Congress

Helpful Hints for Preparing a Clinical Practice Abstract

By Janet S. Fulton, PhD, RN, Dayton, OH

Reprinted from the May 2001 issue of the Clinical Nurse Specialist SIG Newsletter

An abstract is a compact way of reporting. Clinical abstracts most often report on outcomes of a project, the process of creating a project, or an analysis of an issue. Clinical nurse specialists (CNS) influence practice in many ways by developing programs, evaluating products, establishing policy or procedure, and educating the public, to mention a few. These initiatives can be linked to outcomes, may engage unique processes, or involve critical analysis and, therefore, make great topics for sharing with colleagues.

Reporting via abstract at a professional meeting has two advantages. For the presenter, the process can be a catalyst for improving a project through discussion with others. For participants, it creates exposure to ideas that can be adopted or adapted for their clinical settings.

Preparing an abstract can be a challenge. Most CNSs are familiar with challenges, such as developing a prostate screening program. However, these initiatives often are undertaken without the same focused planning that precedes the creation of an abstract that reports research findings. Although a research report is similar to a clinical project report, a different approach is taken. The steps of the research process are standardized somewhat, so the abstract becomes a report of the steps.

Clinical initiatives follow a less consistent approach. Not all clinical initiatives start with the well-developed plan of a research study. In fact, few clinical initiatives start with any sort of detailed plan. A plan may precede a large project from solving clinical problems, such as creating a procedure to increase family involvement in informed consent. The CNS comes to the end of the work year and decides that the initiative produced some unique findings that warrant reporting. How does one proceed?

The writer should begin by examining the topic. The topic should be relevant to the supporting organization or program. Clinical topics submitted to ONS should be important to oncology nursing practice and consistent with the purpose and goals of the program. For Congress, ONS accepts a wide variety of patient-care topics, from prevention and screening through palliative care. ONS will accept general topics that apply to oncology nursing, such as management topics, staffing plans, orientation programs, personnel evaluation methods, and quality assurance programs of interest when applied to oncology nursing.

Focus the topic. Projects are made up of many parts, such as the process of implementation, project outcomes, or an analysis of issues. Attempting to report on the whole project is foolish.

Focus the topic by narrowing it down to one aspect or one activity, such as outcome results. when narrowing a topic, the project's structure should be examined. Ask if subcommittees were used to manage different activities or if individuals were in charge of different tasks. Was the project evaluated as a whole or as individual elements? Consider different topic areas within the project. An abstract explaining a citywide prostate awareness and screening program in its entirety would be too cumbersome. A solution might be to prepare different abstracts to describe the different elements of the same project, "Outcomes of a Nurse-Managed Screening Program" may be one abstract and "Working with Local Media: Lessons Learned" may be another. The first abstract reports on the outcome of the screening follow-up program and the second abstract is an analysis of the issues generated by working with the media.

Identify nursing's unique contribution. CNS practice is multidisciplinary. When preparing an abstract about a multidisciplinary project, make sure the nursing component of the project is the abstract topic. Avoid reporting on a hospital-supported program, the work of other disciplines, or the results of another individual's research study. Report on nursing's unique role within the program or research study, such as patient recruitment or education. Evaluate nursing's role in a program by collecting data under the larger umbrella of the program's evaluation component. Negotiate permission to use another individual's research data to answer a unique nursing question. The focus should remain on nursing.

Develop a title. A working title captures the focus. As the abstract develops, check that the title is accurate. Changing the title or developing a second abstract is not unusual. Use a few key words to communicate the focus. Read the title aloud using only the nouns. Nouns communicate the thing(s) that the abstract is about. Are the most important things stated in the title? A title such as "Citywide Prostate Awareness and Screening" is so broad that it lacks focus and communicates little. The reader is left to wonder "so what about this program?" A better choice would be "Outcomes of Nurse Follow-Up of Patients With Positive Prostate Screening Tests." The abstract clearly is about outcomes.

Also, consider using verbs because they communicate action. Many clinical projects are about doing something in practice. Gerund verb forms (those ending in "ing") communicate action or process. An example would be: "A Family-Centered Model for Obtaining Informed Consent." The reader knows that the abstract is about the process of obtaining consent. In addition, the title communicates three content areas and may appeal to three potential audiences: an audience interested in consent issues, an audience interested in using models in practice, and an audience interested in family care. Abstract reviewers and selection committees are looking for work that will appeal to as many participants as possible. A clear title communicates to all potential audiences. In some situations, abstract titles maybe limited to a specified number of letters, so make every word count and be specific.

State the purpose of the project or analysis. If the abstract is reporting on an activity within a larger project, keep the purpose consistent with the selected activity. Sometimes, the purpose may be the same for both the overall project and the individual activity. More often, various activities of a project have distinct purposes that underlie the primary purpose of the larger project. An abstract, by nature, is a report of some activity; therefore, the abstract purpose implies a report. The writer does not need to say "the purpose of this abstract is to present the results of . . . " The purpose statement presents the purpose of the project or selected activity. Example: The purpose of the nurse follow-up program was to facilitate further evaluation testing of all men with positive prostate screening results. When the abstract's purpose is an analysis of an issue or trend, say so. Example: The purpose of this analysis is to explore the cost-benefit ratio for prostate screening using an economic evaluation model. The statement of purpose should be limited to one sentence.

Provide background about the problem and rationale for the purpose.A snapshot of the situation can be provided so the reader better understands the project. Be brief - two or three sentences. Select the key elements that will link background with the rationale for the project. Background content summarizes hours of clinical observation, library work, conversations with colleagues, and synthesis of literature. If the abstract has a word limit requirement, the background section is the best area to summarize. Potential audiences probably are familiar with much of the background and will be able to fill in gaps. Remember, the rationale is for the project and not the topic. The rationale should be evident from the problem background that the topic is a concern.

Example: Increasing rates of prostate cancer among urban men have been linked to low awareness of and barriers to preventative care. Evidence suggests that, consistent with national trends, men in this city have low participation rates in prostate screening programs and even lower rates of follow-up of positive screening results.

Describe the intervention or practice. Give enough information to describe how the intervention or practice accomplished the project's purpose. Highlight innovative qualities but don't include a lot of details. The details can be outlined in the presentation or on the poster. Example: The program included five outpatient nurses rotating one hour each per day to place follow-up telephone calls. During the call, nurses scheduled follow-up exams for men who requested appointments. Men who stated that they would follow-up at a later date were placed on a two-week call back list. Men who stated they were not interested in follow-up were mailed information. A report of each call was sent either to the man's physician or city health department.

Make an interpretation. Describe the end result or outcome. A description of the outcomes implies that evaluation measures were selected when the project plan was established and that data were collected. If a project plan was made, evaluate the project goals according to the measures specified.

If no formal project plan was initially developed, spend time reflecting. What information is being used to determine that the project met its purpose? What data is being used to judge the success of the project? Data may be obtained if none was collected. Healthcare systems collect and store data that can be used for evaluation. Medical records and financial reports can be good data sources.

In this cost-conscious, evidence-driven era of health care, CNSs must measure the impact of their work. CNS work involves program development and system changes; therefore, CNSs should have a bag of tools for evaluating these efforts. Many abstracts run aground at the point of interpretation because they lack evaluation information. Evaluation does not need to be elaborate statistical analyses. In the example of the prostate screening follow-up program, it would be appropriate to report simple frequency and percentage information about total number screened, by ethnicity, number of positive findings, number contacted, and response by category. When a project does not lend itself to numerical data, consider other evaluation parameters. In the example of creating a pathway for care (a process), the interpretation section of the abstract could include the key elements of the process that facilitated the work, such as outlining the work, creating work groups, safeguarding discussions to include all disciplines. Describe the activities that made the process a success or what was discovered that should not be repeated in a similar situation.

The discussion reflects the author's informed opinion. Identify the implications for oncology nursing practice. In the context of the final result, describe the relevance of the project or process to clinical practice. Suggest what nurses should do with this information now or for the future. Consider the many dimensions of practice: direct patient care, nursing education, public education, public health policy, economics, ethics, and others. If the project was a disaster, state what should be done differently. The nursing literature is filled with should do suggestions backed by little practical insight or systematic evaluation. If something was tried and did not work as expected, reflect on the setting, timing, populations, system, or whatever contributed to unexpected results.

Follow directions. Submit the abstract in the required format. Limit the title and abstract to the word count specified. Use an easy to read font, such as Universal or Arial, in 11- or 12-point size. Spell check and proofread the work. When submitting work on computer disc, label the disc with the title of the work and the author's name. Use the software required. Send the number of copies required. Send copies with and without author name, as specified. If submitting by e-mail, make sure the work was received.

CNSs have been described as the master clinicians in nursing, the attending nurses. To continue advancing nursing practice, CNSs need to report on their work. A clinical practice abstract is a great way to report information. Presenting the abstract is a rewarding experience. If an abstract is not accepted for presentation, review it carefully and ask for reviewer comments. Chances are the idea was good, but the abstract did not contain all the necessary information. Do your best and try again because perfection in an imperfect world is a foolish goal. Looking forward to your presentation at ONS Congress!