Margo Anne Halm

Portland VA Medical Center · Department of Nursing

A regular feature of the American Journal of Critical Care, Clinical Evidence Review unveils available scientific evidence to answer questions faced in contemporary clinical practice. It is intended to support, refute, or shed light on health care practices where little evidence exists. We welcome letters regarding this feature and encourage the su...

Purpose/aims: Common pain assessment tools measure intensity, ignoring other dimensions of pain like function. The aim of this study was to test the psychometric properties of a newly developed functional pain assessment scale (FPAS) for use in clinical practice. Design/methods: In this descriptive correlational study, an FPAS was developed and...

Sustaining a clinical excellence culture for Magnet® redesignation requires continued engagement of frontline nurses, nurse leaders, and executives. Appreciative Inquiry is a strength-based approach emanating from a positive core. From this core, teams discover, dream, design, and create their preferred destiny. This article describes how a Magnet-...

Background: Proficiency in evidence-based practice (EBP) is essential for relevant research findings to be integrated into clinical care when congruent with patient preferences. Few valid and reliable tools are available to evaluate the effectiveness of educational programs in advancing EBP attitudes, knowledge, skills, or behaviors, and ongoing c...

In our journey from Magnet designation to a Lean hospital, a team of advanced practice nurses, a nurse scientist, and Lean specialists developed a crosswalk of evidence-based practice (EBP) with Lean to explicitly embed the use of evidence in our organization's 4-step problem-solving method. Once finalized, the blended Lean-EBP model now guides imp...

Background: Caring for coronary artery bypass (CABG) surgery patients can be challenging. No studies have explored caregiver burden by age and gender. Objective: To describe age and gender-specific concerns, needs and strategies during the first 3 months. Methods: Themes for burden concerns, needs and strategies were derived from interviews of...

Objective: To describe concerns, needs, strategies and advice of coronary artery bypass (CABG) caregivers during the first 3 months post-surgery. Background: Nearly 400,000 patients underwent CABG surgery in 2010. While caregiving demand and difficulty has been investigated in early (4-8 weeks), mid (3 month), and later (6-12 months) recovery, n...

Overview: As the use of complementary and alternative medicine-CAM-has surged in popularity in the United States, many hospitals have begun integrating complementary services and therapies to augment conventional medical care. In this article, the first in a five-part series that will examine various aspects of holistic nursing and forms of comple...

The incidence of Clostridium difficile infection has increased rapidly during the past decade, increasing lengths of stays in the hospital, costs, and mortality rates. To address this increased incidence, we performed a retrospective case-control study using known risk factors to develop a tool to determine which patients are at risk for infection....

The incidence of Clostridium difficile infection has increased rapidly during the past decade, increasing lengths of stays in the hospital, costs, and mortality rates. To address this increased incidence, we performed a retrospective case-control study using known risk factors to develop a tool to determine which patients are at risk for infection....

Purpose: This pilot study compared the effects of an essential oil mixture versus standard care on skin reactions in breast cancer patients receiving radiation. Method: Using an experimental design, 24 patients were randomized to standard care (i.e., RadiaPlexRx™ ointment) or an essential oil mixture. Products were applied topically three times...

The objective of this program was to evaluate an educationally based intervention in developing intercultural competence of postpartum nursing staff using a quality improvement (QI) framework. The method included eighty nursing staff participating in a cultural competence training program (CCTP) infused with Latino culture, including Spanish langua...

This chapter provides an overview of evaluating integrative therapies from both a scientific, empirical standpoint, as well as from a practical clinical perspective. The challenges of evaluating integrative therapies are outlined, including prevailing research paradigms and the nature of integrative therapies themselves and the conditions they are...

BACKGROUND/PROBLEM: End-of-life beliefs and practices are as varied as one's culture. Little is known about what interventions are effective in developing clinician's skills to deliver culturally sensitive end-of-life care. Using a pre-post design, this pilot study aimed to evaluate the impact of a 2-stage educational program on enhancing clinician...

Purpose: To evaluate the usefulness of an educationally-based intervention in promoting intercultural competence of nurses caring for Latino patients in a Family Birth Center. Background/Rationale: Based on Latino birthing experiences at a 454-bed regional community hospital, areas in need of improvement focused on respect for dignity, management...

This study examined the hospital-wide effect of a mandatory 8-hour nurse preceptor workshop on preceptors and orientees. A mixed-methods approach was used. The quantitative surveys were augmented with qualitative short-answer questions (QUAN + qual) to identify the perceptions of preceptorship experiences for both preceptors and orientees. Findings...

This article describes a partnership model between a university and health care organizations for teaching graduate nursing research from a framework of evidence-based practice. Nurses from health care organizations identified topics for graduate students to search the literature and synthesize evidence for guiding nursing practice. Nurse educators...

Preoperative anxiety is prevalent in surgical patients who may require anxiety medications, thus impacting preoperative teaching and patient satisfaction. No studies were found in a comprehensive search on the effect of essential oils on anxiety in the preoperative setting. The purpose of this experimental study was to investigate whether the essen...

In August 2008, the American Association of Critical-Care Nurses' (AACN's) Evidence-Based Practice Resource Work Group met to review current AACN Practice Alerts and to identify new Practice Alerts to be created. The work group was also tasked with reassessment of the grading system used by AACN that evaluates evidence associated with the Practice...

Methods MEDLINE and CINAHL were the search engines used. Key search words were phlebotomy, intravenous catheters, Vacutainers (Becton, Dickinson, and Company, Franklin Lakes, New Jersey), and hemolysis. Both research evidence and manufacturers' evidence were included. Results Eight studies were retrieved (Table 1). Designs included observational, d...

Although frequent ED users account for a small percentage of ED visits, these patients can drain the system, contributing to overcrowding and lowered quality of care. This retrospective descriptive correlational study explored characteristics of frequent ED users at a large Midwestern urban hospital and factors predictive of high ED utilization. Th...

Coronary artery bypass surgery patients often rely on spouses for assistance during recovery. Caregiving may be stressful, adversely affecting caregiver physical and emotional health and, therefore, ability to provide care. This cross-sectional correlational study investigated factors associated with caregiver depressive symptoms, outcomes, and per...

Patients who undergo coronary artery bypass graft surgery often rely on spouses for care during recovery. Although often meaningful, caregiving may be stressful and affect spouses' ability to provide care to the patient. The purpose of this study was to compare burden and caregiving outcomes across three groups of spouses. Spouse groups varied by t...

Coronary artery bypass (CAB) patients often rely on spouses for care and assistance during recovery after surgery. Caregiving can be stressful and meaningful depending upon the interplay of many factors not completely understood. These factors may affect the spouse caregiver's health-related quality of life (HRQL), which may impact ability to care...

Cardiac surgery is a common interventional procedure for ischemic and valvular heart disease. Cardiac surgery is accompanied by postoperative pain and anxiety. The use of music therapy has been shown to reduce pain, anxiety, and physiological parameters in patients having surgical procedures. To compare the effects of music therapy versus a quiet,...

Presence of patients' families during resuscitation has emerged as an important practice issue, sparking considerable controversy worldwide. Early advocates of allowing patients' families to be present during resuscitation faced more resistance than did current advocates because the former had little or no scientific research results to support the...

To conduct an investigation similar to a landmark study that investigated the association between nurse-to-patient ratio and patient mortality, failure-to-rescue, emotional exhaustion and job satisfaction of nurses. Cross-sectional analysis of 2709 general, orthopedic, and vascular surgery patients, and 140 staff nurses (42% response rate) caring f...

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Interdisciplinary rounds are a new care coordination strategy in several healthcare settings. This article describes the process used by clinical nurse specialists in one institution to broaden existing discharge planning rounds to interdisciplinary rounds. In addition, a survey queried advanced practice nurse subscribers to two listserves, the ANP...

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Cardiovascular disease is the number one killer of women. Despite this statistic, many women do not perceive heart disease as a priority health concern. Recognizing that prevention begins in the community, the American Hospital Association launched a national fellowship program in 1998 to improve cardiovascular health. This article describes a prac...

Heart failure affects more than 5 million Americans. Each year, about 400,000 individuals develop heart failure, making it the nation's most rapidly growing cardiac problem. Almost one third of these individuals have New York Heart Association Functional Class III or IV heart failure and are faced with progressive clinical deterioration and frequen...

Early hospital discharge after coronary artery bypass graft surgery has been the standard of practice throughout the United States. This study compared outcomes, readmissions, and costs for patients discharged early with home health care with those of patients discharged a day or more later without home health care. Discharging open-heart surgery p...

In this article, the authors describe ways to create spirit at work--a sense of teamwork and caring for patients, their families, and colleagues. Defining an ideal role model and striving to emulate that model are the first steps to creating a facility that enriches the lives of patients, families, and health care providers.

Heart disease is the primary killer among American women. Differences in referral for cardiac rehabilitation, as well as compliance rates, have been reported between male and female cardiac patients. This study explored the use of Phase I and Phase II cardiac rehabilitation programs by male and female patients. In particular, the study aimed to inv...