Nemours Strategic Plan for The Nurse as Scholar: Research and Scholarly Promoting Evidence- Activity Based Nursing Practice Goal: Become a leading child health system in the nation by 2015 Among Direct Care
From Bench to Bedside; Clinic to Community Nurses
Scholarship as component of all health professionals’ work Elizabeth W. Bayley, PhD, RN
Defined focus areas for research Louanne A. Stratton, PhD, RN
“Bottom up” approach with integrated teams of clinicians, bench researchers, educators

Assumption:

Nurses are Knowledge Workers

Knowledge Worker Roles Boyer’s Model of Scholarship

Analyzing data to
Ability to brainstorm, establish relationships thinking broadly
Discovery
Assessing input in order
Ability to drill down,
Integration to evaluate complex or creating more focus conflicting priorities
Producing a new
Identifying and
Application capability understanding trends
Teaching
Making connections
Creating or modifying a
Understanding cause strategy and effect The Process of EBCP

5 Phases : 1. Ask a clinical question Iowa Model of Evidence-Based 2. Search for the evidence Practice to Promote Quality Care

3. Critically appraise the evidence http://www.uihealthcare.com/depts/nursing/rqom/ 4. Apply the evidence evidencebasedpractice/iowamodel.html

5. Evaluate the effectiveness of the evidence

(Hockenberry et al. .Ped. Nsg. 32(4), 2006)

Skills for EBCP KAP Study

Asking a question- PICO
Nursing Shared Governance Research and (population, intervention, comparison, Education Council goal outcome)
Nurses’ Knowledge, Attitudes and Practices
Literature search- accessing the Related to Research evidence using electronic
R. John, J. Prozzillo, E. Bayley databases
Over 700 Nemours RNs surveyed using 33-
Evaluation of methodological rigor item tool (Burke et al., Aurora Health System) and relevance of literature
>50% response rate
Analytical skills & critical thinking
Results indicated need for increased knowledge
Reading with comprehension

Results Results Factor 2: Establishing Current Factor 1: Identifying Clinical Best Practice Problems

2.5 1.9 1.85 2.45 1.8 2.4 1.75 Knowledge 1.7 Knowledge 2.35 Willngness Willingness 1.65 Ability Ability 2.3 1.6 1.55 2.25 1.5 2.2 1.45 Mean score Mean score Results Results Factor 3: Implementing Research Factor 4: Administering Research into Practice Implementation

2.3 1.8 2.25 1.6 2.2 1.4 2.15 1.2 2.1 Knowledge 1 Knowledge Willingness Willingness 2.05 0.8 Ability Ability 2 0.6 1.95 0.4 1.9 0.2 1.85 0 mean scores mean scores

Results AIDHC EBNP Fellowship Factor 5: Conducting and Communicating Research Program Proposal

2.1 Purpose: 2.05
To promote the use of evidence by 2 professional nurses to improve patient 1.95 outcomes. 1.9 Knowledge Willingness 1.85
To help nurses learn the essential steps Ability 1.8 in the process of EBNP and research. 1.75
To enhance nurses’ ability to engage in 1.7 the scholarship of discovery, integration, 1.65 application and teaching. Mean scores

Administrative Support Role of Research and Education Council
Proposal submitted to CNO by Director of
Nursing Research Guided development
CNO sought support from COO, CEO, CFO of program structure
Budget Approval for 17 Fellows for 12 paid
Reviewed curriculum proposed by 8-hr days in 2010 Director of Nursing Research
Textbook purchased for each Fellow:
Reviewed and approved applications Melnyk, B., & Fineout-Overholt, E. (2010) Evidence-Based
Received regular reports of program Practice in Nursing and Healthcare . 2 nd ed. Wolters Kluwer/ Lippincott/Williams & Wilkins implementation
Reviewed evaluation of program AIDHC EBNP Fellowship Marketing the EBNPF Program Program

12 days of didactic instruction and independent work time scheduled over 8 months
Commitment from Fellows for an additional day or > per month working on project
Classes scheduled at 3-4 week intervals from May 11 to December 17, 2010
Classes provided primarily by Director of Nursing Research with guest lectures by 2 CNSs (R. Lebet, D. Brecher), UDEL professor (Dr. J. Herrman)
Medical Librarian (K. Flathers) provided essential support with individual help for searching literature.

Infolink.lnk

Marketing the EBNPF Program EBNPF Application Process

Application form, including past EBN/research experience; project ideas
Letters of recommendation and support from manager and MSN-prepared mentor
Experience and AIDHC employment criteria
BSN desirable
Resume

EBNPF Curriculum: The EBNPF Curriculum: The Process of EBNP Process of EBNP

Nemours Research Strategy
Planning and Implementing a Change in
The Nurse as Scholar Practice; Models and Strategies for Change
Evidence-Based Nursing Practice: What It Is
Forming Teams for Research and EBNP and What It Is Not
Models for EBN
Diffusion of Innovations
Research vs. EBNP vs. QI
Strategies for Championing EBN on the Clinical
Defining an EBP or Research Problem or Unit Question
Exemplars of EBNP Projects
Evidence Rounds
Implementation Science
Planning and Evaluating Outcomes of Nursing Interventions and Practice Changes
TeamSTEPPS – A Process for Implementing
Evaluation Designs Evidence-Based Clinical Practice EBNPF Curriculum: Accessing, EBNPF Curriculum: Research Reviewing, and Appraising Design and Process Evidence

Essentials of Searching the Literature
Research Design Overview; Sampling, Setting, Infolink.lnk
Introduction to InfoLink Methods
Anatomy of a Research Study- Reading Published
Qualitative Research Methods Research
Quantitative Research Methods and Designs
Appraising the Literature and Developing an Evidence
Triangulation Table
Measurement: Selection and Development of
Hierarchy of Evidence Instruments for EBN and Research; Reliability
Guidelines for Critique of Research Literature and Validity
Guidelines for Critique of Clinical Literature
Data Collection
Meta-Synthesis
Exemplars of Nursing Studies
Meta-Analysis
Funding Research

EBNPF Curriculum: Ethics of EBNPF Curriculum: Data Research and Human Subject Management and Analysis Protection
Data Management and Statistical Tests Security for Research,
Descriptive Statistics Quality Improvement, and
Analysis of Associations: Chi square
Human Subject Protection: CITI and Nemours Evidence-Based Practice
Analyzing Relationships: Correlation University Programs
Planning for Data Analysis
Analyzing Differences:
Interpreting and
Variance
History of Ethics in Research: The Deadly Summarizing Findings
t-test
Analysis of Variance Deception
Statistics for Healthcare
Factorial Analysis Research:
Navigating the Clinical Research Review
Analysis of Covariance - Level of Measurement
Multivariate Analysis of Committee and the Institutional Review Board - Hypothesis Testing Variance - Probability
Analyzing Complex
Nurse’s Role in Clinical Research
Relationships: Multiple - Power Analysis
Regression
Biostatistics: Survival Analysis; Odds Ratios

EBNPF Curriculum: Presenting Project Topics- 2010 Scholarly Work
Obtaining Tobramycin Levels in Patients with
Writing an Abstract Cystic Fibrosis***
Podium Presentations
Procedural Pain Management for Infants with
Designing a Poster Congenital Heart Defects
Using PowerPoint for Presentations and
The Use of EMLA Cream for Procedural Pain Posters Relief in Children
Writing for Publication
Hemostatic Dressings for Femoral Access Sites
Oral and Poster Presentations of EBN Projects in Percutaneous Cardiac Catheterization or Research Proposals Procedures
Fever: Friend or Foe*** Project Topics- 2010 Project Topics- 2010

The Effect of Healing Touch Therapy on the
The Healing Touch Program in the PICU Adolescent with a Gastrointestinal Medical
A Comprehensive Oral Care Protocol for Condition*** Patients at Risk for VAP in PICU
Transitioning to an Evidence Based Protocol for
EBN Protocol for Infection Reduction in the the Infusion of Infliximab (Remicade) in a PICU Pediatric Ambulatory Care Setting
Child Abuse: Nursing Assessment and
Compassion Fatigue: Nothing Left to Give*** Intervention
Assessing the Comfort Level of Bedside Nurses
Parental Satisfaction with Preoperative Implementing Sedation Protocols Assessment and Education
Sedated Children: Oxygen or Not
CPR in the NICU for All Families***

Project Topics- 2011 Project Topics - 2011

Family Centered Care in the Cardiac Center
A Strategy for Educating Nurisng to Access
An Evidence-Based Protocol for Prevention and Nursing Literature Care of Mucositis in the Child with Oncologic
Telling the Story: Report at the Bedside Treatment
Simulation Laboratory Training for New Nurses
Patient Positioning in the OR in the Cardiac Center
Guided Imagery for Pain Management in Post-
Infant Massage in the NICU Operative Spinal Surgery Patients
Best Practice for Safe Narcotic Administration
An Evidence-Based Position Description for the in the PACU Surgical Nurse Liaison
Increasing Comfort and Reducing Stress in the
Temporal Artery Thermometers: EBN Critically Ill Neonate Using Temporal Procedure for Use in ED Thermometry

Evaluation

Baseline and at End of Program KAP Tool- 33 item instrument that measures Knowledge, Aptitude, and Practices related to research/EBP UG Competencies- Likert-type scale applied to Undergraduate Competencies for Evidence-Based Practice (U. TX Acestar Essentials)
Mid-Program
End of Program Overall Program Evaluation Tool; KAP, UGC
Occasionally – 5-Minute Feedback Form
Implementation and Dissemination Activities 2011 EBNP Fellowship Program

15 nurses applied and approved
6 new units represented
7 new mentors
Classes began on March 17
13 projects were presented December 9 in podium and poster session

Plan for 2012

Modify curriculum based on 2011 evaluations
Apply similar marketing and application [email protected] process
Engage more nurses from units that did 302-651-4716 not participate in 2011
Increase mentor communication and support
Classes began March 15 with 20 Fellows