervention has potential for improving NICU nurses' knowledge and certain attitudes about breastfeeding but may not alter other attitudes of interest in the desired direction.

Validation of the Spanish Life Support Preference Questionnaire (LSPQ).

PURPOSE: To translate and validate the Life Support Preference Questionnaire (LSPQ) for use with Spanish-speaking adults, and to further validate the English version of the LSPQ. METHODS: Two samples were included: community-dwelling Hispanic and non-Hispanic adults who were monolingual or bilingual Spanish speakers, and an English-speaking sample, all living in south-central United States. Validation included calculation of internal consistency, stability, and alternate forms reliability estimates for two language versions of the LSPQ. Factorial validity was studied for both language versions and regression and t test analyses were done to explore ethnic differences in selection of the life support choices in the scale. FINDINGS: Both language versions of the LSPQ showed strongly supportive measurement properties. Differences were found between ethnic groups on four of the item choices, indicating that Hispanics in this sample preferred interventions to actively support life more than did the non-Hispanic adults. CONCLUSIONS: Both the English and Spanish versions of the LSPQ have been validated for use in research and practice. Additional validation will be necessary in other samples.

A methodology for supporting research and scholarship.

The Office for Nursing Research and Scholarship was established in the spring of 1999 in a school of nursing on a large health sciences campus. In the first 2 years of operation, 11 federal grants were developed and submitted; 5 are currently funded, 3 have received competitive priority scores, 2 are in revision, and 1 awaits review. Intramural and private funding and preparation of manuscripts for publication have noticeably increased during this interval. Objective and subjective evaluation data from users are encouraging and provide a means for continuous formative evaluation and improvement. Recently, we conducted a systematic assessment of our office, focusing on service use, successful aspects, and organization. Through the assessment, we identified a methodology for organization and the essential elements needed to support successful research and scholarship. This article describes the essential services and how they are interrelated and delivered and how we structure staff responsibilities to facilitate delivery.

Methods to document semantic equivalence of a translated scale.

To ensure the semantic equivalence of the Postpartum Depression Screening Scale (PDSS)-Spanish Version, multiple methods were used, including back-translation, the committee approach, pretest techniques, and alternate forms equivalence. The back-translation process involved eight translators who represented the four predominant Hispanic groups in the United States. In the committee approach the Hispanic translators convened together to discuss the results of the back-translations and to come to group consensus on problematic items. In pretesting the PDSS-Spanish Version was field-tested with five Hispanic mothers, and it was determined that it accurately captured the connotative meanings of the screening scale. Alternate forms equivalence of the two language versions of the PDSS was assessed with a sample of 30 bilingual Hispanic mothers. Alpha reliability estimates ranged from 0.94 to 0.99. Though lengthy, this systematic procedure was needed to guarantee the production of a fully equivalent linguistic version of the PDSS.