Butler, Eve

Ojeda, Maria

Prentiss, Andrea

English

Scholarly Commons@Baptist Health South Florida

Baptist Health South FloridaScholarly Commons @ Baptist Health South FloridaAll Publications6-2016Improving Outcomes Through PerformanceImprovement, Evidence-Based Practice, orResearch: Choosing the Right RoadEve ButlerBaptist Health South Florida, eveb@baptisthealth.netMaria OjedaBaptist Health South Florida, mariaoj@baptisthealth.netAndrea PrentissBaptist Health South Florida, andreap@baptisthealth.netFollow this and additional works at: https://scholarlycommons.baptisthealth.net/se-all-publicationsPart of the Nursing CommonsThis Conference Lecture -- Open Access is brought to you for free and open access by Scholarly Commons @ Baptist Health South Florida. It has beenaccepted for inclusion in All Publications by an authorized administrator of Scholarly Commons @ Baptist Health South Florida. For moreinformation, please contact Carrief@baptisthealth.net.CitationButler, Eve; Ojeda, Maria; and Prentiss, Andrea, "Improving Outcomes Through Performance Improvement, Evidence-Based Practice,or Research: Choosing the Right Road" (2016). All Publications. 1945.https://scholarlycommons.baptisthealth.net/se-all-publications/1945E V E  B U T L E R  P H D ,  R NM A R I A O J E D A A R N P,  M S N ,  M P H ,  D N P / P H D - C ,  N P - CA N D R E A P R E N T I S S  P H D ,  R N ,  C N S - B C , A P R N - B C ,  C C R NImproving Outcomes Through Performance Improvement, Evidence-Based Practice, or Research: Choosing the Right RoadAnnouncements and DisclosuresIn order to prevent bias, we acknowledge:We have no commercial support!Free from any conflicts of interest that could influence content. To verify participation, attendance is:Verified via sign-in sheets.Recorded in Baptist Health University.To earn credit, you must:Attend the entire event.Submit an evaluation form.Achieve 80% on post-test.Return demonstrationObjectivesAt the end of this presentation, the participant should be able to: Describe methods that nurses can implement to influence patient outcomes Describe the purpose, structure and function of the Project Think Tank for Innovation in Nursing Research (PTT-INR) Define methods for communicating performance improvement, evidence based practice, and research findingsSituation at Hand Nurse’s Role Care that is important is often not delivered. Care that is delivered is often not important. (IOM, 2009) Medical errors are now the 3rd leading cause of death in the US. Loss of  reimbursement for hospital acquired conditions. The underpinning for improving outcomes is based on your knowledge of PI, EBP, and Research.Getting StartedPIResearchEBPDestinationImproved     OutcomesTo provide care to patients that is based on scientific evidence and meets the patient’s needs…To improve clinical outcomes.The goal of evidence-based practice, quality improvement and research?Evidence-based Practice“a science-to-service model of engagement of critical thinking to apply research-based evidence (scientific knowledge) and practice–based evidence (art of nursing) within the context of patient values to deliver quality, cost-sensitive care” (American Nurses Credentialing Center, 2008)Performance Improvementa systematic process for measuring and accessing the effects of change, feeding the information back into the clinical setting to make adjustments until successful results are obtained.Researcha systematic, disciplined methodology quantitative or qualitative in nature to develop, uncover, create, find, add new nursing knowledge requiring IRB approvalDefine a Research QuestionScan the LiteratureObtain Organizational Commitment and ResourcesDesign Study Determine Sampling StrategyCollect and Analyze DataApplication and Dissemination (Houser & Bokovoy, 2006)ReviewQI EBP Research Purpose Improve patient care practicesChange practice Generate new knowledgeMethod PDCAShortSimplisticArticles: Qual and QuantExpert opinionGuidelinesLengthyQualitative,Quantitative, Long, ComplexSample Unit or organizationRelated to identified populationRelated to purpose& research questionRepresentativeData collection Short termAction plan & evaluationCritical appraisal of articles Searching for best evidenceEnsure external and internal validity,trustworthinessLong termReviewQI EBP Research Human subjects No IRB unless sharing information externally Assess IRB process described in articleIRBResults Seeks to improve processes in unit and organizationSeeks to impact practiceSeeks to add new knowledgeImplications Change processesDecrease costIncrease efficiencyIncrease patient and staff safetyImprove satisfactionUse of research to impact processComprehensive understanding of issues in a phenomenonInnovative Methods for Generating IdeasProject Think TankDisseminationEBPCommunicating Your FindingsChoose the right audiencePI, EBP, or ResearchPoster presentationsPodium presentationsPublication  Go Off-Roading Hands-on technical assistance Replication guides Targeted training workshops with hands           on experienceStarts with an Abstract Snap shot of your work Follow guidelines Title Background and significance Study aims (purpose) Methods Results Discussion and implication Have another set of eyes review(Lang, 2010)Common Mistakes Doesn’t clearly link to the theme Grammatical and spelling errors Generic, not tailored to the audience Submission guidelines not followed Too long Aims, objectives and content are not clear Does not provide new information Fails to convey implications for the profession PROOFREAD, PROO FREAD, PROOFR EAD or it will be wrong with YUOR NAME   (Lang, 2010)Poster Presentation: The Visual VIEWED – not read Viewers decide in 3 seconds Emphasize main points Use one style, one LARGE font Avoid too much animation, no large blocks of text Use pictures - don’t let them use you Avoid loud, garish colors Use dark text/light background or light text/dark background Avoid Color blind combinations Red-green Blue-yellow (Lang, 2010)Podium Presentation: The Delivery Know your audience Practice, practice, practice Have someone review your presentation Arrive early Maintain eye contact Watch what you say Be aware of body language Provide handouts Finish early Remember, the purpose of a presentation is to present information — not overwhelm the audience(Lang, 2010)Publications: The Word Know your audience Review journal guidelines Hot topics Query letter References Rules of the Road Follow Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines for PI/QI Consolidated Standards of Reporting Trials (CONSORT) for research Uniform Requirements for Manuscripts Submitted to Biomedical Journals  Verify submission has not been submitted elsewhere Abstract (e.g. poster or podium) does not preclude publication of full manuscript on same content One journal at a time until decision is madeNursing and Health Sciences Research JournalNursing & Health Sciences Research Journal is a peer-reviewed, open access online journal, publishing evidence-based projects, original research relating to patient care/outcomes, performance improvement, quality and safety, cost effectiveness, improved work environments, and professional development in clinical settings.Which road will you take?The Pediatric Intensive Care Unit CNS is questioning what factors are associated with the development of occipital pressure ulcers (OPUs) in young children who had been admitted to the unit.A lit review was conducted – found minimal published studies relating to risk factors A retrospective chart review was conducted of all cases for the previous 4 years to identify factors commonly associated with the development of OPUs in this population.Medical records were reviewed and data was abstracted.Data included demographics, lab and test results, assessment data, and bed surfaces.Data was entered into a statistical program, and analyzed using logistic regression.AnswerWhich road will you take?Critical care nurses reviewed national and current best standards and guidelines for prevention of alarm fatigue and found a wide variation in their practices.  This prompted them to ask the following question:  Would implementation of an alarm bundle decrease alarm fatigue among critical care nurses?Lit review was conducted.  Similar organizations were contacted to inquire about their standards for preventing alarm fatigue.Based on their findings they made recommendations for the implementation of a bundle to prevent alarm fatigue. AnswerWhich ROAD? Hospital implemented CAUTI prevention measures (bundle)~ 5 years ago Measured and reported quarterly per unit Rates increasing last two quarters Leadership asked to provide additional education relating to bundles and documentation Individualize monitoring and accountability Rates improved slowly over next yearAnswerThoughts or Questions References American Nurses Credentialing Center. (2008). Application manual: Magnet recognition program. Silver Spring, MD: American Nurses Credentialing Center. Houser, J. & Bokovoy, J. (2006). Clinical Research In Practice: A guide for the bedside scientist (pp. 15-24).  Sudbury, Massachusetts: Jones and Bartlett. Lang, T.A. (2010). How to prepare and present a scientific poster. How to write, publish and present in the health sciences: A Guide for clinicians and laboratory researchers (pp. 289-313). Philadelphia, PA: American College of Physicians.

Improving Outcomes Through Performance Improvement, Evidence-Based Practice, or Research: Choosing the Right Road

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Improving Outcomes Through Performance Improvement, Evidence-Based Practice, or Research: Choosing the Right Road

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