Nursing Reference Center Editorial Policies

Evidence-Based Information:

"Evidence-based" is a descriptor that is often used to describe health care-related reference resources.

For a clinical reference resource to truly be evidence-based, conclusions must be based on the best available evidence. Conclusions can be based on the best available evidence only if the evidence is consistently and systematically identified, evaluated and selected.

The CINAHL Nursing Guide editorial process adheres to the following strict 7-Step Evidence-based Methodology and protocol:

  1. Systematically identify the evidence
  2. Systematically select the best available evidence from that identified
  3. Systematically evaluate the selected evidence (critical appraisal)
  4. Objectively reflect the relevant findings and quality of the evidence
  5. Synthesize multiple evidence reports
  6. Derive conclusions and recommendations from the evidence synthesis; obtain peer review
  7. Change the conclusions when new evidence alters the best available evidence

Every article considered for inclusion in the CINAHL Nursing Guide is processed using this system, and the system ensures the integrity of the conclusions.

Step 1: Identify the Evidence

Perform systematic searching

  • When adding a new CINAHL Nursing Guide topic or critically revising an existing topic, appropriate databases (MEDLINE, CINAHL and others) are searched to identify the best available evidence. In addition, numerous sources are searched for evidence-based reviews (such as Cochrane Database of Systematic Reviews), for guidelines (such as National Guideline Clearinghouse), and more.

Perform systematic literature surveillance and update schedule

The content is updated as follows:

  1. Top Priority Content – These articles may be updated frequently as a result of new studies that impact the information contained in the Quick Lesson or Evidence-Based Care Sheets.
  2. All Other Content – These articles are scheduled for full review within a 12-month period. Articles are rewritten as necessary.

Step 2: Select the Best Available Evidence

Each article is assessed for clinical relevance and each relevant article is further assessed for validity relative to existing CINAHL Nursing Guide content. The most valid articles are used to create the Quick Lessons and Evidence-Based Care Sheets.

Determine Relevance

Determining clinical relevance is the first consideration in systematically selecting the best available evidence from the literature retrieved. The relevance of information is different for every user. CINAHL Nursing Guide is used in clinical care by nurses with a wide range of experience and interests, and is also used in continuing education. When adding information the following is considered:

  1. This information has a direct bearing on patient-oriented outcomes.
  2. This information is useful in clinical decision-making.
  3. In situations where the evidence does not clearly support or refute a clinical fact, opposing views are presented.
  4. Some medical information is not clinically relevant, but is widely publicized. Summarization of this type of information (often with commentary) is relevant to the CINAHL Nursing Guide users if it is likely that nurses will be asked about it during clinical encounters. It is important to point out where this type of information is not clinically applicable.

Determine Validity

Clinically relevant articles must be assessed to determine the scientific validity of conclusions and facts presented before consideration for use.

Step 3: Evaluate the Evidence (Critical Appraisal)

Examine the article to evaluate the article’s methodologic quality and results and determine its level of evidence.

Reports used for updating CINAHL Nursing Guide represent the best available evidence for the specific content under consideration. Evidence may be labeled in several ways as outlined under Levels of Evidence.

Step 4: Objectively Reflect the Relevant Findings and Quality of the Evidence

When reporting the evidence, the following is considered:

  1. What are the most relevant outcomes to report in the topic?
  2. Were all relevant outcomes reported in the original article?
  3. For relevant outcomes, what is the magnitude of effect?
  4. Were the findings clinically significant?
  5. In the case of no statistically significant differences, were the findings robust enough to rule out clinically significant difference?
  6. Are there any methodologic limitations sufficient to alter reliability of clinical conclusions?

Step 5: Synthesize Multiple Evidence Reports

Evaluate the findings, both positive and negative, from the relevant articles and organize in a systematic fashion.

Step 6: Derive Conclusions and Recommendations from the Evidence Synthesis; Obtain Peer Review

Based on the synthesis of relevant evidence, conclusions about current knowledge are drawn and recommendations for clinical practice are made.

Step 7: Change Conclusions When New Evidence Alters the Best Available Evidence

The final step in our evidence-based methodology is changing conclusions when new evidence alters the best available evidence. This step is crucial because new evidence is published every day. Having new evidence summaries handled separately from reviewed content in a manner requiring the nurse or clinician to search in two locations to synthesize the entire story would make finding the best available evidence more difficult.

As soon as new evidence is evaluated, it is added to the appropriate topic(s) in context. Latest Revision date is provided on papers when a paper has been updated based on best available evidence or when a paper has been revised. Original Document date is the date the paper was first written.

The update surveillance process occurs daily and high use content is reviewed quarterly and all content is reviewed annually.
 

Content Sources

CINAHL Nursing Guide Content Sources:

CINAHL Nursing Guide monitors the content of medical and nursing journals indexed in MEDLINE, CINAHL and other appropriate databases (as necessary). Information from appropriate websites such as CDC, specialty organizations and more are also monitored.

 

Coding Matrix

CINAHL Nursing Guide provides easy-to-interpret Coding Matrix labels allowing users to quickly find the best available evidence and determine the quality of it. Evidence is identified as follows:

M
Published meta-analysis
SR
Published systematic or integrative literature review
RCT
Published research (randomized controlled trial)
R
Published research (not randomized controlled trial)
C
Case histories, case studies
G
Published guidelines
RV
Published review of the literature
RU
Published research utilization report
QI
Published quality improvement report
L
Legislation
PGR
Published government report
PFR
Published funded report
PP
Policies, procedures, protocols
X
Practice exemplars, stories, opinions
GI
General or background information/texts/reports
U
Unpublished research, reviews, poster presentations or other such materials
CP
Conference proceedings, abstracts, presentations

Topic Selection & Content Organization:

CINAHL Nursing Guide offers clinically-organized summaries for over 1,000 topics.

A "topic" in the CINAHL Nursing Guide is a summary of an area of information with a defined scope. Topics are based on:

  • Common and uncommon diseases & conditions
  • Symptoms (e.g., chest pain)
  • Other clinically important topics (e.g., breast feeding, end-of-life issues)
  • Specific popular interest (e.g., West Nile Virus, Anthrax, SARS)
  • New scope of information based on developing research (e.g., gait training using electrical stimulation)
  • Suggestions by Nursing Reference Center and CINAHL users
  • Searches performed on the CINAHL databases
  • Surveys of nursing and allied health professionals to continuously assess information needs

Revisions of existing topics are prioritized by frequency of user searches. New topic summaries for CINAHL Nursing Guide may be determined internally or suggested by users or potential authors.

CINAHL Nursing Guide content is organized in an easy-to-use, two page document covering diseases, conditions, symptoms. Other presentations follow a standardized template within the following frameworks:

For Quick Lessons:

  • Description/Etiology
  • Facts and Figures
  • Risk Factors
  • Signs and Symptoms/Clinical Presentation
  • Assessment (may vary according to topic)
    • Patient History
    • Physical Findings of Particular Interest
    • Laboratory Test That May Be Ordered
    • Other Diagnostic Tests/Studies
  • Treatment Goals (specific to topic)
  • Food for Thought
  • Red Flags
  • What Do I Need to Tell the Patient/Patient’s Family

For Evidence-Based Care Sheets:

  • What We Know
  • What We Can Do

 

Editorial Policies for Authors & Reviewers:

CINAHL NURSING GUIDE provides the most relevant, useful information for reference at the point of care. This is accomplished by the CINAHL editorial team and policies. CINAHL NURSING GUIDE seeks contributors, and we encourage clinicians to take part in the ongoing development of CINAHL NURSING GUIDE as authors and reviewers.

What is the role of a CINAHL NURSING GUIDE author?

A CINAHL NURSING GUIDE author either creates a new topic or revises an existing topic.

  • For new topics, an author uses a standard template to create the entry for a disease, condition, or drug that did not previously exist in the database. The author selects evidence from the literature retrieved, organizes the information, and summarizes the findings.
  • For pre-existing topics, the objective is to revise and improve the topic through re-examination. The author reviews the existing topic and current evidence, and validates this material to ensure that it is clinically sound and easy to locate. The end result is the most accurate, current, and valuable information on a given topic.

An author must:

  • Evaluate evidence (provided from a search for the best available evidence) and perform a critical appraisal sufficient to assign level of evidence labels where applicable.
  • Draft a topic summary or critically revise an existing summary.
  • Participate sufficiently in the work to take public responsibility for the content in the topic summary.

What is the role of a CINAHL NURSING GUIDE reviewer?

A reviewer helps to ensure that a new or revised topic meets the needs of practicing nurses and allied health professionals. A reviewer provides recommendations for improving the usefulness of the summary, especially with respect to relevance, completeness, and ease of use. Validity assessment and selection of the best available evidence is welcome, but reviewers rely on CINAHL NURSING GUIDE authors and editors for specific evidence evaluation.

Authors and reviewers are not blinded. After the initial review, authors and reviewers are included collectively in e-mail notices regarding updates and are encouraged to collaborate in continually improving the summary. Authors and reviewers are required to disclose competing interests (financial or otherwise).

Becoming a CINAHL Nursing Guide Author or Reviewer:

Authors and reviewers for the CINAHL Nursing Guide are required to have clinical practice experience. Trainees or professionals without clinical practice experience may be authors or reviewers only if a collaborating reviewer has clinical experience.

CINAHL Nursing Guide Peer Review

All reviewers are listed on Author and Reviewer pages.

Anyone with an interest in contributing to the CINAHL Nursing Guide as an author or reviewer is encouraged to send an email to cngcontributors@cinahl.com.

CINAHL Nursing Reference Team:

List of Staff/Medical Writers:

Carlyn Hansen, RN, MA
Cherie Marcel, BS
Darlene A. Strayer, RN, MBA
Diane Haskins, RN, BSN
Diane Pravikoff, RN, PhD, FAAN
Denise Wilson, RN, MSN
Eliza Schub, RN, BSN
Elizabeth Hermann
Ernest Razo, BFA
Gary Msryan
George Herrera
Geremy Estrella, MD
Gilberto Cabrera, MD
Gina DeVesty, BSN, MLS
Helle Heering, RN, CRRN
Hillary Mennella, FNP, MSN, ANCC-BC
James Chaskey
James Graham, BA
Jennifer Kornusky, RN, MSN
Jennifer Samghabadi, FNP-C
Jenny Kim, BA
Jocelyn Amba, BA
John Shureen, BA
Judy Leinweber, BA
June Levy, MLS, VP
Katherine Burns, BA
Kathleen Walsh, RN, MSN, CCRN
Kevin Herrera
Kristin Ciasulli, RN, BSN, CCRN
Leonard Buckley, MD
Lydia Uribe, Pharm.D., MLIS
Lynne Treat, BSN, RN, BA
Maria Silva, RN, AND, BA
Marc Esposo
Marlene Lawton, RN
Mary Woten, RN, BSN
Megan L. Rabin, MEd
Melanie Tse-Fong, BS
Michele Maines, RN, MSN, MSG, CNL
Michelle Lespasio, DNP, JD, MS, NP
Mitra Layeghi, RN, MSN
Molly Hoffman, RN, MSN
Mona Lisa McCormick, RN
Myrna Esposo, AS
Nathaniel Snow, BSc
Nathalie Smith, RN, MSN, CNP
Neill Levy, BA, LLB
Nicole Edmonds, RN
Patricia Lawrence, RN, BSN, MS
Penny March, PsyD
Rosalyn Robinson, RN, DNP, APNP, FNP-B
Samuel Auyong, DC
Sara Richards, MSN, RN, PHN, CNL, CLE
Sarah Marcarian, RN
Suzanne Dixon, MPH, MS, RD
Tanja Schub, BS
Teresa Barous, RN, MSN, FNP
Teresa-Lynn Spears, RN, BSN, PHN, AE-C
Yoko Mizuguchi, BS
Zahra Fotovat, MLS, PhD
Zeena Kies Engelke, RN, MS

List of Reviewers:

Alina Dersarkissian, Glendale Adventist Medical Center, Glendale, CA

Angela Garcia, Coordinator, Glendale Adventist Medical Center, Glendale, CA

Anne Lee, RN House Supervisor, Glendale Adventist Medical Center, Glendale, CA

Crystal Hung, RN, Quality Review Specialist, Glendale Adventist Medical Center, Glendale, CA

Dana Crumbliss, RN, BSN, NICU Educator, Glendale Adventist Medical Center, Glendale, CA

Dawn Stone, MN, APRN, BC, ANP, COHN-S, Associate Professor, Western University of Health Sciences, Pomona, CA

Debra Douglas, BSN, RN, SANE-A, SANE-P

Debra Balderrama, MSG, RN, CIS Educator, Glendale Adventist Medical Center, Glendale, CA

Debra Guy, RN, BSN, CNOR, MSG, Educator, Glendale Adventist Medical Center, Glendale, CA

Donna Nielsen, RN, MSN, ALNC

Ellen Hooker, RN, Risk Management Safety Officer, Glendale Adventist Medical Center, Glendale, CA

Elsa Cameron, Glendale Adventist Medical Center, Glendale, CA

Emillie Battig, RN, BSN, CIS Educator, Glendale Adventist Medical Center, Glendale, CA

Eva Beliveau, RN, MSN, CNE, Professor of Nursing, Northern Essex Community College, Newburyport, MA

Gary Mittelberg, RN, MSN, Director, Glendale Adventist Medical Center, Glendale, CA

Grace Chung, RN, ASN, BSN, PHN, CIS Educator, Glendale Adventist Medical Center, Glendale, CA

Gautam Kulkarni, MBA, Director of Neuro Science, Glendale Adventist Medical Center, Glendale, CA

Jan Cohen, RN, Manager, Glendale Adventist Medical Center, Glendale, CA

Janice Tostado, RN, AD, Charge Nurse, Educator Ambulatory Surgery Center, Glendale Adventist Medical Center, Glendale, CA

Jeanie Anderson, RRT, Manager, Respiratory Services, Glendale Adventist Medical Center, Glendale, CA

Jennifer Sanguinet, BSIS, CIC, MBA-HCM, Director of Infection Control, Glendale Adventist Medical Center, Glendale, CA

Jocelyn Cajanap, CNS, MSN, RN, FNP, Clinical Educator, Glendale Adventist Medical Center, Glendale, CA

Jodi Gillians, RN, BSN, Senior Clinical Educator, Glendale Adventist Medical Center, Glendale, CA

John Deyell, BSIS, RN, Cardiovascular Clinician, Glendale Adventist Medical Center, Glendale, CA

Judy Blair, CNO, Sr VP, Glendale Adventist Medical Center, Glendale, CA

Karen Brandt, Director, Glendale Adventist Medical Center, Glendale, CA

Kathleen Dor, Staff Physician, Assistant Director, Family Practice Residency Program, Kaiser Permanent, Woodland Hills, CA

Kathryn (Katy) Lancaster, RN, BSN, Clinical Educator, Step-down/Telemetry Units, Glendale Adventist Medical Center, Glendale, CA

Kathy Rodrigue, Glendale Adventist Medical Center, Glendale, CA

Kimberly Crowe , RN, MSN

Lana Rhodes, RN, MSN, ACNP, Critical Care Clinical Educator, Glendale Adventist Medical Center, Glendale, CA

Lee Allen, RN, MS, Nurse Educator, Glendale Adventist Medical Center, Glendale, CA

Leila Adams, Clinical Educator II, Behavioral Medicine, Glendale Adventist Medical Center, Glendale, CA

Lisa Clibourn, Glendale Adventist Medical Center, Glendale, CA

Lora Altis-Parkhurst, Manager, Ambulatory Surgery Center, Glendale Adventist Medical Center, Glendale, CA

Mari Ladnier, RN, Charge Nurse, Glendale Adventist Medical Center, Glendale, CA

Melina Thorpe, MBA, OCN, RN, Director of Cancer Services, Glendale Adventist Medical Center, Glendale, CA

Michele Maines, RN, MSN, MSG, CNL

Michelle Jocson, CNRN, RN, MSN, Stroke Coordinator, Glendale Adventist Medical Center, Glendale, CA

Michelle Tremblay, RN, MAOM, BSN, CCRN, PHN, LNCC, Director of Clinical Practice, Glendale Adventist Medical Center, Glendale, CA

Punnoose Varghese, RN, MS, MSN, Director, Glendale Adventist Medical Center, Glendale, CA

Rachel Gilmer, RN, BSN, CNS, MSN, Perinatal Clinical Educator, Glendale Adventist Medical Center, Glendale, CA

Rebekkah Martinez-Miller, BC, CIC, MHA, RN, MSN, Infection Preventionist, Glendale Adventist Medical Center, Glendale, CA

Ripsime Gozyan, RN, BSN, Head Nurse, Medical Surgical Unit, Glendale Adventist Medical Center, Glendale, CA

Pat DeVeer, RN, MSN, Educator, Glendale Adventist Medical Center, Glendale, CA

Rosalyn Robinson, RN, DNP, APNP, FNP-BC

Rosmarie Salman , RN, Glendale Adventist Medical Center, Glendale, CA

Ruby Babista, RN, BSN, Medical-Surgical Clinical Educator, Glendale Adventist Medical Center, Glendale, CA

Sharon Correa, RN, Associate Vice President, Glendale Adventist Medical Center, Glendale, CA

Sharon Price, RN, Director, Glendale Adventist Medical Center, Glendale, CA

Susan Hawkes, RN, Director, Glendale Adventist Medical Center, Glendale, CA

Suzy Axt, Director, Glendale Adventist Medical Center, Glendale, CA

Tanya Scharenberg, PharmD

Terri Hansen, CDE, RN, Diabetes Educator, Glendale Adventist Medical Center, Glendale, CA

Terri Van Houten, RN, MSN, Ed, Director of Nursing Operations, Glendale Adventist Medical Center, Glendale, CA

Tom Harris, Director, Glendale Adventist Medical Center, Glendale, CA

Tamar Apelian, BS, RD, Clinical Nutrition Manager, Glendale Adventist Medical Center, Glendale, CA

Val Emery, Glendale Adventist Medical Center, Glendale, CA

Vonna Struck, Disaster Preparedness Coordinator, Glendale Adventist Medical Center, Glendale, CA

Wende Brookshire, RN, Director, Glendale Adventist Medical Center, Glendale, CA

Zoe Chen, RN, MSN, Clinical Educator, Glendale Adventist Medical Center, Glendale, CA

List of Editorial Board:

Anne D. Tanner, R.N., M.N., Medical Center Operations, City of Hope National Medical Center, Duarte, CA

Betty Chang, R.N., D.N.Sc., FAAN, Professor Emerita / Coordinator, School of Nursing, University of California, Los Angeles / Southern California Region, Kaiser Permanente, Los Angeles, CA

Colleen Goode, R.N., Ph.D., FAAN, Vice President, Patient Care Services & Chief Nursing Officer, University of Colorado Hospital, Denver, CO

Dana N. Rutledge, R.N., Ph.D., Nursing Research Facilitator at Joseph Hospital; Professor, CSU, St. Joseph Hospital; California State University, Fullerton, Orange, CA

Elizabeth Wood, M.A., M.S.L.S., AHIP, Director, Graff Library, City of Hope, Duarte, CA

Ellen Hall, MALS, Library Director, Kreitzberg Library, Norwich University, Northfield, VT

Felicitas de la Cruz, R.N., D.N.Sc., Professor, School of Nursing, Azusa Pacific University, Azusa, CA

Gerri S. Lamb, R.N., Ph.D., FAAN, Associate Dean for Clinical and Community Services, College of Nursing, University of Arizona, Tucson, AZ

Ida Androwich, R.N., Ph.D., FAAN, Professor, Community Mental Health and Administrative Nursing, Loyola University Medical Center, Maywood, IL

Jean Ann Seago, R.N., Ph.D., Associate Professor, School of Nursing (N531E), University of California, San Francisco, San Francisco, CA

Jean Jarosz, R.N., B.S.N., C.N.A, Disability Management Specialist, Intracorp, Disability Management Services. Arcadia, CA

Joan Otterman, Infection Control Professional, Tuality Healthcare, Hillsboro, OR

Joan Uhl Pierce, R.N., Ph.D., FAAN, President and CEO, Pierce & Associates Nursing Consultants, Knoxville, TN

Judith M. Lewis, R.N., Ed.D., Vice President and CFO, The Claremont Group, Claremont, CA

Karen R. Sechrist, R.N., Ph.D., FAAN, Berlin Sechrist Associates, Irvine, CA

Kathleen Milholland Hunter, R.N., Ph.D., K & D Hunter Associates, Inc., Lithia, FL

Linda Burnes Bolton, R.N., Dr.P.H., FAAN, Vice President, Nursing and Chief Nursing Officer, Cedars-Sinai Medical Center, Los Angeles, CA

Margo C. Neal, R.N., M.N., Malibu, CA

Marilyn Bookbinder, R.N., Ph.D., Director of Nursing, Department of Pain & Palliative Care, Beth Israel Medical Center, New York, NY

Marilyn Verhey, R.N., Ph.D., Dean of Faculty Affairs, San Francisco State University, San Francisco, CA

Maryalice Jordan-Marsh, R.N, Ph.D., FAAN, Associate Professor, Chair, Health Concentration, Nurse Social Work Practitioner Option, USC School of Social Work, Los Angeles, CA

Maureen Hirsch, R.N., M.N., Lecturer, California State University, Dominguez Hills, Dominguez Hills, CA

Nancy Donaldson, R.N., D.N.Sc., Clinical Professor and Director, Center for Research and Innovation in Patient Care, Associate Dean for Practice, University of California, San Francisco, San Francisco, CA

Richard W. Bohannon, Ed.D., P.T., N.C.S, Professor, School of Allied Health, University of Connecticut, Storrs, CT

Sally Rankin, R.N., Ph.D., FAAN, Professor, School of Nursing, University of California, San Francisco, San Francisco, CA

How to Cite Information from the Nursing Reference Center (APA Style):

The following format outlines how a user would cite information found in Nursing Reference Center or Nursing Reference Center Plus.

[Author Last Name], [Author First Name Initial]. ([Date of publication]). [Title of document]. [Source] Retrieved from [URL]

Below is an example using the Spiritual Needs of Hospitalized Patients Evidence-based Care Sheet (please note that this is just an example of format and the URL shown is not meant to link to the content):

March, P. & Caple, C. (2015). Spiritual needs of hospitalized patients. CINAHL Nursing Guide. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&hid=15&db=nrc&AN=5000000657&site=nrc-live

 


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