2016 ADC Professional Development Abstract Boot Campannualdialysisconference.org/.../adc/...SchiraProfessionalDevelopmentAbstractBootCamp.pdfProfessional Development - Abstract Boot

Professional Development - Abstract Boot Camp

Lesley Dinwiddie, MSN, RN, FNP, CNNe Vascular Access Educator and Consultant,

Cary North Carolina

Cynthia L. Russell, PhD, RN, Professor

University of Missouri-Kansas City Kansas City, Missouri, USA

Mary Schira PhD, RN, ACNP-BC Associate Professor

College of Nursing and Health Innovation

Disclosure

• No conflicts of interest to disclose

Objectives

Identify various types of abstracts Describe the process for writing successful

research abstracts. Analyze abstracts for strengths and

weaknesses Discuss Institutional Review Board Issues Evaluate authorship challenges

Program Outline2:00-2:05 Welcome and Introductions 2:05-2:20 Abstracts-Definition, Types and Benefits of Submitting 2:20-2:40 What are the characteristics of stellar abstracts and not-so-stellar abstracts? 2:40-3:00 Abstract Development 3:00-3:45 Institutional Review Boards 3:45-3:55 Authorship 3:55-4:00 Wrap up and Evaluation

What is an Abstract?

• A statement summarizing the points of a presentation

• Why is this important? • What is the goal? • What did you do? • What did you find? • What does it mean?

Russell & Ponferrada, 2012; Happell, 2008; Pierson, 2004

How is an Abstract Different from a Poster Presentation?

• When you submit an abstract you may be asked if you would like to present it orally or in a poster format

• A poster presentation is one method for you to share the results of your work

• You will see many posters during the poster sessions-these were submitted as abstracts

Purpose of Abstract• Allows review panel to determine the quality and

relevance of the paper – Include in presentation – Reject – Accept with low priority

• Enables papers dealing with similar topics to be grouped together in the conference

• Facilitates conference attendees to select the paper that they want to attend

Russell & Ponferrada, 2012; Happell, 2008; Happell, 2007; Sheldon & Jackson 1999

Purpose of Abstract• An “advertisement of what is to

come” • More than just a good idea • Reflects one theme of the

conference • Introduce your topic competently

Russell & Ponferrada, 2012; Happell, 2008; Happell, 2007; Sheldon & Jackson 1999

Should I submit an abstract?

Yes! You will never get an abstract accepted if you

don’t submit!

What are the Benefits of Submitting an Abstract?

• An accepted abstract goes on CV/resume • Peer recognition and personal satisfaction • Catalyst to network with colleagues • Potential for acceptance as an oral presentation • Employer’s recognition:

– Clinical ladder/promotion – Potential for funding conference expenses

• Elevates the profession • Makes a difference in patient care and outcomes!

•

How to Get Started!

• What are the characteristics of stellar abstracts (those likely to be accepted) and not-so-stellar abstracts?

• Where and when do you begin? • Identify your abstract topic • Identify conference • Obtain conference abstract guidelines-ADC’s

as example • Begin process early • Develop timeline

Developing an Idea for an Abstract

Projects from work or school ✓Evidence-based practice ✓Quality Improvement ✓Clinical problem ✓Case Study ✓Research ✓Education

Lesley

Increase your success by. . .

• Ask a more experienced person to assist you – Colleague – Research Chairperson of

your specialty organization – Magnet Status Coordinator – Conference networking

contact

Helpful Hint

• Consider Institutional Review Board and Health Information Portability and Accountability Act (HIPAA) requirement for research and case studies

• Protects the privacy of individually identifiable health information

• Department of Health and Human Services website: • http://www.hhs.gov/ocr/privacy/

ExampleTitle and Content

•Abstracts should be related to the dialysis modalities addressed by the program

Abstract Topics

• Access •Acute renal failure •Adequacy •Anatomy/Physiology •Anemia •Calcium/Phosphorus/Bone •Clinical Experiences •Cost Containment •Dialysis Systems/Equipment •Education •Home HD •Hypertension •Infection •Inflammation •Kinetics •Metabolism/Nutrition •Nursing •Quality Improvement •Quotidian HD •Rehabilitation

Presentation Preferences

•Oral only •Oral preferred •Poster only •Poster preferred

Topics

• Allow you to decide if your areas of interest or expertise are appropriate for the conference

• Provide guidance on how to focus your abstract

Russell & Ponferrada, 2012; Happell, 2008

Example

Due Date

How to Submit

•Website •Fax •Mail •Using template

Lesley

Submission

• Email to website or organizing chairperson • Online submission usually requires user name

and password which you need to keep • Revisions and modifications are usually allowed

until you submit • Keep an electronic or printed copy of your

abstract so that when it is accepted, you can develop presentation

Russell & Ponferrada, 2012 ; Happell, 2008

Abstract Form

What Should I Place in Each Section of the Abstract?

• What should I title my abstract? • What should I place in the background/introduction section? • How should I state the purpose of goals? • What should I include in the methods section of a research abstract? • What should I include in the approach section of a non-research

abstract? • What should I include in the results section? • What should I include in the discussion section? • What should I include in the implications for practice section? • Should I include tables and figures?

Content •Title

•Clearly indicate the nature of investigation/ clinical focus •No authors or institutions in title

Content •Body of the Abstract

•Informative •Background •Methods •Results •Discussion •Conclusion (supported by data) •Standard abbreviations •Generic drug names •Do not identify authors or institutions in text

Content Author(s) and Affiliation(s)

•List last name, first name and middle initials of all authors •Do not include degrees or titles •Affiliation(s) should include only the name of the institution, city, state, and country

Format •Length is approximately 2000 characters if no tables or figures •Small character-based tables or figure may be included •Use type that is 10 pt (12 cpi) or larger •Abstract must fit into a 4 1/8 x 5 7/8 inch space

Careful Attention to Details

Results in more favorable review!!

Content

• Must be realistically delivered in a certain amount of time or on a poster (limited space)

• Frequent mistakes: – Too much content – Wait too late to begin the project

• Abstract may need to be completed to submit – Cannot state “Results will be presented”


Other Common Pitfalls

• Not enough information provided • Too much background and not enough specifics • Too many specifics and not enough background • Not adhering to the submission guidelines • Grammatical, typographical, spelling errors • Poor expression


Title

• Clear and concise • How “clever” should it be? • Should include

– Variables – Population – Design

Russell & Ponferrada, 2012

Examples

• A Description of Older Renal Transplant Recipients’ Medication Non-adherence

• Motivational Interviewing in Dialysis Study (MIDAS)

• Patterns, Predictors, and Outcomes of Medication Non-adherence in Adult Hemodialysis Patients

• Perceptions of Success from Those Who Have Had Their Kidney Transplant for 25 Years or Longer

Examples

• Which way did they go? A look at challenging leadership situations

• CMV in ABOi using CSI after OKT-3 • Work arounds in dialysis units • The ABCs of Hemodialysis care • Hemodialysis 101

Writing the Abstract

• Why is this important? • What is the goal? • What did you do? • What did you find? • What does it mean?


Why is this Important?

• First sentence should describe importance and capture attention


Abstract Examples

Background Motivational interviewing has shown promise as an

effective approach to improve and maintain treatment adherence in diverse populations. Patient demographic predictors (age, gender, ethnicity, and others) have not been consistently correlated with non-adherence in hemodialysis. Interventions, such as motivational interviewing, with cognitive/behavioral components have been shown to be most effective in improving adherence.

What is the goal?

• Purpose of paper


Abstract Examples

Purpose To examine the feasibility and efficacy of a

staff-delivered motivational interviewing technique on treatment, diet, and fluid adherence in adult outpatient hemodialysis patients.

What did you do?

• Approach • Study design • Methods • Brief • Informative


Abstract Examples

Approach Study Design: A pre-post design was used for this

pilot study. Methods: Twenty-nine participants were recruited

from a non-profit, free-standing hemodialysis clinic in the central United States. Dialysis staff were trained to deliver motivational interviewing during dialysis interactions. Prior to and after the 3 month motivational interviewing intervention, 3 months of adherence data and the Health Care Climate Questionnaire were collected.

What did you find?

• Summary of results • Brief • Only the most important findings • Minute elevator speech!

Russell & Ponferrada, 2012; Happell, 2008;

Abstract Example

Results Motivational interviewing appeared to improve dialysis

attendance, decrease the number of shortened treatments, and favorably improve phosphorous and albumin levels while negatively impacting interdialytic weight gain. Changes in the Health Care Climate Questionnaire scores were not statistically significant from pre-to post- intervention, though the trend was in the direction of improvement in autonomy support, a main component of motivational interviewing. Staff and patients found the approach acceptable.

Table

• Include only if can clearly and quickly communicate key information

• Easily readable • Appropriately sized for small space • Numbered with caption usually at top of table • Use key for abbreviations • Place table where it falls in the text • Include reference to table in text

– “Found in Table 1, is information about . . . “


Sample Abstract

Figure

• Include only if can clearly and quickly communicate key information

• Easily readable • Appropriately sized for small space • Numbered with caption usually at bottom of

table • Use key for abbreviations • Place figure where it falls in the text • Include reference to figure in text

– “Found in Figure 1, is an illustration of . . . “


Sample Abstract

What does this mean?

• Implications for practice, research, education

• Should relate to the abstract purpose • No new information should be introduced at

this point • Recommendations should not exceed the

findings of the study


Abstract Examples

Implications Motivational interviewing shows promise as an

intervention to improve adherence in adult hemodiaysis patients. Dialysis staff can use motivational interviewing successfully. Future research should test the use of motivational interviewing in a fully-powered study with diverse dialysis samples.

Example of Abstract with Opportunities for Improvement

Abstract Example #2Live kidney donation has become an increasingly

popular option in the treatment of chronic kidney disease (CKD) / End Stage Renal Disease (ESRD) (?). Today 95 %(?) of living donor nephrectomies for transplantation are performed by laparoscopic techniques. Typically the length of stay (LOS) of hospitalization in this patient population post donation (operatively) is ___ days. (? Worth mention our statistics for this at our hospital or use EBP and/or Cochran?) Variables increasing the LOS include: urinary retention, inadequate pain control and delayed return of gastric motility.

Abstract Example #2 (cont.)At XXXX Medical Center the delayed return

of gastric motility was identified as the most common variable prolonging hospital discharge. As such interventions aimed at reducing the LOS by accelerating the return of gastric motility was worth exploring. Nursing staff on the transplant recovery floor (XXXX) rallied to the challenge in attempts to find a solution.

Abstract Example #2 (cont.)The review of literature indicated that an

aggressive outpatient pre-surgical bowel preparation regimen yielded favorable results in returning normal gastric motility. Specifically reviewed was the XXXX published protocol for laparoscopic nephrectomies. The goal was to reduce the LOS from __days to < two days. The XXXXX protocol consisted of a clear liquid diet, magnesium citrate, fleets enema and Toradol for pain control.

Abstract Example #2 (cont.)Surgical attending staff of the XXXX transplant program was

included in the exploration of the proposed planned implementation of the XXXX experience. However as Toradol might be ____ on kidney function, it was decided that implementation would be acceptable minus the use of Toradol for pain control. Additionally, it was decided by personal preference from the transplant coordinator staff to omit the use of a fleet’s enema in the presurgical phase. As an alternative, our program decided that our regimen would include a clear liquid diet and magnesium citrate 18-24 hours in the pre-operative period. This was followed by nothing by mouth (NPO) at midnight prior to the planned surgery.

Abstract Example #2 (cont.)

Out of ___ number of patients, all of whom voluntarily participated in this bowel regimen in the pre-surgical setting, ____ number of patients achieved an average LOS of ___ days. Data reviewed from the previous 12 month period demonstrated that this bowel regimen was instrumental in decreasing the average LOS. Although our goal of a LOS < two days was not met, it clearly demonstrated that the implementation of this bowel regimen significantly decreased the LOS.

Example of Better Abstract

Abstract Example #3 Background: As chronic renal disease increases in those aged

60 and over, renal transplantation is concurrently increasing as a life-saving therapy that enhances quality of life, prolongs the lifespan, and reduces care costs. Renal transplantation in those aged 65 and older has risen from 3% in 1990 to 14% in 2006. Immunosuppressive medication adherence is crucial to survival of the transplant. Expensive, complex and persistent immunosuppressive regimens with undesirable side effects make medication adherence a challenge. Older renal transplant recipients are at additional risk for poor medication adherence due to cognitive and physical changes associated with aging.

Abstract Example #3

Purpose: This is the first descriptive, longitudinal study in older renal transplant recipients to examine immunosuppressive medication adherence of a twice-daily prescribed immunosuppressive medication.

Methods: Adherence to immunosuppressive medications was electronically monitored using the Medication Event Monitoring System (MEMS) and a diary for 6 months in 12 renal transplant recipients aged 60 years or older.

Abstract Example #3

Results: Mean age was 65 years, 58% (n = 7) were females, and 83% (n = 10) were Caucasian. The most prevalent etiology of kidney disease was diabetes mellitus 41% (n = 5). Nine (75%) had received deceased donor kidney transplants. Monitored medications included cyclosporine 58% (n = 7) and tacrolimus 42% (n = 5). The median percent of prescribed doses taken on time was 83.90% (M = 67.84, SD = 34.10, range = 3.3-97.9). Seven (58%) of subjects achieved >/= 90% adherence to prescribed doses, two (17%) had 80-89% adherence, and three (25%) had <79% adherence.

Abstract Example #3 Implications/Future Research: Preliminary

findings indicate that older renal transplant recipients are a sub-group at substantial risk for undesirable outcomes due to poor medication adherence. A diverse fully-powered study is needed to confirm these early findings. Future study of predictors and outcomes of immunosuppressive medication non-adherence in this growing population is warranted.

ExampleHow/when you will

be notified of decision

Notice of acceptance or rejection will be made by email during November 2010

Next Steps

Institutional Review

• “IRB” = Institutional Review Board • Purpose of Review

– Protect rights, welfare of human subjects participating in research

• Informed consent • Confidentiality of information shared • Protect vulnerable groups (e.g. children, prisoners,

pregnant women and neonates) – Protect investigator – Assure benefit of proposed study > anticipated risk

How Do I Know if Review is Needed?

• Does the project develop or contribute to generalizable knowledge?

• If response to above is “yes”, you’re in the right session!

• What does not require review? – Quality improvement – practice/process within a

particular institution – Program evaluation – improve a specific program for/

about the specific setting • What if I’m not sure? Ask an IRB.

Preparing for a Review• Develop specific description of study – include purpose, benefits

to health care community, patients, families, etc. • Identify exactly the data that will be collected, from whom the

data will be collected, how the data will be collected • Subjects - who will and will not be asked to participate • If no subjects, identify data source(s) and how obtained • Describe where the data will be collected – and who has given

written permission for the data to be collected at the site • Develop a timeline for the study • Determine/locate an Institutional Review Board • Complete training in protection of human subjects

Training – Protection of Human Subjects

• Ethical principles • Federal regulations • IRB procedures • State, local laws (if relevant) • Institutional policies (specific to the IRB

reviewing the study)

Locating an IRB

• Employer (more likely if large company experienced in conducting research studies)

• University (may/may not require the investigator to have “relationship”)

• Health Care System (especially if requesting access to patients, records in the System)

Ethical Principles that Guide IRBs*• Respect for persons

– Informed consent – Autonomy

• Beneficence – Assessment of risks and benefits – Benefits must outweigh risks (both physical and

psychological) • Justice

– Fair selection of subjects *Belmont Report, 1979

Exempt Levels of Review• Still have to submit a protocol • Meet ethical requirements of consent, risk/benefit analysis,

subject selection • Overall characteristics

– Non-sensitive data, non-identifiable data – Less than minimal risks

• Examples – Research conducted in established or commonly accepted educational

settings, involving normal educational practices (e.g. comparing instructional techniques, curricula, methods)

– Involves collection of study of existing data, documents, records, specimens, etc. IF data recorded by the investigator so that subjects cannot be identified

– Observation of public behavior

Steps of Review

• Permission of employer • Permission of other “entities” where data

will be collected (in writing) • Contact Institutional Review Board • Submit Application for review • Respond to any questions from Review

Board

Application for Review

• Every IRB has specific forms and processes (including deadlines) for applications

• Read the application carefully and provide information

• If unsure, call the IRB office for clarity (may wish to meet with a staff member)

Content of Application

• Study/Project purpose • Rationale for study/project • Benefit/Risk analysis • Informed consent (if using human subjects) • Study tools (survey, questionnaire, interview

script, etc.) • Privacy (person), confidentiality (data) and

security (data - e.g. access and storage) • Plans for dissemination

What Will the IRB Look For?

• Are risks minimized to the fullest extend possible? • Does the potential benefit justify potential risks? • Is informed consent adequate and understandable? • Is the selection of subjects fair? • Are all logistics of the study clear, well thought out? • Will the data be stored securely? • Have you maintained the privacy and confidentiality

of your subjects?

Review Feedback• Approval Pending

– Provide information as requested (often consent, subject selection or logistics issues)

• Approval – Acknowledge receipt – Note period of approval – Keep documents with study materials/documents

• Revising an Approved Study – Approval is granted for the study as submitted – If changes to the study are needed (e.g. collect an additional piece of

data, change where the data will be collected, include a larger age range of subjects), need IRB Approval of changes before implementing the proposed changes

Overcoming Potential Challenges

• Time commitment to prepare and submit the review to the IRB

• IRB may question investigator’s ability to conduct the study – work with a co-investigator – Co-investigators can be GREAT mentors

throughout the process (including presentation and publication)

Resources

• US Department of Health & Human Services Office for Human Research Protections (OHRP) http://www.hhs.gov/ohrp/

• US Department of Health & Human Services FAQs for Investigator Responsibilities http://www.hhs.gov/ohrp/policy/investigatorfaqsmar2010.pdf

• Comparison: Characteristics of Different Types of Projects https://www.uta.edu/research/administration/departments/rs/rs_documents/pdf/ultimateChart.pdf

AuthorshipSharing Your Results

• You will naturally want to share your results more widely

• Consider letter to the editor, research article, or clinical (or how to) article

• Make decisions on authorship • Pick your journal • Write the letter or article • Submit

What is Authorship?• Substantial contributions to the conception or design of the

work; or the acquisition, analysis, or interpretation of data for the work; AND

• Drafting the work or revising it critically for important intellectual content; AND

• Final approval of the version to be published; AND • Agreement to be accountable for all aspects of the work in

ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

International Committee of Medical Journal Editors (ICMJE) Guidelines at www.ICMJE.org

What is Not Authorship?

•The following factors by themselves do not • justify authorship: • Obtaining project funding • Writing assistance, technical editing, language

editing, and proofreading • Supervising research group • General administrative support

What is a Corresponding Author?

• Takes primary responsibility for communication with the journal during the manuscript submission, peer review, and publication process.

• Ensures all the journal’s administrative requirements, such as providing details of authorship, ethics committee approval, clinical trial registration documentation, and gathering conflict of interest forms and statements, are properly completed.

ICMJE Guidelines at www.ICMJE.org

How to Avoid Authorship Agonies• Single or multiple authors • If multiple authors discuss authorship order,

responsibilities, and deadlines early in the project with all potential authors

• Have all authors sign agreement • Follow discussion with an email summarizing

decisions to all involved • Deciding what to do when author is not

following agreement

How to Avoid Authorship Agonies

• Do your due diligence before you bring potential authors into your research/writing team – Talk to other co-authors who have worked with

them before – Ask to review their CV

Summary

• Match abstract with conference theme • Prepare and submit abstract using

guidelines • Avoid common pitfalls • Celebrate! • Appreciate key issues in IRB submission • Avoid authorship agonies


References• Happell, B. (2007). Hitting the target! A no tears approach to writing an abstract for

a conference presentation. International Journal of Mental Health Nursing, 16, 447-452.

• Happell, B. (2008). Conference presentations: a guide to writing the abstract. Nurse Researcher, 15, 79-81.

• Kennedy, M., Barnsteiner, J., & Daly, J. (2014). Honorary and ghost authorship in nursing publications. Journal of Nursing Scholarship, 46, 416-422.

• Pierson, D. J. (2004). How to write an abstract an abstract that will be accepted for presentation at a national meeting. Respiratory Care, 49, 1206-12.

• Russell, C. L. & Ponferrada, L. (2012). How to develop an outstanding conference research abstract. Nephrology Nursing Journal, 39(4), 307-311, 342.

• Sheldon, L., & Jackson, K. (1999). Demystifying the aura: preparing an abstract. Nurse Researcher, 7, 75-82.

• Youngblut, J. M., & Brooten, D. (2007). Call for abstracts: Are you ready? JSPN, 12, 115-118

Questions and Evaluation

Documents

2016 ADC Professional Development Abstract Boot Campannualdialysisconference.org/.../adc/...SchiraProfessionalDevelopmentAbstractBootCamp.pdfProfessional Development - Abstract Boot