Much of nursing research is developed for acute care nursing and its many realms. Patient safety and consistency of care can now be enveloped into evidence-based practice (EBP), and home health nursing must dedicate itself to this paradigm. Evidence-based practice can serve a dual purpose for home healthcare (HHC): to improve patient care and to ensure appropriate reimbursement for home care agencies, which can be demonstrated by searching Home Health Compare.
Nursing research can contribute to positive outcomes, improve morbidity for home healthcare patients, and standardize care. Frameworks of EBP can translate research into practice for such clinical concerns as
* Long-term medication compliance
* Decreasing catheter-related infections
* Fall injuries
* Patients/staff education strategies
* Community education on blood pressure control, cholesterol management, psychiatric nursing, and maternal child nursing
* Infection control as related to point-of-service (POS) devices
* Mentoring in nursing, especially in HHC
* Decreasing rehospitalizations
The following recent readings have spurred me to comment about nursing research in home healthcare:
* The excellent article ("Biofilms on Medical Devices") in Home Healthcare Nurse by Silke S. Talsma (2007)
* "Research on Job Satisfaction" by Ellenbecker, Neal-Boylan, and Samia (2006) and Neal-Boylan (2006)
* "EBP News Impacting Psychiatric Nursing" by Duckett (2005)
The books Introduction to Evidence-Based Practice in Nursing and Health Care by Malloch and Porter-O'Grady (2006) and Teaching IOM-Implications of the Institute of Medicine Reports for Nursing Education by Finkelman and Kenner (2007) also document the fact that the use of EBP in the preparation and continuing education of nurses must include "expansion of nursing research to increase nursing's understanding of patient safety's relationship to nursing care and the role of nurses" (Finkelman & Kenner, 2007, p. 41).
Nursing research will contribute to EBP in home healthcare nursing. That said, there must be an acknowledgment of tight budgets and busy home care clinicians who will ask how research can be added to their overburdened schedules. Agency administrators must connect with colleges, universities, and medical centers, where nursing researchers and faculty can direct projects. Funding via grants can include monies toward salaries of any home care nurse participating, providing impetus to obviate any productivity adjustments necessary. Studies can be replicated and do not need large samples to be worthy. All nursing research is encouraged.
Finally, there is much discussion about average ages in our profession and concerns about "the shortage." However, veteran nurses are the very cohort who, with their vast experience and level of knowledge, should be rallied to participate in the development of EBP in home healthcare.
So let's go forward to
* Develop a research problem
* Find a mentor
* Start with Sigma Theta Tau-funding is there
* Present research at National Association for Home Care and other meetings
* Start a Home Healthcare Nurse journal club
I look forward to the forthcoming new edition of the core curriculum for home healthcare nursing and its section on trends, issues, and research to give us direction and guidance. Until then, I challenge all home health nurses, educators, and nursing faculty to conduct research and publish it in every issue of Home Healthcare Nurse.
Secondhand Smoke a Risk for Children Worldwide
Parents worldwide are doing little to protect their children from exposure to secondhand smoke, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health.
Exposure to secondhand smoke has been extensively shown to increase the risk for numerous illnesses and premature death. The household study, conducted in 31 countries, found that 82% of parents who smoked reported smoking around their children. Measurements of nicotine levels from household air and children's hair samples also indicated high exposure to secondhand smoke among those living with a smoker. The study is among the first to demonstrate that secondhand smoke is a global concern, particularly for children. It was published on Feb. 28 in the online version of the American Journal of Public Health and appeared in the journal's April 2008 print edition.
According to the findings, concentrations of nicotine in the air were 17 times higher in households with a smoker compared to those without. Air concentrations were 12.9 times higher in households that permitted smoking indoors, compared to those that voluntarily restricted indoor smoking. Median air nicotine levels in households with smokers were highest in Europe, followed by Latin America and Asia.
Nicotine was detected in hair samples in 78% of children living with a smoker and 59% of those who did not live with a smoker. In most cases, hair nicotine levels were positively correlated with nicotine air concentrations.
A related study, also published in the American Journal of Public Health, concluded that paternal smoking diverts money from basic necessities to cigarettes, putting children at greater risk for chronic malnutrition.
SOURCE:
http://www.jhsph.edu/publichealthnews/press_releases/2008/wipfli_secondhand_smok
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