Determining what type of article to write

Article Outline

• Clinical Articles
• Management and Education Articles
• QI and Research Articles
• Columns
• Next Steps
• Notes
• Copyright

Perioperative nurses are familiar with many types of surgery—from minor procedures, such as removal of a bursa, to major procedures, such as coronary artery bypass. Similarly, a prospective author should become familiar with the many types of articles that may be published in a nursing journal, from case studies to research reports.

The nature of your topic often will dictate the type of article you choose to write. For example, if you want to write about a disease process or surgical procedure, you will write afeature-length clinical article. If you have conducted a formal study, you will write a research article. A more informal quality improvement (QI) project to solve a problem in your own hospital could result in article that offers practical solutions to other facilities. A short article about an innovative process, a clinical exemplar, or a professional opinion might be appropriate for a column (eg, a regularly appearing short article with a designated focus). All articles should be scholarly, with references used to support the information provided.

Read the journal you want to publish in to get a sense of the types of articles it contains. For example, you will find that the AORN Journal publishes feature-length clinical, education, management, and research articles, in addition to columns focused on patient safety and patients with special needs, innovative and exemplary practices, opinions, research synopses, and book reviews. This article discusses the purpose and format for some of the types of articles you may want to consider writing.

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Clinical Articles 

Clinical articles present new skills or knowledge related to patient care, provide an empirically or clinically based review of a disease state and surgical procedure, or analyze the current literature related to a topic. Clinical articles should include research findings, when available, to support the rationale for recommended interventions. The introduction may be a brief presentation of a patient or a situation that a nurse might experience. For example, this introductory sentence—“Placement of the electrosurgical pad can be a challenge in a patient with anorexia who has little body fat or muscle”—immediately tells readers that the information to follow will have practical and specific applications.

The format of clinical articles varies. If you are writing about a specific surgical procedure, after the introduction, you might include a review of the disease or condition associated with the procedure; its incidence and pathophysiology; preoperative, intraoperative, and postoperative information of importance to perioperative nurses; a care plan; and a conclusion that summarizes the information. If you are discussing a new procedure, it makes sense to present the steps in the order in which they occur. After all, you would not teach a new perioperative nurse how to put on a gown before discussing how to scrub. Other article formats are possible as well, depending on the topic.¹ Whatever the format, do not forget to answer the question, “so what?” This helps ensure you are focusing on practical information that readers can apply in their clinical settings.

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Management and Education Articles 

Management articles can be written in a variety of formats, but the topic should be of interest to people who are responsible for, directly or indirectly, the surgical continuum of care. The audience includes managers, supervisors, and directors in the perioperative area, materials management, administration, central service, human resources, and information systems and nurses who are new to or who aspire to work in management positions. Management articles typically are shorter than clinical articles because perioperative leaders appreciate concise information that will help them do their jobs better. Appropriate topics could include information about trends in management and the surgical environment, changing policies and regulations, clinical practice and technology that affect managers, administrative issues, and other areas vital to an understanding of the current health care environment.

Education articles include topics of interest to nurses in academia, nurse educators, mentors, or anyone responsible for developing educational materials and disseminating information to nursing students, nurses, other perioperative team members, and patients. For example, education articles might focus on an innovative program to introduce nursing students to the perioperative environment, a novel way to ensure that nurses achieve a relevant competency, a successful inservice or chapter education program, a review of different teaching methods for adult learners, or new resources for patient education.

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QI and Research Articles 

Quality improvement and research studies can be classified as data-based articles because data are used to support the information presented. Collecting and analyzing data related to a project provides empirical rationale for practice. For example, rather than simply asserting that a new type of OR bed pad reduces the incidence of skin injury, data allow you to quantify the level of improvement. In addition, data help determine whether the results can justify the cost of the intervention or a change in practice.

QI. Quality improvement articles typically report efforts at one hospital or ambulatory care center to improve care or solve a problem. Organize your QI article by answering the following questions.

Be honest about what did and did not work and how you overcame barriers you encountered. Readers will appreciate information that will help them avoid—or at least minimize—similar problems.

Differences between QI projects and research studies. It is important to understand the differences between QI and research articles. First, a research article must put the study in context with other research in the area by including a comprehensive literature review. Second, research methodology tries to control as many variables as possible. Although QI reports are useful, they cannot be generalized to other populations because there is less control over the study variables than in a research study. Finally, the statistical analysis required for a research study is more rigorous than that typically used for a QI initiative (Table 1).

Table 1. Comparison Between Research and Quality Improvement Articles

For example, you and your colleagues might write an article about a QI initiative for warming patients before surgery. You could include information about

If you decided to conduct a research study instead of a QI project, you would

All research studies that involve human participants must have approval from an institutional review board (IRB), which protects the rights of study participants. Be sure to include a statement about IRB approval or exemption in your article. Some QI projects may require IRB approval as well.

Research. It is important for nurses to publish research articles to further evidence-based nursing practice. Research studies may be quantitative or qualitative.

Quantitative research studies generally are devised to test a theory or to build on one. Quantitative research focuses on measurement and statistical analysis of data to test a hypothesis with a goal of discovering relationships or cause and effect between quantifiable variables.² The data analysis is numerical.

The overall aim of a quantitative study is to identify general principles that can predict or explain a phenomenon.³ Quantitative research methods include surveys and experimental or quasi-experimental manipulation of variables.³ These studies can include interventions between two or more groups, with one group acting as a control group.

A qualitative study examines a phenomenon from the individual's perspective in a social context to identify meaning rather than cause and effect. These studies are used to narrow down or identify a problem in which an intervention can later be tested in an experimental study.

Qualitative research methods include verbal descriptions such as interviews, narrative analyses, and participant observation.² The data are not analyzed numerically. For example, whereas a quantitative study might examine the effect of different treatment modalities on the amount of pain that patients experience, a qualitative study would focus on the patient's perspective to attempt to understand patients' experience of pain.²

The typical format for a research article is IMRD (ie, introduction, methods, results, discussion). Each section answers a specific question.⁴ This format is typical for quantitative studies; qualitative studies should contain the same sections, but content may vary according to how the study was conducted.

The AORN Journal has a checklist for research article components that you can use as a guide when you are writing your manuscript (Table 2).

Table 2. AORN Journal Research Article Submission Checklist

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Columns 

Most journals have columns that are published on a regular basis. Columns in the AORN Journal include case studies, exemplars, innovations, opinions, or address issues related to patient safety or special needs populations. Writing a column is an excellent goal for a beginning writer. Editors need content on a regular basis, the length of a column is shorter than a feature article, and some columns may use a specific format. Be sure to query the editor first and read previous columns so you can tailor your article appropriately.

Case studies. Case studies are excellent learning tools. They provide examples of critical thinking and decision making by presenting a patient who has an unusual diagnosis or a particularly complex situation. This type of article is not a comprehensive description of a procedure but an informative summary that emphasizes the roles and responsibilities of a perioperative nurse specific to one type of procedure or an individual patient's needs. A case study also can accompany a feature-length article to illustrate application of the nursing process or the effects of a procedure.

The typical format for a case study is an introduction, including why the case is important, presentation of the patient (eg, demographic characteristics, medical and surgical histories, diagnostic test results, comorbidities); nursing assessment; perioperative nursing and surgical interventions; and outcome, including any advice about what could have been done differently. You may want to make the case study a “mystery” by presenting the details and asking readers to consider the proper treatment decisions.

To ensure privacy and adherence to Health Insurance Portability and Accountability Act regulations, take care that the patient cannot be identified from the description or events. You may need to change some details to conceal the patient's identity. If the patient has a unique condition or the case has been widely reported in the media (eg, conjoined infants whose separation was particularly difficult), work with your risk management department and your editor to obtain the proper permission from the patient or, in the case of a minor child, from the patient's parent or legal guardian.

Exemplars and innovations. Exemplars are first-hand accounts that describe outstanding examples of the actions of individuals in clinical settings that have enhanced patient care. These articles might include discussion of difficult interpersonal, ethical, or clinical judgments. This type of article helps readers relate to benefits and accomplishments on the personal side of nursing that often cannot be quantified but are of critical value.

A clinical innovation article shares a practical story of problem solving in clinical practice, including follow-up information regarding how the solution has worked. Readers can use these articles to determine measures for making changes or incorporating practices into their own settings. Clinical innovations must be consistent with AORN standards, recommended practices, and guidelines.

Similarly, an educational innovation article shares practical stories of teaching-learning strategies for patients or peers with follow-up information regarding how the strategies have solved an educational problem. These articles help educators teach new techniques or help learners improve their educational strategies.

Opinion. Everyone has opinions, and sometimes they are worth publishing. An opinion column should present a well-thought-out, brief discussion of a professional opinion on an issue that will be of interest to perioperative nurses. Use references to support your ideas or refer to positions of other individuals or organizations. The suggested format for this type of article includes stating a point, supporting your position with references, and describing your position's application to professional practice.

Patient safety and patients with special needs. AORN has been publishing monthly patient safety columns since the Patient Safety First initiative was launched in 2002. These articles focus on patient safety issues during surgical patient care. The column provides practitioners with up-to-date information and resources related to safe practices. Recent columns have focused on safe counting practices, ways to achieve the Joint Commission on Accreditation of Healthcare Organizations' National Patient Safety Goals, and how patient safety and workplace safety issues are interrelated.

This month, the Journal debuts a new column on special needs populations. These articles will describe issues, complications, interventions, specific needs, regulatory requirements, and new information regarding care of vulnerable patient groups, including older adult patients, pediatric patients, patients with disabilities or specific illnesses, and patients affected by particular social conditions or cultural issues. Articles should include implications for preoperative, intraoperative, and postoperative care.

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Next Steps 

These are only a sampling of the article and column types that are published in the AORN Journal and similar publications. Table 3 presents a list of representative articles from the AORN Journal for reference. If, after reviewing a publication, you are still unsure where your article might fit best, consult the editor for guidance.

Table 3. Samples of Article Types in the AORN Journal

By now, I hope you are well on your way to developing your feature-length article or column. Next month's column will offer tips on how to use tables, figures, and photographs to strengthen your manuscript and engage readers.

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Notes 

1. Saver C . “Ready to write,” . AORN Journal . May 2006;84:1049–1052
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2. Fain JA . Reading, Understanding, and Applying Nursing Research . second ed.. Philadelphia: F A Davis Co; 2004;
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3. In:  Tarling M ,  Crofts L editor. The Essential Researcher's Handbook for Nurses and Health Care Professionals, . second ed.. London: Bailliere Tindall; 2002;
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4. Oermann MH . In: Writing for Publication in Nursing . Philadelphia: Lippincott; 2002;p. 115–135
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