Writing Publishable Review, Research, Quality Improvement, and

NURSING ECONOMIC$/November-December 2018/Vol. 36/No. 6

268

ITHOUT DISSEMINATION,

innovations, new initia-

tives and ideas, and

findings of research and

quality improvement (QI) studies

cannot reach nurses and other

healthcare professionals who can

use this knowledge in their prac-

tice. There are varied methods of

dissemination such as reports of

projects and studies in one’s own

healthcare setting, presentations

at conferences, sharing findings

through social media and news

outlets, and writing for publica-

tion, among others. Some of these

approaches, such as social media

and publications, disseminate

findings more widely than others,

such as presenting at a conference.

In all approaches to dissemi -

nation, there should be considera -

tion as to the message (what infor -

mation to communicate), audience

(who needs this information to

inform practice), and approach

(how best to reach this audience

with this information) (Brownson,

Eyler, Harris, Moore, & Tabak, 2018).

By thinking about the message and

audience, nurses can more carefully

plan their dissemination methods.

In some situations, sharing the

results of a QI project with unit staff

is sufficient to reach the individuals

who can use this information to

change their processes or practices

on the unit. In other cases, however,

a wider dissemination approach

such as publishing the results of

these initiatives in an academic

journal is a better strategy to share

new knowledge more broadly,

making it available to be used as

evidence for practice.

Regardless of approach, dis -

semination has to be planned, and

this should be done early as the

innovation, initiative, or study is

being developed. This early con -

sideration ensures information

needed later for dissemination is

collected and retained during all

phases of the initiative or study. All

too often, it only becomes apparent

after a project is completed that the

work should be published. Without

documenting the literature review,

process used for implementation,

and modifications during the

Marilyn H. Oermann

Tom Christenbery

Kathleen M. Turner

Writing Publishable Review,

Research, Quality Improvement,

and Evidence-Based Practice

Manuscripts

MARILYN H. OERMANN, PhD, RN, ANEF, FAAN, is Thelma M. Ingles Professor of Nursing,

Duke University School of Nursing, Durham, NC.

TOM CHRISTENBERY, PhD, RN, CNE, is Professor of Nursing, Vanderbilt University

School of Nursing, Nashville, TN.

KATHLEEN M. TURNER, DNP, RN, is Associate Professor of Nursing, Duke University

School of Nursing, Durham, NC.

NOTE: This research did not receive any specific grant from funding agencies in the public,

commercial, or not-for-profit sectors.

EXECUTIVE SUMMARY

Nurses make many and excep-

tional contributions to the health

and well-being of society.

The scholarship on nursing’s

unique practice contributions

must be shared with nurses

and the broader healthcare

community.

A concise resource for dissemi-

nating nursing’s important work

within the contexts of literature

reviews, research reports, qual-

ity improvement projects, and

evidence-based practice manu-

scripts is provided.

Disseminating timely and rele-

vant findings about nursing

practice enriches the nursing

profession and consequently

improves the health of humanity.

269

NURSING ECONOMIC$/November-December 2018/Vol. 36/No. 6

implementation, and ensuring

valid measurement of outcomes,

dissemination may be difficult and

questions may be raised about

whether the findings are valid for

use in practice. Authors also must

consider early whether the study or

project will need institutional

review board (IRB) approval.

The focus of this article is on

dissemination through pub-lica -

tions. By writing for publication,

nurses can share ideas and ad -

vances in clinical practice, educa-

tion, leadership, and research

(Batcheller, Kirksey, VanDyke, &

Armstrong, 2012). Articles pub -

lished in journals that are indexed

in bibliographic databases such as

PubMed/Medline and the Cumu -

lative Index to Nursing and Allied

Health Literature (CINAHL) can be

searched by readers, making the

information more widely available

than presenting at conferences or

sharing via other approaches.

Manuscripts must include critical

information about the innovation,

new initiative, or study for readers

to evaluate the intervention and

findings and consider possible use

in their own settings. The purpose

of this article is to describe the

preparation of four types of manu -

scripts for submission to nursing

and healthcare journals: literature

reviews, research reports, QI

studies, and evidence-based prac -

tice (EBP) initiatives.

Writing a Publishable Literature

Review

A literature review is a com-

prehensive survey that provides a

description, summary, and evalua-

tion of what other authors have

published about a specific topic

(Aveyard, 2010; Reitz, 2004).

Literature reviews are a unique

form of nursing scholarship that is

adapted from scholarly traditions

in other disciplines such as anthro-

pology, psychology, and sociology.

However, reviews published in

nursing journals offer discipline-

specific perspectives of healthcare

phenomena infrequently found in

other disciplinary journals.

Selecting the topic. The disci-

pline of nursing has a need for

scholarly literature reviews, stem-

ming in part from the publication of

an increasing number of scientific

and scholarly healthcare publica-

tions. For example, compared with

2008, in 2018, there were 8,719

more papers on opioid addiction

and 104,500 more papers on obesi-

ty indexed in PubMed. Given the

vast amount of publications, nurs-

es, especially those in demanding

practice settings, rely on reviews of

recent, relevant literature.

Because well thought out top-

ics help lead to publication, careful

deliberation should be given to

selecting a review topic that will be

of maximum interest and benefit to

readers of the target journal. When

selecting a literature review topic,

three points need to be considered.

First, an ideal topic should be one

that is important to the author. For

example, doctor of nursing practice

(DNP) students generally select

scholarly project topics in which

they have a strong interest. These

students spend considerable time

in preparing an overview and a

critical analysis of their topic and

in writing the literature review.

Second, the author should deter-

mine if the topic is important to

nurses and relevant to the health

care they provide to patients.

Editors are interested in publishing

manuscripts that appeal to their

journal’s readers. For instance, pal-

liative care as a review topic may

have limited interest for readers of

Advances in Neonatal Care. On the

other hand, Gibson, Hofmeyer, and

Warland’s (2018) review about

nurses who provide end-of-life

care for infants and families will

likely be of keen interest for readers

of Advances in Neonatal Care.

Third, it is important to clearly

define the topic. A poorly defined

topic may yield articles that are a

poor fit for the intent of the review.

Ideal topics are those in which

there are a number of peer-

reviewed research and conceptual

articles without a previous review

of past works. If there is an

unmanageable number of topic-

specific articles to review, it is a

good idea to restrict the review to

a certain timeframe (e.g., 5, 10, 15

years). An example of a literature

review that used a timeframe lim-

itation is Boytim and Ulrich’s

(2018) article on factors contribut-

ing to perioperative medication

errors during the past 15 years.

In addition to timeframe, other

important inclusion and excl-

usion criteria for topic-specific arti-

cle selection must be considered to

find the most relevant litera-

ture. Examples include databases

searched (PubMed, CINAHL,

PsycINFO), clinical and demograph-

ic data (age, race, ethnicity, gender,

disease entity), type of studies (ran-

domized controlled trial [RCT],

qualitative, historical), and setting

(medical center, rural clinic). In the

literature review example in Table 1,

the authors identified the databases

searched and keywords and combi-

nations used for the search. To assist

with possible replication and

enhance the review’s credibility, all

inclusion/exclusion criteria need to

be described in the methodology

section of the manuscript.

Finally, to provide a compre-

hensive review of a topic, authors

should examine a wide range of

both conceptual and empirical arti-

cles. A creative and comprehensive

review of a selected topic requires

an examination of articles in a dis-

cipline’s journals as well as inter-

professional journals. For example,

in their review of the association

between baccalaureate-prepared

nursing staff and patient outcomes,

O’Brien, Knowlton, and Whichello

(2018) reviewed articles in nursing

journals, such as the Journal of

Nursing Administration, as well as

interprofessional specialty jour-

nals, such as the Journal of the

American Medical Association.

Generally, literature review articles

are enhanced when they include a

wide, rich stream of scholarly con-

ceptual and empirical work about

the topic.

Once the review topic is

selected, and before beginning the

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270

review of relevant literature,

authors must decide on the type of

literature review to conduct. In

addition to traditional literature

reviews, emphasized in this article,

there are systematic reviews and

meta-analyses. A systematic review

uses a more methodical and rigor-

ous approach to conducting a liter-

ature review than used for a tradi-

tional or standard literature review.

A meta-analysis integrates the find-

ings from RCTs about a specific

phenomenon to statistically tabu-

late a score, and can be used to

draw conclusions and identify pat-

terns among the selected RCTs

(Christenbery, 2018).

Information about preparing a

manuscript for submission to a

journal is provided in the journal’s

author guidelines. In addition to

these instructions, guidelines

have been developed to improve

the reporting of specific types of

studies, referred to as reporting

guidelines (Oermann et al., 2018).

The Preferred Reporting Items for

Systematic Reviews and Meta-

Analyses (PRISMA) is a checklist

for items to include when report-

ing systematic reviews and meta-

analyses, but this also can be used

when writing a literature review

(Oermann & Hays, 2019). The

PRISMA website (www.prisma-

statement.org) provides resources

authors can download.

Comprehensive review of rele-

vant literature. Once the topic has

been decided and the appropriate

literature has been found, the next

goal is to conduct a thorough

review of the literature. In addition

to the review, authors seek to pro-

vide a comprehensive understand-

ing of the selected topic. Authors

should aim to provide a balanced

overview of the topic, which

includes presenting the topic’s

strengths and limitations as

described in the literature. For

example, Schnock, Biggs, Fladger,

Bates, and Rozenblum (2017) cri-

tiqued the absence of methodologi-

cal rigor in studies evaluating the

impact of radio frequency identifi-

cation of retained surgical instru-

ments. Because the authors brought

methodological problems to the

forefront, scholars and practitioners

in the surgical field can respond

with more rigorous studies and

development of systematic reviews,

thereby enhancing the potential for

patient safety and well-being.

The most impactful literature

reviews provide an encapsulation

of general themes that have been

detected across studies (Short,

2009). Less-impactful literature

reviews provide minimal informa-

tion about general themes and

instead provide extensive report-

ing of each study’s detail, which

often spans numerous pages.

Reporting individual study detail,

instead of general themes, taxes

readers’ attention spans and

negates the purpose of a review.

As a rule, the best reviews provide

a succinct table that summarizes

key features from each of the

reviewed articles. Such tables are

often easily understandable with-

out readers needing to review

voluminous amounts of informa-

tion in the text portion of an arti-

cle. As an example, Wilbanks,

Watts, and Epps (2018) produced

a concise review table about elec-

tronic health records in simula-

tion education that consisted of

columns depicting author, year,

population, article, study type,

and a succinct summary of impor-

tant findings.

A relevant literature review is

more than only an arrangement of

facts (Short, 2009). For example, a

review may provide identification

of incidence and prevalence of

tobacco smoking-related diseases,

and although the review may be

timely and factual, it is nonetheless

of limited interest to a broad read-

ership. A more enticing review can

provide insights into new alterna-

tive methods for smoking cessation

and/or alternative nursing commu-

nication therapies to promote

smoking cessation that have not

been considered by a journal’s

audience.

To assess whether a proposed

literature review has the potential

to have a meaningful impact for

nurses and patients, it is important

to analyze a review table. Analysis

of a concise, yet thorough, review

table of relevant articles often

leads an author to clearly under-

stand why the topic matters to

nurses. In addition, analysis of the

table allows authors to consider

how to best outline the review to

maximize its consistency and

logic. If the chosen topic for review

has been published in other works,

a critical analysis of a table can

generate fresh ideas about how to

best present the material. It may be

that the last topical review was

many years in the past, so analysis

of a current table can provide

insight into controversies that exist

on the topic and possible alterna-

tives for addressing a topic’s ambi-

guity and/or inconsistency (Short,

2009).

Thoughtful analysis of a table

also serves as a reminder to avoid

creating a generic template where

almost any body of research

would produce a similar finding;

for example, a literature critique

such as “the topic of work motiva-

tion in direct care nursing is woe-

fully underrepresented in various

types of clinical settings.” While

this statement may be true, such

insights are typically uninterest-

ing and will not serve as a spur to

move nursing research and prac-

tice forward. Instead, review find-

ings should impact the way nurses

perform and the way healthcare

organizations support optimal

care and patient safety. Perreira,

Innis, and Berta (2016) could have

dwelled on clinical setting differ-

ences found in their literature

review about work motivation in

health care. Instead, they took a

more interesting and scholarly

approach and described important

implications for practice includ-

ing how work motivation can be

influenced and changed, how to

effectively address hostile behav-

iors in the work setting, and how

best to optimize worker autono-

my.

Well-developed literature re -

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views are a critical type of nursing

scholarship that can enhance the

care clinicians provide to individ-

ual patients and populations.

Writing a useful literature review

can be a somewhat challenging

process, but the reward of contribut-

ing to nursing’s knowledge makes

the endeavor worthwhile. The sub-

stantive findings produced in well-

written literature reviews impact

patient care. Table 1 can serve as a

guide and checklist when preparing

a review manuscript.

Writing a Research Report

Research reports, manuscripts

that describe a research study,

typically have a structured format

that follows the research process

(Oermann & Hays, 2019). These

manuscripts explain why the study

was needed, method used for the

study, results, and what the findings

mean. The format used to organize a

research report is IMRAD (introduc-

tion, methods, results, and discus-

sion). If the study was an RCT,

authors should follow the Con -

solidated Standards of Reporting

Trials (CONSORT) checklist to

ensure their reports include all of the

critical information needed to inter-

pret the study. These guidelines are

found at www.consort-statement.org.

Introduction and theoretical

framework. Research reports begin

with an introduction or background

that reviews the prior research and

identifies gaps in our knowledge,

leading into the need for the current

study. This section of the manu -

script should make it clear why the

research is important and how it

builds on prior studies. In their

article on the mentoring process in

new graduate residency programs,

Williams, Scott, Tyndall, and

Swanson (2018) explain how their

study, comparing one-to-one and

group mentoring, builds on prior

research and fills a gap in our

understanding of mentoring in new

nurse residencies (see Table 1). The

literature review can be part of the

introduction or included as a

separate section. Regardless of

format, articles reviewed must be

synthesized rather than reporting

each study separately (Oermann,

Turner, & Carman, 2014). The

purpose of the study should be

presented early in the manuscript,

within the first few pages.

Most research reports describe

theories or framework that guided

the study. The depth of discussion

about theoretical concepts depends

on the extent of explanation needed

to understand the study and

outcomes as well as the journal

format. For example, Hung, Truong,

Yakir, and Nicosia (2018) examined

key variables that promoted use of a

community-based transitions pro-

gram for older adults. Their study

was guided by the Care Transitions

Framework, an adaptation of the

Consolidated Framework for Imple -

mentation Research. The authors

described the framework in one

paragraph, which was sufficient to

understand the variables, findings,

and implications for promoting care

transitions. Authors are advised to

review research articles in the target

journal to gain a sense of how

theories or framework are generally

presented.

Methods. The methods sec-

tion of a research report explains

how the study was done and pro-

vides the framework for reproduc-

ing it (Sessler & Shafer, 2018).

This section typically includes

subsections on the design, sub-

jects and setting, measures (instru-

ments), procedures, and data

analysis (summary of the analy-

sis), depending on the type of

study. The principle in writing

this section is to present sufficient

information for readers to repli-

cate the study. The methods sec-

tion also should contain a state-

ment about the ethical aspects of

the study and how they were

addressed.

Results. The results section

reports the findings and is general-

ly ordered consistent with the

methods. Typically this section

begins with the demographic data

and then proceeds to the measures

(Sessler & Shafer, 2018) (see Table

1). Authors should present the

measures in the methods section

and findings in the results section

following the same order used for

stating the purposes, research ques-

tions, and/or hypotheses in the

beginning of the paper. This facili-

tates reading the article and under-

standing the research (Oermann &

Hays, 2019). Authors should pres-

ent the main findings in the text

with specifics in tables or figures.

Data presented in the text should

not overlap with these, and authors

need to plan this before beginning

to write this section.

Discussion. The discussion

section is where the author

explains what the findings mean,

integrating studies reported earlier

in the introduction and literature

review. How does the current

study build on that work? In what

ways do the findings support

other research and if not, why not?

What are variables that might

explain why the findings differ

from other studies? The discus-

sion should not repeat the find-

ings and should not introduce

new information not reported ear-

lier in the results. One major area

of the discussion is the implica-

tions of the findings for practice,

education, leadership, or research,

either as part of the discussion or

as a separate subsection. Some

research reports end with the dis-

cussion section while others have

a short summary or conclusions

that review what was done and

the main findings.

Writing a Quality Improvement

Article

The need to improve quality

and safety of health care has led to

a significant growth of initiatives

and studies on QI and recognition

this work needs to be disseminat-

ed. This is particularly true in nurs-

ing with the growth of DNP pro-

grams, in which many scholarly

projects are QI. Similar to research

reports, descriptions of QI studies

must be complete, but in addition,

QI manuscripts also include

detailed information about the con-

text of the study – the local setting

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272

– which affects the interventions

and decisions about transferability

to other settings (Mosher & Ogrinc,

2016; Oermann, 2017). To ensure

these manuscripts are complete,

authors should use the Standards

for Quality Improvement Reporting

Excellence (SQUIRE) (www.squire-

statement.org).

Introduction. QI articles follow

an IMRAD format similar to

research reports (Oermann & Hays,

2019; Ogrinc et al., 2016). With QI,

however, the introduction should

not only provide the background of

the problem with related literature

but also should explain the local

problem that led to the need for the

QI initiative. In the example in

Table 1, the introduction on imple-

menting new smart pump technol-

ogy began with an explanation of

issues with this type of technology,

challenges of preparing staff across

45 departments in using it, and

need to increase compliance with

drug library use and reduce dosing

alerts (Lehr, Vitoux, Zavotsky,

Pontieri-Lewis, & Colineri, 2018).

In addition to a description of

the local problem, the introduc-

tion should address the frame-

work used to guide the study. In

the initiative on smart pumps,

authors used Lean principles and

identified QI metrics to measure

changes in performance (Lehr et

al., 2018).

Methods. The methods sec-

tion describes what was done and

how outcomes were measured and

generally begins with details

about the context. This includes

any aspects of the local setting

that might influence effectiveness

of the QI initiative such as the

location and teaching status of the

healthcare system, types of

patients and other patient charac-

teristics, sample size, staffing, and

care processes, among others

(Oermann, 2017; SQUIRE, 2015).

Goodman and co-authors (2016)

identified two reasons why these

details are important: they assist

readers in evaluating whether the

intervention would be relevant to

their own settings and might work

there, and they help in analyzing

the impact of context on success

of the intervention. For example,

nurses may have recently partici-

pated in another QI project, which

might influence the intervention

or outcomes in the study reported

in the manuscript.

After describing the context,

authors should include a descrip-

tion of the intervention (in suffi-

cient detail for replication and

with information about the team

and stakeholders involved in the

QI initiative), approach used for

assessing the impact of the inter-

vention, measures (instruments),

and data analysis (quantitative

and qualitative methods such as

focus groups and root cause analy-

ses). Lehr and associates (2018), in

their QI report on implementing

new smart pump technology,

describe initiating the project

charter and project team, which

included Lean PI Green Belt facil-

itators and Black Belt mentors (see

Table 1). Their methods section

also reports training end users on

the new smart pumps, including

creating and implementing educa-

tion for 1,500 registered nurses,

and each phase of implementation

(distributing pumps, setting up a

central command center, and

deploying teams to the units to

change to the new pumps and

guide nurses on programming

sequences and using the drug

library).

Similar to research reports,

the methods section should con-

tain a statement about the ethical

aspects of the QI study and how

they were addressed. This state-

ment should include if the study

was reviewed and approved by

the IRB or had another type of eth-

ical review. Some QI studies may

need at least an expedited review

by the IRB depending on the

nature of the study. In many

healthcare systems, QI studies are

not reviewed by the IRB, consis-

tent with U.S. Department of

Health and Human Services

(2018) regulations, in contrast to

research. A sentence about this

can be included in the manu-

script. A sample statement is:

“This was a quality improvement

study, and these studies were not

reviewed by the institutional

review board in this setting.”

Results. In a manuscript on

QI, results are presented similarly

to a research report. However,

with QI, it also is important to

describe implementation of the

intervention over the period of the

study and any changes that were

made. This can be seen in the QI

example in Table 1. In this section,

authors might include a PERT

(program evaluation and review

technique) chart or a timeline dia-

gram, among others.

Discussion. The discussion

section is similar to research

reports. When the intervention

was not effective or as successful

as anticipated, authors should dis-

cuss possible reasons for this such

as staff or leadership turnover or

other factors. These additional fac-

tors are important in QI and for

readers in interpreting results. In

the study on smart pump imple-

mentation, in the methods sec-

tion, the authors listed the four

metrics established to measure

performance: (a) train 80% of staff

members, (b) achieve 95% drug

library compliance, (c) reduce

drug library dosing alerts, and (d)

reduce pump-related medication

errors. The outcomes were report-

ed in the results, and the discus-

sion included some possible

explanations (e.g., why nurses

were bypassing the drug library

and overriding alarms) with solu-

tions the authors then implement-

ed. This section also includes lim-

itations and can end with the dis-

cussion or have a summary or con-

clusions as the final section.

Writing an Article about an EBP

Project

Evidence-based practice is the

use of the most relevant empirical

evidence from research, clinician

expertise, and patient values and

preferences (Ackermann, Porter

O’Grady, & Melnyck, 2018). Similar

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Table 1.

Examples Comparing Parts of Literature Review, Research, Quality Improvement,

and Evidence-Based Practice Manuscripts

Literature Review Research

Quality Improvement

(QI)

Evidence-Based Practice

(EBP)

Title

High-Stakes Testing in

Nursing Education: A

Review of the Literature

New Nurse Graduate

Residency Mentoring: A

Retrospective Cross-

sectional Research Study

Achieving Outcomes with

Innovative Smart Pump

Technology: Partnership,

Planning, and Quality

Improvement

The Evaluation of the

Implementation of the

Vascular Preventative

Bundle and Development of

Suggested Interventions for

Improvement and

Sustainability

Introduction

To improve NCLEX-RN pass

rates, some schools require

high-stakes testing. Schools

hold differing definitions of

high-stakes testing. This

review explored faculty and

student perceptions about

high-stakes testing.

Goals of nurse residency

programs (NRP) are to

promote socialization,

clinical competency… Need

for study of two types of

mentoring in NRPs: one-to-

one and group. Purpose

was to compare…

There was low compliance

with drug library use and

high rate of dosing alerts.

Purpose of article was to

describe transition to smart

pump technology through a

partnership with supplier,

use of Lean principles, and

defined quality improvement

metrics.

A vascular surgical-site

infection (SSI) preventive

bundle was implemented.

Study aims were to measure

fidelity, determine if

implementation of the

bundle decreased SSIs

rates, and recommend

evidence-based practice

(EBP) interventions.

Methods

High-stakes test, high-

stakes exam, exit exam, and

nursing education were

searched in CINAHL,

ProQuest, Google Scholar.

Search limited to English-

only journals and articles

from 2005-2017.

Design: Retrospective,

cross-sectional design using

existing database (of 3,484

new graduates)

Instruments:

Procedures:

Data analysis: SPSS 24 was

used. Descriptive statistics

examined… Effect sizes

were calculated.

Sections on establishing

project charter, defining

roles and responsibilities of

varied teams, building drug

library, training, and

implementation stages.

Details included in each

section.

Sections on setting and

sample, study design

(retrospective), data

collection plan, privacy and

storage, timeline, and

statistical analysis

Results

Major themes were defining

the concept of high-stakes

testing, use of high-stakes

testing, consequences of

high-stakes testing, and

recommendations for use of

high-stakes testing.

Sample included nurse

residents from 102 hospitals

across 14 states...

Individuals receiving one-to-

one mentoring rated

mentoring experience higher

in helping in transition to

pract

ce… Relationship

between group mentoring

and turnover intent was

significant, X

…

Using Lean principles, drug

library phase was completed

in 9 weeks, significantly

shorter timelines than

reported in literature. Non-

intensive care unit nurses

bypassed drug library 34%

of the time… Alert frequency

decreased to 0.79%...

Fidelity results were

statistically significant for all

measures, increasing over

time. No statistically

significant change in

infection rates.

continued on next page

to QI projects, implementation of

EBP is a common focus of scholarly

work for the DNP student. DNP stu-

dents should be encouraged, if not

required, to disseminate their

scholarly work to support imple-

mentation of EBP. Other nurses

implementing EBP projects should

also be encouraged to disseminate

their work.

Evidence-based practice usu-

ally begins with a question to

improve patient outcomes. Models

are often used to guide implemen-

tation of EBP. These models

describe the synthesis of the evi-

dence leading to the recommenda-

tions, implementation of the evi-

dence, evaluation of the impact,

and considerations based on con-

text or setting (Tilter, 2014). Many

settings have adopted EBP imple-

mentation models to support nurs-

es in the process and dissemina-

NURSING ECONOMIC$/November-December 2018/Vol. 36/No. 6

274

tion of findings (Oermann & Hays,

2019). Guidelines for disseminat-

ing EBP projects are similar to QI

and research studies. The main

difference in the dissemination of

an EBP initiative is in the actual

focus of the project.

Evidence-based practice manu-

scripts follow the IMRAD format.

The introduction includes the prob-

lem and background, a condensed

literature review highlighting level

of evidence supporting or leading

to recommendations, and overall

project focus and aims. An example

of an EBP manuscript evaluating

implementation of a preventive

bundle to prevent surgical-site

infections (SSIs) is shown in Table

1. The introduction reports the gen-

eral scope of the problem, describes

the bundle or preventive interven-

tions and evidence associated with

the interventions, indicates costs

associated with SSIs, and identifies

the aims to measure the fidelity and

areas for improvement and sustain-

ability (Franklin, Turner, Hudson,

Guest, & Dillavou, 2018).

The methods section of an EBP

manuscript describes what was

done and outcomes including set-

ting, sample, study design, data

collection plan, privacy and stor-

age, timeline, and description of

statistical analysis. The results sec-

tion reports findings as aligned

with the focus of the EBP project

and often highlights fidelity of

implementation of the interven-

tion. A table summarizing the

results is helpful and will facilitate

replication of the study. In addition

to the applicable discussion com-

ponents of QI and research reports,

the discussion section of the EBP

manuscript may focus on sustain-

ability of the implemented best

practice. This may be demonstrat-

ed with the model or tool chosen to

support implementation of the

intervention. In the SSIs bundle

implementation study (see Table

1), the discussion section included

a recommendation to in corporate

the Agency for Healthcare Re -

search and Quality Compre hensive

Unit-based Safety Program method

to address safety concerns (Franklin

et al., 2018).

The separation of EBP from

dated research utilization in clini-

cal decision making is that more

goes into the delivery of patient

care than empirical data. Ackerman

and colleagues (2018) suggested

that with the evolution of digital

health and availability of digital

resources, nurses are challenged to

address the status quo of the cur-

rent process. With the digital age

and rapid development of re -

sources, information is readily

available and now leads to more

opportunities for innovation. Inno -

vation-based practice occurs when

there is a discrepancy between

what is known and what is desired

or needed. Innovation is creating a

solution where evidence does not

exist. Constructing the bridge

between evidence and innovation

is essential for validation of legiti-

mate practice that is innovative

and grounded in evidence

(Ackernan et al., 2018). Innovation-

based practice presents an addi-

Table 1. (continued)

Examples Comparing Parts of Literature Review, Research, Quality Improvement,

and Evidence-Based Practice Manuscripts

Literature Review Research

Quality Improvement

(QI)

Evidence-Based Practice

(EBP)

Discussion

Evidence indicates high-

stakes standardized tests

are not valid indicators of

successful NCLEX-RN pass

scores.

New graduates with one-to-

one mentoring are helped in

transition to practice…

Future studies…

Override incidence of 66%

was par with or better than

other studies reporting 61%

to 95% overrides.

Recommend EBP

interventions for

sustainability based on

AHRQ CUSP method.

Conclusion

Lack of experimental studies

in high-stakes testing;

minimal information from

state boards on

recommendations for high-

stakes testing

There was no association

between mentoring and

turnover intention except

when nurses were mentored

in groups.

Hospital implemented new

smart pump technology in a

3-month period using Lean

process improvement team

in combination with clinical

nurse specialist/consultants.

Study includes evidence-

based interventions to

support implementation and

sustainability of measures to

prevent SSIs.

AHRQ = Agency for Healthcare Research and Quality, CUSP = Comprehensive Unit-based Safety Program

SOURCES:

Hunsicker & Chitwood, 2018.

Williams et al., 2018.

Lehr et al., 2018.

Franklin et al., 2018.

275

NURSING ECONOMIC$/November-December 2018/Vol. 36/No. 6

tional opportunity for dissemina-

tion of scholarly work.

Summary

Nurses make valuable and

exceptional contributions to the

health and well-being of society.

The scholarship on nursing’s

unique practice contributions must

be shared with the broader health-

care community and the patient

populations they serve. In this arti-

cle, nurses are provided a concise

resource for disseminating their

important work within the contexts

of literature reviews, research

reports, quality improvement proj-

ects, and evidence-based practice

manuscripts. Disseminating timely

and relevant findings about nursing

practice enriches the nursing pro-

fession and consequently improves

the health of humanity. $

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