Dear NANN Colleagues,
Have you been recognized as a clinical expert on your unit? Do you have a favorite type of infant population or favorite procedure where your expertise really shows? Is there a current care practice that you question or you want to better understand based on the evidence? Or, is there an area of neonatal nursing or neonatal care that you want to learn more about? Why not share your curiosity and expertise with others through development of a manuscript for our Clinical Issues in Neonatal Care section? We know the next words out of your mouth will be, “I can't do that!” But why not? We believe that with a little guidance, you can do just that! Writing a clinically focused manuscript is not as difficult as you might think. In this editorial, we will take you through the necessary steps and provide you with the resources and mentorship through this process. We want to help you see your name and your neonatal expertise in print.
Although much of the information included in this editorial is reflected in the Advances in Neonatal Care (ANC) author guidelines,1 we felt that an editorial focused particularly on writing clinical issues manuscripts would be important and helpful to many of our readers and authors. Even authors with writing expertise often struggle with choosing a topic for their manuscripts. Please let your clinical passion guide you in taking this next step. Writing a manuscript can be demanding so using passion to keep you motivated during the process can be important.
Manuscripts submitted for the Clinical Issues in Neonatal Care section contain information that is fundamental to neonatal nursing practice. The content of this section should enrich and expand the readers' clinical knowledge and inform their practice. Every neonatal nurse wants to remain competent in their practice. Reading clinical issues articles is one avenue to accomplish this goal. It is important that information included in a clinical issues manuscript is user friendly and based on good evidence that brings research findings to nurses at the bedside.
For this section of the journal, we welcome manuscripts related to unit-based policy changes, critical reviews of the literature about a neonatal disease process or caregiving activity, and examples of clinical excellence with infants and families. Ideas often come from the author's own practice or from practices they have seen or discussed with others on their unit.2 Overall, manuscripts included in this section of the journal capture the essence of neonatal clinical care. Examples of these types of articles include:
- concept analysis of ideas central to neonatal nursing
- clinical excellence related to specific neonatal or infant/family problems
- descriptions of essential nursing care strategies for specific diagnosis from the novice to the expert, or targeted to a specific audience such as the new staff nurse or the advanced practice nurse
- pathophysiology related to a specific disease process and the targeted medical/nursing management
- care practices (or bundles) based on evidence-based interventions you have researched or tried on unit; sharing what worked and what did not work is often quite helpful to others reading your article
- neonatal assessment processes.
Manuscripts for the Clinical Issues in Neonatal Care section of ANC are best begun with reflection on the topic; outline what you believe are the important points. Consider what you intend to accomplish in the manuscript and what you expect readers of your manuscript to get from the content. The first outline can be pretty rough and broad; many writers begin their work in this manner. Another good way to begin is by putting everything you intend to include or think you might include in the manuscript into the outline; do not worry about order at first. Freely draft your ideas; you can organize them later in the process. Doing this reflection at the onset of the project can help you relate to what your readers might want to see in the manuscript. Many manuscripts submitted for Clinical Issues in Neonatal Care begin as school assignments or as an outcome of a clinical project. Even if the beginning work is a very good idea, more work often is needed to make the writing suitable for publication. Publication is a process and the manuscript may go through several drafts and refinements before it is ready for our readers. Do not be wearied by this process; persistence is all you need to see your name and work in print.
In addition, to begin the outline, you should review the literature. Often the review of the literature will help you refine the outline for your manuscript. The type of manuscript you intend to write often will determine the search strategy you use, but completing a systematic search regardless of the outcome can help you ensure the work you complete is less biased and provides both the advantages and disadvantages or challenges related to better understanding or implementing your clinical topic.3
During your literature search you will want to keep track of the keywords you use to begin and refine your search process. You will be asked to include a list of 5 to 10 keywords with your manuscript so listing them as you search will be helpful later when you are ready to upload your manuscript. For ANC we use the American Medical Association guidelines for referencing so it will be important to keep track of all the referencing information as you go so you do not need to go back later and hunt for the article where you found important information you plan to use in your manuscript.4 Although ANC has a standard structured abstract format that comes at the beginning of a manuscript, most authors find it is easiest to write the abstract last. We will talk about the abstract later in this editorial. However, if you have difficulty thinking about the structure for your manuscript, the headings we require in the abstract can be a good place to begin. Then you can add subheadings within each of the areas to guide the reader.
The first section of a Clinical Issues in Neonatal Care manuscript is the introduction or background. This is an important section because if it is poorly written, the reader will stop before getting to the real message of the manuscript. Depending on the purpose of the manuscript, you could begin this section in several different ways. A good way to decide how to begin is go to previous issues of the journal and look at articles already published in this section. Find 1 that is similar to what you plan for your manuscript and use it as a way to outline your manuscript. You could also begin by discussing the topic in terms of a clinical situation or assessment findings so the reader will quickly relate to the topic from his or her own clinical encounters. This is a section where you might want to include statistics to demonstrate the importance of the clinical topic and how often it might be encountered in the clinical arena.2
Holzmueller and Pronovost5 provide a great overview for how best to organize a manuscript related to quality improvement or patient safety projects. They recommend using the SQUIRE guidelines, which we also recommend for manuscripts of this type.6 Systematic and integrative reviews are also common types of manuscripts included in the Clinical Issues in Neonatal Care section of ANC, and for these manuscripts we require the use of the PRISMA guidelines, which can be found at http://www.prisma-statement.org/statement.htm. PRISMA provides a discrete step-by-step approach to the reporting of the review process,7,8 particularly the search process and how the reporting of the results are outlined so that readers can see the objective way the overall manuscript and the findings have been developed.
If the manuscript is about a disease process or clinical situation, the sections within the results/findings heading provide information about what, how, when, where, and why. An interesting way to outline these areas within your manuscript is to begin each paragraph with a question and then provide the answer in that paragraph or in the next few paragraphs.
Clinical Issues in Neonatal Care manuscripts are typically 10 to 12 pages (double spaced, not including abstract, references, and title page). Systematic and integrative reviews are typically longer and could be as many as 18 pages. Right now ANC does not have strict page limits in place; however, we may be considering changes in the future so please check the author guidelines again as you finish your manuscript to ensure no changes have occurred since you first reviewed them.
Do not forget that adding tables, pictures, and figures adds appeal for readers. If you have a picture to include, you will need permission from the people in the picture and you will need to remove any identifying information (eg, anything with a name must not be visible like armbands and bed cards). If you do not have pictures but have an idea about a picture that would enhance your manuscript, please let us know in your manuscript cover letter so we can try to recruit a suitable image. We now require that you include 1 table titled Summary of Recommendations for Practice and Research using these headings—(1) what we know, (2) what needs to be studied, and (3) what we can do today. See the ANC general author guidelines for details. Additional tables that support the topic may include summary of studies, key recommendations for practice, or sample protocols. Remember as you are browsing through the journal that tables and figures are often what make readers stop and read a manuscript.
A section within a Clinical Issues in Neonatal Care manuscript that can sometimes get looked over in development is implications for families. No matter the clinical issue or disease process, there are always implications for families and these need to be addressed in your manuscript. For example, what are the short- and long-term effects of the disease process? What information does the family need or how best can you explain this disease process in terms that the family will easily understand? What decisions will the family need to make and how will nurses best support them in the process? What will the needs of the infant be after discharge and what resources will the family need to obtain to support their infant? Considering the family in all areas of neonatal nursing care sends the message to everyone caring for high-risk infants that families are vitally important to the overall outcomes of the infants.
Now that your manuscript is beginning to come together, this is a good time to discuss the abstract. Abstracts for ANC are 250 words or less and have standard format with structured headings. The Background section usually contains a sentence or 2 about why this topic is important. This might be the issue or concern that motivated you to write the manuscript in the first place. Next is the Purpose section. In this section, you outline in a purpose statement the knowledge that the reader will gain from reading the manuscript. What is the overall driving objective for the work? The next section of the abstract is the Methods/Search Strategy section. This is usually 1 to 2 sentences about the manuscript structure you chose to portray your finding. For example, this will be different if it is a concept analysis as opposed to an integrative review. The Findings/Results section comes next and includes what you found in the literature. Findings could be grouped into central themes or ideas. Again, the sentence you use in the abstract provides the most critical or high points of those included in your manuscript. Implications for Practice is the next section of the abstract. This section tells the reader what recommendations you are providing that will help to guide their practice. Include in the section the important takeaway points you feel are important for decision making. Last in the abstract is the Implications for Research section. In this section, make recommendations for what still needs to be studied about your topic. Where do the gaps exist in our understanding of the topic and what still needs to more thoroughly explored? Begin the abstract by writing at least 1 sentence for each of the 6 sections and then add content as the 250 word limit allows. Typically, the background, purpose, and methods sections should be more succinct to allow for more detail in the results and implications for practice/research sections.
Now is also a good time to talk about the title of your manuscript. The title is important because it tells readers in a concise, deliberate way what they will find in the article. You want the title to be enticing to readers but not so cliché that they may misunderstand the purpose of the article. Titles are important. Think about other articles you have read. Did the title always help you understand the manuscript? Did you sometimes read the title and get excited that this article was exactly what you were looking for only to discover that was not the case when you read the article? That is what you want to avoid, so be careful in choosing a title.
Please do not be afraid of the writing process; we are here to help you through this journey. If you need mentorship through the process, consider looking to an expert or mentor on your unit or at a nearby university. If you do not find the mentorship you are seeking nearby, please let us know. We will put you in contact with 1 of our editorial board members to help guide you through the writing process. We want you to be successful so please have an outline of your idea and the type of manuscript you are planning to write developed. When you contact us, please share your questions openly—there are no “dumb” questions. Please refer often to our author guidelines during the writing process. Details for how best to submit a manuscript for the Clinical Issues in Neonatal Care section are outlined within the author guidelines. Finally, it is important to remember that ANC is a 4-color journal, so please submit full-color tables, graphs, and pictures to enhance the readability of your manuscript. During the editorial process we will do everything we can to facilitate and enhance your work. We will make recommendations that we believe will increase its scholarly application to improving neonatal care and outcomes. Revisions are often requested. After peer review, the section editor and coeditors will review the manuscript well in advance of the production deadline and provide additional feedback as needed. The end goal is excellent presentation of materials for our readers.
If you are a reviewer for ANC, the next time you are asked to review a Clinical Issues in Neonatal Care manuscript, please consider the quality of the manuscript in relationship to guiding clinical care at the bedside and make recommendations to improve the manuscript so that staff nurses will best relate to the content. Do not be afraid to make recommendations about missing content or suggestions about ways to enhance the content and make it easier for clinicians to understand. Help us and the authors to increase their creativity and enhance their work. We want ANC to be the best clinical and research journal in neonatal care with articles of all styles that help us to enhance our caregiving and patient outcomes!
Thank you for your support,
Jacqueline M. McGrath, PhD, RN, FNAP, FAAN
Coeditor; Advances in Neonatal Care
Debra Brandon, PhD, RN, CCNS, FAAN
Coeditor; Advances in Neonatal Care
2. Oerman MH. Writing for Publication in Nursing: Chapter 7—Clinical Practice Articles and other Types of Writing. Philadelphia, PA: Lippincott; 2002: 145–168.
3. McGrath JM, Brown RE, (Abou) Samra H. Before you search the literature: how to prepare and get the most out of citation databases. Newb Infant Nurs Rev. 2012;12(3):162–170.
4. JAMA and Archive Journals. AMA Manual of Style: A Guide for Authors and Editors, 10th ed. New York, NY: Oxford University Press; 2007.
5. Holzmueller CG, Pronovost PJ. Organising a manuscript reporting quality improvement or patient safety research. BMJ Qual Saf. 2013;22:777–785.
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7. Moher D, Liberati A, Tetzlaff J, Altman DG The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(6):e1000097. doi:10.1371/journal.pmed1000097.
8. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100. doi:10.1371/journal.pmed.1000100.