Comparing Research, QI, and EBP
IRB required
nursing research IRB
florence nightingale
nursing research history
Evaluate effectiveness of nursing interventions and to provide direction for further improvement in the achievement of quality clinical outcomes and cost effectiveness. -Not designed to develop nursing practice standards or nursing science
definition of quality improvement
is focused on systematically reviewing the evidence
evidence based practice
Assess IRB process related to intended project and the level of risk, benefits, confidentiality, generalizability, and publishing plans.
evidence based practice IRB
Integration of best clinical research evidence, clinical expertise and patient values. -Is the conscious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide health care decisions (LoBiondo-Wood & Haber, 2010) -A scholarly and systematic problem-solving paradigm that results in the delivery of high-quality health care.
evidence based practice definition
-Best practices for tracheotomy dressing -For adult acute care medical surgical patients receiving blood transfusions, what are the best monitoring practice to assess for the incidence of adverse transfusion reactions? -Does the evidence say that manual vs. automatic blood pressures as most accurate? synthesis
evidence based practice examples
medicine
evidence based practice history
To improve practice. Seeks to positively impact practice. Translates the knowledge.
evidence based practice impact on practice
PICO or PICOT -Iowa Model of Evidence-based Practice -ACE Star Model of Knowledge Transformation (2004) -Ask a focused clinical question Find the best clinical evidence Critically appraise the evidence Apply evidence to practice Evaluate outcomes
evidence based practice methods
Identify the clinical problem Search for the best evidence Critically appraise the evidence Synthesize the evidence Apply the evidence Evaluate outcomes
evidence based practice nursing role
Translate research into practice -Increase the effectiveness of treatment -Encourage some consistency in practice -Utilize interdisciplinary approach in practice -Encourage practice not based on tradition (because that is how we have always done it)
evidence based practice purpose
The registered nurse integrates evidence and research findings into practice (p. 51): -Utilizes current evidence-based nursing knowledge, including research findings to guide practice. -Incorporates evidence when initiating changes in nursing practice. -Participates, as appropriate to education level and position, in the formulation of evidence-based practice through research. -Shares personal or third-party research findings with colleagues and peers.
evidenced based practice ANA stuff
conducts scientific studies when the evidence is lacking
nursing research
The registered nurse integrates evidence and research findings into practice (p. 51): -Participates, as appropriate to education level and position, in the formulation of evidence-based practice through research. -Shares personal or third-party research findings with colleagues and peers. The graduate-level prepared specialty nurse or the advanced practice registered nurse: -Contributed to nursing knowledge by conducting or synthesizing research and other evidence that discovers, examines, and evaluates current practice, knowledge, theories, criteria and creative approaches to improve healthcare outcomes. -Promotes a climate of research and clinical inquiry. -Disseminates research findings through activities such as presentations, publications, consultation and journal clubs.
nursing research ANA stuff
Formal, systematic and rigorous process of inquiry used to generate and test theories about the health-related experiences of human beings within their environments and about the actions and processes that nurses use in practice. (Fawcett& Garity, 2009) -Systematic investigation designed to generate or contribute to new knowledge that can be generalized for broader application
nursing research definition
-3 year study examining symptoms clusters of patients with congestive heart failure -Does a review of the literature indicate a need for new knowledge regarding blood pressure management? Knowledge development
nursing research examples
To generate new knowledge for practice. -Seeks to add to professional literature.
nursing research impact on practice
-Scientific Method Research Question/Hypothesis Methods Interpretation of Data Implications for practice Dissemination of findings -Qualitative Research -Quantitative Research
nursing research methods
Participate in the implementation of nursing research -Disseminate findings of nursing research studies -Participate on nursing research related committees (NR, QI, EBP). Masters Graduate -Be active research team member -Assume the role of clinical expert -Collaborate with an experienced researcher in proposal development, data collection, data analysis and interpretation -Take active role in quality improvement projects to improve nursing practice in the clinical situation Doctorate Prepared Graduate -Appraise, design and conduct research -Serve as role model, mentor, guide and encourage nurses to engage in the nursing process -Collaborate and consult with social, educational, government and health care institutions in research -Disseminate research findings to the scientific community
nursing research nursing role
Answer the research question -Test the hypothesis -Describe -Explain -Predict -Explore -Discover
nursing research purpose
is used to monitor practice and evaluate patient outcomes
quality improvement
the registered nurse participates in quality improvement. Activities may include (p. 52): -Identifying aspects of practice important for quality monitoring. -Using indicators to monitor quality, safety and effectiveness of nursing practice. -Collecting data to monitor quality and effectiveness of nursing practice. -Analyzing quality data to identify opportunities for improving nursing practice. -Formulating recommendations to improve nursing practice or outcomes. -Implementing activities to enhance the quality of nursing practice. -Participating on and/or leading interprofessional teams to evaluate clinical care or health services. -Participating in and/or leading efforts to minimize costs and unnecessary duplication. -Identifying problems that occur in day-to-day work routines in order to correct process inefficiencies. -Analyzing factors related to quality, safety and effectiveness. -Analyzing organizational systems for barriers to quality healthcare consumer outcomes. -Implementing processes to remove or weaken barriers within organizational systems. The graduate-level prepared specialty nurse or the advanced practice registered nurse: -Provide leadership in the design and implementation of quality improvements. -Designs innovations to effect change in practice and improve health. -Evaluates the practice environment and quality of nursing care rendered in relation to existing evidence. -Identifies opportunities for the generation and use of research and evidence. -Obtains and maintains professional certification, if it is available in the area of expertise. -Uses the results of quality improvement to initiate changes in nursing practice and the healthcare delivery system.
quality improvement ANA stuff
No IRB
quality improvement IRB
-Reduce wait time for OR patients -Decrease boarding time for PACU patients -Evaluate how nursing measures blood pressure and the accuracy of data entry -Improving documentation of critical lab values. Process
quality improvement examples
business and industry
quality improvement history
To improve patient care processes -Seeks to improve processes in unit and organization -Incorporates the knowledge.
quality improvement impact on practice
-Plan-Do-Check-Act (PDCA) -Plan-Do-Study-Act (PDSA) -Six Sigma, Lean Six Sigma
quality improvement methods
Identify practice that requires improvement Collect data Analyze data Generate Recommendations Implement processes for change Analyze organizational barriers Analyze cost effectiveness of changes Implement processes to decrease barriers and cost
quality improvement nursing role
Bring about immediate improvement of care in a specific setting -To compare organization to standards or benchmarks. -Increase cost effectiveness -Make processes more efficient/better
quality improvement purpose