311 Gray by g9QIiKZf


									 Getting Published in the
Journal of Wound, Ostomy
 and Continence Nursing
  (and other places as well)
           Mikel Gray
          Gary Mawyer
         Managing Editor
• Discuss benefits of publication for the
  practicing clinician
• Describe the process of publishing, focusing
  on generation of articles with original data or
• Outline obstacles to publication and
  strategies to overcome obstacles
• Review the process of peer review and
  revision, and identify usual timelines from
  submission to publication
• I am Editor of the Journal of
  Wound, Ostomy &
  Continence Nursing
• JWOCN is the official
  publication of WOCN
• I believe it is the premiere
  journal for WOC practice
• This presentation is
  saturated with this bias
                Why Publish?
• Benefit for tenured or tenure track nursing faculty is
  apparent; it is universally written into criteria for
  academic promotion and tenure
• Benefits for clinician are less formal, but no less
              Why Publish?
• Publication is the basis for establishing and
  sharing your expertise and becoming known
  in your field
  – Publication gets your message out to a global
  – JWOCN is indexed in MEDLINE, PubMed, and
  – It is accessed by nurses, other clinicians and
    researchers on a world wide basis
                    Why Publish?
• Publication ensures you receive credit for your
  ideas (more effective than any other available means)
   – Chariker, Jeter, Tintle & Bottsford1 described a case
     where they managed an ECF with suction wound
   – This work continues to be mentioned as seminal to the
     rapidly expanding evidence base for negative
     pressure wound therapy
   – Many others employed this therapeutic approach at
     the time, but their voices have been lost to history
     because they did not publish!
           1. Chariker ME, Jeter KF et al. Contemporary Surgery 1989; 34:59.
               Why Publish?
• Publication is the one and only permanent
  record we have of WOC practice
  – More than 100 abstracts/ posters were presented
    last year at WOCN and an equal number at
  – Less than 1 in 10 made it to publication
  – The ideas and knowledge in the abstracts are no
    less valuable, but they will be lost rapidly unless
    published and stored in a major journal (JWOCN,
    Advances, etc)
                        Why Publish?
• Publishing your clinical experiences and insights often forms
  the basis for the big studies and product development that
  advance practice
   – Caralee Sueppel1 published her experiences with preoperative
     pelvic floor muscle training; this directly influences Kathy Burgio
     who completed an RCT confirming its positive effect2
   – PJ Zwanziger3 described challenges pouching ECF due to
     mesenteric arterial blockage; this article provided part of basis
     for development of the fistula and wound management system
     described by Barbara Hocevar and colleagues4
   1. Sueppel C, Kreder K, See W. Urologic Nursing 2001; 21(1): 201.                  2.
   Burgio KL et al. Journal of Urology 2006; 175(1): 196.
   3. Zwanziger PJ. Journal of Wound, Ostomy and Continence Nursing 1999; 26(1): 25.
   4. Hocevar B et al. Journal of Wound, Ostomy and Continence Nursing 2008; 35(4): 417,

•   Lack of time
•   Fear of rejection
•   Not sure where to start
•   Deterred by the length of the process
• Sometimes it starts with an idea…
  – Every journal highly values original data
  – Urban Myth: the term original data does not mean
    research; it simply means that you base your article
    on your own clinical experiences with your own
  – Write it up as a case study, or multiple case studies
    (sometimes called case series)
  – JWOCN has a format that allows you to do just
Process: Publishing a Clinical Challenges Article
  • Remains the most popular and most widely
    read single feature in the Journal
    – Ideas come from posters presented at National,
      Regional, or Affiliate Conferences
    – Ideas come from WOCN discussion forum
    – Ideas come from your day to day practice
  • Urban Myth: Clinical Challenges is not meant
    to be based on unusual or rare cases;
    readers actually prefer hearing innovations
    related to every day clinical issues
          Clinical Challenges
• The outline for the feature is a pre-set
  formula; following the formula will reduce time
  and need for revision
  –   Structured Abstract
  –   Introduction
  –   Case
  –   Discussion
  –   Summary
  –   References
Clinical Challenges: Structured Abstract
• Background: Write 1-2 sentences describing the
  clinical issue or technique you are discussing
• Case (Cases): Write 2-4 sentences briefly
  describing your illustrative case or cases
• Conclusion: Write 1-2 sentences describing the
  main points (or main 2 points) you want readers to
  take away when reading your article
  Clinical Challenges: Structured Abstract
• Tips: Follow the formula…
              • We require a structured abstract because it allows
                readers using PubMed, MEDLINE or CINAHL to get a
                quick overview of your article
              • Most experienced authors write the abstract last; after
                they have written up other components of Challenges
 Woodward LM. Woodward, Linda M.
 Title Management of an enterocutaneous fistula in a patient with a gastrointestinal stromal tumor.
  ournal of Wound, Ostomy, & Continence Nursing. 37(3):314-7, 2010 May-Jun.
 BACKGROUND: Gastrointestinal stromal (GIS) tumors are rare malignancies that affect the esophagus, stomach, gallbladder, liver, small intestine, colon, or
 rectum. These tumors are often refractory to treatment with radiotherapy and chemotherapy and usually treated with a combination of surgery and imatinib
 mesylate, a tyrosine kinase inhibitor.
 CASE: This case study describes the management of an enterocutaneous fistula in a patient with a rare GIS tumor who ultimately required radical excision of the
 mesenteric GIS tumor by enteroenterostomy and colocolostomy. He subsequently developed an enterocutaneous fistula within his dehisced surgical wound.
 This fistula along with the wound required various dressings and pouching modifications to meet treatment goals and enable the patient to be discharged from
 the hospital.
 CONCLUSION: Although rare, WOC nurses may care for a patient with GIS tumors. Fistulas may occur due to the disease or as a result of treatment. The use of a
 fistula pouching system, combined with individualized and detailed education, may allow patients to maintain a quality of life despite the poor prognosis
 associated with this malignancy.
   Clinical Challenges: Introduction
• Introduction is a 3-6 sentence paragraph that tells
  readers why this problem is clinically relevant
  – Include the problem you are addressing (wound type,
    ostomy type; description of incontinence)
  – Include the approach, technique you used to manage
    the problem
  – Tell readers why you find this approach or technique
  – Include a reference if you make a statement like…
    “Negative pressure wound therapy is considered the
    primary (standard) treatment for …”
            Clinical Challenges: Case
• Describe one or more cases that illustrate the point of your
  article; this can vary from 3-5 paragraphs to as much as 5
  pages or more
   – Start with basic demographic information about the patient,
     gender, age, principal diagnosis and reason you or your service
     was consulted… Mr A is a 75 year old male admitted to
     hospital for…
   – Describe the underlying wound, ostomy or continence problem in
   – Include pertinent laboratory values and results of relevant
     diagnostic tests
   – Describe the patient’s course of treatment in chronological order,
     avoid specific dates – better to use month and day or simply say
     something like… “Two weeks later she underwent …”
            Clinical Challenges: Case
• Be sure to describe WOC interventions and
  assessments in detail
• List specific products; use a generic (product
  category) name, then the brand name, manufacturer
  city and state/ country the first time, then use the
  generic name only after that…
• For multiple cases, tell readers how EACH new case
  contributes to your point; such as how an intervention
  applies to multiple wound or ostomy types or how it
  applies to multiple care settings
         Clinical Challenges: Discussion
• Begin with a brief discussion of the underlying problem;
  we do not need a comprehensive review, recent review
  articles are often good sources for this…
• Then describe how your innovation or approach compares
  to “traditional” of “typical” care; use references to
  document what typical care is…
• Include published examples of your approach if available
  (such references usually do not exist)
• The entire discussion may be as brief as 1 page or as
  much as 3 pages depending on the literature you find
           Clinical Challenges: Figures
• Figures are highly
• Multiple figures are welcome;
  if we cannot publish every
  one in the printed Journal,
  we will post the rest on
  jwocnonline.com as
  supplemental digital content
• Figures taken with higher
  resolution cameras and
  saved as .tiff files are best
  (bigger truly is better)
Clinical Challenges: Conclusion & References
• Conclusion
  – Single paragraph 2-3 sentences restating the most
    important points readers should remember after
    reading your article
• References
  – We do not use APA style; it is inefficient for published
    literature and most major journals avoid it
  – References in text are numbered in order of appearance
  – When in doubt, simply copy the style of another article
    published in JWOCN (or whatever journal)
        From Academic Paper To Article
• You worked on that academic paper for your MSN, DNP,
  PhD; now you want to see it in the literature…
   – First, determine whether your paper is a review article,
     or a research report
   – Determine what type of review you completed…
   – Integrative Review: traditional review paper, synthesis
     of a broader topic based on whatever references you
     found and chose to include in the manuscript
   – Systematic Review: highly structured review (a study
     of studies); includes questions to be addressed,
     inclusion and exclusion criteria for identifying articles,
     evidence ranking ± pooling data and meta-analysis in
     some cases
                Integrative Review
• Unstructured Abstract
   – 2-3 sentences introducing topic of your paper
   – 1-2 sentences providing rationale for its clinical
      relevance (why is this important)
   – Final sentence should begin with something like:
      “This article will review…”
• Remaining article can be structured like any
  integrative review with introduction, subheads,
  followed by conclusion
                 Integrative Review
• Tips about Integrative Reviews
  – We publish fewer than in past; this trend is true for most
  – Reviews with very basic information are especially likely
    to fail peer review (remember average reader has
    considerable expertise in WOC nursing)
  – Most are tied to CME
• Follow JWOCN format; manuscripts sent without
  converting do not receive top priority
• We strongly encourage special features; they break up
  the longer review narratives and make your article
  easier to read
• A table organizes information in 2 or more columns
• A box summarizes information as a list
• Graphs, photos, pie charts are all classified as figures
• We will publish your instrument as a figure, box or
  supplemental digital content
                     Systematic Review
• Engberg1 describes systematic reviews and
  metaanalysis as a “study of studies”
• JWOCN treats these as containing original data, gives
  these submissions the correspondingly higher priority
• Unlike integrative review, these reviews need to be
  presented in a more structured manner… in other words,
  via a given formula
• Because the format is newer, the formula lacks structure
  of “traditional research report” but there are essential
     Engberg S. Journal of Wound, Ostomy and Continence Nursing 2008; 35(3): 258.
   Systematic Review: Essential Elements
• We strongly recommend putting the words
  “systematic review” in your title
• Unstructured Abstract for this one (1 paragraph, 3-
  6 sentences)
  – Your review will be based on one or more questions
    focusing on effectiveness of intervention or accuracy of
    assessment (they do not focus on mechanisms of action,
    pathophysiology, etc)
  – State the question in your abstract; tell readers you are
    performing a systematic review; describe methods of
    review in no more than 2 sentences and state major
    findings in no more than 2 sentences
   Systematic Review: Essential Elements
• Introduction
  – Length varies, usually 3 paragraphs to no more than
    several pages describing underlying condition/ disorder
  – End this section with a statement that tells readers why
    this review is needed
  – This is treated like a traditional review; the purpose is to
    let your readers know a bit about underlying condition;
    you do not need a comprehensive review in this portion
    of your manuscript
  – Recent review articles and latest edition of the WOC
    core textbooks are strongly recommended
   Systematic Review: Essential Elements
• Methods (essential for systematic review)
  – Tell readers what databases searched (MEDLINE,
    etc.), and complementary methods for searching (
  – Tell readers what years you searched
  – List inclusion criteria (written in English, RCT and
    comparison cohort studies, measure the outcome of interest, etc)
  – List exclusion criteria (case studies, case series, some
    excluded based on judgement of study quality, etc)
  – Describe review process (reviewed by 2 authors, how you
    judged study quality, etc) and how evidence was ranked
   Systematic Review: Essential Elements
• Study Narrative
  – Briefly describe methods and outcomes of studies
    included; we recommend using Evidence Based Report
    Cards as a template for this portion of manuscript
  – Include a table summarizing included studies; again we
    recommend using either EBRC or systematic reviews
    published in JWOCN
  – Here are three good examples:
     • Salvadalena 2008; 35(6); 596 [Stomal and peristomal complications]
     • Ramundo J, Gray M. 2009; 36(6 Suppl): S4 [Collagenase for
     • Baich L, Wilson D, Cummings GG 2010; 37(1): 53 [ET in Home Care in
       Canadian System]
    Systematic Review: Essential Elements
• Evidence Ranking
   – These may be bulleted or placed in a box if you prefer
   – Most use an ordinal ranking system
   – Metaanalysis is optimal but it is a demanding statistical
     task and we do not require this technique for publication
   – Consort criteria is ideal (Levels 1a – 5); you may also
     use WOCN rankings if you prefer (A – C)
• Clinical Implications
   – Include a statement recommending how practice should
     be maintained or changed based on this evidence
   Systematic Review: Essential Elements
• Conclusion
  – Single paragraph 2-3 sentences restating the most
    important points readers should remember after
    reading your review
• References
  – We do not use APA style; it is inefficient for published
    literature and most major journals avoid it
  – References in text are numbered in order of appearance
  – When in doubt, simply copy the style of another article
    published in JWOCN (or whatever journal)
                Research Reports
• This has risen from a minority to the most common
  platform article
• All research reports receive the highest priority during
  the publication process
• This applies equally regardless of design
• Our emphasis is on application to WOC practice
• We use the IMRAD standard format for research
• IMRAD is the acronym for Introduction, Methods,
  Results And Discussion
• Other necessary elements are the Abstract,
  Conclusions and References but IMRAD is the core of
  the paper
• Your paper will probably also include tables and
TIP: The JWOCN website contains links to Instructions
  for Authors which will be very useful for all authors.
• FOLLOW THE FORMULA. IMRAD is designed to
  assist the expert clinician or researcher who might
  not happen to be an expert writer
• IMRAD makes your paper easier to write, as well
  as easier to read and comprehend. The better
  organized your paper is, the easier it is to review it
  and the easier it is to revise it
• This speeds the publication of your findings
• Start with your Introduction. The first 3 to 5 paragraphs
  should address the underlying problem or context of your
  study. A literature review is not an essential component of
  a research paper.
• We realize many authors have prepared a literature review
  as part of an assignment but limiting its length of
  eliminating it may be advisable.
• The final paragraph of your introduction should state the
  research aims you addressed (this is essential).
• This final paragraph should persuade readers to read
  onward in the article
• After the Introduction has been organized, move
  on to say:
• What did I do? (Materials and Methods)
• What happened when I did it? (Results)
• What did it mean? (Discussion)
• Write the Abstract and Conclusions last
• Start by telling the readers how you selected your subjects
  and describe the study setting
• CSE and COPE demand an explicit statement of IRB
• Then describe study procedures; tell readers how you
  collected data, including any instruments used to collect
• Describe each instrument; include paper tools, physiologic
  measurement tools, and references documenting the
  reliability and validity of all paper instruments
                DATA ANALYSIS
• One paragraph only
• Tell readers how you analyzed your data
• Include all inferential statistical analyses used, and
  tell readers why you chose each test
• You may describe descriptive statistics but this is
• TIP: let your statistician help you write this
  paragraph if possible
• Tell readers what you found
• Address your research questions or research aims
  in the order originally presented in your statement
  of purpose paragraph
• Do NOT include discussion with your results.
• Do NOT make statements about clinical
• Do NOT compare your results to the findings of
• We always recommend a table summarizing
  sample or subject characteristics (age, gender,
  pertinent diagnoses)
• Graphs depicting your results are strongly
  recommended; they help readers quickly grasp
  complex statistical relationships. HINT: your
  statistician may be able to help you design figures
  and tables
• Most people start by summarizing their findings in a
  single paragraph
• Organize your discussion based on your study aims
  in the order they were originally presented
• The discussion must compare your findings to those of
• Therefore references are essential to your discussion
• Include 1 to 2 paragraphs describing clinical
  implications of your findings
• Insert a single paragraph addressing study limitations;
  think beyond sample size alone
• Some feel the abstract is the most important part of the paper. It is the
  part most likely to be read.
• We use a structured abstract:
   – Purpose: no more than 2 sentences telling readers why you did the
   – Subjects and Setting: 2 to 3 sentences describing research
     participants and setting
   – Methods: one sentence summarizing the design (RCT, cross-
     sectional study, etc). 3 to 5 sentences describing what you did
   – Results: 3 to 5 sentences describing the most important findings
   – Conclusions: 1 to 2 sentences telling readers what the most
     important take-home message of your study is
          Conclusion & References
• Conclusion
  – Single paragraph 2-3 sentences restating the most
    important points readers should remember after
    reading your article
• References
  – We do not use APA style; it is inefficient for published
    literature and most major journals avoid it
  – References in text are numbered in order of appearance
  – When in doubt, simply copy the style of another article
    published in JWOCN (or whatever journal)
• Publication is no less important for clinicians than
• Clinical Challenges is the best place to start if you
  have never published before
• Successful authors FOLLOW THE STANDARD
  FORMULA rather than trying to produce the Great
  American Novel; your content speaks for itself

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