How Cochrane Nursing is influencing clinical practice globally

Evidence-based health care is a combination of clinical experience and knowledge about recommended practice at the point of care. But getting the best outcomes to the bedside of patients is not limited to the development and publication of high quality systematic reviews. Not all healthcare providers have access to, the ability to understand, or even the desire to consider long research papers written in scientific language. It is often more pragmatic for clinicians to rely primarily on embedded workplace protocols and their own clinical expertise when administering care to patients. And in environments strained by limited resource and governed by practices entrenched in policy and tradition, initiating change can be challenging. But notwithstanding the benefits of a healthcare worker’s experience and the perceived reliability of those ‘tried and tested’ methods, the absence of a sound evidence basis when making clinical decisions will only prevent practitioners learning from the vast experience of others, which inevitably results in greater mortality for patients. So how do we get the best available systematic review outcomes to those who need it on the frontline of patient care when the evidence is not easily understood or readily accessible, and healthcare settings are generally reluctant to deviate from their operational status quo?

In 2009, Cochrane Nursing (CN), formerly known as the Cochrane Nursing Care Field, was established by pioneer of evidence-based nursing and founder of the Joanna Briggs Institute, Emeritus Professor Alan Pearson AM. The principal objective of CN was to provide an international evidence base for nurses and related healthcare professionals involved in delivering, leading or researching nursing care. The purpose of CN was to take the best available systematic review outcomes developed by Cochrane and disseminate them in a way that was reliable, accessible, and communicated in a language that could be easily interpreted and implemented. Initially, the group did this predominantly through the production of evidence summaries based on nursing-care-relevant Cochrane reviews. The CN established agreements with general and specialised nursing journals from around the globe for the regular publication of these summaries, which were rebranded as ‘Cochrane Corner’ columns. Since its inception, CN has substantially grown its collaboration to include regular publication in 15 healthcare journals, including some of the highest impact international nursing periodicals in circulation, and now publishes between 80–100 summaries annually. These articles have become a reliable source of information for countless nursing professionals internationally because of the way they translate research findings into everyday language while ensuring the interpretation of the systematic review evidence is maintained.

More impressive than the size and scope of its evidence dissemination methods is the way CN produces and assures the quality of its content. CN has established an impressive international network in excess of 1600 members, comprising medical professionals and research academics from a variety of backgrounds and geographical locations. And it is these people who understand the culture of healthcare settings and can benefit from access to the outcomes, who volunteer to write the CN evidence summaries for publication. Although the columns look similar to systematic review abstracts, each summary is developed with nurses in mind, with the writer including an ‘implications for practice’ section that is to some extent influenced by their own professional experience and perspective. Ultimately, the CN’s output is the result of a large collaborative process with all participants sharing the common goal of bringing the best available evidence to patients and to make Cochrane evidence easily accessible throughout the world. CN is an inclusive international group that effectively utilises the experience and skills of its members and the wide circulation of its international publication network to create greater awareness of evidence-based practice and bring the best available health advice to patients.

Expanding the reach of Cochrane’s review evidence is a constantly developing endeavour for the CN, with the group now working at new distribution techniques and strategic planning that will see the focuses of this evidence dissemination entity change and expand in the years to come. Since Cochrane’s Structure and Function Review and the establishment of its Knowledge Translation Strategic Plan up to 2020, CN has redefined its evidence development and dissemination objectives to align with Cochrane’s intentions for the future. The CN Director, Associate Professor Craig Lockwood, and CN Coordinator, Alex Mignone, have spent considerable time working closely with Cochrane Executive in the development of CN’s own Strategic Plan for the better utilisation of its evidence summaries and the skills of its members. CN also invested time into developing a clearer understanding about all Cochrane Fields and the way other groups have been developing and disseminating evidence. The ultimate outcome of this investigative work was the relaunch of CN in 2019 and the establishment of a more comprehensive evidence distribution strategy that introduced new methods for disseminating the group’s summary evidence and creating awareness of Cochrane systematic reviews.

In January 2019 CN launched the following new evidence dissemination projects in addition to its ongoing summary production and publication work –

• •

  CN Podcast Project – the development and dissemination of podcasts based on previously published ‘Cochrane Corner’ columns;

• •

  CN Wikipedia Project – CN has established a team of members to be trained as Wikipedia Editors and responsible for adding Cochrane references to Wikipedia pages of relevance; and

• •

  CN Translation Project – CN has established agreement in non-English speaking countries for the translation and publication of ‘Cochrane Corner’ columns previously published in English.

In keeping with this, the editors of the Spanish journal “Enfermería Intensiva” (Intensive Care Nursing) contacted CN in June 2019 regarding a potential collaboration. “Enfermería Intensiva”, the official Journal of the Spanish Society of Intensive and Coronary Care Units (in Spanish, SEEIUC), is a peer-reviewed journal that has been publishing quarterly issues for the last 27 years, with the mission of making evidence widely available through different publication formats (original articles, clinical cases, position articles and comments to research papers, among others).

As a result of the efforts by Susana Arias-Rivera, one of the editors of Enfermeria Intensiva’s editorial board, the CN now has an active translation agreement in place with the journal for the regular supply, translation and publication of its evidence summaries. Ms Arias-Rivera strongly advocated that systematic review evidence can be a very powerful tool for nurse practitioners at the point of care. Furthermore, she has always been passionate about bringing CN summaries to Spain, in an effort to highlight how important can evidence-based practice be for local nurses.

As the CN now moves into this new period of knowledge translation, the group is delighted to report on the success of its newly established dissemination projects in widening the reach of Cochrane evidence. In addition to its publication contract with the ‘Enfermería Intensiva’, CN has also established agreements for the translation of its columns in Portugal and Israel, with intentions to expand this translation work even further. CN has established an active team of members who are regularly adding Cochrane references to Wikipedia pages, and has established a further group who are developing podcasts based on its evidence summaries.

For more information about CN and how to get involved, go to - https://nursing.cochrane.org/