Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

Evidence-Based Practice New Grad Cohort Class

No description
by

Kristy Gorman

on 15 September 2016

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Evidence-Based Practice New Grad Cohort Class

Conclusion
And one more thing...
is here
Improves care on the unit, department
No intent to publish, present
Not rigorous methods, care as usual
Systematic, Rigorous methods
Develop, Refine knowledge
Plan to share findings
Nursing Best Practice
Process/Quality Improvement
Nursing Evidence-Based Practice at UMMC
Three ways to answer clinical questions
Process/Quality Improvement
Nursing Research
Evidence-Based Practice
PDSA
Plan:
Prevent future falls by improved communication and awareness of fall rates and contributing factors

Do:
Implement the Falls Tracking Board on C5E

Study:
Audit fall rates and tracking board compliance

Act/Adjust:
Fall rates decreased on C5E. Falls Tracking Board implemented on every unit
Nursing Research
Gum Chewing Study
Use of chewing gum in reducing postop ileus after colorectal resection for traumatic injury.

RCT
Gum chewing tid x 15 minutes
Bracelet tid x 15 minutes
Usual care
Evidence-based Practice
Systematic Review of Evidence
Critical Appraisal of Evidence
Best Evidence to Improve Care
Post-op Voiding Protocol
Prewarming prior to Surgery
The EBP Process
Practice
Question
Review the
Evidence
Translate into
Practice
UMMC EBP Continuum
Consumer
Producer
Participates in journal clubs.
Participates in appraising evidence.
Uses established EBP guidelines in patient care.
Assumes leadership role of an EBP team.
Responsible for locating, appraising and rating the evidence.
Recommend changes in care based on the strength of the evidence.
CNI
CNII
SCNI
SCNII
UMMC Support for EBP
Nursing Research Council
Journal Clubs
Nursing Grand Rounds
Clinical Practice Summits
Education Sessions
http://intra.umms.org/ummc/nursing/cppd/research/events
Access to HS/HSL library using hospital ID
Hopkins EBP model to guide actions
PAM novice-to-expert behaviors
Librarian
Nursing Research Council
Clinical Practice & Professional Development (CPPD)
Division-wide teams (Directors, managers, SCN I’s & SCN II’s)
Advanced Practice Nurses
Director of Nursing Research
Director of Translation to Nursing Practice
Director of Outcomes for Nursing and Patient Care Services
People
Processes
Structures
The Practice Question
Problem-Focused
Safety/risk management concerns
Unsatisfactory patient outcomes
Wide variations in practice
Significant financial or cost concerns
Differences between hospital and community practice
Procedures, processes that waste time
Practices with no scientific basis
APN competency in first year of practice
RN turnover within first year of practice

Knowledge-Focused
New evidence, changes to guidelines, new information from professional organizations
Origins of EBP Questions
Nurse Sensitive
Quality Indicators
NSQI
Hospital Acquired Pressure ulcers
Patient falls
Restraint Use
Pain management
VAP
CLABSI
CAUTI
Patient Satisfaction
Role Satisfaction
PICO =
An Answerable
Question

P
Patient, Population, Problem
Patient
Nurse (staff issues)
Age
Gender
Specific clinical population
i.e. intraabdominal hypertension
I
Intervention
C
Another treatment/intervention
Gold standard (Not always available)
Placebo
Usual practice
May not always be a comparison
Comparison
O
Outcome
Quality of life
Improved treatment outcome
Decreased rate of adverse events
Improved patient safety
Decreased cost
Improved patient satisfaction
Improved nurse satisfaction
Steps for PICO development
The Burning Clinical Question
Clinical problem
FDA warning 2006
Heparin induced thrombocytopenia (HIT)
What solution should we use to flush lines? – Use PICO
Developing the PICO Question
P
atient/
p
opulation/
p
roblem
Intravenous device/ catheter/ arterial/…
All age groups?
I
ntervention of interest
Intermittent normal saline flush
C
omparison of interest
Intermittent heparin flush
O
utcome of interest
Patency of device/catheter
Decreased incidence of HIT (Secondary benefit)
What's the final question?
In adult patients, do intermittent normal saline flushes as compared to intermittent heparin flushes maintain patency of central intravenous catheters?
More examples...
"In critically ill patients and their family members, does the use of a communication protocol improve patient/family satisfaction?"

"Does the use of filter needles reduce the risk of blood stream infections compared with regular needles?"
Group Work Time
In the MICU population, what is the best practice to prevent yeast CAUTIs and reduce the overall CAUTI rate?
What are the three ways to answer clinical questions?
Guidelines for New Graduate
Nurse Resident EBP Poster Presentation
http://intra.umms.org/ummc/nursing/cppd/research/nursing-ebp/ebp-tools
No more than 5 people per group
Can work with a different cohort
Try to find 3-5 RCT's and a mix of others
Model or Guideline
Treatment
Protocol
Equipment/Supplies
Education
See Appendix B: Question Development Tool
Break up into Groups
Discuss problems on your units you would like to fix
using the EBP process
Formulate a PICO question using Appendix B
Share!
Full transcript