BOOK
Integrating Evidence into Practice for Impact, An Issue of Nursing Clinics of North America, E-Book
(2014)
Additional Information
Book Details
Abstract
This issue begins with an overview that distinguishes evidence-based practice (EBP) and translation science, followed by a description of Hawaii’s statewide EBP program that uses active and multifaceted translation science strategies to facilitate the rate and extent of adoption of EBP changes. With one exception, the remaining articles describe individual EBP projects from five different health care facilities that used the Iowa Model to guide their work. Each article includes an evidence summary, a description of implementation strategies, an evaluation of the innovation, and lessons learned. These completed projects were initiated between 2009 and 2012, address a variety of topical nursing issues, and, for the most part, focus on preventing complications (ie, blood sugar elevations, increased lengths of stay, extubation failures, noise-related injury, pain, surgical site infections, pneumonia, restraint use, delirium, and fever). An additional article describes the use of evidence to inform simulation-based learning, a possible strategy for ensuring competencies in and compliance with EBP interventions. Nursing leaders will come away with solid information about utilizing EBP to improve patient outcomes. The Hawaii program demonstrates that health care quality can be realized by employing the best available evidence and empowering the nursing workforce. It also offers a glimpse of the care that the future nursing workforce could provide to create a health system that provides accessible, affordable and quality care to everyone in the United States.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Integrating Evidenceinto Practice for Impact | i | ||
| Copyright | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Nursing Clinics of\rNorth America | xi | ||
| Foreword | xiii | ||
| Preface | xv | ||
| Overview of Evidence-based Practice and Translation Science | 269 | ||
| Key points | 269 | ||
| Evidence-based practice and translation science | 269 | ||
| The National Nursing Practice Network | 270 | ||
| Nursing leadership in EBP and translation science | 271 | ||
| Summary | 271 | ||
| References | 272 | ||
| Hawaii's Statewide Evidence-based Practice Program | 275 | ||
| Key points | 275 | ||
| Introduction | 275 | ||
| Evidence for practice improvement | 276 | ||
| Implementation strategies | 276 | ||
| The Innovation | 276 | ||
| Annual workshop | 276 | ||
| Internship program | 277 | ||
| Curricular revisions | 277 | ||
| Attributes or Characteristics of the Innovation | 277 | ||
| Relative advantage | 277 | ||
| Compatibility | 279 | ||
| Complexity | 279 | ||
| Ability to be trialed | 280 | ||
| Observability | 280 | ||
| Communication Channels or Processes | 280 | ||
| Interpersonal channels | 280 | ||
| Mass media channels | 280 | ||
| Social Systems | 281 | ||
| Communication structure | 281 | ||
| System norms | 282 | ||
| Opinion leaders and change champions | 282 | ||
| Consequences of innovation | 284 | ||
| Users of the Innovation | 284 | ||
| Evaluation | 284 | ||
| Rate and Extent of Adoption | 284 | ||
| Knowledge | 285 | ||
| Persuasion | 285 | ||
| Decision | 285 | ||
| Implementation | 285 | ||
| Confirmation | 285 | ||
| Lessons learned and recommendations for others | 287 | ||
| Projects Across Institutions and Units | 287 | ||
| Organizational Barriers | 287 | ||
| User Barriers | 287 | ||
| Summary | 288 | ||
| Acknowledgments | 288 | ||
| References | 288 | ||
| Part I: Triggers for an Evidence Based Practice Project | 291 | ||
| Key points | 291 | ||
| Introduction/background | 291 | ||
| Setting | 292 | ||
| Evidence for practice improvement | 293 | ||
| Identification of the Opportunity | 293 | ||
| Methods | 295 | ||
| Design | 295 | ||
| Sample | 295 | ||
| Procedure | 295 | ||
| Analysis | 295 | ||
| Results | 295 | ||
| Discussion | 296 | ||
| Summary | 297 | ||
| References | 298 | ||
| Part II: Managing Perioperative Hyperglycemia in Total Hip and Knee Replacement Surgeries | 299 | ||
| Key points | 299 | ||
| Introduction | 299 | ||
| Triggers | 300 | ||
| Form a Team | 300 | ||
| Evidence for practice improvement | 302 | ||
| Assemble Relevant Literature | 302 | ||
| Critique and Synthesize Research | 302 | ||
| Implementation strategies | 303 | ||
| Pilot the Change in Practice | 303 | ||
| Evaluation | 305 | ||
| Staff | 305 | ||
| Impact of Practice Change | 305 | ||
| Lessons learned/recommendations | 306 | ||
| Dissemination | 307 | ||
| Summary | 307 | ||
| Acknowledgments | 307 | ||
| References | 307 | ||
| Decreasing Inpatient Length of Stay at a Military Medical Treatment Facility | 309 | ||
| Key points | 309 | ||
| Introduction | 309 | ||
| Evidence for practice improvement | 310 | ||
| Staff Perspective | 311 | ||
| Administrative Priorities | 311 | ||
| Implementation strategies | 312 | ||
| Discharge-Planning Meeting | 312 | ||
| Documentation | 312 | ||
| Discharge Advocate | 312 | ||
| Changing the Culture | 313 | ||
| Evaluation | 313 | ||
| Length of Stay | 314 | ||
| Cost Savings | 314 | ||
| Discharge Advocate Revisions | 315 | ||
| Barriers to Discharge | 315 | ||
| Impact on Nursing Staff | 316 | ||
| Lessons learned and recommendations | 316 | ||
| Challenges | 316 | ||
| Institutional Changes | 316 | ||
| Pilot Phase | 317 | ||
| Other Recommendations | 317 | ||
| Summary | 317 | ||
| Acknowledgments | 317 | ||
| References | 318 | ||
| Appendix 1 | 318 | ||
| Preventing Extubation Failures in a Pediatric Intensive Care Unit | 321 | ||
| Key points | 321 | ||
| Introduction | 321 | ||
| Evidence for practice improvement | 322 | ||
| Critiquing and Synthesizing the Literature | 322 | ||
| Implementation strategies | 323 | ||
| Identifying the Stakeholders and Recognizing Triggers | 323 | ||
| Implementing Evidence into Practice | 324 | ||
| Evaluation | 326 | ||
| Recommendations and lessons learned | 327 | ||
| Summary | 327 | ||
| References | 328 | ||
| Shhh… I’m Growing: Noise in the NICU | 329 | ||
| Key points | 329 | ||
| Introduction | 329 | ||
| Organizational priority and form a team | 330 | ||
| Evidence for practice improvement | 330 | ||
| Literature review | 330 | ||
| Recommended Safe Sound Levels | 332 | ||
| Noise Exposure Linked to Developmental Outcomes | 332 | ||
| Methods of Sound Level Measurement | 332 | ||
| Associated Operational and Structural Causes of Noise | 333 | ||
| Implementation strategies | 333 | ||
| Outcomes to Be Achieved | 333 | ||
| Project: Phase 1, Baseline Data | 333 | ||
| Step 1 | 333 | ||
| Step 2 | 333 | ||
| Step 3 | 334 | ||
| Step 4 | 335 | ||
| Project: Phase 2, Developing and Implementing the Guideline | 336 | ||
| Quiet Time Guidelines | 338 | ||
| Open-Bay NICU | 339 | ||
| SFRs | 339 | ||
| Evaluation | 340 | ||
| Lessons learned | 341 | ||
| Recommendations | 342 | ||
| Summary | 343 | ||
| Acknowledgments | 343 | ||
| References | 343 | ||
| Evidence-Based Practice for Pain Identification in Cognitively Impaired Nursing Home Residents | 345 | ||
| Key points | 345 | ||
| Introduction | 345 | ||
| Evidence for practice improvement | 346 | ||
| Implementation strategies | 350 | ||
| Evaluation | 352 | ||
| Lessons learned/recommendations | 353 | ||
| Summary | 355 | ||
| References | 355 | ||
| Pulmonary Management of the Acute Cervical Spinal Cord Injured Patients | 357 | ||
| Key points | 357 | ||
| Introduction | 357 | ||
| Background | 357 | ||
| Triggers | 358 | ||
| Forming a Team | 358 | ||
| Evidence for practice improvement | 359 | ||
| Literature Review | 359 | ||
| Literature Critique | 359 | ||
| Invasive versus noninvasive ventilation | 359 | ||
| Prevention of atelectasis and pneumonia | 360 | ||
| Secretion management | 360 | ||
| Surgery | 361 | ||
| Tracheostomy | 362 | ||
| Activity/Mobility | 362 | ||
| Speech and swallow | 363 | ||
| Practice Recommendations | 363 | ||
| Implementation strategies | 363 | ||
| Piloting and Instituting the Practice Change | 363 | ||
| Baseline data and outcomes | 363 | ||
| Guideline development | 363 | ||
| Guideline implementation | 365 | ||
| Education and marketing | 365 | ||
| Evaluation | 365 | ||
| Monitor and Analyze Structures | 365 | ||
| Outcomes | 365 | ||
| Lessons learned | 366 | ||
| Instituting the Practice Change | 366 | ||
| Summary | 367 | ||
| Acknowledgments | 368 | ||
| References | 368 | ||
| Reducing Restraint Use in a Trauma Center Emergency Room | 371 | ||
| Key points | 371 | ||
| Introduction | 371 | ||
| Evidence for practice improvement | 372 | ||
| Triggers | 372 | ||
| Organizational priority | 373 | ||
| Forming a team | 373 | ||
| Assemble relevant literature | 373 | ||
| Critique and synthesis of literature | 373 | ||
| Analysis | 374 | ||
| Practice Analysis | 374 | ||
| Environment Analysis | 375 | ||
| Outcomes to be achieved | 375 | ||
| Implementation strategies | 375 | ||
| Education | 375 | ||
| Pilot | 375 | ||
| Environment | 376 | ||
| Data | 376 | ||
| Documentation Audits | 377 | ||
| Data Collection | 377 | ||
| Evaluation | 377 | ||
| Staff | 377 | ||
| Number of Episodes | 377 | ||
| Restraint/Seclusion Hours | 378 | ||
| Restraint Nursing-Sensitive Indicator | 379 | ||
| Lessons learned | 379 | ||
| Leadership | 379 | ||
| Analysis | 379 | ||
| Data Transparency | 380 | ||
| Stakeholder | 380 | ||
| Providers | 380 | ||
| Summary | 380 | ||
| References | 381 | ||
| Promoting Sleep in the Adult Surgical Intensive Care Unit Patients to Prevent Delirium | 383 | ||
| Key points | 383 | ||
| Introduction | 383 | ||
| Triggers | 384 | ||
| Organizational Priority | 385 | ||
| Formation of a Team | 385 | ||
| Evidence for practice improvement | 386 | ||
| Assemble Relevant Research | 386 | ||
| Critique and Synthesize Research | 386 | ||
| Implementation strategies | 388 | ||
| Outcomes to be Achieved | 388 | ||
| Baseline Data | 388 | ||
| Design the EBP Guideline | 388 | ||
| Implement EBP | 388 | ||
| Evaluation | 391 | ||
| Lessons learned and recommendations for others | 395 | ||
| Summary | 396 | ||
| Acknowledgments | 396 | ||
| References | 396 | ||
| Normothermia for NeuroProtection | 399 | ||
| Key points | 399 | ||
| Introduction | 399 | ||
| Evidence for practice improvement | 400 | ||
| Knowledge and Problem Triggers | 400 | ||
| Forming a Team | 401 | ||
| Assemble, Critique, and Synthesize Literature | 401 | ||
| High incidence of fever | 401 | ||
| Nursing management | 402 | ||
| Normothermia recommended | 402 | ||
| Sufficient evidence | 402 | ||
| Implementation strategies | 402 | ||
| Development of the EBP Guideline | 402 | ||
| Impact of Shivering | 404 | ||
| Educational Strategies and Marketing | 405 | ||
| Evaluation | 407 | ||
| Monitoring Practice Change | 407 | ||
| Nursing Compliance | 408 | ||
| Lessons learned | 408 | ||
| What Worked? | 408 | ||
| What Were the Challenges? | 409 | ||
| Recommendations | 410 | ||
| Summary | 411 | ||
| Acknowledgments | 411 | ||
| References | 411 | ||
| Improving Pain Management in Orthopedic Surgical Patients with Opioid Tolerance | 415 | ||
| Key points | 415 | ||
| Introduction | 415 | ||
| Evidence-based practice model | 416 | ||
| Triggers | 416 | ||
| Organizational Priority | 416 | ||
| Form a Team | 416 | ||
| Evidence for practice improvement | 417 | ||
| Literature Search | 417 | ||
| Literature Synthesis | 417 | ||
| Baseline Data | 418 | ||
| Implementation strategies | 418 | ||
| Preoperative Phase | 418 | ||
| Intraoperative Phase | 419 | ||
| Postoperative Phase | 421 | ||
| Evaluation | 423 | ||
| Lessons learned and recommendations | 427 | ||
| Summary | 428 | ||
| Acknowledgments | 428 | ||
| References | 429 | ||
| A Simulation Model for Improving Learner and Health Outcomes | 431 | ||
| Key points | 431 | ||
| Background | 432 | ||
| Model development | 433 | ||
| Learning event | 433 | ||
| Active engagement | 434 | ||
| Debriefing | 435 | ||
| Learner outcomes | 435 | ||
| Health outcomes | 436 | ||
| Exemplar | 437 | ||
| Summary | 437 | ||
| References | 437 | ||
| Index | 441 |