AACN News—May 2000—Practice

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Vol. 17, No. 5, MAY 2000

Congratulations to Research Grant and Award Recipients

Nursing research grants and awards are part of the AACN Circle of Excellence recognition program. The deadlines for these awards vary. Following are the recipients for 2000, as well as brief descriptions of the grants and awards that are available for 2001.

AACN Distinguished Research Lecturer Award
This award honors a nationally known researcher, who presents the annual Distinguished Research Lecture at the NTI. The lecturer receives an honorarium of $1,000, as well as $1,000 toward NTI expenses. Nov. 1, 2000, is the deadline to apply for the 2001 award. The recipient will present the Distinguished Research Lecture at the 2001 NTI, May 19 through 24 in Anaheim, Calif.

The recipient of the award for 2000, who is presenting the lecture at the 2000 NTI, May 20 through 25 in Orlando, Fla., was:

Sandra Hanneman, RN, PhD, FAAN
Houston, Tex.

AACN Research Abstract Award
This award recognizes research abstracts that have outstanding scientific merit and particular relevance to critical care nursing. Up to three research abstract awards and one research utilization abstract award are selected each year. The presenters receive $1,000 toward NTI expenses. The recipients for 2000 were selected from among the research and research utilization abstracts submitted for the NTI in Orlando. Sept. 1, 2000, is the deadline to submit abstracts for 2001 awards.

Recipients of the awards for 2000 were:

Barbara Daly, RN, MSN, PhD, FAAN
Cleveland, Ohio
“Post-Discharge Outcomes and Resource Needs of Long-Term Ventilator Patients”

Suzanne S. Prevost, RN, PhD, CNAA
Murfreesboro, Tenn.
“Research-Based Improvements in Pain Management”

Sandra Smith, RN, MS, PhD, APRN, NNP
Salt Lake City, Utah
“Physiologic Responses of Intubated Very-Low-Birth-Weight Infants During Skin-to-Skin Care (Kangaroo Care)”

Jill M. White, RN, PhD
Mequon, Wis.
“Patterns of Heart Rate Variability, Myocardial Ischemia, and Ventricular Ectopy During Recovery from Acute Myocardial Infarction”

Agilent Technologies-AACN Critical Care Nursing Research Grant

This grant, which is cosponsored by Agilent Technologies and AACN, provides research support for a study conducted by a critical care nurse. One $35,000 grant is awarded, providing $33,000 for the research and $2,000 for travel expenses associated with presentations of the study findings. The recipient may use up to $3,000 of the research award to purchase a personal computer, utility software and a printer to support the study. Computer-related expenses should be included in the budget and justified.

The grant is intended to support a well-defined, well-described project. The award selection is based on the scientific merit of the project; scientific and professional background of the applicant; adequacy of the facilities and resources available for the research; originality; and potential benefits to the care of critically ill patients. The preferred topic for this grant is the information technology requirements of patient management in critical care. Because this grant is intended to support research with direct clinical application to critical care nursing practice, proposals for basic science or animal studies are not eligible. Proposals must be received by Sept. 1, 2000.

The recipient of the Agilent Technologies-AACN Critical Care Nursing Research Grant for 2000 was:

Nelda Martin RN, MSN, CCRN, CS
St. Louis, Mo.
“Influence of Automatic External Defibrillators and ECG Telemetry Monitoring on In-Hospital Cardipulmonary Arrest Response Time and Patient Outcomes”

AACN Clinical Inquiry Grants
These grants provide awards of up to $250 to qualified AACN members who are carrying out clinical research projects that will directly benefit patients or their families. Funds are awarded for projects that address one or more AACN research priority and link with AACN’s vision. Applications must be received by July 1, 2000, or Jan. 1, 2001.

Receiving a Clinical Inquiry Grant for 2000 was:

Onna Koeneman, RN, BSN
Indianapolis, Ind.
“Traumatic Brain Injury Support Group for Families in the Acute Care Hospital Setting”

AACN Certification Corporation Research Grants

Up to four grants of up to $10,000 each are awarded to support research related to certified practice. Eligible projects may include, but are not limited to, studies that focus on continued competency; the Synergy Model; the value of certification as it relates to patient care or nursing practice; and credentialing concepts.

This program provides support for research studies. The proposed research may be used to meet the requirements of an academic degree. Although AACN members are encouraged to apply, AACN membership is not required. Applications must be received by Feb. 1, 2001.

Receiving the AACN Certification Corporation Research Grant for 2000 was:

Daphne Stannard, RN, PhD
San Francisco, Calif.
“Phase One of Patients’ and Families’ Perceptions of Being Cared For Well: A Phenomenological Study”

Sigma Theta Tau-AACN Critical Care Grant

This $10,000 grant is cosponsored by AACN and Sigma Theta Tau International. The grant may be used to fund research for an academic degree. Proposals for this grant must be received by Oct. 1, 2000.

Receiving the grant for 2000 was:

Mary Elizabeth Happ, RN, PhD
Philadelphia, Pa.
“Feasibility Study of an Augmentative Communication Device with Temporarily Voiceless Patients in Critical Care”

AACN Mentorship Grant

This $10,000 grant provides research support for a novice researcher with limited or no research experience to work under the direction of a mentor with expertise in the area of proposed investigation. The novice researcher is the principal investigator and receives the award. The novice researcher may be conducting the research to meet requirements for an academic degree, though the mentor may not. The mentor must show strong evidence of research in the proposed area. The mentor may not be a mentor on an AACN Mentorship Grant in two consecutive years. Proposals for this grant must be received by Feb. 1, 2001.

Receiving the Mentorship Grant for 2000 was:

Debra Lynn-McHale, RN, MSN, CS, CCRN
North Wales, Pa.
“Family Experiences Withdrawing Life Sustaining Therapy”

AACN Clinical Practice Grant

This $6,000 grant supports research focused on one or more AACN clinical research priority. Research conducted in fulfillment of an academic degree is acceptable. Proposals must be received by Oct. 1, 2000.

Receiving the Clinical Practice Grant for 2000 was:

Mary Ellen McNamara, RN, BSN
Melrose, Mass.
“The Effects of Back Massage Before Cardiac Catheterization”

AACN Data-Driven Clinical Practice Grant
This program provides six $1,000 awards to stimulate the use of patient-focused data or previously generated research findings to develop, implement and evaluate changes in acute and critical care nursing practice. Applications must be received by March 1, 2000, or Oct. 1, 2000.

Receiving Data Driven Practice Grants for 2000 were:

Janie Heath, RN, MSN ,CCRN, ACNP, ANP
Washington, D.C.
“Tobacco Dependence Curricula in Acute Care Nurse Practitioner (ACNP) Education”

Susannah Kish, RN, MSN, CCRN, CPAN
Houston, Tex.
“The Influence of Outcome Data on the Decision to Initiate Cardiopulmonary Resuscitation”

AACN Critical Care Grant

This grant awards up to $15,000. The proposed research may not be used to meet requirements of an academic degree. Proposals for this grant must be received by Feb. 1, 2001.

Receiving the Critical Care Grant for 2000 was:

Shu-Fen Wung, RN, PhD
“Early Assessment of Patients with Acute Posterior Myocardial Infarction Using a New ECG Criteria”

Medtronics Physio-Control AACN Small Grants Program

This program awards up to $1,500 to qualified individuals carrying out projects that focus on aspects of acute myocardial infarction resuscitation, such as the use of defibrillation, synchronized cardioversion, or noninvasive pacing or interpretative 12-lead electrocardiogram. Eligible projects may include patient education programs, staff development programs, competency-based educational programs, continuous quality improvement projects, outcomes evaluation projects, or small clinical research studies. Proposals must be received by July 1, 2000.

American Nurses Foundation Research Grant

Up to $5,000 is awarded by the American Nurses Foundation for this AACN-sponsored grant. The proposal deadline is May 1, 2001. Additional information about this grant and applications can be obtained from the American Nurses Foundation, (202) 651-7298, or by visiting the ANF Web site at www.nursingworld.org.

For more information about these Circle of Excellence grants and awards, call (800) 899-AACN (2226) or visit the AACN Web site at http://www.aacn.org.

Nursing Interventions Target Global Community

By the time Marilyn S. Sommers, RN, PhD, CCRN, FAAN, returned to graduate school in 1985, she had six years’ experience as a critical care nurse, had achieved her CCRN certification and had worked both as a clinical nurse specialist and a director of critical care.

Although she said she had been interested in testing nursing interventions through research, she did not believe she had sufficient skill and knowledge to do it. Certainly, she had no expectation of investigating global problems, she said.

As a surgical ICU nurse who had an interest in trauma nursing, Sommers joined ranks with Janice Dyehouse, RN, PhD, a social psychologist and therapist who treated people with alcohol problems. They began a series of preliminary studies at the University of Cincinnati College of Nursing in Cincinnati, Ohio, to test the effectiveness of a "brief intervention” strategy to reduce problem drinking and repeated trauma in hospitalized patients with alcohol-related injuries. When the intervention’s effectiveness appeared promising, they applied to the National Institutes of Health (NIH) for funding.

The initial responses from the review process were not particularly positive, Sommers recalled.

“The reviewers told us that, though we had a great idea, they didn’t think we were experienced enough to carry it out,” she explained. “I also sensed that they were uncertain about two nurses actually being capable scientists.”

Dyehouse subsequently attended a technical workshop conducted by the NIH, and returned with strategies to increase the team’s chance for obtaining funding. Using outside experts as consultants and extensively revising their proposal, Sommers and Dyehouse were able to secure $2 million in funding as principal investigators for clinical trials from two federal agencies—the National Institute on Alcohol Abuse and Alcoholism and the Centers for Disease Control and Prevention.

With the clinical trials under way, Sommers began traveling to international conferences.

“I had a particular interest in vehicular injury, and realized that traffic injuries are the next global epidemic,” she commented.

Both the National Safety Council and the World Health Organization echo her concerns. The National Safety Council’s International Accident Facts for 1999 revealed that motor vehicle crashes are the leading cause of unintentional death in 25 of 37 reporting countries. The World Health Organization reported that one in every 10 hospital beds in the world are used for injured patients.

“There has been a great deal of interest in our brief intervention work because it is a tangible strategy that healthcare professionals can use to prevent injury recidivism,” Sommers said. “I think it works particularly well with nurses, because they can learn the intervention easily, and they have great access to patients.”

Sommers has consulted with psychologists and physicians in Montreal, Canada, and traveled to Barcelona, Spain, where she explained the brief interventions strategy and reported the team’s preliminary findings to help the Spanish government lay the groundwork to establish a similar program. In addition, the Mexican Institute of Transportation is interested in collaborating with the team to address vehicular injury as a public health problem there.

“This year, we hope to start a clinical trial in Monterrey, Mexico, with nurse-interventionists,” Sommers said.

How does a surgical ICU nurse become an international researcher?

“We built a strong scientific team, asked important questions about nursing interventions and thought globally when it came to research dissemination,” Sommers responded. “The rest just fell into place.”

Nevertheless, Sommers said her roots remain tied to her clinical practice.

“I still work in the surgical ICU when I can, and will present at the NTI (AACN’s National Teaching Institute) this year, just as I have often before. “The main difference is that, as soon as I have given my NTI talks, I’m heading to the airport to travel to a traffic conference and continue a consultation in Sweden. That is a big change!” Sommers noted.

Marilyn S. Sommers is a professor in the College of Nursing at the University of Cincinnati, Cinncinnati, Ohio.

Link Research With the Bedside Practitioner

By Kathleen M. Vollman

How do you or your staff react to the word research? “I could never do that.” “I don’t know how I would ever get started.” Do you frequently hear comments such as: “Research is so boring.” “The process seems frightening and overwhelming.” This type of thinking can deter the advanced practice nurse (APN) and the staff nurse from entering the world of clinical nursing research.

Many nurses have little or no exposure to research as part of their initial nursing education. The tendency is to liken reading research to trying to decipher a highly specialized code. However, there are strategies that can help overcome the fear of research, and create a passion for inquiry, as well as a unit culture that always questions the practice and begins to look for the answers.

How do we start the journey? The key is creating a researchfriendly climate, for which three conditions are necessary—mentorship by the APN; an increased comfort level in reading research; and frequent and consistent questioning of practices and actions.

APNs as Mentors
To serve as a resource to the bedside nurse and encourage involvement in making changes to incorporate research in clinical practice, the APN must have strong knowledge and skills in research and the managing change process. Staff nurses often feel that exploring new areas is overwhelming and not within their reach. Encouraging and motivating staff to continue growing are important aspects of mentorship. Role modeling research utilization behaviors is also an essential component of the mentoring process. An effective response when staff inquire about a clinical question is to respond with “the literature says” or “this research study demonstrated,” which points to evidence of research utilization.

As part of the mentoring process, the APN must connect with knowledgeable resources not only to mentor the staff, but also to find mentors for themselves in the research process. One strategy is to create a successful marriage between clinical practice and education by linking the bedside nurse with a graduate student or the APN with a doctorate-prepared faculty member.

Journal Clubs
There are a number of ways to make learning to read research less painful and, possibly, even fun. One way to initiate the beside nurse into the adventure of reading and understanding research is through the development of a journal club. Before beginning, provide the staff with a process or structure that outlines a step-by-step mechanism for reviewing a research article. Included in this structure are the definitions of research terms that might be unfamiliar to the participant. This process is similar to a “how to” guide that staff would complete prior to the journal club by reading the article and scoring each phase of the study.

The journal club group then meets quarterly in an informal setting with an APN facilitator. The research article chosen is always based on a clinical question that arises from the bedside. The article and worksheet are placed in the staff mailboxes two weeks prior to the meeting.

This allows staff adequate time to get answers to their questions and significantly increases personal ownership and participation in the process.

The secret and strength of the journal club learning process is that, in the process of learning how to read research, some of the knowledge and skills needed to conduct research are developed. In addition, the outcomes of the reviews often lead to revisions in policies and procedures, thus moving away from tradition and closer to nursing practice based on science.

Some examples of journal club topics that arise from clinical questions asked at the bedside are;
• Is it necessary to use pre- and posthyperoxygenation with in-line suctioning?
• Should we routinely use saline with suctioning?
• Does the Trendelenburg position have any real benefit on blood pressure and cardiac output?
• Which patients benefit from lateral rotation and prone positioning therapy?

Questioning Practice
The third essential component to creating a research friendly climate is the process of continually questioning practices and actions within the work environment. When a nurse raises a question at the bedside, the immediate response should be, “I wonder what the literature says about that”; then examine the literature together. By continuing this process of always questioning what we do and attempting to find the answers in the literature, a new culture is set for the unit environment.

Once the questioning environment exists, you will see the attitudes of the staff changing as they become more comfortable with research. Through questioning practices and finding answers, staff members realize that they can make a difference. At this point, the bedside nurse is ready to move into projects that help them learn the skills to find the answers to their own clinical questions.

The most successful way to become comfortable with conducting research is to take “baby steps” in your preparation. Two strategies have been suggested to help the bedside nurse learn research skills without becoming overwhelmed—participating in quality improvement projects and conducting product evaluations. These projects help build research skills by refining techniques for asking a clinical question and developing skills for designing methodologies and data collection. Introducing the nurse to the world of statistics can be accomplished without a formal research project that could scare off interested participants. An additional benefit of starting with quality improvement projects or product evaluations is that most of these programs can be revised and turned into formal research, which provides the participant with a head start.

Research-based practice is necessary to achieve cost-effective, quality outcomes when caring for the critically ill patient. Knowledge of the research utilization process and of conducting research is key not only to changes in practice at the bedside, but also to continued advancement of the science of nursing. Without a planned, systematic program to create a research-friendly climate, successful and consistent application or conduct of nursing research will not take place.

Kathleen M. Vollman, RN, MSN, CCNS, CCRN, is a clinical nurse specialist in medical critical care at Henry Ford Hospital, Detroit, Mich. She is a member of the AACN Advanced Practice Work Group.

Submit Your Research or Creative Solutions Abstracts

Submit your research and research abstracts or your creative solutions abstracts for AACN’s National Teaching Institute™ and Critical Care Exposition in 2001 in Anaheim, Calif. Sept. 1, 2000, is the deadline for submissions.

Presenters of selected abstracts receive a $75 reduction in NTI registration fees. All other expenses are the responsibility of the presenter, who can be either the first author or a designate of the author.

NTI 2001 is scheduled for May 19 through 24. Following is information about these abstracts:

Abstracts can focus on any aspect of critical care nursing research including reports of research studies or reports of research utilization. Only abstracts of completed projects will be accepted.

Abstracts reporting research studies must address the purpose; background and significance; methods; results; and conclusions.

Creative Solutions
Abstracts should focus on specific strategies and practice innovations that are used by nurses to solve difficult, unique or interesting problems in patient care, nursing practice, nursing management or nursing education. The creative solution must have been implemented, with outcomes evaluated.

Abstracts must address the purpose of the project and include a description of the creative solution, as well as evaluation and outcomes.
Accepted abstracts will be designated either as an oral presentation or as a poster presentation.

To obtain abstract forms, call (800) 899-AACN (2226), or visit the research area of the AACN Web site at http://www.aacn.org.

Geriatric Corner: ELDERS Tool Helps in Early Intervention

As explored in earlier “Geriatric Corner” columns, the care that hospitalized older adults require is not straightforward. In fact, it is often complex.

A distinguishing characteristic of caring for elderly patients is the prominence of certain recurring clinical problems. Because these presenting symptoms or syndromes often do not help identify where a disease is located, a comprehensive evaluation is needed.

In addition, the hospitalized elderly patient typically presents with a unique set of problems, issues and concerns. To improve the care given older patients and initiate timely and therapeutic interventions, all healthcare professionals must keenly assess these.

Following is a description of a helpful program tool that was developed by Denise Adams, RN, MSN, CCRN, CS, NP, cardiology nurse practitioner at the Veterans Administration Ann Arbor Health Care System, Ann Arbor, Mich., and Angela Lambing, RN, MSN, CS, nurse practitioner coordinator of the Geriatric Service at Henry Ford Hospital, Detroit, Mich.

The Geriatric Intervention Team
A Geriatric Intervention Team (GIT) was formed to actively assess the elderly patient’s primary condition, issues and concerns, and to assist the medical team in caring for these patients. The specific objective of the GIT was to provide early and ongoing geriatric-focused assessment, planning, intervention and evaluation of patients older than 65 years. Some of the GIT’s outcome measurements focused on timely initiation of age-appropriate assessment and interventions, as well as early identification of plans for discharge.

The acute care geriatric nurse practitioner (ACGNP) was determined to be the pivotal member of the GIT. Patients are identified by the ACGNP via daily review of hospital-wide admission logs and formal consultation with a hospital team member, primarily the bedside nurse.

The ACGNP then identifies key unit-based, interdisciplinary personnel to review specific care recommendations and ensure timely follow-through of the plan. These interdisciplinary team members may include the geriatrician, pharmacist, primary nurse, rehabilitative services, dietitian and case management. Complicated cases are reviewed in daily team meetings, in collaboration with the geriatrician.

To ensure timely initiation of the geriatric assessment process and consultation with the geriatric experts, a tool was developed. The mnemonic ELDERS was developed to highlight basic assessment considerations for specific geriatric patients, who may require further investigation and patient care management. (See chart.) Related issues frequently affect length of stay and the development of further complications. The interdisciplinary team members have found this tool extremely useful. The GIT sees more than 100 patient referrals each month and the preliminary outcomes include:
• Nutritional issues are identified on average in 56% of all patients
• Physical therapy needs are addressed 53% of the time which includes identifying them for early rehabilitation interventions and/or mobilizing the patient
• 50% of the patients are found to require a bowel/bladder continence program
• Advance directives and code status issues have been identified and addressed with 43% of the patients
• Hospice appropriateness and pain management issues are addressed in 5-10 patients/ month

� Impact on length of stay, access to services and an improvement in functional activities are currently being reviewed

This tool was not meant to replace a thorough physical assessment. Through this team approach, expert, timely care is being provided to the elderly population.

ELDERS Assessment Tool
Are these ACTUAL versus POTENTIAL
problems of your >65 year-old patient?
E Eating difficulties
Decreased oral intake
Low albumin
Decreased appetite
L Lack of adequate pain control or comfort
Acute versus chronic pain
D Dementia/Delirium
Cognitive assessment:
Mini-Mental Status Exam
Acute confusion
Recent mental status changes
Impaired communication
Sleep pattern disturbances
E Elimination
Incontinence care
Potential versus actual alteration in skin integrity
R Range of Motion
Impaired physical mobility
Potential for injury
Frequent falls
S Social Support
Unclear discharge planning needs
Placement issues
Self-care deficits at discharge
End-of-life care

For more information about the GIT program, contact Angela Lambing, RN, MSN, CS, Nurse Practitioner Coordinator, Geriatric Service, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI 48202-2689; (313) 916-0074; fax, (313) 916-9481 or Denise Adams, RN, MSN, CCRN, CS, NP, Nurse Practitioner, Cardiology, VA Ann Arbor Health Care System, Cardiology (III-A), 2214 Fuller Road, Ann Arbor, MI 48105; phone, (734) 769-7100, ext. 7117; fax, (734) 761-7001.

Do you have an age-related care story or idea? AACN wants to provide a vehicle for the sharing of information that can enhance practice for all members who provide care to the older population. Send information to AACN Clinical Practice Specialist, Justine Medina, RN, MS, 101 Columbia, Aliso Viejo, CA 92656; fax, (949) 448-5520; e-mail, Justine.Medina@aacn.org, or call (800) 394-5995, ext. 401.

Practice Resource Network: Frequently Asked Questions

Q:Does AACN support mandatory ACLS certification for critical care nurses?

A:AACN supports the concept that individuals and institutions are responsible for making decisions about whether specific educational programs should be required, based on patient needs. Thus, any program that is aligned with AACN’s vision of creating a healthcare system driven by the needs of patients can provide a means to meet these needs.

ACLS is highly recommended, because it is an excellent, standardized educational program, which is based on solid research. Among the benefits of the ACLS program are its standardized resuscitation approach, its multidisciplinary approach to patient care, its research-based practice recommendations and its interactive educational format.

The American Heart Association (AHA) is careful not to refer to ACLS (PALS and BLS) as certification or competency validation. Instead, it is marketed as an educational program, which does not guarantee clinical performance.

As with standardized procedures in all patient care areas, standardized criteria must be used to identify and validate core competencies. Programs such as ACLS provide the educational content necessary for the competency validation process.

In an effort to continue to provide cutting edge resources to its members, AACN, in conjunction with the AHA, has developed three ACLS pocket cards containing the latest AHA-sanctioned ACLS and PALS recommendations and strategies. The cards are titled “ACLS Strategies,” “ACLS Essentials” and “PALS Pocket References.”

To order, call (800) 899-AACN (2226). Request Item #400761 (ACLS Strategies), #400760 (ACLS Essentials) or #400762 (PALS Pocket Reference). Price is $5 each, or $15 for all three (Item #400763), plus shipping and handling.

The Power of One: What Are Nurses’ Duties to Vulnerable Populations?
By M. C. Sullivan

Included among the many basic considerations in ethics are three fundamental questions: What is my duty? To whom is that duty owed? Of all the things that I could do in any given situation, what should I do? In addition, there are guiding ethical principles, such as justice.

In light of these rudimentary concepts, it seems evident that one focus of ethical analysis, ethical consideration and ethical behavior must be a concern about those who are, for a variety of reasons, vulnerable.

The nature of the healthcare setting is that there is a power imbalance. Those who possess the technical knowledge to understand the activities, as well as those who are sophisticated enough to successfully navigate the clinical setting landscape, are more empowered than those who do not possess these skills. It is a simple and indisputable fact that patients are generally less empowered in a healthcare delivery context than the caregivers. It is also evident that some people are more vulnerable than others, even beyond the circumstance of being patients.

What then are the duties and obligations of nurses to members of vulnerable populations?

Protecting Vulnerable Patients
Nurses must first be sensitive to and seek to identify vulnerable patients. In fact, protecting those who are least well off has been cited as a basic moral value by at least one author, Charles Daugherty, in an article in the March-April 1997 issue of Health Progress.

Characteristics for potential vulnerability vary. Among these are culture, race, gender, age, social and economic class, physical and mental disability.

Gather Information
Although it may be unreasonable or unrealistic to expect nurses working in understaffed units to be able to take the time necessary to gather much technical knowledge about the factors contributing to a patient’s vulnerability, some information-gathering is necessary to perform any measure of patient advocacy or protection.

Garnering available institutional resources to address and, where possible, redress the reasons for a patient’s vulnerability certainly falls under the role of nurse as advocate.

Patient-Provider Relationships
As nurses establish the frameworks for the patient-provider relationships that will direct formulation of comprehensive care plans, efforts must be made to appropriately compensate for the source of the power imbalance in the specific patient-provider relationship.

For example, many institutions market the fact that they provide language assistance for patients from multicultural communities. Yet, a mere grasp of vocabulary is not an adequate service when clinical information is being sought or offered. To ask an apparently bilingual member of the housekeeping staff or, worse, a child from the family of a patient to serve as translator is not a satisfactory method of communicating.

Not only are confidentiality and patient dignity compromised, but so too are the adequacy and appropriateness of information exchanged. Nurses can be part of the push to ask for better interpretive services, not just translators.

Sensitivity in Social Histories
Nurses can be more sensitive when taking social histories during the initial admission assessment. A simple question can be added to the interview: What are the community resources that patients have used in the past for their healthcare concerns or access?

This information can help members of the medical, social service and pastoral care teams learn about new patients. More importantly, understanding a patient’s relationships with community organizations can provide a cultural, sociological or anthropological context.

These preliminary recommendations are neither difficult nor time-consuming. In fact, with little or no extra effort, they can be folded into what is already a nurse’s basic responsibility. The beneficial results to both a patient and a more culturally-sensitive nurse demonstrate again the amazing power of one that yields such abundant return!

M.C. Sullivan, RN, MTS, JD, is a member of the AACN Ethics Integration Work Group. She is vice president and chief operating officer of Midwest Bioethics Center, Kansas City, Mo.

Apply for Nursing Research Grants

The deadlines to apply for several nursing research grants are approaching. Following is information about each of these grants:

Medtronics Physio-Control AACN Small Projects Grant
Cosponsored by Medtronics Physio-Control and AACN, this grant awards up to $1,500 to a qualified individual who is carrying out a project that focuses on aspects of acute myocardial infarction, resuscitation or sudden cardiac death, such as the use of defibrillation, synchronized cardioversion, noninvasive pacing and interpretative 12-lead electrocardiogram.

To be eligible, the applicant must be an active or affiliate member of AACN, who is not currently conducting a study funded by an AACN research grant.

To obtain application materials and instructions, call (800) 899-AACN (2226), or visit the research section of the AACN Web site at http://www.aacn.org. Applications must be received by July 1, 2000.

AACN Clinical Inquiry Grants
These grants, funded by an anonymous donor, support projects that address one or more AACN research priority and that link to AACN’s vision. Selected projects will receive up to $250 each.

The principal investigator in the proposed study must be an RN, a current member of AACN, employed in a clinical setting and directly involved in patient care.

To obtain application materials and instructions, call (800) 899-AACN (2226), or visit the research section of the AACN Web site at http://www.aacn.org. Applications must be received by July 1, 2000.

Agilent Technologies-AACN Critical Care Nursing Research Grant
Cosponsored by Agilent Technologies and AACN, this grant supports research conducted by a critical care nurse.

The total of $35,000 includes $33,000 for research and $2,000 for travel expenses associated with presentations of the study findings. The recipient may use up to $3,000 of the research award to purchase a personal computer, utility software and printer to support the study. Computer-related expenses should be included and justified in the project budget.

The grant is intended to support a well-defined, well-described research project. The award selection will be based upon the scientific merit of the project; scientific and professional background of the applicant; adequacy of facilities and resources available for the research; originality; and potential benefits to the care of critically ill patients.

The preferred topic for this grant is the information technology requirements of patient management in critical care. Because this grant is intended to support research that has direct clinical application to critical care nursing practice, proposals for basic science or animal studies are not eligible. Reviewers’ comments will not be provided to applicants.

To be eligible, the applicant must be both an RN and an active AACN member. The grant can be used to fund research associated with an
academic degree.

To obtain application materials and instructions, call (800) 899-AACN (2226), or visit the research section of the AACN Web site (http://www.aacn.org). Proposals must be received by AACN by Sept. 1, 2000.

Guide Is a Resource for Home Care Setting

The AACN Guide to Acute Care Procedures in the Home is now available from Lippincott Williams & Wilkins. Edited by Gloria J. McNeal, RN, MSN, PhD, CS, this guide is a valuable resource for nurses who care for acutely ill patients in the home setting.

Covered are some of the most technically challenging procedures that likely will be performed in this setting, including uterine activity monitoring; transplanted organ and tissue management; chemotherapy administration; tocolytic infusion; ventilator management; ECG and apnea monitoring; and blood transfusion.

To order, call Lippincott Williams & Wilkins (800) 638-3030.

Vox Populi: AACN Online Quick Poll

Are you comfortable talking with patients and families about advance directives?

Yes 88%

No 12%

Number of Responses: 1,656

The AACN Online Quick Poll is a voluntary, nonscientific survey on a variety of topics. Participate by visiting the AACN Web site at http://www.aacn.org.

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