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Research Nurses (research + nurse)
Selected AbstractsInterrater Agreement between Nurses for the Pediatric Canadian Triage and Acuity Scale in a Tertiary Care CenterACADEMIC EMERGENCY MEDICINE, Issue 12 2008FRCPC, Jocelyn Gravel MD Abstract Objectives:, The objective was to measure the interrater agreement between nurses assigning triage levels to children visiting a pediatric emergency departments (EDs) assisted by a computerized version of the Pediatric Canadian Triage and Acuity Scale (PedCTAS). Methods:, This was a prospective cohort study evaluating children triaged from Level 2 (emergent) to Level 5 (nonurgent). A convenience sample of patients triaged during 38 shifts from April to September 2007 in a tertiary care pediatric ED was evaluated. All patients were initially triaged by regular triage nurses using a computerized version of the PedCTAS. Research nurses performed a second evaluation blinded to the first evaluation using the same triage tool. These research nurses were regular ED nurses performing extra hours for research purposes exclusively. The primary outcome measure was the interrater agreement between the two nurses as measured by the linear weighted kappa score. Secondary outcomes included the proportion of patient for which nurses did not apply the triage level suggested by Staturg (override) and agreement for these overrides. Results:, A total of 499 patients were recruited. The overall interrater agreement was moderate (linear weighted kappa score of 0.55 [95% confidence interval {CI} = 0.48 to 0.61] and quadratic weighted kappa score of 0.61 [95% CI = 0.42 to 0.80]). There was a discrepancy of more than one level in only 10 patients (2% of the study population). Overrides occurred in 23.2 and 21.8% for regular and research triage nurses, respectively. These overrides were equally distributed between increase and decrease in triage level. Conclusions:, Nurses using Staturg, which is a computerized version of the PedCTAS, demonstrated moderate interrater agreement for assignment of triage level to children presenting to a pediatric ED. [source] Clinical research networks in diabetes: the evolving role of the research nurseEUROPEAN DIABETES NURSING, Issue 1 2007P Chester PhD Visiting Academic Abstract The importance of evidence-based care for patients with diabetes is well established, and the evidence required to make decisions about patient care is generated through research and audit. The rigours of the research process and the need to enrol large numbers of patient volunteers in a timely manner has meant that most studies are now conducted at multiple sites. Research infrastructure is costly to implement, but is important for successful clinical research projects. By establishing permanent networks this infrastructure can be maintained and built upon. Research nursing has evolved as a new but very important discipline within the nursing profession in recent years and it has been pivotal for the success of many studies. In this article we examine the potential for clinical research networks to facilitate high quality clinical research and in particular the development of the research nurse role. Copyright © 2007 FEND. [source] Role boundaries , research nurse or clinical nurse specialist?JOURNAL OF CLINICAL NURSING, Issue 4 2002A literature review ,,This paper focuses on issues relating to the role components of clinical nurse specialists and clinical research nurses working in breast cancer care. ,,Identified issues relate to the lack of agreement as to the role and definition of clinical nurse specialists. At the same time there has been an increase and emergence of clinical research nurses, both within the NHS and university departments. ,,The review fails to reveal the relationship between these two specialist groups in terms of role overlap and role boundaries. ,,The lack of knowledge in this area substantiates the need for further research to be carried out. [source] Patient priorities of care in rheumatology outpatient clinics: a qualitative studyMUSCULOSKELETAL CARE, Issue 4 2007Vicky Ward PhD Abstract Objective:,To provide more understanding of what rheumatoid arthritis (RA) patients want and need from an outpatient visit. Methods:,25 patients who experienced care in a nurse practitioner clinic (n = 10), junior doctor clinic (n = 9) or consultant clinic (n = 6) in a large teaching hospital in West Yorkshire were interviewed about their perceptions and experiences of care. Interviews were approximately 11/2 hours in duration and were carried out in a neutral environment by a research nurse. Interview data were subjected to atheoretical content analysis, which resulted in the identification of emergent themes. Results:,Five main themes emerged from the analysis of interview data: 1) patients want to be communicated to clearly and effectively and value positive relationships with practitioners. These help to give patients confidence in the care they are receiving; 2) patients want to feel in control of their condition and tend to refuse interventions as a way of gaining control; 3) patients want to be given clear explanations during consultations, and want information in oral and written forms; 4) patients want to be able to access practitioners between scheduled appointments as a way of gaining reassurance; and 5) patients want to feel valued by society through having their difficulties appreciated and understood by others. Conclusion:,This research adds to the body of evidence on what patients want from their rheumatology care, and each theme has clear implications for future practice. Copyright © 2007 John Wiley & Sons, Ltd. [source] Assessment is not enough: a randomized controlled trial of the effects of HRQL assessment on quality of life and satisfaction in oncology clinical practicePSYCHO-ONCOLOGY, Issue 12 2007Sarah K. Rosenbloom Abstract The potential benefits of health-related quality of life (HRQL) assessment in oncology clinical practice include better detection of problems, enhanced disease and treatment monitoring and improved care. However, few empirical studies have investigated the effects of incorporating such assessments into routine clinical care. Recent randomized studies have reported improved detection of and communication about patients' concerns, but few have found effects on patient HRQL or satisfaction. This study examined whether offering interpretive assistance of HRQL results would improve these patient outcomes. Two hundred and thirteen participants with metastatic breast, lung or colorectal cancer were randomly assigned to one of three conditions: usual care; HRQL assessment or HRQL assessment followed by a structured interview and discussion. Interviews about patients' assessment responses were conducted by a research nurse, who then presented HRQL information to the treating nurse. HRQL and treatment satisfaction outcomes were assessed at 3 and 6 months. No significant differences were found between study conditions in HRQL or satisfaction. Results suggest that routine HRQL assessment, even with description of results, is insufficient to improve patient HRQL and satisfaction. It is suggested that positive effects may require supplementing assessment results with specific suggestions for clinical management changes. Copyright © 2007 John Wiley & Sons, Ltd. [source] Reliability and Validity of the Emergency Severity Index for Pediatric TriageACADEMIC EMERGENCY MEDICINE, Issue 9 2009Debbie A. Travers PhD Abstract Objectives:, The Emergency Severity Index (ESI) triage algorithm is a five-level triage acuity tool used by emergency department (ED) triage nurses to rate patients from Level 1 (most acute) to Level 5 (least acute). ESI has established reliability and validity in an all-age population, but has not been well studied for pediatric triage. This study assessed the reliability and validity of the ESI for pediatric triage at five sites. Methods:, Interrater reliability was measured with weighted kappa for 40 written pediatric case scenarios and 100 actual patient triages at each of five research sites (independently rated by both a triage nurse and a research nurse). Validity was evaluated with a sample of 200 patients per site. The ESI ratings were compared with outcomes, including hospital admission, resource consumption, and ED length of stay. Results:, Interrater reliability was 0.77 (95% confidence interval [CI] = 0.76 to 0.78) for the scenarios (n = 155 nurses) and 0.57 (95% CI = 0.52 to 0.62) for actual patients (n = 498 patients). Inconsistencies in triage were noted for the most acute and least acute patients, as well as those less than 1 year of age and those with medical (rather than trauma) chief complaints. For the validity cohort (n = 1,173 patients), outcomes differed by ESI level, including hospital admission, which went from 83% for Level 1 patients to 0% for Level 5 (chi-square, p < 0.0001). Nurses from dedicated pediatric EDs were 31% less likely to undertriage patients than nurses in general EDs (odds ratio [OR] = 0.31, 95% CI = 0.14 to 0.67). Conclusions:, Reliability of the ESI for pediatric triage is moderate. The ESI provides a valid stratification of pediatric patients into five distinct groups. We found several areas in which nurses have difficulty triaging pediatric patients consistently. The study results are being used to develop pediatric-specific ESI educational materials to strengthen reliability and validity for pediatric triage. [source] Detection of Delirium by Bedside Nurses Using the Confusion Assessment MethodJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2006Joke Lemiengre RN A prospective, descriptive study was used to assess the diagnostic validity of the Confusion Assessment Method (CAM) administered at the bedside by nurses in daily practice. Two different scoring methods of the CAM (the specific (SPEC) and sensitive (SENS) methods) were compared with a criterion standard (CAM completed by trained research nurses). During a 5-month period, all patients consecutively admitted to an acute geriatric ward of the University Hospitals of Leuven (Belgium) were enrolled in the study. The 258 elderly inpatients who were included underwent 641 paired but independent ratings of delirium by bedside and trained research nurses. Delirium was identified in 36 of the 258 patients (14%) or in 42 of the 641 paired observations (6.5%). The SENS method of the CAM algorithm as administered by bedside nurses had the greatest diagnostic accuracy, with 66.7% sensitivity and 90.7% specificity; the SPEC method had 23.8% sensitivity and 97.7% specificity. Bedside nurses had difficulties recognizing the features of acute onset, fluctuation, and altered level of consciousness. For both scoring methods, bedside nurses had difficulties with the identification of elderly patients with delirium but succeeded in diagnosing correctly those patients without delirium in more than 90% of observations. Given these results, additional education about delirium with special attention to guided training of bedside nurses in the use of an assessment strategy such as the CAM for the recognition of delirium symptoms is warranted. [source] Bathing Disability in Community-Living Older Persons: Common, Consequential, and ComplexJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2004Aanand D. Naik MD Objectives: To identify the specific bathing subtasks that are affected in community-living-older persons with bathing disability and to determine the self-reported reasons for bathing disability. Design: Cross-sectional study. Setting: General community of greater New Haven, Connecticut. Participants: A total of 626 community-living persons, aged 73 and older, who completed a comprehensive assessment, including a detailed evaluation of bathing disability. Measurements: Trained research nurses assessed bathing disability (defined as requiring personal assistance or having difficulty washing and drying the whole body), the specific bathing subtasks that were affected, and the main reasons (up to three) for bathing disability. Results: Disability in bathing was present in 195 (31%) participants; of these, 97 required personal assistance (i.e., dependence), and 98 had difficulty bathing. Participants with bathing disability reported a mean±standard deviation of 4.0±2.4 affected subtasks. The prevalence rate of disability for the eight prespecified bathing subtasks ranged from 25% for taking off clothes to 75% for leaving the bathing position. The majority of participants (59%) provided more than one reason for bathing disability. The most common reasons cited by participants for their bathing disability were balance problems (28%), arthritic complaints (26%), and fall or fear of falling (23%). Conclusion: For community-living older persons, disability in bathing is common, involves multiple subtasks, and is attributable to an array of physical and psychological problems. Preventive and restorative interventions for bathing disability will need to account for the inherent complexity of this essential activity of daily living. [source] Role boundaries , research nurse or clinical nurse specialist?JOURNAL OF CLINICAL NURSING, Issue 4 2002A literature review ,,This paper focuses on issues relating to the role components of clinical nurse specialists and clinical research nurses working in breast cancer care. ,,Identified issues relate to the lack of agreement as to the role and definition of clinical nurse specialists. At the same time there has been an increase and emergence of clinical research nurses, both within the NHS and university departments. ,,The review fails to reveal the relationship between these two specialist groups in terms of role overlap and role boundaries. ,,The lack of knowledge in this area substantiates the need for further research to be carried out. [source] Agreement between administrative databases and medical charts for pregnancy-related variables among asthmatic women,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2008Anne Vilain MSc Abstract Purpose To determine the validity of pregnancy variables recorded in administrative databases of Quebec using patient medical charts as the gold standard among asthmatic pregnant women. Methods Three administrative databases were linked and provided information on maternal, pregnancy and infant characteristics for 726 pregnant asthmatic women who delivered in 1990,2000. Algorithms were developed to measure variables that were not recorded directly in the databases or to minimize the number of missing values for variables recorded in two or more databases. Medical file data were collected by two trained research nurses in 43 hospitals. The validity of categorical variables was assessed with sensitivity, specificity, predictive positive values (PPVs) and predictive negative values (PNVs), whereas the validity of continuous variables was assessed with Pearson correlation using the medical chart as the gold standard. Results The sensitivity of the sex of the baby, previous live birth and previous pregnancy ranged from 0.97 to 0.99. Corresponding figures were 0.92,0.98 for specificity. We also found high correlation coefficients, ranging from 0.875 to 0.999 for the length of gestation, dates of last menstruation and delivery, maternal age and birth weight. Conclusion Pregnancy-related variables recorded in administrative databases or derived from algorithms based on two or more databases were found to be highly valid as compared to the medical chart among asthmatic women. Copyright © 2008 John Wiley & Sons, Ltd. [source] Prenatal Risk Factors Among Foreign-Born Central American Women: A Comparative StudyPUBLIC HEALTH NURSING, Issue 6 2000F.N.P., Kathleen F Gaffney Ph.D. The purpose of this study was to compare the incidence of empirically established prenatal risk factors for low birthweight (LBW) outcomes among two groups of low-income mothers: foreign-born Central American women and nonimmigrant, non-Hispanic women. Two hundred ninety-six women who were part of a larger study of maternal role sufficiency were included in the present study: 127 Central American women and 169 nonimmigrant, non-Hispanic women who identified themselves as Black (n= 59) or White (n= 110). Data were collected by public health nurses (PHNs) during home visits and by research nurses in prenatal health department clinics. Comparisons were made between the two groups in areas of demographic characteristics, prenatal health behaviors, and prenatal stressful life-events. Foreign-born Central American mothers were found to be less educated, more likely to be living with their partners, less likely to engage in prenatal health risk behaviors, and less likely to identify stressors in their lives. The initiation of prenatal PHN services by the target group was similar to the comparison group. Their rate of LBW deliveries did not reflect the protective effect often attributed to foreign-born Hispanic mothers. Findings are discussed in light of the paradox of LBW and Hispanic heritage. Recommendations for practice, clinical research, and public policy are also addressed. [source] Interrater Agreement between Nurses for the Pediatric Canadian Triage and Acuity Scale in a Tertiary Care CenterACADEMIC EMERGENCY MEDICINE, Issue 12 2008FRCPC, Jocelyn Gravel MD Abstract Objectives:, The objective was to measure the interrater agreement between nurses assigning triage levels to children visiting a pediatric emergency departments (EDs) assisted by a computerized version of the Pediatric Canadian Triage and Acuity Scale (PedCTAS). Methods:, This was a prospective cohort study evaluating children triaged from Level 2 (emergent) to Level 5 (nonurgent). A convenience sample of patients triaged during 38 shifts from April to September 2007 in a tertiary care pediatric ED was evaluated. All patients were initially triaged by regular triage nurses using a computerized version of the PedCTAS. Research nurses performed a second evaluation blinded to the first evaluation using the same triage tool. These research nurses were regular ED nurses performing extra hours for research purposes exclusively. The primary outcome measure was the interrater agreement between the two nurses as measured by the linear weighted kappa score. Secondary outcomes included the proportion of patient for which nurses did not apply the triage level suggested by Staturg (override) and agreement for these overrides. Results:, A total of 499 patients were recruited. The overall interrater agreement was moderate (linear weighted kappa score of 0.55 [95% confidence interval {CI} = 0.48 to 0.61] and quadratic weighted kappa score of 0.61 [95% CI = 0.42 to 0.80]). There was a discrepancy of more than one level in only 10 patients (2% of the study population). Overrides occurred in 23.2 and 21.8% for regular and research triage nurses, respectively. These overrides were equally distributed between increase and decrease in triage level. Conclusions:, Nurses using Staturg, which is a computerized version of the PedCTAS, demonstrated moderate interrater agreement for assignment of triage level to children presenting to a pediatric ED. [source] Mothers' attitudes to the randomized controlled trial (RCT): the case of acute lymphoblastic leukaemia (ALL) in childrenCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2005C. Eiser Abstract Objectives Survival rates for childhood cancer have improved substantially partly as a result of national and international randomized clinical trials (RCT). However, the decision for families is complex and emotional. Our aim was to describe the views of mothers of children newly diagnosed with ALL regarding consent to randomized controlled trials. Design Qualitative interview to explore mothers knowledge, and reasons for involving their child in RCTs. Interviews took place in mothers' homes. Participants Fifty mothers of children with newly diagnosed ALL (age 4,16 years; mean = 7.4) recruited through research nurses at outpatient appointments. Results All but three families had consented for their child to be treated in the RCT, although there was wide variation in their understanding of the aims, costs and benefits. Most mothers reported the aim of the trial to compare ,old' and ,new' treatments. Conclusion Despite detailed verbal and written information, mothers were poorly informed about the purpose of the trial, and possibility of side effects. Individual preferences for either standard or new treatment were routinely reported. The data raise questions about the extent to which families give truly informed consent to recruitment of their child to an RCT. [source] | ||||||||||