An Introduction to Evidence-Based Practice Lulu Rosales, RN, BSN May 8 th , 2007

Objectives: Define Evidence-Based Practice (EBP). Recognizing the barriers to EBP. Breaking barriers with education. How EBP and the Nursing Process relate. Questions and initial staff survey.

Define Evidence-Based Practice (EBP).

Recognizing the barriers to EBP.

Breaking barriers with education.

How EBP and the Nursing Process relate.

Questions and initial staff survey.

Definitions: EBP is a “problem-solving approach that incorporates the best available scientific evidence, clinicians’ expertise, and patients’ preference and values.” (Fineout-Overhold, 2005) The Institute of Medicine (IOM) identifies EBP as crucial in closing the quality chasm . The intended effect of EBP is to standardize healthcare practices to science and best evidence to reduce illogical variation in care, which leads to unpredictable health outcomes.

EBP is a “problem-solving approach that incorporates the best available scientific evidence, clinicians’ expertise, and patients’ preference and values.” (Fineout-Overhold, 2005)

The Institute of Medicine (IOM) identifies EBP as crucial in closing the quality chasm .

The intended effect of EBP is to standardize healthcare practices to science and best evidence to reduce illogical variation in care, which leads to unpredictable health outcomes.

Definitions: Quality Chasm described by the IOM as what we know to be best healthcare and what is actually practiced. (Stevens, 2006) Institute of Medicine non-profit organization specifically created to provide unbiased, evidence-based, and authoritative information and advice concerning health and science policy to policy-makers, professionals, health care leaders, and the public at large. (IOM website)

Quality Chasm described by the IOM as what we know to be best healthcare and what is actually practiced. (Stevens, 2006)

Institute of Medicine non-profit organization specifically created to provide unbiased, evidence-based, and authoritative information and advice concerning health and science policy to policy-makers, professionals, health care leaders, and the public at large. (IOM website)

Other Facts: Although literature documents the significant importance of evidence based nursing practice, data suggest that 85% of current practice is not scientifically validated. (Shirey, 2006) Understanding the importance of evidence is crucial for meeting the excellence requirements of Magnet designation.

Although literature documents the significant importance of evidence based nursing practice, data suggest that 85% of current practice is not scientifically validated. (Shirey, 2006)

Understanding the importance of evidence is crucial for meeting the excellence requirements of Magnet designation.

Barriers to EBP Limited time to access, critique and apply the data. Nurses who believe in the value of EBP to improve patient care and outcomes often do not have the knowledge to use EBP. Lack of confidence or skill to use EBP and a feeling that the articles are hard to read and apply to practice. (Vratny, 2007)

Limited time to access, critique and apply the data.

Nurses who believe in the value of EBP to improve patient care and outcomes often do not have the knowledge to use EBP.

Lack of confidence or skill to use EBP and a feeling that the articles are hard to read and apply to practice.

Breaking Barriers Nurses can and need to learn how to find and evaluate research. Regular education programs to understand research and the 5 steps involved in EBP. As a result increase knowledge of EBP will help to develop confidence in practice and in communication of practice issues. (Vratny, 2007)

Nurses can and need to learn how to find and evaluate research.

Regular education programs to understand research and the 5 steps involved in EBP.

As a result increase knowledge of EBP will help to develop confidence in practice and in communication of practice issues.

Evaluate effectiveness Evaluate effectiveness Evaluate pt progress Evaluation Integrate evidence with clinical expertise Applying evidence to practice Initiate interventions Implementation Critically appraises literature Analyzing the evidence to practice Develop plan of care Planning Organizes literature review Summarizing the evidence Determine/prioritize pt goals Outcome ID Collects data relevant to pt’s problems/needs Searching for Evidence Analyze data determine Nsg Dx Diagnosis Clear ID of pt problems/needs Asking the Question Collect Data Assessment Action EBP Action Nursing Process

Summary: The fruits of EBP include quality patient care and outcomes, clinical excellence, cost-effectiveness, professional growth, and empowerment of staff. Being involved with EBP process helps nurses feel more in control of their practice which in turn leads to empowerment. Empowerment is essential in making nurses feel they have autonomy of practice. EBP will allow staff to be able to communicate with confidence as they speak to the evidence that supports their practice, therefore assisting with job satisfaction and retention.

The fruits of EBP include quality patient care and outcomes, clinical excellence, cost-effectiveness, professional growth, and empowerment of staff.

Being involved with EBP process helps nurses feel more in control of their practice which in turn leads to empowerment.

Empowerment is essential in making nurses feel they have autonomy of practice.

EBP will allow staff to be able to communicate with confidence as they speak to the evidence that supports their practice, therefore assisting with job satisfaction and retention.

References: Vratny, A. (2007). A conceptual model for growing evidence- based practice. Nursing Administration Quarterly. 31(2): 162- 170. Shirey, M.R. (2006). Evidence-based practice: how leaders can facilitate innovation. Nursing Administration Quarterly. 30(3): 252-265. Stevens, K.R. (2006). The quality chasm reports, evidence-based practice, and nursing’s response to improve healthcare. Nurse Outlook. 54: 94-101. Fineout-Overholt, E. (2005). Strategies for advancing evidence-based practice in clinical settings. Journal of New York State Nurses Association. 35(2): 28-32.

Vratny, A. (2007). A conceptual model for growing evidence-

based practice. Nursing Administration Quarterly. 31(2): 162-

170.

Shirey, M.R. (2006). Evidence-based practice: how leaders can facilitate innovation. Nursing Administration Quarterly. 30(3):

252-265.

Stevens, K.R. (2006). The quality chasm reports, evidence-based practice, and nursing’s response to improve healthcare. Nurse Outlook. 54: 94-101.

Fineout-Overholt, E. (2005). Strategies for advancing evidence-based practice in clinical settings. Journal of New York State Nurses Association. 35(2): 28-32.

Survey/Questions 1.) Would you be interested in attending a 30 min – 1hour tutorial on how to access clinical journals online? Yes No 2.) If CEU’s were offered and light refreshments were served? Yes No 3.) If interested in attending a tutorial session please provide your email /contact information below: ____________________________ 4.) On a scale of 1-10 (1= least satisfied 10= extremely satisfied), how would you rate current methods/styles of change of shift report? 5.) How satisfied are you with the amount of information you obtain during change of shift reports? (Same scale as above) 6.) How often do you feel you receive inadequate change of shift report (missing information, important problems, loss of focus)? 1= not very often 10= all the time (scale of 1-10)

1.) Would you be interested in attending a 30 min – 1hour tutorial on how to access clinical journals online?

Yes No

2.) If CEU’s were offered and light refreshments were served?

Yes No

3.) If interested in attending a tutorial session please provide your email /contact information below:

____________________________

4.) On a scale of 1-10 (1= least satisfied 10= extremely satisfied), how would you rate current methods/styles of change of shift report?

5.) How satisfied are you with the amount of information you obtain during change of shift reports? (Same scale as above)

6.) How often do you feel you receive inadequate change of shift report (missing information, important problems, loss of focus)?

1= not very often 10= all the time (scale of 1-10)