Which Nursing Journal is good? — the Impact Factor

thinkingIn Off the Charts, the official blog of the American Journal of Nursing, it states that 71% of bedside nurses use Google to search for Evidence Based Practice to better their practice (and here’s how to do it better). However, how do you know about the quality of a journal? There are 100s of nursing journals. One of the best ways to evaluate a nursing journal is through the Impact Factor (IF).

The Impact Factor tells the reader that how often the articles in that journal have been cited in other journals. The higher the number, the better it is. On this website, it has links to nearly all of the nursing journals and has a impact factor written next to it, if it has one at all

The American Journal of Nursing has a impact factor of 1.319, which places it at #18 out of all of the nursing journals for 2014. A couple of the ones I’m interested in are the Journal of Cardiovascular Nursing (1.431), American Journal of Critical Care (1.656), and Critical Care Nurse (1.077). While each article may not be the best, the journal as a whole tend to produce quality information. 

Now, in order for these journals to make money, they charge for the articles. But there are a few ways to get them for free.

  1. Join the Nursing Association that is associated with the journal. For example, joining the Preventative Cardiovascular Nurse Association (PCNA) for $75 includes the Journal of Cardiovascular Nursing (normally $129/year) for free. Plus, by joining the PCNA, you’ll also receive other resources, discounts on meetings, etc. Another great organization is the American Association of Critical Care Nurses (AACN), which also includes the American Journal of Critical Care and Critical Care Nurse.
  2. Go to the Nursing Center. They have updated new and free journal articles. Even better, they offer a free journal for you to look through every twice a month.
  3. Go to your college’s library website. Part of your tuition goes into purchasing these journals for students to use (because they can get very expensive if you bought them on your own!). If you are attending NYU, go to library.nyu.edu, go under find resources, then click on journals. Or go to getit.library.nyu.edu. Be sure to log in to read the journals!

I hope that by understanding what the Impact Factor is, you can make better decisions on which Nursing Journals you should read or even buy. Maybe you’ll even join a nursing organization! Keep updated on the latest and greatest in this constantly evolving field. And share what you learn with other nurses. Maybe it’ll even make a difference.

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Talking to intubated patients make a difference

I’ve taken care of my fair share of intubated patients. But over the last 2 nights, I encountered something different. They went from calm to wild in just a few minutes. If the sedation was down, then I increased that. Normally it works pretty fast.

But it wasn’t so in this case. Both patients were ‘bucking the vent.’ One didn’t have a PRN order ready so for one I had my coworker help me get an order and prepare ativan. But in the meantime, I remember reading critical care nursing journals about the experiences of previously intubated patients. They said to always assume that the patient can hear you. They said that when the nurse talked to them about where they were, what’s going on, and what to do, in a strong confident voice, that the patients felt comforted by that. So that’s exactly what I did.

This patient kept biting down on the tube (which is a big no no because we don’t want a punctured tube!!). “You’re in the hospital and you’re very sick. I’m Jessica, your nurse. Right now you’re having trouble breathing so you have a breathing tube. I know it’s uncomfortable but you need this. Try to calm down and take slow breaths. Open your mouth. Your face is very red but calming down will allow you to breathe better.”

Once I said this, the patient did calm down and opened her mouth.

“Good, your face is looking better and you’re oxygenating better. We are going to turn you to the side to clean you because you had a little accident, ok?”

She was able to cooperate much more at this point. And this happened before giving the ativan. My coworker then came in, administered it (“we’re going to give you something to help you relax now”), and she was at peace again.

Even though she couldn’t focus her eyes and couldn’t follow simple commands, it seems as though what I said did make a difference.

 

5 Triggers for Palliative Care in the ICU

Right now, I notice that some patients get palliative care too late in their stay at the hospital and sometimes pass away a day later after the consult was put in. We can do better than that to ensure patients are living the way they want to!!

I came across an article in a critical care newsletter called Estimates of the Need for Palliative Care Consultation across United States Intensive Care Units Using a Trigger-based Model. It said 1 in 7 patients need palliative care and that there are 5 triggers that indicate the patient has a poor prognosis and the healthcare team should put in a consult. It will give the patient and the family members more support and help guide them through difficult decisions. Here are the 5 triggers:

  1. ICU admission after hospital length of stay of at least 10 days
  2. failure of three or more organ systems
  3. stage IV malignancy
  4. status after cardiac arrest
  5. intracerebral hemorrhage requiring mechanical ventilation