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(Evidence-Based Practice in Nursing and Health Care) 2nd Collegiate Nursing Research Congress
Objectives
At the end of the presentation, the participants will be able to: Explain the role of developing best practices vis--vis evidence-based practice visevidencein patient care outcomes in the context of research; Appreciate role of EBP in individual, organizational and community dynamics.
Community-Engaged Teaching, Research and Service Scholarship in discovery, integration, application and teaching.
Practice-based research Communitybased learning
Research
Teaching
CommunityEngaged
Community/communityoriented service Academic community practice
Service
Systematic inquiry designed to develop knowledge about issues of importance to the nursing profession It is a diligent, systematic inquiry or study that validates and refines existing knowledge and develops new knowledge; indicates planning, organization and persistence. The ultimate goal of research is the development of a research body of knowledge for a discipline or profession, such as nursing.
Nursing is a practice profession, thus research is essential to develop and refine knowledge that can be used to improve clinical practice. Professional Nurses need to be able to: - read research reports, - identify effective interventions for practice, and - implement these interventions to promote positive outcomes for patients and families
BSN: Critique research findings for use in practice; use research findings in practice MSN/MAN: Collaborate in research projects; provide clinical expertise for research PhD: Develop nursing knowledge through research and theory development; conduct funded independent research projects PostDoc: PostDoc: Develop and coordinate funded research programs
Knowledge is essential information acquired in a variety of ways, expected to be accurate reflection of reality, and incorporated and used to direct a persons actions. The quality of nursing practice depends on the quality of the knowledge that you acquired.
Traditions Authority Borrowing Trial and Error Personal Experience (Novice, advanced beginner, competent, proficient, expert) Role Modeling (mentorship) Intuition Reasoning (Inductive vs. Deductive)
For nursing as a discipline to be effective in research, the focus of research-directed activity researchshould be creating a culture
As practitioners of a discipline, nurses must perceive that research is important in developing evidenceevidence-based nursing practice in all settings and specialties.
Developing Best Practices for the Nursing Profession through Research: Building an Evidence-Based Practice
From best evidence to best practice: effective implementation of change in patients care
Richard Grol, Jeremy Grimshaw Grol,
A best practice is a technique, technique, method, process, activity, incentive, or reward which conventional wisdom regards as more effective at delivering a particular outcome than any other technique, method, process, etc. when applied to a particular condition or circumstance.
A
practice in which the clinician is aware of the evidence that bears on her/his clinical practice, and the strength of that evidence
an approach to decision making in which the clinician uses the best evidence available, in consultation with patient, to decide upon the option which suits that patient best
Each nurse possesses, through basic education and continuing learning, knowledge relevant to her/his professional practice
Seeking and reviewing research in nursing, health sciences and related disciplines Using research to inform practice/professional service
Ensuring practice is based in theory and evidence and meets all relevant standards/guidelines Assessing/describing the client situation using a theory, framework or evidence-based tool evidenceManaging multiple nursing interventions simultaneously
Evaluating/describing the outcome of specific interventions and modifying the plan/approach Integrating research findings into professional service and practice
2. Link
Problem, interventions, outcomes
3.Synthesize 3.
Best evidence
4. Design
Practice change
5.Implement
& evaluate change in practice
6.Integrate &
Maintain change in practice
Include stakeholders Collect internal data about current practice Compare internal data with external data Identify problem
Use standardized classification systems and language Identify potential interventions and activities Select outcomes indicators
Search research literature related to major variables Critique and weigh evidence Synthesize best evidence Assess feasibility, benefits and risks
Define proposed change Identify needed resources Plan implementation process Define outcomes
Pilot study demonstration Evaluate process and outcome Decide to adapt, adopt, or reject practice change
Communicate recommended change to stakeholders Present staff in service education on change in practice Integrate into standards of practice Monitor process and outcomes
Rosswurm, M. A. & Larrabee, J. H. (1999). A model for change to evidence-based practice. Image: Journal of Nursing Scholarship, 31(4), 317-322. doi: 10.1111/j.1547-5069.1999.tb00510.x
Evidence Pyramid
Make decisions about patient care Implement proven and accepted best practice Utilize to its maximum available resources Advance profession, enhance quality of life and learning, keep practice up-toup-todate and current
Reasons why Best Practices and EBP is taking too long to take root
Attitudes: lack of value for research Presence of other goals with higher priorities: money, leadership gradient Huge gap between information literacy and computer skills Limited access to high quality information resources (whats going on with the rest of the world?)
The Tasks-at Hand for the Tasksdeveloping best practice and EBP
Obtain knowledge and skills Disseminating that EBP improves care and outcomes Believing in the ability to foment change in the front line among healthcare practitioners Developing mentorship and practice
Gain
administrative and organizational buy-in in order buyto be able to change policy where it is identified and needed common terms and processes to make EBP one of the global languages of nursing
Develop
A Global Language
Congratulations ! You are doing your share towards developing best practices and evidence basedbased-practice.
References
1. Ackley B, Ladwick G, Swan B, Tucker S. Evidence-Based EvidenceNursing Care guidelines, Medical- Surgical Interventions. MedicalMosby Elsevier St Louis Missouri, 2008. 2. Fineout-Overholt E, Melnyk B. Building a culture of best Fineoutpractice. Nurse Leader. 3:6, Dec 2005, pp 26-30 263. Polit, D.F and Beck, C.T. Nursing Research: Generating Polit, and Assessing Evidence for Nursing Practice. Lippincott Williams and Wilkins, USA. 2008