Use, knowledge, and attitudes toward evidence-based practice among nursing staff.

BACKGROUND: Little information is known about the use, knowledge, and attitudes toward evidence-based practice (EBP) among nurses in a large academic hospital. This cross-sectional, descriptive study examined the knowledge, attitudes, and use of EBP by nurses at a large academic, Magnet(®)-designated medical center. METHODS: Data were collected from 593 nurses who completed the Clinical Effectiveness and Evidence Based Practice Questionnaire between November 2011 and March 2012. Statistical analyses included correlations and multivariate analysis of covariance. RESULTS: Most nurses (96%) reported that they were aware that an EBP and Research Council existed. The average scores were highest on the Attitudes subscale, followed by the Knowledge/Skills and Practice subscales. CONCLUSION: Continuing education for nurses makes a difference in nurses' attitudes, knowledge, and use of EBP in practice. Participation in EBP and research educational activities or Council meetings may affect EBP culture in a large academic medical center.

Nicotinic acetylcholine receptor subunits in rhesus monkey retina.

PURPOSE: The purpose of this study was to detect and establish the cellular localizations of nicotinic acetylcholine receptor (nAChR) subunits in Rhesus monkey retina. METHODS: Retinas were dissected from the eyes of monkeys killed after unrelated experiments. RNA was extracted and analyzed by RT-PCR, using primers designed against human sequences of alpha3-alpha7, alpha9, and beta2-beta4 nAChR subunits. The RT-PCR products were separated by gel electrophoresis and sequenced. Frozen sections of postmortem fixed monkey eyes were immunolabeled with well-characterized and specific monoclonal antibodies against the alpha3, alpha4, alpha6, alpha7, beta2, or beta4 nAChR subunits and visualized with fluorescence labeling. RESULTS: Products of the predicted size for the alpha3-alpha7, alpha9, and beta2-beta4 nAChR subunits were detected by RT-PCR in Rhesus monkey retina. Homology between transcripts from monkey retina and human nucleotide sequences ranged from 93 to 99%. Immunohistochemical studies demonstrated that neurons in various cell layers of monkey retina expressed alpha3, alpha4, alpha7, or beta2 nAChR subunits and cells with the morphology of microglia were immunoreactive for the alpha6 or beta4 nAChR subunits. CONCLUSIONS: nAChR subunits are expressed in the monkey retina and localize to diverse retinal neurons as well as putative microglia. Besides mediating visual processing, retinal nAChRs may influence refractive development and ocular pathologies such as neovascularization.

What nurses do: use of the ISO Reference Terminology Model for Nursing Action as a framework for analyzing MICU nursing practice patterns.

This study utilized the ISO RTM for Nursing Action as a model to decompose nursing actions and as a framework for analyzing the practice patterns of nurses working in a medical intensive care unit (MICU). Observations were made in a 25-bed MICU and nursing actions recorded in terms of model attributes. 1013 actions were observed; decomposed into the ISO RTM categories, they represented 68 distinct actions, 166 targets, 6 recipients of care, 81 means, 16 routes and 115 sites. The most frequent actions were 'assessing' (19.1%) and 'documenting' (10.5%). The most frequent target was 'medication' (8.5%) and the most frequent recipient of care was 'patient' (94.1%). Data revealed nurses perform, yet do not document all actions. Thus in this setting, the existing documentation system does not adequately represent all aspects of nursing practice. The ISO RTM permits evaluation of the depth and breadth of nursing care by identifying all nursing actions.

An analysis of narrative nursing documentation in an otherwise structured intensive care clinical information system.

Most structured nursing documentation systems allow the entry of data in a free text narrative format. Narrative data, while sometimes necessary, cannot easily be analyzed or linked to the structured portion of the record. This study examined the characteristics of free text narrative documentation entered in an otherwise structured record utilized in a cardiovascular intensive care unit. The analysis revealed that nurses documented 31 categories of narrative entries. Approximately 25% of these entries could have been entered into the structured portion of the record through the use of existing documentation codes. Nurses most frequently used the narrative documentation as a means to communicate summarized information for the coordination of healthcare team members. Development of tools to summarize structured data into an 'at a glance' format could enhance the coordination of healthcare team functioning. The authors discuss these results in the context of developing strategies to increase structured documentation and decrease free text in the patient record.

Rabbit retinal ganglion cells express functional alpha7 nicotinic acetylcholine receptors.

It is well known that cholinergic agents affect ganglion cell (GC) firing rates and light responses in the retinas of many species, but the specific receptor subtypes involved in mediating these effects have been only partially characterized. We sought to determine whether functional alpha(7) nicotinic acetylcholine receptors (nAChRs) contribute to the responses of specific retinal GC classes in rabbit retina. We used electrophysiology, pharmacology, immunohistochemistry, and reverse transcriptase-polymerase chain reaction to determine the pharmacological properties and expression of nAChR subtypes by specific rabbit retinal GC classes. Choline was used as an alpha(7) nAChR agonist. Methyllycaconitine (MLA) was used as a competitive alpha(7) nAChR antagonist. The application of choline before synaptic blockade resulted in changes in retinal GC activity, including increases or decreases in maintained firing and/or enhancement or suppression of light responses. Many physiologically identified GC types, including sustained off, sustained on, transient off, and transient on cells, demonstrated responses to choline application while under synaptic blockade. The choline-induced responses could be blocked with MLA, confirming alpha(7) nAChR activation. Individual choline-responsive GCs displayed mRNA transcripts consistent with the expression of functional alpha(7) nAChRs. Other GCs demonstrated physiological responses and mRNA expression consistent with the expression of both alpha(7) and non-alpha(7) nAChRs. Thus mRNA is present for multiple nAChR subunits in whole retina extracts, and functional alpha(7) nAChRs are capable of modulating the responses of GCs in adult rabbit retina. We also demonstrate through physiological responses that subsets of GCs express more than one nAChR subtype.