Butler, Eve

Prentiss, Andrea

English

Scholarly Commons@Baptist Health South Florida

Baptist Health South FloridaScholarly Commons @ Baptist Health South FloridaAll Publications12-2016Empowering Nurses Through Evidence-BasedPractice (EBP), Quality Improvement (QI), andResearchEve ButlerBaptist Health South Florida, eveb@baptisthealth.netAndrea PrentissBaptist Health South Florida, andreap@baptisthealth.netFollow this and additional works at: https://scholarlycommons.baptisthealth.net/se-all-publicationsPart of the Neurology Commons, and 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 and Prentiss, Andrea, "Empowering Nurses Through Evidence-Based Practice (EBP), Quality Improvement (QI), andResearch" (2016). All Publications. 1946.https://scholarlycommons.baptisthealth.net/se-all-publications/1946Empowering Nurses Through Evidence-Based Practice (EBP), Quality Improvement (QI), and ResearchEve Butler, PhD, RNAndrea Prentiss, PhD, RN, CNS-BC, APRN-BC, CCRNNursing and Health SciencesBaptist Health South FloridaAnnouncements and DisclosuresIn order to prevent bias, we acknowledge:We have no commercial support!Free from any conflicts of interest that could influence content. ObjectivesAs a result of this presentation, participants will be able to:Discuss differences between evidence-based practice, quality improvement, and research.Explain the challenges and rewards of conducting evidence-based practice, quality improvement, and research projectsEmpowered Cambridge Dictionary (2016) defines empowerment as something that makes you more confident and makes you feel that you are in control of your lifeConfident & in control of your  PracticeEBPQIResearchThree Ways to become Empowered in Your PracticeInstitute Of Medicine (IOM) has set a goal that by 2020, 90 percent of clinical decisions will be supported by accurate,  timely, and up-to-date clinical information, and will reflect the best available evidence.  (IOM, 2008) What is the Goal of EBP, QI, and Research?To provide care to patients that is based on scientific evidence and meets the patient’s needs…To improve clinical outcomes.Evidence-Based PracticeMicrosoft Stock PhotosEvidenced-Based PracticeDefinition– Evidence-based practice is "a total process beginning with knowing what clinical questions to ask, how to find the best practice, and how to critically appraise the evidence for validity and applicability to the particular care situation. The best evidence then must be applied by a clinician with expertise in considering the patient's unique values and needs. The final aspect of the process is evaluation of the effectiveness of care and the continual improvement of the process" (DePalma, 2000).EBP Models• John Hopkins Nursing EBP Model • Iowa Model of EBP to Improve Quality Care• Stetler Model of Research Utilization• ACE Star Model of Knowledge Transformation• Clinical Excellence Through Evidence-based Practice (CETEP) “Systematic, data-guided activities designed to bring about immediate positive changes in the delivery of health care in particular settings.” Improving the quality of care of patients is a fundamental obligation of health care providers.  The QI process involves evaluating and learning from experience.Hastings Center (2006) A systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge. 45 CFR 46.102(d)Quality Improvement ResearchQuality Improvement Research Similarities: QI & Research Involve human participantsConcerned with inquiryEngage in a process where empirical or systematic inquiry generates a question that data is designed to answerPropose outcome measures that will support proposalTesting of solutionsCritical Evaluation of the dataQI ResearchImproves performance or processes to strengthen patient care.Answers a question or hypothesis to advance general knowledgeFindings used for internal improvement. Findings contribute to generalized knowledge outside of the hospitalImplementation of established evidence-based standards.Investigates untested methods or standards.Implementation will result in direct benefitSubjects may not directly benefit from knowledge gainedFollows the plan, do, study, act cycle Follows a research design (e.g. randomization)Usually involves all or most people participating in the processInvolves a subset of the population with inclusion and exclusion criteriaQI ResearchHIPAA covers the use of protected health information for QI purposesMust get written consent from patients and identify how health information will be protectedMay make changes during the process based upon preliminary dataNo deviation from set protocol. Data is usually not analyzed until completionThe hospital agrees that it is a QI project. Project is not a risk or burden to patientsApproval from the hospital and the institutional review board (IRB) neededThe results are not initially intended to be published; may be published as a quality project.Results are expected to be published and presented outside the hospitalNot funded by an external research grant.External funding may be sought.Merrill (2015)QI- Three Components of  Health Care Quality                                  StructureResourcesProcessHow the system works/measures aspects of careOutcomeThe final product/outcomeDonabedian (1980)Reducing pressure ulcer rates: Number of RNs working Frequency of pressure ulcer risk assessment % of patients who get a pressure ulcer•State the objective of the test. •Make predictions about what will happen and why. •Develop a plan to test the change. (Who? What? When? Where? What data need to be collected?) •Carry out the test on a small scale•Document problems and unexpected observations. •Begin analysis of the data. •Complete the analysis of the data. •Compare the data to your predictions. •Summarize and reflect on what was learned. •Determine what modifications should be made. •Prepare a plan for the next test. QI ToolResearch Process• “Burning clinical QuestionResearch Ideas• Start writing literature reviewSystematic Review of Literature• Who? What? When?  Where?  How?Planning• Study design, Budget, IRB Proposal, Consent, Type of data, Data collection forms, Letters, Inclusion/exclusion, Time line, Power analysisResearch Tasks• Recruit subjects, Enroll subjects, Interventions, Follow up, Collect data, Enter data, Analyze data, Write Abstract, Write ManuscriptResearch ActivitiesHouser, J. and Bokovoy, J. (2006). Roadblocks to EBP, QI, and Research  Lack of time Lack of knowledge Lack of interestHuman resources Limited organizational/peer supportBreimaier, Halfens, & Lohrmann 2011Solomons & Spross, 2011Facilitators for EBP, PI, and ResearchAccess to InformationSufficient timeStructural availabilityHuman resourcesTeam Breimaier, Halfens, & Lohrmann 2011How to get Started?Ask a QuestionReferences Breimaier, H. E., Halfens, J. G., and Lohrmann, C. (2011).  Nurses’ wishes, knowledge, attitudes and perceived barriers on implementing research findings into practice among graduate nurses in Austria.  Journal of Clinical Nursing, 20, 1174-1756. doi: 10.1111/j.1365-2702.2010.03491.x DePalma, J. (2000). Evidence-based clinical practice guidelines. Seminars in Perioperative Nursing, 9(3), 115-120. Donabedian, A (1980). Explorations in quality assessment and monitoring. The definition of quality and approaches to its assessment. Ann Arbor, MI, Health Administration Press. “Empowerment.”  The Cambridge Dictionary, 2016.  Cambridge University Press, 2016 http://dictionary.cambridge.org/us/dictionary/english/empowering . Accessed 25 Oct. 2016. 2011.  Hastings Center Special Report. (2006).  The ethics of using QI methods to improve health care quality and safety.  Retrieved from  http://www.thehastingscenter.org/wp-content/uploads/The-Ethics-of-Using-QI-Methods.pdf Houser, J. and Bokovoy, J. (2006).  Clinical research in practice; A guide for the bedside scientist. Sudbury, MA; Jones and Bartlett. Merrill, K. C. (2015). Is this quality improvement or research?  American Nurse Today, 10(4).  Retrieved from https://americannursetoday.com/quality-improvement-research/ Solomons, N. M. and Spross J. A.  (2011).  Evidence-based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review.  Journal of Nursing Management, 19, 109-120.

Empowering Nurses Through Evidence-Based Practice (EBP), Quality Improvement (QI), and Research

https://scholarlycommons.baptisthealth.net/cgi/viewcontent.cgi?article=3136&amp;context=se-all-publications

Empowering Nurses Through Evidence-Based Practice (EBP), Quality Improvement (QI), and Research

Abstract

Similar works

Full text

Available Versions

Scholarly Commons@Baptist Health South Florida