TEACHING EVIDENCE-BASED PRACTICE IN NURSING A Guide for Academic and Clinical Settings Dr. Rona F. Levin, PhD, RN, is Professor and Project Director for the Joan M. Stout, RN Evidence-Based Practice Initiative at the Lienhard School of Nursing, Pace Univer- sity, and is Visiting Faculty Member at the Visiting Nurse Service of New York. She is Professor Emeritus at Felician College, Lodi, New Jersey, where she was director of the division of nursing and subsequently director of the division of health sciences. She received her AAS degree in nursing from Queens College, her BS and MS degrees from Adelphi University, and her PhD from New York University. During her career Dr. Levin has held positions as staff nurse, head nurse, educator, researcher, and educational administrator. She has conducted and published research on pain management, nursing diagnoses, and diagnostic competencies of nurses, and has written on a wide variety of nursing research and educa- tional issues. She presents locally, regionally, nationally, and internation- ally on evidence-based practice (EBP) in relation to curriculum development and research on mentoring nurses to integrate EBP into their clinical practice. Harriet R. Feldman, PhD, RN, FAAN, is dean and professor of the Lienhard School of Nursing, Pace University. She re- ceived her BS and MS degrees from Adelphi University, and PhD from New York Uni- versity. She has held positions in administra- tion, teaching, and clinical practice. From 1997 to 2005, she was the editor of Nursing Leadership Forum. Her book Nurses in the Political Arena: The Public Face of Nursing, coauthored with Sandra Lewenson in 2000, received an AJN Book of the Year and Sigma Theta Tau International Nursing Print Media awards. Recent edited books are The Nursing Shortage: Strategies for Recruitment and Reten- tion in Clinical Practice and Education (2003) and with Martha J. Greenberg, Educating Nurses for Leadership (2005). Dr. Feldman holds the following appointments: Board of the Commission on Collegiate Nursing Education; Public Policy Chair of the Greater New York/Nassau/ Suffolk Organization of Nurse Executives; and Health Advisory Commit- tee to US Representative Nita Lowey. She is a Fellow of the American Academy of Nursing and Fellow of the New York Academy of Medicine. TEACHING EVIDENCE-BASED PRACTICE IN NURSING A Guide for Academic and Clinical Settings Rona F. Levin, PhD, RN and Harriet R. Feldman, PhD, RN, FAAN Editors New York Copyright © 2006 Springer Publishing Company, Inc. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechani- cal, photocopying, recording, or otherwise, without the prior permission of Springer Publishing Company, Inc. Springer Publishing Company, Inc. 11 West 42nd Street New York, NY 10036 Acquisitions Editor: Ruth Chasek Production Editor: Sara Yoo Cover design: Joanne Honigman Composition: International Graphic Services, Newtown, PA 0607080910/54321 Library of Congress Cataloging-in-Publication Data Teaching evidence-based practice in nursing: a guide for academic and clinical settings / [edited by] Rona F. Levin and Harriet R. Feldman. p. ; cm. Includes bibliographical references and index. ISBN 0-8261-3155-7 1. Nursing—Study and teaching. 2. Evidence-based medicine. [DNLM: 1. Nursing Education Research—education. 2. Evidence- Based Medicine—education. 3. Nursing Education Research— methods. WY 18 T2516 2006] I. Levin, Rona F. II. Feldman, Harriet R. RT71.T335 2006 610.73'071'1—dc22 2005022198 Printed in the United States of America by For Sebastian Bryce, Tyler Reardon, and Emerson Rae with love and my hope that you will become all that you want to be. “Mimi” To my family, who keeps me grounded in reality yet encourages me to dream, and especially to my husband, Ron, and mother, Florence, who are always supportive and take pride in all that I do. Harriet This page intentionally left blank Contents Contributors xi Preface xv Acknowledgments xvii Foreword by Bernadette Mazurek Melnyk xix Part 1 Setting the Stage Introduction to Part 1 3 Harriet R. Feldman 1. Evidence-Based Practice in Nursing: What Is It? 5 Rona F. Levin 2. Our Approach to Teaching/Learning EBP: The Talking 15 Head Versus the Dancing Feet Harriet R. Feldman and Rona F. Levin Part 2 The Basics of Teaching/Learning Evidence-Based Practice Introduction to Part 2 25 Harriet R. Feldman 3. Teaching Students to Formulate Clinical Questions: 27 Tell Me Your Problems and Then Read My Lips Rona F. Levin 4. Strategies to Teach Evidence Searching: It Takes a 37 Library Rona F. Levin and Helen T. Lane 5. Synthesizing Evidence and Separating Apples From 49 Oranges Rona F. Levin 6. Teaching Meta-Synthesis: Summarizing Qualitative 59 Research Teresa L. Panniers vii viii Contents 7. Teaching Meta-Analysis: Summarizing Quantitative 99 Research Michael J. Barnes and Rona F. Levin 8. Creating Clinical Protocols With an Apgar of 10 121 Ellen R. Rich and Jamesetta A. Newland 9. How to Assess Clinical Protocols for an Evidence Base 133 Rona F. Levin and Lillie M. Shortridge-Baggett 10. Evaluating Educational Outcomes: Measuring Success 143 Ellen Fineout-Overholt Part 3 Teaching/Learning Evidence-Based Practice in the Academic Setting Introduction to Part 3 161 Harriet R. Feldman 11. Transforming a Graduate Nursing Curriculum to 165 Incorporate Evidence-Based Practice: The New York University Experience Barbara Krainovich-Miller and Judith Haber 12. Incorporating Evidence-Based Practice Into Clinical 193 Education for Nurse Practitioners: The Pace University Experience Joanne K. Singleton, Marie Truglio-Londrigan, and Janet Allan 13. Teaching Evidence-Based Practice to Second-Career 205 Nursing Students Jeanne T. Grace 14. Teaching Evidence-Based Practice Throughout an 221 Undergraduate Curriculum: Here, There, and Everywhere Rona F. Levin 15. Teaching How to Make Accurate Nurses’ Diagnoses 229 Using an EBP Model Dina´ de Almeida Lopes Monteiro da Cruz, Cibele Andrucioli de Mattos Pimenta, and Margaret Lunney 16. Learning From the Past: Using Nursing History as 247 Evidence Sandra B. Lewenson 17. Why We Need Evidence-Based Teaching Practices 261 Theresa M. Valiga Contents ix Part 4 Teaching/Learning Evidence-Based Practice in the Clinical Setting Introduction to Part 4 275 Harriet R. Feldman 18. Teaching Evidence-Based Practice in a Hospital Setting: 279 Bringing It to the Bedside Patricia Quinlan 19. Making EBP Part of Clinical Practice: The Iowa Model 295 Linda Q. Everett and Marita G. Titler 20. Using Journal Clubs to Introduce Evidence-Based 325 Practice Ellen Fineout-Overholt 21. Traveling Posters: Communicating on the Frontlines 337 Priscilla Sandford Worral Glossary of Selected Terms in EBP 347 Annotated Bibliography 355 Relinie Rosenberg Index 361 This page intentionally left blank Contributors Janet Allan, PhD, RNC, FAAN Linda Q. Everett, PhD, RN, Dean and Professor CNAA, BC University of Maryland School of Associate Director, University of Nursing Iowa Hospitals and Clinics Baltimore, Maryland Director, Nursing Services and Patient Care/Chief Nursing Officer Michael J. Barnes, PhD University of Iowa Hospitals and Associate Professor Clinics Clinical Psychology Iowa City, Iowa Hofstra University Hempstead, New York Ellen Fineout-Overholt, PhD, RN Director, Center for Advancement Dina´ de Almeida Lopes Monteiro of Evidence-Based Practice da Cruz, PhD Associate Professor, Clinical Nurse and Associate Professor Nursing University of Sa˜o Paulo School of Arizona State University College Nursing of Nursing Sa˜o Paulo, Brazil Tempe, Arizona Jeanne T. Grace, RNC, PhD Cibele Andrucioli de Mattos Associate Professor of Clinical Pimenta, MNSc, PhD Nursing Professor Chair Biomedical Board 03, University of Sa˜o Paulo School of RSRB Nursing University of Rochester Sa˜o Paulo, Brazil Rochester, New York xi xii Contributors Judith Haber, PhD, RN, FAAN Bernadette Mazurek Melnyk, New York University College of PhD, RN, CPNP/NPP, FAAN, Nursing FNAP Professor & Director of Dean and Distinguished Master’s & Post-Master’s Foundation Professor in Programs Nursing New York, New York Arizona State University College of Nursing Barbara Krainovich-Miller, EdD, Tempe, Arizona RN, APRN, BC Coordinator, Nursing Education Master’s and Post-Master’s Jamesetta A. Newland, PhD, RN Certificate Programs Director, Primary Health Care New York University College of Associates Nursing Pace University, Lienhard School New York, New York of Nursing University Health Care Helen T. Lane, MLS New York, New York Instructional Services Librarian Pace University, Lienhard School Teresa L. Panniers, PhD, RN of Nursing Associate Professor New York, New York Assistant Dean for Graduate Nursing Programs Sandra B. Lewenson, PhD, RN George Mason University College Associate Dean for Academic of Nursing and Health Science Affairs Fairfax, Virginia Pace University, Lienhard School of Nursing Pleasantville, New York Patricia Quinlan, RN, MPA, CPHQ Margaret Lunney, RN, PhD Director of Nursing Education, Professor Quality, and Research College of Staten Island, City Hospital for Special Surgery, University of New York Department of Nursing Staten Island, New York New York, New York Contributors xiii Ellen R. Rich, PhD, RN Marita G. Titler, PhD, RN, Associate Professor and Director FAAN of the Center for Nursing Director, Research, Quality, and Research & Scholarly Practice Outcomes Management Molloy College, Department of University of Iowa Hospitals and Nursing Clinics, Department