Evidence-Based Practice in Action

by Mile High

Overview

One of the biggest challenges of evidence-based practice (EBP) is translating knowledge, research, and clinical expertise into action. Failure to execute EBP well is rarely due to lack of information, understanding, or experience; rather, it comes down to lack of tools and practicality for implementing EBP into care. Evidence-Based Practice in Action is a unique, application-oriented EBP resource of the latest Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care. This book offers a detailed plan to guide nurses and healthcare leaders in promoting EBP adoption and implementation. This practical, easy-to-use guide directs healthcare leaders through preparing, implementing, and evaluating any EBP process model and provides tools for topic selection, literature searches, research and evidence review, implementation, and evaluation. The authors provide comprehensive building blocks along with strategies, tools, and tips to guide individuals and teams who make the important day-to-day decisions that ultimately affect patient outcomes.

Product Details

ISBN-13:	9781940446936
Publisher:	Sigma Theta Tau International, Center for Nursing Press
Publication date:	12/01/2017
Product dimensions:	6.00(w) x 1.25(h) x 9.00(d)

About the Author

Laura Cullen, DNP, RN, FAAN, is an Evidence-Based Practice Scientist at University of Iowa (UI) Hospitals and Clinics and Adjunct Faculty at UI College of Nursing.

Kirsten Hanrahan, DNP, ARNP, CPNP-PC, is Interim Director of Nursing Research, Evidence-Based Practice, and Quality at UI Hospitals and Clinics and Adjunct Faculty at UI College of Nursing.

Michele Farrington, BSN, RN, CPHON, is a Clinical Healthcare Research Associate at UI Hospitals and Clinics.

Jennifer Deberg, OT, MLS, is a User Services Librarian at the Hardin Library for the Health Sciences at the UI Libraries.

Sharon Tucker, PhD, RN, PMHCNS-BC, FAAN, is the Grayce Sills Endowed Professor in Psychiatric-Mental Health Nursing and Director of the Translational Research Core of the new Helene Fuld Health Trust National Institute for Evidence-based Practice (EBP) in Nursing and Healthcare at The Ohio State University College of Nursing.

Charmaine Kleiber, PhD, RN, FAAN, is an Associate Research Scientist at UI Hospitals and Clinics and Associate Professor Emeritus at UI College of Nursing.

Table of Contents

Acknowledgments vi

About the Authors vii

Foreword xiii

Overview xvi

1 Identify Triggering Issues/Opportunities 3

Clinical or Patient Identified Issue 4

Organization, State, or National Initiative 4

Data or New Evidence 5

Accrediting Agency Requirements or Regulations 6

Philosophy of Care 6

Tool 8

2 State the Question or Purpose 11

Using PICO: When and How 12

Examples 15

Tools 17

3 Is This Topic a Priority? 21

Tools 25

4 Form a Team 29

Examples 32

Tools 35

5 Assemble, Appraise, and Synthesize Body of Evidence 39

Assemble 41

Appraise 45

Clinical Practice Guidelines 46

Systematic Reviews 47

Research 47

Other Literature 48

Synthesize 49

Examples 51

Tools 60

6 Is There Sufficient Evidence? 77

Strength of Evidence 78

Evidence Grade and Recommendations for Practice 80

The Decision Point 83

Evidence Is Sufficient 84

Evidence Is Not Sufficient 84

Examples 88

Tools 96

7 Design and Pilot the Practice Change 103

Engage Patients and Verify Preferences 105

Consider Resources, Constraints, and Approval 105

Develop Localized Protocol 106

Create an Evaluation Plan 107

Collect Baseline Data 107

Develop an Implementation Plan 107

Prepare Clinicians and Materials 107

Promote Adoption 108

Collect and Report Post-Pilot Data 108

Examples 109

Tools 116

8 Implementation 119

Implementation Strategies for EBP 120

Select Implementation Strategies 122

Combine Implementation Strategies 124

Examples 125

Tools 127

Phase 1 Create Awareness & Interest 135

Phase 2 Build Knowledge & Commitment 156

Phase 3 Promote Action & Adoption 207

Phase 4 Pursue Integration & Sustained Use 263

9 Evaluation 295

Baseline Data Collection 296

Sample Size 296

Sample Plan 297

Components to Evaluate 297

Knowledge Assessment 298

Perception or Attitude Assessment 299

Behavior or Practice Assessment 299

Outcomes 300

Balancing Measures 300

Patient and/or Family Feedback 300

Data Analysis and Interpretation 300

Results 301

Examples 304

Tools 315

10 Is Change Appropriate for Adoption in Practice? 325

Use Evaluation Data 326

Outcome Data and Balancing Measures 326

Process Data 326

The Decision Point 327

Change Is Appropriate for Adoption in Practice 329

Change Is Not Appropriate for Adoption in Practice 329

Tools 331

11 Integrate and Sustain the Practice Change 337

Identify and Engage Key Personnel 340

Hardwire Change Into the System 340

Monitor Key Indicators Through Quality Improvement (QI) 340

Reinfuse as Needed 343

Tools 344

12 Disseminate Results 361

Internal Dissemination 362

External Dissemination 362

Approval Process 363

Conference Abstracts 363

Presentation Preparation 363

Publication 364

Examples 366

Tools 386

References 393

A The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care 455

B Implementation Strategies for Evidence-Based Practice 457

C UI Hospitals and Clinics Evidence-Based Practice Publications Reporting Use of the Iowa Model 459

D Select Evidence-Based Practice Process Models 463

E Glossary 465

Index 475