Running Head: REVIEW OF REFERENCES 1

Review of References
Jennifer Mynhier
Ferris State University

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Abstract
This paper will explore evidence-based practice (EBP), and the significance of research articles
and clinical studies. In addition, nursing research in particular will be defined as well as safety
and quality in nursing care. The goals of nursing research will be clarified. Levels of evidence
and impact factors will be defined to support the use of credible sources. It is vital to use
techniques in nursing that can be backed up by research.

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Review of References
Finding credible, reliable sources is very important for supporting current practices used
in the nursing clinical setting. The purpose of this paper is to re-evaluate references used to
guide practice decisions, using knowledge gained from the first few weeks of class (Singleterry,
p. 8). It is important to discuss finding trustworthy research articles based on levels of evidence.
With the tremendous emphasis on the importance of basing nursing care decisions on the best
available evidence to promote the highest quality of care for patients and families, evidence-
based practice has become a common phrase in healthcare (Armola et al., 2009, p. 70). It is
vital to know where this information is coming from and whether it can be relied upon.
Credibility
EBP is very important to the nursing community. Locating reliable studies and research
to support what nurses are doing in common practice is vital to patient safety. A credible source,
also known as scholarly or peer-reviewed as defined by Christianberry (2011), states peer
review is the process of manuscript assessment conducted by a panel of reviewers to evaluate
both the quality and relevance of a submitted manuscript (Christianberry, 2011, p. 15).
Healthcare is an ever changing field, so in order to change current practice or improve on it, it is
necessary to do research and clinical studies to prove that improvements can be made. Adding to
the above definition, Shattell, Chinn, Thomas, & Cowling (2010), made the point that
publication of research and other forms of scholarly work is critical to the development of
nursing knowledge that can be used in clinical practice (Shattell et al., 2010, p. 58).
Many studies that are done to improve clinical practices are not done by nurses, but by
doctors or scientists. It is useful to also find support from nursing research, as this is most often
done by nurses, therefore these studies may more directly relate to nursing care from the
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viewpoint of those that have been in the profession. Nursing research is directly defined by
Taylor, Lillis, LeMone, & Lynn (2011), encompasses both research to improve the care of
people in the clinical setting and also the broader study of people and the nursing profession,
including studies of education, policy development, ethics, and nursing history (Taylor et al.,
2011, p. 73). According to Nieswiadomy (2012), there are four goals of nursing research that
include the support of EBP, ensure credibility of the nursing profession as a whole, arrange for
accountability of nurses, and to document the cost effectiveness of care (Nieswiadomy, 2012, p.
4). These goals are necessary to keep in mind when attempting to change common practice by
using current research and available clinical trials.
To gage the creditability of an article, the American Association of Critical-Care Nurses
(AACN) has a new level of evidence system to replace the old method (see tables in Appendix
A). The new levels of evidence will be referred to in the articles referenced below. Armola et al.
(2009), explain the significance of using these levels. It is preferred to have research to back up
nursing practices, but research based on clinical trials and studies are not always available, so
case studies and the opinion of experts in the field can also be used, but will be listed as a
different level of evidence (Armola et al, 2009, p. 70). Furthermore, the impact factor of each
journal is referenced. The impact factor is a number used to evaluate the influence of a
particular journal. The higher the impact factor number, the more influence the journal is
thought to have (Nieswiadomy, 2012, p. 265). These levels and impact factors are tools that
can be used to determine the dependability of a study or article.
Article A
The first article to be discussed is by Tashkin, Klein, Colman, Zayed, & Schonfeld
(2007), this is a study done comparing three different treatments for chronic obstructive
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pulmonary disease (COPD). The study was published in The American Journal of Medicine
(AJM). This is a clinical research study of 140 randomized COPD patients (Taskin et al., 2007,
p.435). According to their website, the AJM publishes studies performed by multi-center
groups in the various disciplines of medicine, including clinical trials and cohort studies from
large patient populations and lists an impact factor of 4.768 (AJM, 2014). In reference to
Appendix A, this study would be considered to be a Level C, it includes a randomized control
study done, which was in support of a concomitant treatment, but did list some shortcomings of
the study that may prevent it from being a higher level. All five authors of this research study
have an MD or PhD, which supports them to be well qualified to run this study. As the authors
were doctors and not nurses, and it more aims towards the medical aspect rather than the nursing
side, this study would not be considered to be nursing research.
Article B
The second article to be discussed is done by Vermeeren, Wouters, Geraerts-Keeris, &
Schols (2004). It is a randomized controlled trial on patients with COPD nutritional support
during hospitalization. It is explained that many COPD patients are malnourished, and discusses
the use of oral nutritional supplements added to the patients diet (Vermeeren et al., 2004, p.
1184). This was published in the Clinical Nutrition Journal, which according to their website
the journal publishes guidelines, consensus statements, original articles, short communications,
letters to the Editor and review papers on those factors in acute and chronic diseases, which have
metabolic and nutritional implications and lists an impact factor of 3.298 (Clinical Nutrition
Journal, 2014). This was a randomized, double-blind, placebo-controlled two-center trial on 56
participants. It would be considered to be a Level B for evidence as outlined in Appendix A.
This study is considered to be nursing research as it can be used to support EBP in nursing care.
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Significance to Nursing
Related to the goals listed previously about nursing research, it is essential to find studies
and research directly related to nursing. It supports the profession as a whole, but also the safety
and quality of patient care. In relation to one of the goals of nursing research listed previously of
ensuring credibility of nursing, Nieswiadomy (2012), explains that one of the criteria for a
profession is the existence of a body of knowledge that is distinct from that of other disciplines
(Nieswiadomy, 2012, p. 5). Obtaining nursing research is the correct path to take to gain the
respect and knowledge to be competent in this line of work.
As stated by Cronenwett et al. (2007), quality improvement is defined as using data to
monitor the outcomes of care processes and use improvement methods to design and test changes
to continuously improve the quality and safety of healthcare systems (Cronenwett et al., 2007,
p. 127). The article also defines safety to minimize risk of harm to patients and providers
through both system effectiveness and individual performance (Cronenwett et al., 2007, p. 128).
The primary goal of nursing is not only for safety and quality of care to patients, but also safety
of those caring for the patients. It is key to keeping everyone as healthy and as safe as possible
to uphold best practice in the field.
Nurses in practice must demonstrate a significant competency in many aspects of care.
One source that outlines these roles is by the American Nurses Association (2010). It explains
the prominence of different nursing standards. One of the reasons for this publication is because
registered nurses are accountable for their professional actions to themselves, their healthcare
consumers, their peers, and ultimately to society (American Nurses Association, 2010, p. 18).
A few of these important standards that relate to this topic include Standard 9 which is in support
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of the importance of integrating EBP and research into nursing care. Standard 13 is based on
collaboration between nurses and the community, other nurses, healthcare consumers, and
families. All of the American Nurses Association standards should be used as guidelines for all
nursing care to help encourage responsibility in the nursing profession.
Conclusion
EBP is such a common theme in nursing now, that nursing research is becoming more
conventional. It is crucial to the profession to be sure that nurses are not practicing a certain way
just because that is the way it has always been done, but for the reason that there is actually
evidence to support that practice. There are several ways to go about determining the reliability
of the available research.


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References
American Nurses Association (2010). Nursing: Scope and standards of practice (2
nd
ed.). Silver
Spring, MD: American Nurses Association.
Armola, R. R., Bourgault, A. M., Halm, M.A., Board, R. M., Bucher, L., Harrington, L., Heafey,
C.A.,Medina, J. (2009). AACN levels of evidence: Whats new? Critical Care Nurse
29(4). Retrieved from: http://www.aacn.org/WD/Practice/Docs/Research/01%20-
%20AACN%20Evidence%20Levels.pdf
Christenbery, T. L. (2011). Manuscript peer review: A guide for advanced practice nurses.
Journal of the American Academy of Nurse Practitioners, 23(1), 1522.
doi:10.1111/j.1745-7599.2010.00572.x
Clinical Nutrition Journal (2014). About the journal. Retrieved from:
http://www.clinicalnutritionjournal.com/
Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., Warren, J.
(2007). Quality and safety education for nurses. Nursing Outlook, 55(3), 122131.
doi:10.1016/j.outlook.2007.02.006
Nieswiadomy, R. M. (2012). Foundations of nursing research (6th ed.). Boston, MA: Pearson
Shattell, M. M., Chinn, P., Thomas, S. P., & Cowling, W. R. (2010). Authors and editors
perspectives on peer review quality in three scholarly nursing journals. Journal of
Nursing Scholarship, 42(1), 5865.
Tashkin, D. P., Klein, G. L., Colman, S. S., Zayed, H., & Schonfeld, W. H. (2007). Comparing
COPD treatment: Nebulizer, metered dose inhaler, and concomitant therapy. The
American Journal of Medicine, 120(5), 435441. doi:10.1016/j.amjmed.2006.07.043
Singleterry, L. (2014) NURS 350 Research in Nursing [Syllabus]. p. 8.
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Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of nursing: The art and
science of nursing care (7
th
ed.). Philadelphia, PA: Wolters Kluwer Health Lippencott
Williams & Wilkens.
The American Journal of Medicine (2014). About the journal/journal vision. Retrieved from:
http://www.amjmed.com/aims
Vermeeren, M. A. P., Wouters, E. F. M., Geraerts-Keeris, A. J. W., & Schols, A. M. W. J.
(2004). Nutritional support in patients with chronic obstructive pulmonary disease during
hospitalization for an acute exacerbation: A randomized controlled feasibility trial.
Clinical Nutrition, 23(5), 11841192. doi:10.1016/j.clnu.2004.03.008
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Appendix A


http://www.aacn.org/WD/Practice/Docs/Research/01%20-%20AACN%20Evidence%20Levels.pdf