From Nurse Author & Editor, 1999.
As the author of several pediatric nursing textbooks, I face the challenge of providing accurate, up-to-date information on literally hundreds of topics - from diapers to death. Almost thirty years of experience has taught me some successful strategies to tackle this formidable task. However, recently I participated in a new strategy for improving accuracy of nursing publications. The event was a conference dedicated to improving the quality of information on end of life (EOL) care in medical and nursing texts. This method of ensuring accurate information can be applied to other content areas.
The purpose of the conference was to review with invited authors and publishers the results of an analysis of 50 medical and 50 nursing textbooks regarding the accuracy and comprehensiveness of information on EOL care. The nursing texts were selected to represent key books used in undergraduate education and were reviewed by a panel of nurse experts in EOL care. Although the medical reviewers and nursing reviewers adopted different methodologies for their respective analyses, the results were strikingly similar. From a broad perspective of EOL content, almost all books devoted a very small number of pages to this discussion. A major focus of the review for EOL information was on symptom management, including pain, nutrition, dyspnea, nausea / vomiting, confusion, and so on. Overall, the most comprehensive discussion in the nursing texts, with the exception of nursing pharmacology texts, was on pain assessment and management. However, many texts included incorrect statements and very few books had discussions of pain assessment and control specifically related to EOL (Ferrell, Virani, and Grant, 1999).
In my opinion, the second purpose of the conference was ever more important: to present solutions for improving EOL content. Each participant received a large binder of information that covers nine areas considered essential for EOL care. The information is substantive; it will be the basis for my next revision. A bibliography is provided, as well as a resource list of numerous organizations and individual experts. After revising the respective content areas, I will ask experts in EOL to review the updated material. With this level of assistance, the formidable task of "keeping current" has been efficiently simplified.*
Although this EOL care conference was part of a larger national project to improve care for the dying, the process developed to improve education can be adopted on a smaller scale. For example, publishers could establish a panel of recognized experts for key content areas and submit sections of manuscripts to the panel for their review before publication. Each panel could develop a curriculum of essential content for the topic. Professional organizations could assume a key role in offering this "expert review and content" to publishers and to authors. For example, the president of the American Society of Pain Management Nurses attended the textbook conference to identify approaches to ensuring accurate pain content in books.
This process of "expert review" is not new. Publishers routinely solicit reviews of potential manuscripts, and authors send their writing to content specialists. Most professional journals are "refereed" which includes a blind review of a manuscript by more than one "expert." However, I am suggesting that this process be improved in five ways:
I am indebted to the sponsors of the textbook conference on EOL care for their efforts in raising our awareness of strengths and weaknesses in our publications and in providing structured assistance to improve. Now the onus rests on the authors and publishers to do better. I believe this systematic and scholarly process of analysis and assistance can be applied to numerous topics in nursing that can ensure "cutting edge" information in nursing publications.
* For further information about EOL materials contact:
Betty Ferrell, PhD, RN, FAANMarch 15, 2002
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