Overcoming Barriers on the Way to Evidence-Based Practice
Acknowledgements
The authors would like to thank the following staff from the Moffitt Cancer Center for their valuable contributions to this project: Maria Bering, oncology technologist; Janelle Brown, RN; Christina Dethloff, RD; Jane Fusilero, RN; Kelley Gonzalvo, RN; Terry Gruchow, PA; Ebone Hill, MD; Megan Hoffman, RN; Jessica Hurst, RD; Wendy Isler, RN; Jason Kawa, RN; Bryan McIver, MD; April Monsman, RN; Smitha Pabbathi, MD; Erika Richter, RPh; Christy Thai, RPh; and Darcy Wolf, RN. We would also like to thank the staff of Electronic Training Solutions in Cocoa Beach, Florida, for their expert performance improvement guidance and for assisting us with implementation of the Six Sigma process.
Diane Garry is a registered nurse and has been the patient safety officer at the Moffitt Cancer Center for the past eight years. She has a bachelor’s degree in nursing and a master’s degree in health education. Her previous experience includes nursing education, regulatory compliance, and quality management. She obtained her green belt in Six Sigma in 2014. Garry may be contacted at Diane.Garry@Moffitt.org.
Bob Bradbury has a bachelor’s degree in pharmacy from Ohio State University and a master’s degree from Dallas Theological Seminary; he obtained a green belt in Lean Six Sigma in 2014. Bradbury has worked in the oncology pharmacy setting for 32 years. He has served in various roles at the Moffitt Cancer Center over the last 27 years, most recently as pharmacy operations manager and medication safety officer. He may be contacted at Bob.Bradbury@moffitt.org.
References:
The Advisory Board Company (2013). Are you leading an evidence-based organization? Retrieved from https://www.advisory.com/research/physician-executive-council/resources/posters/leading-an-evidence-based-organization.
Braun, S., Bitton-Worms, K., & LeRoith, D. (2011). The link between the metabolic syndrome and cancer. International Journal of Biological Sciences, 7(7), 1003–1015.
Brutsaert, E., Carey, M., & Zonszein, J. (2014). The clinical impact of inpatient hypoglycemia. Journal of Diabetes and Its Complications, (4), 565.
Clement, S., Braithwaite, S., Magee, M., et al. (2004). Management of diabetes and hyperglycemia in hospitals. Diabetes Care, 27(5), 1255.
De Vos-Schmidt, D., & Dilworth, K. (2014). Management strategy for steroid-induced malglycemia during cancer treatment. Clinical Journal of Oncology Nursing, (1), 41.
Giovannucci, E., Harlan, D. M., Archer, M. C., Bergenstal, R. M., Gapstur, S. M., Habel, L. A., … Yee, D. (2010). Diabetes and cancer: A consensus report. Diabetes Care, 33(7), 1674–1685.
Habib, S. L., & Rojna, M. (2013). Diabetes and risk of cancer. ISRN Oncology, 1-16.
Hammer, M. J., & Voss, J. G. (2012). Malglycemia and cancer: Introduction to a conceptual model. Oncology Nursing Forum, 39(3), E275–E287.
Hershey, D. S., Bryant, A. L., Olausson, J., Davis, E. D., Brady, V. J., & Hammer, M. (2014). Hyperglycemic-inducing neoadjuvant agents used in treatment of solid tumors: A review of the literature. Oncology Nursing Forum, 41(6), E343–E354.
Hurria, A., Wildes, T., Blair, S. L., Browner, I. S., Cohen, H. J., De Shazo, M., … Sundar, H. (2014). Senior adult oncology, version 2.2014: Clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network, 12(1), 82–126.
The Joint Commission. (2007). The Joint Commission announces the 2008 National Patient Safety Goals and Requirements. Joint Commission Perspectives, 27, 1, 9–22.
Kitabchi, A. E., & Nyenwe, E. (2007). Sliding-scale insulin: More evidence needed before final exit? Diabetes Care, 30(9), 2409–2410.
Kong, A. P., Yang, X., Luk, A., Ma, R. C. W., So, W. Y., Ozaki, R., … Chan, J. N. (2014). Severe hypoglycemia identifies vulnerable patients with type 2 diabetes at risk for premature death and all-site cancer: The Hong Kong diabetes registry. Diabetes Care, 37(4), 1024–1031.
Martinez, E., Chavez-Valdez, R., Holt, N., et al. (2011). Successful implementation of a perioperative glycemic control protocol in cardiac surgery: Barrier analysis and intervention using Lean Six Sigma. Anesthesiology Research & Practice, 1, 1–10.
Melnyk, B. M., Fineout Overholt, E., Fischbeck Feinstein, N., Li, H., Small, L., Wilcox, L., & Kraus, R. (2004). Nurses’ perceived knowledge, beliefs, skills, and needs regarding evidence based practice: Implications for accelerating the paradigm shift. Worldviews on Evidence Based Nursing, 1(3), 185–193.
Miller, D. B. (2011). Perspectives in practice: Why won’t the sliding scale go away? Canadian Journal of Diabetes, 35, 340–343.
Moghissi, E. S., Korytkowski, M. T., DiNardo, M., Einhorn, D., Hellman, R., Hirsch, I. B., … Umpierrez, G. E. (2009). American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care, 32(6), 1119–1131.
The National Institute of Diabetes and Digestive and Kidney Diseases. (2014). Retrieved from http://www.niddk.nih.gov/.
Nau, K., Lorenzetti, R. C., Cucuzzella, M., Devine, T., & Kline, J. (2010). Glycemic control in hospitalized patients not in intensive care: Beyond sliding scale insulin. American Family Physician, 81(9), 1130–1135.
Pande, P. S., Neuman, R. P., & Cavanagh, R. R. (2000). The Six Sigma way: How GE, Motorola, and other top companies are honing their performance. New York: McGraw-Hill.
Psarakis, H. (2006). Clinical challenges in caring for patients with diabetes and cancer. Diabetes Spectrum, 19(3), 157–162. doi:10.2337/diaspect.19.3.157.
Rubin, D. J., & Golden, S. H. (2013). Hypoglycemia in non-critically ill, hospitalized patients with diabetes: Evaluation, prevention, and management. Hospital Practice, 41(1), 109–116.
Sandhu, M. S., Heald, A. H., Gibson, J. M., Cruickshank, J. K., Dunger, D. B., & Wareham, N. J. (2002). Circulating concentrations of insulin-like growth factor-I and development of glucose intolerance: A prospective observational study. Lancet, 359, 1740–1745.
Storey, S., & Von Ah, D. (2012). Impact of malglycemia on clinical outcomes in hospitalized patients with cancer: A review of the literature. Oncology Nursing Forum, 39(5), 458–465.
Tague, N. R. (2005). The quality toolbox (Vol. 600). Milwaukee, WI: ASQ Quality Press.
Umpierrez, G. E., Isaacs, S. D., Bazargan, N., You, X., Thanler, L. M., & Kitabchi, A. E. (2002). Hyperglycemia: An independent marker of in-hospital mortality in patients with undiagnosed diabetes. Journal of Clinical Endocrinology and Metabolism, 87(3), 978–982.
Umpierrez G.E., Palacio, A., Smiley, D., (2007). Sliding scale insulin use: myth or insanity? American Journal of Medicine, 120:563-567.
Zanders, M. M., Haak, H. R., van Herk-Sukel, M. P., van de Poll-Franse, L. V., & Johnson, J. A. (2015). Impact of cancer on adherence to glucose-lowering drug treatment in individuals with diabetes. Diabetologia, 58, 951–960.
Zhang, P., Chen, Z., Lv, D., Xu, Y., Gu, W., Zhang, X., … Zhu, Y. (2012). Increased risk of cancer in patients with type 2 diabetes mellitus: A retrospective cohort study in China. BMC Public Health, 12, 567.