Evidence for Nursing: new evidence and resources – September 2021

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

Helping you keep up-to-date with evidence

We are now changing these blogs from quarterly to every two months, bringing you new evidence more quickly, and now giving you the bottom line of the Cochrane Reviews we include. You can still give your feedback on our content – how can we make it more useful for you?

COVID-19

COVID-19

This year, Cochrane is continuing to produce new and updated reviews in response to the pandemic. We have blogged about many of them and this blog COVID-19 evidence: a Cochrane 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 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.

Those updated in July include:

Cochrane 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.

Air pollution

Cochrane news item: What can individuals do to avoid the effects of air pollution?

Care of the newborn, including preterm infants

Early postnatal discharge from hospital

Cochrane Clinical Answer: What are the effects of early postnatal discharge from hospital for healthy mothers and term infants?

Opioid withdrawal in newborns

The Cochrane Review Opioid treatment for opioid withdrawal in newborn infants was updated in July 2021 with new trials added and conclusions changed.

Patent ductus arteriosus

Cochrane Clinical Answers:

Tube feeding of preterm and low birth weight infants

Cardiac rehabilitation

Cochrane Clinical Answer: What are the effects of exercise‐based cardiac rehabilitation for adults after heart valve surgery?

Delirium prevention

Delirium is common in hospitalised patients. The authors of a Cochrane Review on Non‐pharmacological interventions for preventing delirium in hospitalised non‐ICU patients (July 2021) have concluded:

  • “There is moderate‐certainty evidence regarding the benefit of multicomponent non‐pharmacological interventions for the prevention of delirium in hospitalised adults, estimated to reduce incidence by 43% compared to usual care.
  • We found no evidence of an effect on mortality.
  • There is emerging evidence that these interventions may reduce hospital length of stay, with a trend towards reduced delirium duration, although the effect on delirium severity remains uncertain.”

Dementia

Our blog Tube feeding for people with severe dementia: making decisions includes professional and personal reflections, plus practical advice and resources.

Take-home points: Supporting someone with a poor appetite, difficulties with swallowing or other problems with eating is complex and can be very emotive A Cochrane Review has found that the effects of tube feeding on quality of life, pain, nutrition, mortality and survival are uncertain, while there is evidence that it is probably linked with a higher risk of pressure ulcers People with dementia, their families and carers need access to clear, balanced information, ideally as part of advanced care planning, but also later on if this has not been possible

There is a also a Cochrane Clinical Answer What are the benefits and harms of enteral tube feeding for people with severe dementia?

Dietary salt for people with chronic kidney disease

Dietary salt for people with chronic kidney disease

The authors of a Cochrane Review Altered dietary salt intake for people with chronic kidney disease (June 2021) found high certainty evidence that salt reduction reduced blood pressure in people with chronic kidney disease (CKD), and albuminuria in people with earlier stage CKD in the short‐term. They state that “if such reductions could be maintained long‐term, this effect may translate to clinically significant reductions in CKD progression and cardiovascular events. Research into the long‐term effects of sodium‐restricted diet for people with CKD is warranted.”

Hypertension – walking

Cochrane Clinical Answer: What are the benefits and harms of walking to prevent and control hypertension?

There is also an Evidently Cochrane blog Can walking help lower your blood pressure? The latest Cochrane evidence.

Take home points: A Cochrane Review (published in February 2021) suggests that walking for 150 minutes per week for 3 months probably lowers your systolic blood pressure by around 4mmHg, a small but likely important effect A similar reduction in blood pressure is seen across all adult ages The majority of the studies did not report information about adverse effects but - of those that did - adverse effects were rare

Infertility and subfertility

IVF add-ons

The Cochrane Special Collection In vitro fertilisation – effectiveness of add-ons was updated in July 2021. There is also an Evidently Cochrane blog IVF add-ons: the latest Cochrane evidence:

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.

Preconception lifestyle advice

Cochrane Podcast: Does preconception lifestyle advice help people with infertility to have a baby?

Lifestyle modifications for people with non-alcohol-related fatty liver disease

Cochrane Clinical Answer: For people with non–alcohol‐related fatty liver disease, how do lifestyle modifications compare?

Pressure ulcers

In a blog for nurses, Support surfaces for managing pressure ulcers: which to choose?, Chunhu Shi, a nurse and lead author of a Cochrane Overview Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta-analysis, shares what the latest evidence tells us about support surfaces for managing pressure ulcers, and what we still don’t know.

A Cochrane Overview of five Cochrane Reviews with network meta-analysis has made multiple comparisons of different support surfaces (medical grade beds, mattresses or overlays) Overall, it is unclear which support surface is best in preventing and treating pressure ulcers, but the evidence suggests that: A reactive air surface (such as a static air mattress) may be better than a foam surface (such as a foam mattress) for preventing and healing pressure ulcers Alternating pressure air surfaces (such as alternating pressure air mattresses or overlays) may be better than foam surfaces for preventing pressure ulcers, and probably cost less in relation to their benefit in preventing ulcers Reactive gel surfaces (such as gel pads used on operating tables) may be better than foam surfaces for preventing pressure ulcers

Cochrane Clinical Answer: What are the effects of alternative reactive support surfaces (non‐foam and non‐air‐filled) for preventing pressure ulcers

Reducing sedentary behaviour in older adults

In a Cochrane news item Get up, stand up: new review looks at reducing sedentary behaviour in older adults the lead author of the review Interventions for reducing sedentary behaviour in community‐dwelling older adults (June 2021) discusses the findings.

Spatial neglect/inattention following stroke or adult brain injury

The authors of a Cochrane Review Non‐pharmacological interventions for spatial neglect or inattention following stroke and other non‐progressive brain injury (July 2021) have concluded that “no rehabilitation approach can be supported or refuted based on current evidence from RCTs. As recommended by a number of national clinical guidelines, clinicians should continue to provide rehabilitation for neglect that enables people to meet their rehabilitation goals. Clinicians and stroke survivors should have the opportunity, and are strongly encouraged, to participate in research.”

Urethral catheters – strategies for removal

The Cochrane Review Strategies for the removal of short‐term indwelling urethral catheters in adults was updated in June 2021. The authors conclude “There is some evidence to suggest the removal of indwelling urethral catheters late at night rather than early in the morning may reduce the number of people who require recatheterisation.

It appears that catheter removal after shorter compared to longer durations probably reduces the risk of symptomatic catheter‐associated urinary tract infection (CAUTI) and may reduce the risk of dysuria. However, it may lead to more people requiring recatheterisation. The other evidence relating to the risk of symptomatic CAUTI and dysuria is too uncertain to allow us to draw any conclusions.”

The review is one of several included in the blog Short-term catheterisation: considerations for best practice.

Vaccine uptake 

Based on evidence from systematic reviews, Cochrane Effective Practice and Organisation of Care (EPOC) has prepared three information leaflets for health systems planners and implementers involved in developing vaccine communication strategies. You can read more and find the leaflets in Communicating to the public about vaccines and using digital strategies to promote vaccine uptake: information for planners and implementers.

Venous leg ulcers

A Cochrane Review Compression bandages or stockings versus no compression for treating venous leg ulcers (July 2021) has found that:

  • “If using compression bandages or stockings, people with venous leg ulcers probably experience complete wound healing more quickly, and more people have wounds completely healed.
  • The use of compression bandages or stockings probably reduces pain and may improve disease‐specific quality of life.
  • There is uncertainty about adverse effects, and cost effectiveness.”

Opportunities, news and events

Cochrane Nutrition have a newsletter and invite you to sign up to keep up with nutrition evidence and news.

Our colleagues at Cochrane Rehabilitation describe their function as “a bridge between Cochrane and all Rehabilitation stakeholders. On one side, it drives evidence and methods developed by Cochrane to the world of Rehabilitation, and on the other, it conveys priorities, needs and specificities of Rehabilitation back to Cochrane.” Learn more from their recent conversation with Science in the Break.

On this page, Important Cochrane Links, you can find opportunities to get involved, including how to join Cochrane, find volunteer tasks, or jump into the Cochrane Library.

This year World Evidence-Based Healthcare (EBHC) Day will be on October 20. Cochrane and six other leaders in evidence-based health care put the spotlight on the global impact of evidence on healthcare research, policy, practice and health outcomes. Read here about the Launch of World Evidence-Based Healthcare Day 2021: the role of evidence in an infodemic.

Please note that this page includes a round-up of materials mainly published within the last two months, and is not updated after it’s posted.

References (pdf)

Join in the conversation on Twitter with @SarahChapman30 and @CochraneUK or leave a comment on the blog.

Please note, we cannot give medical advice and do not publish comments that link to individual pages requesting donations or to commercial sites, or appear to endorse commercial products. We welcome diverse views and encourage discussion but we ask that comments are respectful and reserve the right to not publish any we consider offensive. Cochrane UK does not fact check – or endorse – readers’ comments, including any treatments mentioned.



Evidence for Nursing: new evidence and resources – September 2021 by Sarah Chapman and Selena Ryan-Vig

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

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