Evidence for Nursing: new evidence and resources – Quarter 1 2021

The latest evidence and resources for nurses and clinical support workers. You can either scroll through this page or click on any of the links below to jump to the relevant section.

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COVID-19 

Cochrane is producing reviews and resources for the COVID-19 pandemic. We have blogged about many of them and this blog Cochrane evidence on COVID-19: a round-up brings together a large collection of evidence and resources, starting from when this evidence was first being produced in spring 2020. Like the reviews themselves, all our blogs are updated to reflect new evidence.

Cochrane’s response to the pandemic had to meet the needs of evidence users and decision‐makers as it developed and how this is being done is discussed in an editorial COVID-19: working together and making a difference for decision-makers.

Drawing on a Cochrane Review on supporting resilience and mental well-being in frontline healthcare professionals during and after a pandemic (November 2020) there is now a brief for health systems planners and implementers. You might also be interested in the Special Collection Coronavirus (COVID-19): support for wellbeing in the healthcare workforce.

Cochrane Special Collections

Cochrane Special Collections assemble Cochrane Reviews on important topics for the prevention and treatment of COVID-19. They are developed with experts from our global Cochrane network. They are based on World Health Organization interim guidance, and continuously updated. You can find Coronavirus (COVID-19) Special Collections here.

Cochrane COVID-19 Podcasts

Cochrane COVID-19 Podcasts offer short summaries of Cochrane COVID-19 reviews from the authors themselves. A good way to hear the latest Cochrane evidence in under 5 minutes each.

Cochrane Clinical Answers

Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically-focused entry point to rigorous research from Cochrane Reviews. They are designed to be actionable and to inform point-of-care decision-making. Each CCA contains a clinical question, a short answer, and data for the outcomes from the Cochrane Review deemed most relevant to practising healthcare professionals. The evidence is displayed in a user-friendly tabulated format that includes narratives, data, and links to graphics.

You can find Cochrane Clinical Answers related to COVID-19 here. 

Assisted reproductive technology

An Evidently Cochrane blog IVF add-ons: the latest Cochrane evidence was written for people undergoing IVF but is useful also for nurses, setting the latest evidence in context.

Although many different IVF add-ons are available, none have been evaluated in high-quality studies to show that they actually help people to get pregnant and have a baby, and are safe to use. There is some evidence, but it is not high-quality, that three of these add-ons may benefit people having IVF: addition of hyaluronic acid to embryo transfer media, using an advanced sperm selection technique known as hyaluronic acid binding, and injection of high doses of a pregnancy hormone (hCG) into the womb near the time of embryo transfer. People undergoing IVF might like to read the summaries of these Cochrane Reviews, and even take them along to IVF consultations to discuss the evidence with the fertility specialist, to help them make decisions about using IVF add-ons.

The Special Collection In vitro fertilisation – effectiveness of add-ons summarizes evidence for specific IVF add-ons from Cochrane Reviews, to support health professionals and people undergoing IVF in decision-making about offering or using IVF add-ons. 

Cancer

Don’t miss Contemplating Cancer – a special series of thought-provoking blogs in which people share personal and professional experience of cancer, along with Cochrane evidence and artwork.

Liz O’Riordan reflects on the Cochrane Review ‘Communication skills training for healthcare professionals working with people who have cancer’ from her perspective as both breast surgeon and someone with recurrent breast cancer.

Accept you won’t always get it right. Be humble enough to get regular feedback and be prepared to change. The best-prognosis cancer can still be devastating to a patient. Give them the time and space to come to terms with that. It’s not healthy to spend your working life breaking people. Talk to your peers and trainees about how to cope after breaking bad news.

Charlotte Squires reflects on the importance of communication skills for healthcare professionals working with people who have cancer, from her perspective both as doctor and a patient with advanced Hodgkin Lymphoma.

A Cochrane Review found that communication skills training can lead to improvement in the use of open-ended questions, and in displayed empathy, but the effect seems to be short-lived. Patient satisfaction is a common measure of healthcare interactions but may not be appropriate when considering instances of receiving significant news. Communication skills are not linearly associated with experience, which raises questions about how both clinicians at all stages should be trained and assessed.

Sally Crowe reflects on her experiences of post-traumatic stress (PTS) after being diagnosed and treated for a rare cancer – a common, but little talked about outcome of having cancer.

Cancer-related post-traumatic stress appears to be common, but little talked about. Good communication from my cancer care team helped me accept and adapt. The effects of cancer post-traumatic stress (PTS) may inhibit recovery and return to work. Identifying trigger points in post-traumatic stress can help in self-management and recovery. For some living with secondary, metastatic or incurable cancer – there is no ‘post’ in PTS.

We invited people to share their experiences and views on communicating about cancer on Twitter. In this blog, Sarah Chapman reflects on what emerged.

In conversations about cancer, choice of words and body language have a big impact at the time and are also likely to be remembered. People appreciate being listened to and given time to process information and ask questions, during consultations, in a private space with family, or later in follow-up calls. The mental health impacts of cancer can last, or even begin, long after treatment is finished, but may not be recognised or talked about. Sources of support include patient-led groups and charities.

In this blog for people making treatment decisions about prostate cancer, surgeons Francisco Lopez, Freddie Hamdy and Alastair Lamb explore the evidence, weigh up the benefits and harms, and suggest some questions that you may wish to discuss with your clinician.

Many men with prostate cancer do not need to receive radical treatment as the disease will not cause them harm in their lifetime.  A Cochrane Review shows that one form of treatment - radical prostatectomy - reduces progression and spread of prostate cancer when it is contained, but at the cost of side-effects such as urine leakage and erectile dysfunction. There is therefore an important ‘trade-off’ that each patient needs to consider when selecting his treatment option. Men need to consider their attitude to risk to consider their preferred approach if diagnosed with prostate cancer.

In this blog for informal cancer caregivers, Beverley Lim Høeg and Pernille Envold Bidstrup, who are both psychologists and cancer researchers, look at the challenges faced by those caring for a loved-one with cancer and explore why informal caregivers deserve more support and focus in cancer treatment and research. Pernille is also the mother of a 9 year old cancer survivor.

Take-home points Informal caregivers provide important practical help and emotional support to people with cancer before, during, and after cancer treatment. Providing care to an ill loved-one is stressful and caregivers need to remember to look after their own physical and mental well-being, while healthcare providers and researchers need to find ways to better support the caregiver population in this important role. Informal caregivers can help advocate for their own needs and the needs of their ill loved-one through direct involvement in treatment consultations, or through indirect means such as participating in patient organizations, as well as hospital and research committees that involve patients and members of the public.

 

Cardiovascular disease

Cardiovascular disease

An Evidently Cochrane blog “Reducing saturated fat intake: is it worth the effort?” by Robert Walton, a Cochrane UK Senior Fellow in General Practice, looking at the evidence on reducing saturated fat in the diet to help prevent cardiovascular disease.

A Cochrane Review has found that reducing saturated fat intake probably results in an important reduction in the risk of having a heart attack or stroke for people who are not also taking drugs to lower lipids, such as statins. It is uncertain whether the benefits could still be achieved by people modifying their diet if they are also taking drugs to lower lipids. There is low-certainty evidence that dietary modification to reduce saturated fat intake may cause little to no harm. 

There is a Cochrane Clinical Answer relating to the same review For people with or without cardiovascular disease (CVD), what are the effects of reducing saturated fat intake? 

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Care of the newborn, including pre-term infants

Neonatal jaundice: Cochrane evidence on prevention and treatment is a blog for health professionals, written by Paediatric Registrar Katie Westwood, looking at relevant Cochrane evidence from multiple reviews.

Fluid supplementation may shorten the duration of phototherapy. Using reflective materials with standard phototherapy probably reduces hospital stay. Prebiotics may be of benefit in preventing neonatal jaundice. This evidence is from small studies and more research is required before recommendations can be made for clinical practice.

Cochrane Reviews: 

Cochrane Clinical Answer: For very preterm or very low birth weight infants, what are the effects of probiotics for preventing necrotizing enterocolitis? 

Cochrane Podcast: Probiotics for prevention of necrotising enterocolitis in very preterm or very low birthweight infants.

Central venous catheter management 

Cochrane Clinical Answer: How does low molecular weight heparin (LWMH) compare with low‐dose unfractionated heparin (UFH) for preventing central venous catheter–related thrombosis in children? 

Cochrane Nursing

Cochrane Nursing aims to promote awareness of and access to the Cochrane Library for the international nursing community. You can become a member of Cochrane Nursing and there are opportunities to get involved in activities. Find out more in this bulletin.

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Critical and emergency care

Enhanced rehabilitation for people with dementia after hip fracture

Cochrane Clinical Answer: What are the effects of enhanced rehabilitation and care models for adults with dementia undergoing hip fracture surgery?

Healthcare worker education and training

 Cochrane Clinical Answers:

Healthcare worker health and wellbeing

Cochrane Clinical Answer: Do psychological interventions help foster resilience among healthcare students? 

Healthy ageing

Healthy ageing

The United Nations has designated 2021-2030 as the Decade of Health Ageing in an initiative that aims to bring together different sectors and countries to take action to improve the lives of older people, their families and communities. As part of this, a special healthy ageing issue of Cochrane Library app has been released. The Cochrane Library app presents the latest up-to-date evidence from the Cochrane Library in a convenient, easy to navigate format which provides you with relevant, accessible research, when you need it. All content is free and new issues will download regularly.

There is also a Cochrane Special Collection: Physical activity for healthy ageing.

Organisation and delivery of care

Palliative care

Featured Review: Hospital-based specialist palliative care for adults with a terminal illness

Perioperative care

Cochrane Review: Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta‐analysis (October 2020).

There is a related Cochrane Podcast: Which medicines work best to prevent people from being sick (vomiting) after an operation? and a Cochrane Clinical Answer: For adults who have undergone general anaesthesia, what are the effects of postoperative antiemetic drugs?

Regional anaesthesia

For adults with hip fracture, peripheral nerve blocks (PNBs) reduce pain on movement within 30 mins of block placement and reduce the risk of confusion compared with no nerve block or sham block (high-certainty evidence). PNBs probably also reduce the risk of chest infections and time to first mobilization after surgery (moderate-certainty evidence). There may be a small reduction in the cost of analgesic drugs with a single injection of PNB (low-certainty evidence). There is not enough evidence about the effects on risk of death or myocardial infarction (low-certainty evidence).There is not enough information about possible harms of PNBs.Cochrane Review (November 2020); 49 studies with 3061 adults undergoing surgery for hip fracture, comparing PNBs used as preoperative analgesia, as postoperative analgesia, or as a supplement to general anaesthesia, versus no nerve block or sham block.

 

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Smoking cessation

Cochrane Clinical Answers:

Stroke

Coming up…

On 20-22 April 2021, Cochrane UK and Cochrane Ireland are holding an online event ‘Virtually Cochrane’ for all those involved with, or interested in, planning, doing, sharing and using research evidence. Registration will open in February.

The next collection of evidence will be published here in April 2021. We may have new blogs and blogshots on individual reviews meanwhile. You can find all our blogs relevant to nursing here and blogshots here.

Join in the conversation on Twitter with @CochraneUK or leave a comment on the blog. Please note, we will not publish comments that link to commercial sites or appear to endorse commercial products. We welcome diverse views and encourage discussion but ask that comments are respectful and reserve the right to not publish comments we consider offensive.

References (pdf)

Sarah Chapman and Selena Ryan-Vig have nothing to disclose.



Evidence for Nursing: new evidence and resources – Quarter 1 2021 by Sarah Chapman

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

1 Comments on this post

  1. Informative

    DeepaRajesh / Reply

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