Explain how poster presentations are useful to disseminate new knowledge
What Is an Outcome?
At the end of this section, you will be able to:
• < Define outcome
• < Discuss ways outcomes can be classified
Implementing an innovation, policy or procedure does not necessarily guarantee that it will become the standard of care. Ongoing evaluation of an innovation through outcome measurements is necessary to ensure successful incorporation into clinical practice. An outcome is defined as the consequence or visible result (Webster, 2001). Nursing outcomes measure states, behaviors, or perceptions of individuals, families, or communities (Moorehead, Johnson, & Maas, 2004). Outcomes research examines the effects of care and treatments on individuals and populations (Rubenfeld et al., 1999). In nursing research, the outcome is frequently known as the dependent variable (Polit & Hungler, 2006).
Outcomes may be classified by several different methods. One way outcomes can be classified is by focusing on who is being measured. Nurses may measure outcomes for individuals, groups, or organizations.
Another way that outcomes can be grouped is by type: care-related, patient-related, and performance-related outcomes (Kleinpell, 2001). An example of a care-related outcome is the rate of pressure ulcer formation in patients on bed rest for more than 24 hours. Patient knowledge related to fluid restriction is an example of a patient-related outcome. Nursing staff adherence to best practice guidelines when providing discharge education to a heart failure patient is an example of a performance-related outcome.
KEY TERMS
Outcome: Consequence or visible result
Nursing outcomes: Measures of states, behaviors, or perceptions of individuals, families, or communities
Outcomes research: Studies about the effects of care and treatments on individuals and populations
Care-related outcomes: Category of outcomes that measures the effect of nursing interventions
Patient-related outcomes: Type of outcome related to patient behaviors or actions
Performance-related outcomes: Type of outcome related to how nurses perform their jobs
Short-term outcomes: Results achieved in a brief period of time
Time is another way of classifying outcomes. Short-term outcomes are results achieved in a relatively brief period of time that usually involve a change in condition, such as absence of postoperative pain, or an increase in knowledge or skills, such as a patient’s ability to draw up insulin. Another category of outcome classified by time is intermediate outcomes. They exist when changes occur after an innovation is introduced. Lifestyle modifications, such as weight loss and smoking cessation after enrolling in a wellness program, can be examples of intermediate outcomes. Long-term outcomes are primary changes in patients’ behaviors or status, such as a reduction in blood cholesterol levels (Plantz, Greenway, & Hendricks, 1996).
Nursing administrators are responsible for reporting nursing-sensitive outcomes at their institutions to demonstrate effectiveness of nursing care. Outcomes of nursing care should be measurable. These measurements can assist in determining responsibility in patient care (Krau, 2001). One nursing-sensitive outcome considered a National Patient Safety Goal mandated by The Joint Commission (JC) is to reduce the risk of patient harm resulting from falls (Joint Commission, 2007a). The Joint Commission requires healthcare organizations to have fall reduction programs. Two desirable outcomes that may result from an evidence-based fall prevention protocol are a reduction in the number of patient falls and fewer fall-related injuries.
Outcome-based measurements are a means used to establish evidence-based practice (EBP) and to evaluate the care delivered. In healthcare organizations, many activities are outcome driven. The rising costs of health care, increasingly stringent accreditation standards, and public reporting are several reasons why outcomes are closely scrutinized and are integral to ensuring the successful implementation of an innovation. In health care, outcomes are typically quantitative, not qualitative.
CRITICAL THINKING EXERCISE 17-1
Consider your last clinical experience. Are you aware of any outcomes that are being monitored on the unit or in the facility? If so, what are they and how would you classify them?
KEY TERMS
Intermediate outcomes: Changes that occur after an innovation is introduced
Long-term outcomes: Primary changes in patient behaviors or status overtime
Nursing-sensitive outcomes: Results that demonstrate the effectiveness of nursing care
TEST YOUR KNOWLEDGE 17-1
Match the type of outcome with the indicator
1.
system-related outcome a. Patient will not hemorrhage after delivery
2.
patient-related outcome b. Patient will maintain weight loss over two years
3.
care-related outcome c. Patient will be afebrile after surgery
4.
long-term outcome d. The rate of hospital-acquired infections
5.
short-term outcome e. Patient satisfaction will be 90% or greater
How did you do?
1.
d, e;
2.
a, b, c;
3.
d;
4.
b;
5.
a, c
Evaluating outcomes is not static, but rather an ongoing process. Outcomes must be well defined for the evaluation to be meaningful. The effectiveness of any innovation is measured by the outcomes that result. These results are compared to baseline data in order to draw conclusions about the effectiveness of the innovation. The process continues as the innovation becomes standard practice.
17.2 Choosing Outcomes
At the end of this section, you will be able to:
< Discuss factors that should be considered when selecting outcomes
FYI
Outcome-based measurements are a means used to establish EBP and to evaluate the care delivered. The effectiveness of any innovation is measured by the outcomes that result.
KEY TERMS
Indicators: Quantitative criteria used to measure outcomes
Choosing outcomes that appropriately fit an innovation is vital. This allows for an accurate evaluation of practice changes. During the selection process, outcomes should be considered for their significance and scope. Considerations may include morbidity, quality of life, and appropriate use of resources (Ciliska, DiCenso, & Guyatt, 2005). Outcomes should be measured using specific quantitative criteria, sometimes referred to as indicators. For example, if postoperative pain control is of interest, then pain should be quantified through a recognized indicator such as the numeric rating scale. If focusing on an outcome such as quality of life, then using an established instrument, such as the SF-36 published by Ware and Sherbourne, is preferred over the use of a self-developed instrument (Padilla, Frank-Stromborg, & Koresawa, 2004). Instruments that have been tested for reliability and validity will improve credibility of the evaluation process. Table 17-1 lists examples of outcomes and associated indicators.
When determining outcomes to be measured, there are four major factors to consider: patient populations, team membership, organizational priorities, and mandated reporting. It is best when the selected outcomes address multiple factors. Journals, books, and websites are available to assist. Table 17-2 lists selected organizations with their associated websites that contain health outcome information.
KEY TERMS
Patient populations: A group of patients with similar characteristics
Team membership: The composition of a team with respect to expertise and leadership
Organizational priorities: Situations of high importance because of volume of patients or costs
Mandated reporting: Data that must be shared with supervising or governmental agencies by a specified timeline
Patient Population
TABLE 17-1 Outcomes and indicators
Outcome indicator
Dyspnea reduction Dyspnea rating scale
Decrease in postoperative pain Pain numeric rating scale
Absence of skin ulcers Pressure sore staging
Fluid restriction compliance Daily weight
Knowledge: blood pressure medication Blood pressure
It is necessary to select outcomes that reflect the patient population served by the healthcare facility. Use of a generic patient outcome is a good strategy to measure outcomes when populations are diverse. For example, measuring symptom control or increased knowledge may apply to many disease conditions (Whitman, 2003). The nursing outcomes classification (NOC), developed at the University of Iowa College of Nursing, is a standardized list of generic patient outcome classifications that can be used to evaluate the efficacy of nursing interventions (Moorehead et al., 2004). There are currently 330 outcomes in the NOC system that are associated with the North American Nursing Diagnosis Association and the nursing interventions classification. Each outcome is coded and consists of several components: a definition, a list of numeric indicators from which the nurse selects to evaluate the patient’s status, a target outcome rating, and a five-point Likert-type scale for measuring the status. “Knowledge: diet” is an example of an NOC patient outcome and is defined as the extent of understanding conveyed about the recommended diet. The outcome may be applied to a diverse group of patients in a wide spectrum of healthcare settings. Included in this outcome are 15 indicators that the nurse may choose for evaluation purposes, such as description of diet and description of potential for food and medication interaction (Moorehead et al., 2004). The Likert-type scale yields data ranging from none (1) to extensive (5) for each indicator.
TABLE 17-2 Selected Health Outcome Information Websites
Organization Website
AcademyHealth http://www.academyhealth.orgAgency for Healthcare Research and Quality http://www.ahrq.gov/clinic/outcomix.htmCenters for Medicare and Medicaid Services http://www.hce.orgHarvard College Library Health Data Resources http://hcl.harvard.edu/research/guides/health_us/Institute for Healthcare Improvement http://www.ihi.orgJoint Commission on Accreditation of Healthcare Organizations http://www.jointcommission.orgNational Cancer Institute http://outcomes.cancer.gov/National Committee for Quality Assurance http://www.ncqa.org/United Way http://liveunited.org/our-work/health/University of Iowa College of Nursing http://www.uihealthcare.com/depts/nursing/rqom/index.htmlTeam Membership
When selecting an outcome, consideration should be given to the composition of members who form the team responsible for monitoring the outcome (Whitman, 2003). This includes the personnel members and capabilities that would be involved in implementing the innovation and outcome measurements. Utilizing an interdisciplinary approach including nursing, education, ancillary support services, and quality improvement allows for incorporation of different viewpoints and knowledge. It may also result in recommendation of new outcomes that were not previously considered. The creation of interdisciplinary relationships in the formulation and approval of policies and protocols is required to achieve American Nurses Credentialing Center (ANCC) Magnet Recognition (ANCC, 2005). Advanced practice nurses (APNs) are integral members of interdisciplinary teams. The APN has expert clinical knowledge about rapidly occurring changes in the healthcare environment. APNs are familiar with institutional data and are able to assist with comparison to national benchmarks. APNs can assist with selecting realistic outcomes. An outcome that is realistic has a base definition that is true to life (Minnick, 2001). For example, selecting an outcome such as “improved quality of life in heart failure patients” is vague and has a multitude of meanings dependent upon the individual and the severity of the associated disease condition. People with slight limitation of physical activities might have a different perception of quality of life than individuals who are unable to carry out physical activities without discomfort or symptoms at rest. Therefore, the vaguely written outcome cannot be realistically evaluated. APNs can assist to narrow the focus, thus making an outcome more measurable. Staff nurses may be involved at several different levels during outcome selection and subsequent measurements. Nurses are familiar with the continuous quality improvement (CQI) process through participation with internal quality improvement measures. Staff nurses are often members of the interdisciplinary team involved in protocol development. They frequently provide insightful suggestions on approaches that can be used in the clinical setting to obtain outcome measurements. Staff nurses can identify patients who meet criteria for inclusion in the protocol. They can also collect data such as reviewing charts for compliance in documentation.
KEY TERM
Continuous quality improvement: Participatory process involving indicators that measure quality
FYI
Choosing outcomes that appropriately fit an innovation is vital. Outcomes should be considered for their significance and scope and should be measured using specific quantitative criteria, called indicators. The four major factors to consider are patient populations, organizational priorities, mandated reporting, and team selection.
Organizational Priorities
A second consideration is selecting outcomes that address organizational priorities (Whitman, 2003). Sometimes outcomes can be linked to the mission of the healthcare organization. For example, a faith-based hospital may focus attention on ensuring that all patients receive a spiritual assessment. Organizations may also use outcomes to evaluate specific areas that need improvement. CQI activities are an evaluation of existing practices that involve delivery of services to the people (Reinhardt & Ray, 2003). The goal of CQI is to improve service. CQI measures can be generic indicators or narrowed into disease-specific outcomes.
CRITICAL THINKING EXERCISE 17-2
Your nurse manager selects you to represent the unit on a team monitoring patient safety. What outcomes would you suggest the team monitor?
Mandated Reports
There are multiple publicly reported nursing indicators that can be used to measure outcomes of EBP protocols. Hospitals and other healthcare agencies are required to gather data on specific disease entities and to report their findings to public agencies. Outcome data, available on State Boards of Health and the Centers for Medicare and Medicaid Services (CMS) websites, are published to make comparisons among healthcare facilities. Organizations use these data to gain a picture of how they compare to similar facilities. This is known as benchmarking. Clinical practice guidelines or standards of care recommended by professional organizations can also drive outcome selection. There is often overlap among the various organizations that mandate reporting. For example, consider when a healthcare organization implements a smoking cessation program for patients with cardiac disease. The American College of Cardiology (ACC) and American Heart Association (AHA) have issued joint guidelines delineating the expected standards of care for patients experiencing an ST-elevation myocardial infarction (MI) (AHA, 2004). These guidelines recommend offering smoking cessation counseling to all patients who either currently smoke or have quit smoking within the past year (AHA, 2004). The Joint Commission requires hospitals to report on two of the four core measures that include MI (Joint Commission, 2007b). The CMS has eight MI quality care measures that hospitals must report about, one of which measures smoking cessation counseling (CMS, n.d.).
KEY TERM
Benchmarking: Comparison of organization outcome data to other organizations or national databases
In addition to reporting mandatory CMS and JC data, many healthcare facilities are members of not-for-profit organizations to benchmark indicators. For example, hospitals can subscribe to databases maintained by the ACC and The Society of Thoracic Surgeons (STS). The ACC (2007) has four databases that include cardiac catheterization/percutaneous coronary intervention, implantable cardioverter defibrillator, carotid revascularization, and acute coronary syndrome. The STS (2007) provides statistics on adult and congenital heart surgery and for thoracic surgery patients. Organizations such as these provide EBP guidelines for various disease entities, allowing subscribers to review the latest information for protocol development and implementation within the facility.
Another such organization is the Institute for Healthcare Improvement (IHI). The IHI (n.d.) initially developed a program known as the 100,000 Lives Campaign, now known as the 5 Million Lives Campaign. This initiative targets saving 100,000 lives through instituting six major hospital programs: a rapid response team, MI care, prevention of adverse drug effects, reduction of central line infection, reduction of surgical site infection, and ventilator-associated pneumonia (VAP). For example, a reduction in the incidence of VAP was proposed through implementation of five interventions grouped together known as the “ventilator bundle” (Resar et al., 2005). VAP is defined as a nosocomial pneumonia that develops 48 hours or longer after a patient has an artificial airway such as a tracheostomy or endotracheal tube inserted (De Rosa & Craven, 2003). The mortality rate for patients diagnosed with VAP ranges from 25% to 40%, and the diagnosis adds an estimated cost of $40 thousand to a hospital admission (Tablan, Anderson, & Besser, 2004). The ventilator bundle consists of these strategies: keeping the head of the bed elevated at least 30 degrees at all times unless clinically contraindicated, daily sedation vacations, assessments of weaning readiness, peptic ulcer prevention, and deep vein thrombosis prophylaxis. To evaluate VAP protocol, based upon the ventilator bundle, an outcome could be to reduce the incidence of VAP by 75%.
TABLE 17-3 Fourteen Forces of Magnetism
Force 1 Quality of Nursing Leadershipn
Force 2 Organizational Structure
Force 3 Management Style
Force 4 Personnel Policies and Programs
Force 5 Professional Models of Care
Force 6 Quality of Care
Force 7 Quality Improvement
Force 8 Consultation and Resources
Force 9 Autonomy
Force 10 Community and the Healthcare Organization
Force 11 Nurses as Teachers
Force 12 Image of Nursing
Force 13 Interdisciplinary Relationships
Force 14 Professional Development
Source: Adapted from American Nurses Credentialing Center. 2005. Magnet recognition program (pp. 2-3). Silver Springs, MD: Author.
KEY TERM
Forces of Magnetism: Qualities that exhibit nursing excellence
In the Magnet Recognition Program (ANCC, 2005), healthcare organizations are required to provide examples of nurse-sensitive quality indicators as part of the application process or to maintain Magnet Recognition. There are 14 components, known as Forces of Magnetism, that exhibit nursing excellence. Table 17-3 lists these forces. For example, for a healthcare organization to meet force seven, quality improvement, evidence must show that nursing staff members participate in CQI activities and that CQI is perceived to improve care within the facility (ANCC). In addition, the organization must provide examples of a change in nursing practice that occurred as a result of data originating from fiscal, satisfaction, or clinical outcomes. The following scenario demonstrates how one outcome can be used to address mandates from the Joint Commission, IHI, and the Magnet Recognition Program.
Continuing with VAP as an example, suppose the infection control nurse in your facility reports that, despite implementing the ventilator bundle, the VAP rate has not decreased in the last two quarters.
A multidisciplinary committee consisting of nursing, respiratory therapy, infection control, quality improvement, and staff education examines the evidence. The committee determines that regularly scheduled oral hygiene, including teeth brushing, while on the ventilator has been linked with a reduction of plaque and oropharyngeal colonization.
The committee decides to change oral care products currently used in your facility and recommends a change in protocol. The new ventilator oral care protocol is developed and presented to the staff along with a review of related infection control findings related to VAP. The staff are enthusiastic about the change in oral care products and the new protocol. Over the next few months, follow-up reporting will be provided to the nursing staff. The quarterly VAP rate will be compared to the rate prior to the implementation of the new protocol to determine the effectiveness of the practice change.
TEST YOUR KNOWLEDGE 17-2
1.
Which of the following are considerations when selecting outcomes?
a.?organizational mission
b.?publicly reported benchmarks
c.?type of patients served at healthcare facility
d.?expertise of team members
2.
Which of the following statements is false?
a.?Journals, books, and websites are available to assist nurses in selecting outcomes.
b.?NOC outcomes could be used in evaluation plans.
c.?Benchmarking is a way to compare facility with national data.
d.?Clinical guidelines are only suggestions and are not evidence based.
How did you do?
1.
a, b, c, d;
2.
d
17.3 Evaluating the Outcomes
At the end of this section, you will be able to:
< Discuss how data are used to evaluate outcomes
CRITICAL THINKING EXERCISE 17-3
You are asked to join an interdisciplinary committee being formed to examine glucose management in intensive care unit (ICU) patients. You note that the current ICU practice is to administer a sliding scale subcutaneous insulin dose based upon the bedside glucose obtained at 6-hour time intervals. A retrospective chart review on 50 ICU patients receiving the sliding scale insulin dosage for 24 hours reveals that glycemic control in ICU patients is not present. Consequently, the committee develops an evidence-based intravenous (IV) insulin protocol based upon hourly glucose measurements. Glycemic control in ICU patients is the outcome selected and you are going to use a blood sugar result between 80–110 mg/dL within 8 hours of instituting the IV protocol as a measurement indicator. Staff nurses collect data on 50 patients over a 3-month time period and compared that to the baseline data as shown here:
Mean Blood Glucose Level Before Change Mean Blood Glucose Level After Change
On admission 250 248
8 hours after admit 235 122
12 hours after admit 230 110
24 hours after admit 212 111
While these reductions were statistically significant (p = .02), the outcome was not met. What other variables could be accounting for the fact that the outcome was not met? Would you continue to use the IV insulin protocol?
After an outcome has been selected and measured, data are compiled and evaluated to draw conclusions. Demonstrating the effectiveness of an innovation is a challenge, and conclusions must not extend beyond the scope of the data. Evaluation is facilitated when appropriate outcomes and associated indicators are chosen. If the outcome is not clearly defined, then the measurements and subsequent evaluation will be flawed. For example, suppose that you are a member of an interdisciplinary team that has developed a nursing protocol that reduces the amount of time the patient remains on bed rest after a cardiac catheterization procedure from 6 hours to 4 hours. The outcome selected is absence of bleeding from the femoral arterial puncture site. No other indicators are measured. The results obtained after implementing the protocol revealed that there was an increase in bleeding at the femoral arterial site in the 4-hour bed rest patients compared to the 6-hour bed rest patients. Before concluding that a shorter bed rest time leads to an increase in femoral bleeding, a few additional questions need to be considered. First, was absence of bleeding defined in a measurable way? Because bleeding might be interpreted in several different ways, a precise definition of bleeding should have been provided to ensure consistency in reporting. Second, when should patients be assessed for absence of bleeding? Is the absence of bleeding to be assessed when the patient first ambulates or at a later time? Input from the staff prior to changing the nursing protocol could have clarified these questions resulting in more reliable results.
Another consideration in outcome evaluation is to obtain data relative to current practice for comparison purposes. To document the need for a practice change and to support a new protocol, baseline data might need to be collected to demonstrate limitations of the current standard of care. Consideration must be given to all extraneous variables that may be influencing the outcome, such as time, equipment, safety, and costs. It could be helpful to involve a statistician to perform complex analyses.
FYI
After an outcome has been selected and measured, data are compiled and evaluated to draw conclusions. Evaluation is facilitated when appropriate outcomes and associated indicators are chosen—conversely, if the outcome is not clearly defined, then the measurements and subsequent evaluation will be flawed.
TEST YOUR KNOWLEDGE 17-3
True/False
1.
Baseline data are unimportant in outcome measurement.
2.
Precise description of indicators is essential.
3.
For complex analyses, the assistance of a statistician may be needed.
4.
Input from staff can help clarify outcome measurement.
1.
F;
2.
T;
3.
T;
4.
T;
17.4 Keeping It Ethical
At the end of this section, you will be able to:
< List three dilemmas that can arise when nurses are involved in testing protocols
FYI
When nurses are involved in testing protocols, there are ethical dilemmas that can arise. Issues can concern the selection of the sample, data collection, and reporting.
As a staff nurse, it is likely that you will be involved at some point in evaluating patient care outcomes. At the very least, your documentation will be a source of data. There are other ways for you to become involved in evaluation. When nurses are involved in testing protocols, there are ethical dilemmas that can arise. Issues can concern the selection of the sample, data collection, and reporting. When considering the recruitment of patients to participate in protocol testing, you must make certain that they fit the criteria and are not included simply to reach the sample size needed. You are obligated to collect data as directed by the protocol. Reflect back to the example of reducing the number of hours on bed rest following cardiac catheterization. Suppose you were to assess for bleeding in one of your patients but were unable to do that assessment because of an emergency on the unit. You might be tempted to guess or enter data collected at a later time. But for the integrity of the process, it would be preferable to indicate that the data are missing. Another issue that can arise is that sometimes nurses have a tendency to change behaviors when they are aware that data are being collected. For example, a hospital is implementing a smoking cessation program. Because the nursing staff knows that their unit is being compared to other units in the facility, they are very careful to follow the program exactly as outlined. However, after data collection is concluded and the protocol is found to be effective, it would not be in the best interest of patients for nurses to return to using former protocols.
TEST YOUR KNOWLEDGE 17-4
1.
Which of the following behaviors is unethical?
a.?ensuring patients enrolled in a protocol meet criteria
b.?filling in all missing data at the conclusion of your shift
c.?refusing to participate in outcome measurement
d.?continuing to follow protocols after data collection ends
How did you do?
1.
b, c
RAPID REVIEW
An outcome is a consequence or a visible result. Nursing outcomes measure states, behaviors, or perceptions of individuals, families, or communities.
Outcomes research examines the effect of care on individuals and populations.
Outcomes can be classified by focusing on who is to be measured: individuals, groups, or organizations. They can also be grouped as care related, patient related, and performance related. They also may be classified according to time: short term, intermediate, and long term.
Outcomes that demonstrate the effectiveness of nursing care are known as nursing-sensitive outcomes.
Indicators specify how the outcome should be measured. Usually, quantitative measures are used.
Four major factors should be considered when considering outcomes: patient populations, team selection, organizational priorities, and mandated reporting.
Outcomes may be derived from a variety of sources such as NOC, clinical practice guidelines, standards of care, and Forces of Magnetism. CQI and benchmarking are processes that involve outcome evaluation.
Conclusions are best drawn when outcomes are clearly defined, data are carefully collected, and findings are compared to baseline data. Considerations should be given to possible extraneous variables.
CHAPTER 18 Sharing the Insights With Others
Janet M. Brown and Nola A. Schmidt
CHAPTER OBJECTIVES
At the end of this chapter, you will be able to:
• < Discuss the importance of dissemination of research findings to building evidence-based practice
• < Recognize the importance of dissemination in the cycle of science
• < Explain how poster presentations are useful to disseminate new knowledge
• < List the essential components of a well constructed poster
• < List elements that must be considered when preparing a manuscript
• < Discuss the process for submitting a manuscript for publication
• < Describe strategies that make oral presentations successful
• < Demonstrate professional behaviors when attending conferences
• < List strategies to get the most out of conference attendance
• < Discuss why nurses are obligated to participate in the process of dissemination
KEY TERMS
authorship
call for abstracts
dissemination
manuscript
networking
papers
posters
presentations
18.1 Dissemination: What Is My Role?
At the end of this section, you will be able to:
< Discuss the importance of dissemination of research findings to building EBP
< Recognize the importance of dissemination in the cycle of science
EBP cannot be successful if nurses fail to read or hear about new knowledge. Evidence must be made available in accessible and comprehensible ways so that innovations are adopted. Dissemination is the communication of clinical, research, and theoretical findings for the purpose of transitioning new knowledge to the point of care. EBP cannot evolve unless communication channels in the societal system are used effectively to bring about change. Dissemination of findings is most successful if multiple methods are used over time. In the profession of nursing, there are three major ways that new knowledge is disseminated: posters, papers, and presentations. These are often referred to as the 3 Ps of dissemination.
Every healthcare discipline faces the challenge of conveying research findings to clinicians in a timely manner. Cronenwett (1995) notes that most nurses are not familiar with research methods and that because they are busy providing patient care, they have little time to keep up with new knowledge. She suggests that attention be given to: a) what information should be disseminated, b) the most effective way for nurses to access the information, and c) to whom the information should be targeted.
Recall the four phases of the cycle of scientific development: theory development, research, dissemination, and application to practice. All nurses must be accountable for professional activities that facilitate dissemination. Just as theorists and researchers have responsibilities to communicate findings, nurses have responsibilities to actively seek and apply new knowledge. Without dissemination, there is no reason to develop theories and conduct research because nurses would not read and hear about the latest findings.
FYI
Dissemination is the communication of clinical, research, and theoretical findings for the purpose of transitioning new knowledge to the point of care. EBP cannot evolve unless communication channels in the societal system are used effectively to bring about change.
TEST YOUR KNOWLEDGE 18-1
1.
New knowledge is effectively disseminated through
a.?papers
b.?posters
c.?proclamations
d.?presentations
2.
Dissemination is important for which of the following reasons?
a.?Publishers need to make a profit.
b.?Most research grants require reporting.
c.?New knowledge is transmitted to patient care.
d.?Theorists and researchers need something to do.
3.
Dissemination is an important phase in
a.?the cycle of scientific development
b.?the Krebs cycle
c.?the cycle of life
d.?the cycle of professional nursing
How did you do?
1.
a, b, d;
2.
c;
3.
a
KEY TERM
Dissemination: Communication of clinical research and theoretical findings to transition new knowledge to the point of care
18.2 The 3 Ps of Dissemination
At the end of this section, you will be able to:
< Explain how poster presentations are useful to disseminate new knowledge
< List the essential components of a well constructed poster
< List elements that must be considered when preparing a manuscript
< Discuss the process for submitting a manuscript for publication
< Describe strategies that make oral presentations successful
Posters
Posters are an important scholarly venue for disseminating evidence (Horne, Kosper, & Carpenter, 1993). A major advantage of poster presentations over other methods is that opportunities for networking exist. Poster sessions allow for interactions among professionals. Presenters receive immediate feedback from a variety of individuals who attend the poster session. Interactions allow for the exchange of ideas about areas of common interest (Moneyham, Ura, Ellwood, & Bruno, 1996). The versatility of the poster as a medium for dissemination makes it effective in a variety of situations. Posters are often used in the clinical arena to convey innovations or describe EBP. At professional conferences, research studies are often summarized in a poster display. Nurses may have opportunities to display posters at their places of employment. A poster could be displayed on a unit or in an area where staff members are likely to gather, such as the cafeteria or hallway. Because dissemination from individuals in clinical practice is essential to building nursing knowledge, unit-based posters are an excellent opportunity for nurses to disseminate the unique knowledge they possess. Evidence-based projects, quality improvement, and interesting patient case studies lend themselves to poster presentations. For example, a nurse notes that a better way is needed for securing scalp needles used with infants. Over time, he devises a technique that is superior to other taping methods. A poster presentation would be an ideal way to share his innovation with other nurses. Poster presentations are a mainstay of professional conferences. Most all major conferences include at least one poster session, and such sessions are growing in popularity to the point that it is not uncommon to have several sessions throughout a conference. Because poster submissions are usually competitive, it is an honor to have a poster selected for display.
KEY TERMS
Poster: Scholarly venue for disseminating evidence
Networking: Interacting with colleagues to exchange information and build relationships
Call for abstracts: Notices publicizing the desire for posters or presentations at conferences
FYI
The three Ps of dissemination are: posters, papers, and presentations. Nurses have an obligation to facilitate dissemination, and can best participate in this by learning the proper processes and methods of the three Ps of dissemination.
How to Be a Poster Presenter
There is a typical process for selecting individuals to present at poster presentations. To be considered for presentation, individuals are required to submit an abstract summarizing the project. Abstracts are peer reviewed using stringent criteria. To increase the likelihood of having an abstract selected, attention to poster guidelines when writing an abstract for submission is critical. For example, it would be expected that the abstract contain the exact headings as specified in the guidelines. Another way to increase the chances of having an abstract accepted for presentation is to consider whether the poster would be appropriate for the audience expected at the conference. Notices, also known as a call for abstracts, publicize that submissions for abstracts are being sought. Calls for abstracts typically include information about submission and provide clues about the intended audience. Information in the call for abstracts can help one decide if a topic is congruent with the conference objectives. For example, if childhood obesity is the focus of a conference, it is unlikely that a poster about obesity in older adults would be selected. Carefully matching one’s scholarly work to the appropriate conference can reduce wasted effort and disappointment. See Table 18-1 for tips on how to write a good abstract.
TABLE 18-1 Tips on How to Write a Good Abstract
< Target appropriate audience and conference aim
< Ensure abstract is submitted by the deadline
< Carefully follow directions for formatting
< Use appropriate font and font size (Arial and Times New Roman 10 and 12 allow maximum wordage in a limited space)
< Adhere to the word limit specified
< Provide biographical and contact information as requested
< Keep title clear and concise using less than 10 words
< Write in past tense
< Provide key information in a succinct manner
< Correct errors
< Ask a colleague to provide feedback
< Check for spelling mistakes
< Take 5 minutes to conduct a final check
Source: Adapted from Coad & Devitt (2005) and Duchin & Sherwood (1990).
Individuals who submit abstracts for consideration at a conference are notified about the outcome of the review. With the acceptance of an abstract come several professional obligations. It is important to indicate acceptance of the invitation. If circumstances have changed and it is necessary to decline, doing so in a timely manner will allow the selection committee to fill the spot. When a commitment to present is made, it is essential to fulfill that commitment. Conference attendees become disgruntled if presenters are absent. If circumstances warrant an absence, having a colleague present is an acceptable alternative. Registration and payment of conference fees is required of most presenters but, sometimes a reduced fee is available.
When at the conference, presenters have a responsibility to fulfill the obligations of being a presenter. There are designated times for setting up and taking down posters. Presenters should adhere to these scheduled times. Presenters should make themselves available next to their posters during poster sessions to answer questions and convey excitement about the topic (Ellerbee, 2006). It is not unusual for attendees to seek out specific presenters who have similar interests. This type of networking is invaluable. Poster sessions provide an excellent forum for nurses from different settings to meet and exchange information (Botter, Giardino, & Wolf, 1990). Having handouts containing information not included in the abstract promotes dissemination. It is often helpful to offer business cards to individuals who are interested in your work (Ellerbee). If your organization does not provide business cards, it is easy to make your own (Figure 18-1).
FIGURE 18-1 Example of Self-designed Business Card
Tips for Creating Effective Posters
Regardless of the environment or setting in which posters will be displayed, they should be created to effectively communicate ideas. Attention to both content and appearance is necessary. Creating posters requires more skill and effort than is usually anticipated, but while it is time consuming, most nurses find the process to be rewarding (Botter et al., 1990). There are many strategies that can be used to enhance delivery of the message. No matter how attractive a poster appears, if attention is not given to content, dissemination of information is diminished. It is helpful to ask, “What is it that viewers should know after reading this poster?” Having this outcome in mind focuses the scope of the content to be presented. The message should be straightforward, and the text should be written in a common and meaningful language. Complete sentences are not needed, and content can be mixed with charts and graphs. Staggering bullets in an outline format is an effective way to present content and avoid redundancy. Jargon, abbreviations, and symbols should be avoided unless it is certain that the intended audience will recognize them. The goal is to be succinct yet deliver a complete message (Duchin & Sherwood, 1990). It should take viewers no longer than 5 minutes to read a poster (Ryan, 1989).
Specific content to be included on a poster is often outlined in the call for abstracts. Every poster should have a title and indicate the authors and their affiliations. It is acceptable to include a logo of the affiliation. Most posters will also include a purpose statement. Other content is determined by the type of information that is being presented. See Table 18-2 for a listing of content typically included in posters. Acknowledgment should be given to organizations that provided funding for the project. It is also acceptable to acknowledge individuals who provided assistance for the project.
TABLE 18-2 Content Typically Included in Posters
Research EBP Clinical Case Study Quality Management Project
Title/Author/Affiliation Title/Author/Affiliation Title/Author/Affiliation Title/Author/Affiliation
Research Aim, Question, Hypothesis PICO Question Clinical Problem Clinical Issue
Review of Literature Review of Literature Background Information Description of Team
Conceptual Model Method Assessment Preparation
Research Design Synthesis of Findings Nursing Diagnosis Planning
Sample Decision About Practice Plan Assessment
Results Implementation Implementation Implementation
Limitations Evaluation Evaluation Diversification
Discussion of Findings Discussion Discussion Discussion
Implications
Source: Adapted from Small Business Encyclopedia (n.d.)
No matter how well content is articulated in a poster, if the display is not visually appealing, individuals will not be enticed to read it. Consideration should be given to the layout, font, color, and graphics.
Arranging poster elements in a logical sequence allows the viewer to move easily from one section to another through the material. Title, author, and affiliation are usually centered at the top of the poster. Layout of the poster should be balanced with content flowing from top to bottom of each section. Typically, displays are divided into three sections. For example, 6 by 4 feet is a common poster size. The center section should be 4 feet wide, leaving a 1-foot section on each side (see Figure 18-2). Important information should be placed at eye level at the center of the poster. Arrows can be used to direct viewers, and it is acceptable to vary the orientation of the pages (Ellerbee, 2006; Moneyham et al., 1996). Layouts should appear scholarly and professional. Presenters should avoid cluttering layouts with items such as ribbons, lace, and flowers because these items distract from the information being presented.
It is important to select fonts that make the content easy to read (Ellerbee, 2006). Titles and headings should be easily visible from 3 to 6 feet away. This means that letters should have a font size of 96 points or more (2–3 inches high). Other text should be visible from 2 to 4 feet away; therefore, font sizes of 24 to 36 points (about 1 inch high) are recommended. A simple way to test if the font is large enough is to place the poster on the ground. If it can be read while standing over it, the font size is sufficiently large. Fonts should be limited to one or two different styles. A roman-style font with a serif type is recommended. It is easier to differentiate similar looking letters and numbers because serif typefaces have tails or feet. By limiting each line to no more than 30 characters and having no more than six lines of text per heading, content can be kept organized and succinct. Consistency in the use of capitalization and punctuation should be maintained. Capital letters are usually used for titles and headings.
FIGURE 18-2 Logical Layout for EBP Posters
Source: Image © Photos.com
While selecting colors for posters is fun, choices should make material more attractive and emphasize important content (Duchin & Sherwood, 1990). Sometimes easels are provided for poster displays. If this is the case, background colors are not easily altered and will usually be brown, dark blue, or dark gray (Ellerbee, 2006). Selecting colors that compliment standard backgrounds is advised. Dark-colored fonts on lighter backgrounds are the easiest to read. Bright colors attract while complementary colors provide the greatest contrast (Duchin & Sherwood). Red and green are often used to highlight critical information; however, use of these two colors should be limited because some individuals have difficulty distinguishing them (Ellerbee). Sometimes presenters select colors because they represent a particular topic. For example, a poster on breast cancer may include pink as an accent color because this color is associated with breast cancer. Construction paper, color-coded art paper, or commercial paper with preprinted designs are inexpensive ways to add color (Duchin & Sherwood). Picture mattes, another way to add color, add dimension and provide distinct boundaries for content sections. Preformed letters or stencils are sometimes used on picture mattes for the title, author, and affiliation. Although mattes can be more costly than construction paper, they can be reused over a number of years. Because color choices have both scientific and artistic implications, presenters can make color choices based on evidence from the literature.
Including graphics is an effective way to present content in a parsimonious manner. Bar charts, line graphs, pie charts, diagrams, and scatter plots can communicate a wealth of information in a limited space. They are also an effective way to integrate color into the display. Clip art is another kind of graphic that can add interest to posters. For example, if the topic is about infant care, then a border showing babies would be appropriate. Overuse of clip art is discouraged. Clip art of nurses’ caps and the medical caduceus are not suitable to include in scholarly nursing presentations.
There are several alternatives available for printing and assembling posters. The most cost-effective approach is to create PowerPoint slides. Printing slides on higher grade paper conveys a sense of quality and professionalism. Some presenters laminate their slides to protect them; however, glare may result, making reading more difficult. Office supply companies can print and laminate PowerPoint slides, but it is wise to obtain price quotes before engaging in these services. Some presenters have access to large printers capable of printing on paper up to 4 feet wide. Entire posters are printed on a single sheet of paper that can be rolled and placed in a tube for easy transport to conferences. There are some disadvantages to this approach. Because large printers are slow and require skill to use, printing ahead of time is advisable. If typographical errors are found and revisions are needed, the entire poster, rather than a single slide, could require reprinting. Another drawback to using large printers is that presenters have a tendency to include too much information, making it difficult to read the posters. Regardless of the method selected to print materials, it is never acceptable to handwrite posters for a professional presentation. Presenters often use Velcro, push pins, or staples to attach their posters to display boards. Regardless of the method used, it is important to securely anchor the poster. Coming prepared with extra supplies is helpful because it is not uncommon to encounter problems when hanging posters. If traveling to conferences by air, it is wise to carry aboard posters to ensure that materials arrive with you.
No matter how many times presenters proofread their posters, it is still possible for an error to be overlooked. Completing posters with sufficient time for obtaining feedback from colleagues is invaluable. For feedback to be constructive, colleagues must be comfortable offering criticism and suggestions. It is recommended that after assembling posters, presenters step back and critically appraise their work. Referring back to submission criteria while appraising can ensure that posters meet conference goals.
Papers
Scholarly papers are published in a variety of venues and are essential for disseminating knowledge. Nurses in clinical areas are in an excellent position to write and submit papers about case studies, EBP, and quality management projects. Researchers, theorists, and nurse educators also publish papers for the purpose of extending nursing’s body of knowledge. While there are many types of scholarly papers, the process of submission tends to be the same and is similar to the process of submitting a poster abstract. There are several helpful strategies that can assist novice writers to get started. One strategy is to submit a paper based on an already presented poster because the abstract and outline are already prepared. Gray (2005) recommends writing daily for 15–30 minutes and provides some tips for accomplishing this (see Table 18-3). Writing daily helps to form good habits about writing and leads to feelings of accomplishment. Another strategy is to recruit a colleague and have standing appointment times designated for writing. Collaborating with others creates accountability and can also be fun. It can be productive when novice writers collaborate with more seasoned writers.
KEY TERM
Papers: Manuscripts published in professional journals
Authorship: List of authors in order that reflects the amount of their contributions
Manuscript: A scholarly paper prior to its publication
TABLE 18-3 Tips for Writing for 15-30 Minutes a Day
< Write in the same place every day.
< Write at the same time every day, preferably in the morning.
< Put your writing time in your calendar as an appointment.
< Start your writing session in the same way each day.
< Learn to stop internal and external interruptions.
Source: Adapted from Gray, 2005.
When collaborating with others, it is important to determine authorship at the onset. Authors are listed in terms of their contribution to the paper. Usually the idea for the paper was generated by the first author. Other authors are listed in an order reflecting the amount of their contributions. When writing teams have good collegial relationships, authorship may be rotated among members of the team. Early in one’s career, it is advisable to give consideration to the way one’s name will appear in publications. For example, some authors include a middle name or initial. Consistently using the same format builds publication recognition and facilitates citation chasing.
CRITICAL THINKING EXERCISE 18-1
When you publish an article, how will you want your name to appear?
After the decision to publish has been made, the next decision is to determine where the manuscript will be submitted. A manuscript is the term used for a scholarly paper prior to its publication. Just as with poster abstracts, consideration should be given to matching the topic and the intended audience with the purpose of the publication. Reading articles in journals to get a feel for their styles can help in determining if the manuscript would be a good fit. Query letters can be sent to journal editors to receive feedback about their interest in publishing the manuscript. It is accepted practice to send query letters to several editors simultaneously because the letter does not obligate the author to publish in that particular journal. See Box 18-1 for an example of a query letter.
When a decision is made about where the manuscript will be submitted, reviewing author guidelines is necessary. Adhering to the guidelines from the beginning saves time by eliminating the need to adjust a manuscript later. Journals specify the type of style to be used for preparation of manuscripts and expect that authors adhere strictly (Sigsby, 1992). For example, some journals require American Psychological Association style, while others may require Modern Language Association style. Guidelines will also specify the number of words in an abstract, page limits, font, headings, and other criteria. It is essential that the guidelines be followed meticulously because manuscripts can be rejected when authors fail to follow the criteria. Familiarity with the language and tone used in the journal will also facilitate writing. For example, it is preferred in some journals to use the term “nurses” while the term “clinicians” is used in other journals. There are resources available, such as Pyrczak and Bruce (2007), that provide suggestions for writing effective research reports or other types of articles.
BOX 18-1 Example of Query Letter
September 1,2010
Ms. Amy Sibley
Acquisitions Editor
Jones & Bartlett Learning
40 Tall Pine Drive
Sudbury, MA 01776
Dear Ms. Sibley:
I am in the process of preparing a manuscript entitled “How to Publish for Nursing: Tips for Getting it Done.” The intended audience is staff nurses, and it will be about 15 pages in length. Would you be interested in reviewing this manuscript for Hot Issues in Nursing? Please contact me regarding your interest as indicated below.
Cordially,
Suzanne Smith, BSN, RN
Critical Care Staff Nurse
123 Main Street
Springfield, IN 11111
555-454-6789
Suzy.Smith@yahoo.com
Obtaining feedback from colleagues during the writing process can be invaluable. Gray (2005) suggests sharing early drafts with nonexperts and later drafts with experts. Nonexperts can include family members, students, or colleagues in other disciplines. Because these individuals are less likely to understand the content, problems with organization and clarity are more likely to be identified. Experts are individuals with advanced degrees in nursing. Such individuals can provide reviews about the content as well as organization and clarity. Another way to obtain feedback is to join a writing circle (Gray, 2005). In writing circles, writers convene weekly, giving feedback on only a few manuscript pages. The group is given 5 minutes to read the work of one member. Discussion follows during which members indicate for each paragraph the topic sentence, providing rationales for their choices. If the writing is clear and organized, there will be agreement about the topic sentences. For nurses affiliated with universities, writing centers offer another resource for obtaining feedback. Just as with submission of poster abstracts, it is essential to review manuscripts many times prior to actually submitting them for publication.
There are many similarities between the process of submitting an abstract for presentation at a conference and submitting a manuscript for publication. It is important to review the author guidelines for instructions about submission. Many journals only accept submissions online. Editors of peer-reviewed journals will send blinded copies of manuscripts to several experts for review. Peer reviewers may be selected because of their expertise about the topic, the research method, method of analysis, or theory. For journals not using a peer review process, manuscripts are reviewed by the editor. The length of time it takes for the review varies among journals, but one can expect to wait 3–6 months for a response. It may be tempting to submit manuscripts to multiple journals at the same time, but this is absolutely unacceptable practice. A manuscript cannot be submitted to a second journal unless it is rejected by the first or the author withdraws the manuscript submission. Eventually, authors receive notice about the status of manuscripts. Editorial decisions about manuscripts usually fall into one of four categories: accept, accept with minor revisions, accept with major revisions, and not accepted for publication. Feedback from peer reviewers is usually included with notification of the decision. It is rare for a manuscript to be accepted for publication outright. Most often, minor or major revisions are required. Using feedback from peer reviewers to make revisions is often an effective way to ensure acceptance of the manuscript on a second submission. While it is natural for authors to be disappointed when manuscripts are rejected, they should immediately investigate other opportunities for submission. Feedback from peer reviewers can be used to make revisions, and another journal can be targeted.
Oral Presentations
Like posters and papers, oral presentations are an effective way to disseminate new knowledge. The submission process is very similar to poster abstract submissions. In fact, nurses must often decide whether to deliver a poster or presentation when submitting an abstract to a conference. Authors elect to present orally when the topic is too complex to present in the space of a poster. Philosophical and theoretical work is best suited for oral presentations. While posters work especially well for disseminating information about pilots and work in progress, completed work may be disseminated best through oral presentations.
KEY TERM
Presentations: Scholarly oral presentations to disseminate new knowledge
There are professional responsibilities, similar to poster presentations, which must be fulfilled when accepting invitations to present papers. Many times presenters must submit their PowerPoint slides and handouts in advance of the conference. Objectives for presentations are often requested so that conference planners can apply for continuing education credits. Late fees might be assessed to presenters failing to meet deadlines. Should presenters find themselves unable to attend a conference, sending colleagues to substitute is preferable to canceling.
Successful oral presentations are a result of careful preparation and attention to detail. Principles related to layout, font, color, and graphics of poster preparation are applicable to the preparation of slides that accompany oral presentations. Presentations begin by showing a title slide followed by a slide acknowledging funding sources and contributors. It is recommended to have one slide for every 30–60 seconds. Novice presenters are advised to read papers from typed scripts rather than ad-libbing. Without experience, ad-libbing frequently results in a disorganized presentation that goes beyond the time limits. One can expect that one double-spaced typed page with 1-inch margins using an average sized font equals 2 minutes of speaking time. The best way to gauge the length of the presentation, however, is to rehearse the presentation aloud while using the visual aids. Typically, people speak faster when presenting than when rehearsing. Inserting visual cues into the script, such as “slow down” or “breathe,” serves as a reminder for maintaining an appropriate speaking pace. Another helpful strategy to aid delivery is to enlarge the font so that the script is easier to read. Time should be allotted for questions at the end of the presentation.
CRITICAL THINKING EXERCISE 18-2
You have been asked by a professor at your college to collaborate on a paper for publication in a peer-reviewed nursing journal. The professor expects you to do all of the research and writing, and stated that you will be acknowledged for your assistance, but that your name will not appear as an author on the article. What ethical issues need to be discussed in this situation? What action, if any, would you take?
It is smart to avoid the two most common mistakes made by presenters. First, the audience can become disengaged from the presentation when presenters read directly from slides. Keeping PowerPoint slides bulleted with phrases discourages this practice. Presenters should strive to present more depth and detail about the topic through speaking rather than through visual aids. The second most common mistake occurs when presenters disregard time constraints. It is expected that presenters adhere to the time limitations for their presentations. It is inconsiderate to continue speaking after room moderators have indicated that the time has expired. Another way presenters disregard time constraints is by failing to be present during the entire paper session. Four to six papers are typically grouped together over 90 minutes. Presenters should arrive well before paper sessions begin and confirm their presence with room moderators and confirm that last-minute scheduling changes have not been made. Arriving early also allows an opportunity to test audiovisual aids. Presenters are expected to make themselves available at the conclusion of paper sessions because attendees might wish to network. Having business cards to share with colleagues during this time is advisable.
TEST YOUR KNOWLEDGE 18-2
1.
When making a poster, which of the following should you do?
a.?Use full sentences and avoid using bullets.
b.?Use color to emphasize important points.
c.?Fancy or script font is desirable because viewers find them attractive.
d.?Acknowledgment of funding sources is not included because of space limitations.
2.
Which of the following are strategies that are helpful when beginning to write a paper?
a.?Writing 15–30 minutes a week
b.?Collaborating with others
c.?Selecting a journal for submission
d.?Adapting a poster presentation
3.
When delivering oral presentations, presenters should do which of the following?
a.?Respect time constraints
b.?Remain to the end of the paper session to network
c.?Read from the PowerPoint slides
d.?Ad-lib to make the presentation more conversational
How did you do?
1.
b;
2.
b, c, d;
3.
a, b
18.3 Making the Most of Conferences
At the end of this section, you will be able to:
< Demonstrate professional behaviors when attending conferences
< List strategies to get the most out of conference attendance
Not only are conferences excellent venues for dissemination of new knowledge, but they also provide opportunities for developing connections with colleagues having similar interests, meeting experts in the field, and exploring career opportunities. Conference participants should take full advantage of networking opportunities to make the most of their experiences (French, 2000).
Maintaining a professional demeanor at all times is advantageous because you never know who you might meet or what opportunities could arise. For example, it is possible to be offered the opportunity to interview for a position with a leading expert in your specialty. Invitations to collaborate on papers and research studies are not uncommon. For individuals considering graduate study, networking with students and faculty from programs under consideration can be helpful. Questions about various programs can be answered when conversing with these individuals. It pays to be professional at all times. For example, individuals may find themselves sitting next to the dean of the graduate program under consideration. It would be quite uncomfortable to have an admission interview with this dean if the image portrayed is unfavorable.
FYI
Not only are conferences excellent venues for dissemination of new knowledge, but they also provide opportunities for developing connections with colleagues having similar interests, meeting experts in the field, and exploring career opportunities. Professional behaviors always make favorable impressions and should be practiced when attending conferences.
Professional behaviors always make favorable impressions and should be practiced when attending conferences. Participants should dress professionally. While attending a conference is a day away from work, it should not be considered a day off. Wearing sweatpants or jeans to be comfortable is not acceptable. It is customary for individuals to wear business suits or skirts or trousers that are paired with conservative blouses, sweaters, or jackets. Layering clothing is always wise because presentation rooms can vary in temperature. Arriving on time, introducing yourself to others, and offering a handshake make excellent first impressions. Inquiring where someone is from or why they chose to attend this conference are good ways to begin a conversation. If individuals find areas of common interest, having a business card to share facilitates networking. Allowing cell phones to ring during presentations shows disrespect for both presenters and members of the audience. Phones should be either turned off or silenced. It is also rude to converse with other attendees during presentations.
It is best to take full advantage of conferences because they can be costly to attend. Reviewing conference programs in their entirety allows participants to select sessions that pertain to their interests. Abstracts contain valuable information that helps identify presentations and posters of interest. Highlighting or writing out a schedule of preferred sessions ensures that time is maximized. It can be disappointing to overlook a scheduled session of interest. When planning a schedule, keep in mind that it is acceptable to change rooms between presentations during the same session time. If attending conferences with colleagues, it can be tempting to attend all sessions together. However, to maximize exposure to new ideas, it is wise to split up and share information later.
TEST YOUR KNOWLEDGE 18-3
1.
When attending a conference, which of the following behaviors are acceptable?
a.?Wear business attire.
b.?Keep cell phones on silent or vibrate.
c.?Feel free to come in and out of sessions at will.
d.?Share business cards with other attendees.
2.
Which of the following strategies help make the most of conferences?
a.?Attending receptions.
b.?Attending all sessions with your friends.
c.?Planning a schedule in advance.
d.?Talking with experts.
How did you do?
1.
a, b, d;
2.
a, c, d
In addition to the sessions, conferences offer many other opportunities for networking. Some of the most important exchanges of information occur during conversations in hallways or at receptions. Viewing poster sessions, visiting vendor exhibits, and attending meals and breaks provide opportunities to meet new people or renew friendships. If there is a respected authority you would like to meet, introduce yourself. Most experts are eager to discuss their work. Networking, like dissemination, is vital to building the discipline of nursing.
18.4 Keeping It Ethical
At the end of this section, you will be able to:
< Discuss why nurses are obligated to participate in the process of dissemination
“The overall purpose of research dissemination is to begin the process of getting new knowledge used for the good of society” (Cronenwett, 1995, p. 430). There are increased demands for healthcare providers and systems to be efficient and effective in providing patient care. Nurses can no longer plead ignorance of new knowledge. They must be accountable for creating best practice by rapidly moving new information to the point of care (Cronenwett).
FYI
Nurses have a responsibility to actively participate in the process of dissemination. Reading articles, attending conferences, presenting posters and papers, and networking with other professionals are expected activities.
Having accountability means that nurses must use their resources wisely. Opportunities for dissemination are limited; space in journals and presentation times at conferences must be allocated fairly. Authors should never simply tweak a manuscript that has already been published to resubmit to another journal for publication as original work. Furthermore, it is a waste of time and money for nurses to attend conferences but not participate fully. Nurses are obligated to fulfill expectations placed on them by employers who sponsor attendance at conferences.
Nurses have a responsibility to actively participate in the process of dissemination. Reading articles, attending conferences, presenting posters and papers, and networking with other professionals are expected activities. Nurses can organize scholarly events in their facilities such as research days where posters about unit-based projects are presented. It is ethical practice to acknowledge authorship on all scholarly works. The power of sharing information about unit-based activities should not be underestimated. The discipline of nursing is lacking dissemination from individuals in clinical practice. Dissemination of knowledge within nursing also raises the visibility of nursing to the public. To support these types of activities, nurses must advocate for budget dollars and release time from employers.
TEST YOUR KNOWLEDGE 18-4
True/False
1.
Because information is growing at a rapid pace, it is acceptable for nurses to plead ignorance about new knowledge.
2.
All nurses are obligated to participate in the process of dissemination.
How did you do?
1.
F;
2.
T
By concluding the journey through this textbook, it is hoped that an appreciation for nursing research and its importance to EBP has ensued. With the knowledge and skills acquired through the content and application exercises, you are equipped to be an innovator by engaging in the process of moving evidence over time through the communication channels of social systems to improve patient care.
RAPID REVIEW
Dissemination is the communication of clinical, research, and theoretical findings for the purpose of transitioning new knowledge to the point of care. It is an important step of the cycle of scientific development.
The 3 P’s of dissemination are posters, papers, and presentations.
Posters are an excellent medium for disseminating information in a succinct and visually interesting manner. A mainstay of professional conferences, they can also be used at places of employment to communicate unit-based projects.
A manuscript is a scholarly paper prior to its publication. Like posters, many papers undergo a rigorous peer review process before being accepted for publication.
Oral presentations are an effective way to disseminate new knowledge when the topic is too complex to present in the space of a poster. Presenters have professional responsibilities, such as adhering to the time allotted and making themselves available for networking.
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