Writing is time consuming and difficult to do—the last thing you want is to spend time working on a manuscript that has little chance of being published. There are many strategies you can use to enhance the likelihood of publication, which we discuss throughout this series, but the first and most important is writing the type of article that journal editors want to publish.
WHAT A JOURNAL EDITOR WANTS
Although many nursing journals focus on specific topics, journal editors generally want articles that provide nurses with clinical information they can apply to their practice, help advance the profession through education or policy initiatives, improve the delivery of patient care and outcomes, or contribute to the body of scientific knowledge. All articles must meet ethical authorship and publishing standards (I'll review this next month). As discussed in the last installment, articles must be clear and concise and written at a scholarly level. And finally, information must be supported by current evidence.
What follows are brief descriptions of the types of articles nursing journals publish, as well as tips for writing each type based on common mistakes authors make.
Research that builds knowledge. Research forms the foundation of nursing science and evidence-based practice. The two most important considerations for the publication of research are determined even before the writing begins: the significance of the research and the conduct of the study. Research must address an important question and add something new to the body of knowledge. The study methodology must be rigorous; inadequate samples, errors in analysis, or problems with bias are all considered fatal flaws that cannot be overcome no matter how important the topic or how good the writing. Research reports follow the IMRAD (Introduction, Methods, Results, and Discussion) structure outlined by the ICMJE, the International Committee of Medical Journal Editors. The guidelines can be accessed at www.icmje.org.
* Introduction: contains background information, as well as the significance and purpose of the study.
* Methods: includes information about how the study was conducted and why those methods were chosen. This section needs to be detailed enough for others to replicate the study.
* Results: a description of the findings. Highlight important findings by describing them first. Do not comment on the findings in this section.
* Discussion: tells the reader what the findings mean and contrasts them to those of prior studies. Implications for practice and future research are included. Strengths and limitations are described here as well.
(For more information on writing these sections, see “Writing Your Manuscript: Structure and Style,” April.)
* Engage your reader with a compelling introduction. Readers, including journal editors and peer reviewers, are inundated with information. Here's your opportunity to make them care about your topic.
* A strong discussion section can help convince editors and reviewers to publish your study. Show them the importance of the results by clearly describing what contribution they make to the literature, as well as their practice, education, and policy implications.
Quality improvement (QI) projects with supporting data. It's important to publish QI reports, as many clinicians and organizations struggle with issues related to patient outcomes and delivery of care. When planning a QI project, make sure you collect baseline data and outcome data—it's a must for publication. Knowing what doesn't work is important, too; even failed projects have something to teach us. If you provide an insightful analysis of why your project wasn't successful and next steps, it still has the potential to be published. Biomedical and nursing journals require use of the SQUIRE, or Standards for Quality Improvement Reporting Excellence, guidelines (www.squire-statement.org) for writing QI reports. They follow an IMRAD structure similar to the one for research reports discussed above.
* Include enough details so readers can replicate the project in their organization.
* If your QI project is an educational intervention for nurses, it's not enough to do a pretest–posttest analysis to show that learning took place. You'll increase the value of your work (and the likelihood of getting it published) if you include evidence that the learning translated to practice.
Clinical review articles that provide the most up-to-date evidence on best practice for specific diseases or conditions. Nursing and medical knowledge is constantly growing, and nurses need up-to-date information in order to provide optimal care. Clinical review articles provide an in-depth understanding of a disease, condition, or procedure. They are evidence based, using the most current research to support the information they provide, and should include the following:
* Significance of the problem: why are the topic and the supporting evidence important?
* Epidemiology: contains the most recent data regarding prevalence and incidence; morbidity and mortality; and, where applicable, economic costs.
* Pathophysiology: may include processes within the body leading to the disease or condition (pathogenesis), what is happening within the body to cause symptoms, or transmission factors for infectious diseases.
* Diagnosis and management: a discussion of disease or condition manifestations, diagnostic workup, nursing assessment and care, nonpharmacologic and pharmacologic interventions, patient teaching, and prevention, among others.
* A clinical article must provide nurses with more in-depth understanding and information than they would get from a textbook.
* Editors are always looking for articles on “hot topics” in health care—for example, emerging infections such as the Zika virus, heroin and opioid addiction, mental health care of children and adolescents, care of veterans, and patient safety.
Systematic or integrative literature reviews. The results of one study aren't enough to determine best practice; we need to know what the overall body of research tells us about a particular topic or intervention. That is what systematic reviews and integrative reviews provide. These are literature reviews conducted in a rigorous, systematic way that identify, appraise, and synthesize what is known about a topic. A systematic review differs from an integrative review in that it includes only experimental research, while an integrative review also includes nonexperimental and “gray,” or unpublished, literature. Though systematic and integrative reviews are not original research in the sense that they don't create new knowledge, they are considered a form of research because of the scientific approach used to conduct them. As such, we can use their findings to make recommendations for practice. And because they are considered a form of research, the likelihood of their being published depends on what happens before you start to write: you can't fix an ill-chosen clinical question or a poorly conducted review after the fact. Systematic reviews should follow the PRISMA, or Preferred Reporting Items for Systematic Reviews and Meta-Analyses, guidelines (www.prisma-statement.org).
* Systematic reviews must be conducted by a team. A review conducted by one researcher is not considered rigorous and is unlikely to be published.
* When writing an integrative review, pay special attention to the search strategy and results section. Make sure your search strategy is detailed and clear enough so that others can replicate your search and come up with identical results. In the results section, make sure you synthesize the studies; do not list and describe them one by one.
Insightful analysis of professional issues or health care policy. It's important that nursing's voice is part of the dialogue when it comes to policymaking at all organizational and legislative levels. Policy decisions directly influence nurses’ roles and how we are able to do our jobs. The nursing perspective is essential to ensuring that patient care is delivered safely, holistically, and cost effectively. Policy articles can inform nurses about the current health care environment, provide information on current nursing practice issues or initiatives, or analyze current policy-related issues and events. Topics of interest can include scope of practice for advanced practice; policy initiatives that influence the care of specific populations, such as the homeless or mentally ill; ongoing evaluation of national health care policies; specific laws under consideration in the legislature; reproductive health issues; and protection and services for vulnerable populations, such as victims of violence or trafficking.
* Include nursing implications related to patient care, education, and professional practice. What does this policy or issue mean for nurses and their patients?
* Policy analysis should be balanced, not biased. If you want to argue a particular viewpoint, see the next section on opinion pieces.
Opinion essays that present a well-reasoned argument or discussion of topics of concern in health care. The vitality and growth of the nursing profession relies on spirited discussions of nursing and health care–related issues. Many journals provide a forum for this through publication of opinion pieces and editorials. These can be related to direct patient care, health care policy, social justice, nursing education, advanced practice, or health care disparities, among many other topics. If there is an issue you feel strongly about, this is an excellent way to be heard and to start a dialogue on that issue.
* Don't rant. It's OK to feel passionately about a topic, but keep your tone even and your arguments reasonable and thoughtful.
* Just because you say it doesn't make it so. Provide support for your assertions, particularly if they're controversial. You can quote experts, cite statistics, or present research evidence.
Personal narratives that provide insight into nursing or patient experiences. Stories are a powerful medium for fostering understanding of diverse experiences and discovering commonalities. Personal narratives can help nonnurses understand the depth and breadth of what we do and our contribution to health care. They can also help lessen the burdens that are part of nursing; writing and publishing our stories allows us to acknowledge and share the uncertainties, fears, regrets, grief, frustration, and disappointments that all nurses experience at one time or another. It also gives us an opportunity to share what is so rewarding—those times we know we've made an important difference in people's lives.
* The power is in the details. Focus on one event or experience and use concrete language that engages the readers’ senses.
* Don't tell readers how to feel about what you're writing. Allow the details of your story to evoke their responses.
WHERE DO YOU START?
Consider writing different types of articles in your area of expertise so that you reach different audiences. Just make sure that each article is original and adds something substantive and unique to the literature. For example, suppose you did a study and then wrote a research report you submitted to a research-focused journal. You could also write an in-depth analysis of the policy issues related to your findings or to your topic in general. Or you could write a clinical review for nurse clinicians that provides evidence-based guidance for practice (these articles are particularly needed because translation of research to practice is an ongoing challenge).
Along with the types of articles outlined above, there are many others that journals publish. Some of these are brief reports or abstracts of research studies, conference reports, short columns on specific areas of nursing, pharmacy reports, synopses of studies in other journals, and health care–related news. Look through the tables of contents of broad-based nursing journals, like AJN, and of specialty journals in your area of expertise to become familiar with what they are publishing.
WHO PUBLISHES WHAT
You can learn the types of articles a journal publishes on its Web site. First take a look at the mission statement, usually found on the journal's home page by clicking the “About” tab. The mission statement will tell you the journal's focus and the kinds of articles it publishes. Also take a look at the journal's author guidelines, which may have more detailed information. Nurse Author and Editor (http://naepub.com) has a comprehensive directory of peer-reviewed nursing journals that includes a description of the types of articles each publishes.
It can be hard to send your work out there to be judged, but fear not. Editors are always looking for new authors, and your manuscript might be just the one they're waiting for. The next and final article in this series will review the submission process and provide the information you need to understand biomedical publishing and the publishing process. In the meantime—keep writing!