Leveling Evidence-based Practice Across the Nursing Curriculum

Evidence-based practice (EBP) competencies represent essential components of nursing education at all levels. The transition of EBP learning goals from the baccalaureate to the master of science in nursing and doctor of nursing practice levels provides a blueprint for the development and advancement of student knowledge, skills, and attitudes. The purpose of this article is to describe 3 nursing curricula related to EBP competencies at the baccalaureate, master’s, and doctor of nursing practice levels.     

Valvular Heart Disease

Nurse practitioners will encounter patients with valvular heart disease (VHD) because 5 million Americans are diagnosed with VHD every year. The American Heart Association and the American College of Cardiology released VHD guidelines in 2014. Once VHD is recognized, evidence-based guidelines need to be used in the management of patients with VHD. Nurse practitioners must have an understanding of the latest guidelines in order to initiate treatment, collaborate with the heart team members, and monitor and follow up on patients with VHD. Timely referral to cardiology and cardiac surgery is imperative for optimal outcomes in patients with VHD.     

Antipodean forensics: a comment on ANZFSS’s response to PCAST

Recently, one of the world’s leading scientific and technical advisory groups, the U.S. President’s Council of Advisors on Science and Technology (or PCAST), published an assessment of the research supporting several forensic science procedures in regular use. PCAST was particularly interested in pattern recognition or comparison procedures, specifically: simple and mixed DNA profiles; bite marks; latent fingerprints; firearms; footwear; and hair analysis. In its report and recommendations PCAST emphasised the primacy of validation. In response, the Council of the Australian and New Zealand Forensic Science Society produced a short statement suggesting that the PCAST report has limited application to forensic science in Australia and New Zealand. This short commentary offers an alternative perspective.     

Surveillance and uncertainty: community pharmacy responses to over the counter medicine abuse

The sale of over‐the‐counter (OTC) medicines from community pharmacies offers important opportunities for members of the public to access medicines and self‐treat conditions. They are increasingly recognised, however, as having the potential for abuse and harm despite their perceived relative safety. This study reports on a qualitative study that explored the experiences and views of community pharmacy staff in relation to current practices and concerns, management and support relating to OTC medicine abuse. Semi‐structured interviews were undertaken with a purposive sample of ten pharmacists and seven medicines counter assistants in the United Kingdom. Analysis of interviews indicated that a range of medicines was implicated, including opiates, sedative antihistamines, laxatives and decongestants. A surveillance role was apparent for assistants, who placed emphasis on regulations, procedure and monitoring frequency of purchases to manage abuse, with referral on to pharmacists. Frequency of purchase was central to assistants’ definition of those suspected of OTC medicine abuse, which pharmacists also utilised as well as a distinction between intentional abuse and unintentional medicine misuse. A lack of information about customers, easy access to, and poor communication between community pharmacies were emergent barriers to pharmacists providing more support. Many appeared uncertain of referral options or how pharmacists could effectively stop the problem of abuse. The commercial environment was a particular concern, in relation to customer expectations, medicine advertising and easy access to different community pharmacies. A key tension emerged between providing medicine supplies that permitted consumer freedom, with the needs of healthcare professionals to understand more about those consumers qua patients. Policy implications include the need for improved knowledge for community pharmacy staff about signposting to relevant services, increased awareness of who might be affected, and a review of how pharmacists can have more information about patients to inform OTC medicine sales.