Understanding and Articulating the Differences Between QI, Research or Evidence Based Practice - PowerPoint PPT Presentation

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Understanding and Articulating the Differences Between QI, Research or Evidence Based Practice

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Nursing research studies from the past 2 years, ongoing or completed, generated from the structure(s) and process(es) above. Provide a table including: ... – PowerPoint PPT presentation

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Title: Understanding and Articulating the Differences Between QI, Research or Evidence Based Practice


1
Understanding and Articulating the Differences
Between QI, Research or Evidence Based Practice
  • Regina Taylor, MN, RN, ACNS-BC

2
Objectives
  • Differentiate between quality improvement,
    research and evidence based practice in nursing
  • Discuss strategies to ensure nurses at all levels
    in all areas of practice understand and can
    describe the differences

3
A precursor to leading is understanding the
distinct differences, yet overlapping
associations between those 3 important
activities. (Newhouse, p.435)
4
Quality Improvement
  • Systematic, data-guided activities designed to
    bring about immediate improvement in healthcare
    delivery in particular settings.
  • (Lynn, et al, 2007, p. 667)
  • From ANCC Magnet Application Manual, 2008

5
Examples of QI
  • Nursing Sensitive indicators
  • Performance Measures
  • Compliance checks
  • Example Examination of use of intervention at
    unit/facility level to attempt to decrease
    patient falls

6
Nursing Research
  • A systematic search for knowledge about issues
    of importance to the nursing profession. (Polit
    and Hungler, 1995)

7
Example of Nursing Research
  • Testing of an innovation that may impact nursing
    practice in general (i.e. including outside of
    the facility), such as to prevent falls or injury
    from falls or pressure ulcers

8
QI or Research
  • Research Process
  • QI Rapid Cycle Process
  • Plan
  • Do
  • Study
  • Act
  • Form hypothesis
  • Study protocol/Data collection
  • Analysis and interpretation of data
  • Implementation into practice
  • (Kring, p. 163)

9
QI or Research?
  • Intervention
  • Risk
  • Audience
  • Data source
  • (Reinhardt and Ray, p.5)

10
Differences
  • Philosophical underpinning
  • Purposes
  • EBP value
  • Generalizability
  • Beneficiaries
  • Risks and Burdens
  • Sample Size
  • Instruments
  • Design and methods
  • Implementation of findings
  • Social acceptance

(Kring, 2008)
11
Evidence-Based Practice
  • Conscious use/integration of the best research
    evidence with clinical expertise and patient
    preferences in nursing practice (adapted from
    Sackett, et al, 2000)
  • EBP is a science-to-service model of engagement
    of critical thinking to apply research-based
    evidence (scientific knowledge) and
    practice-based evidence (art of nursing) within
    the context of patient values to deliver quality,
    cost-sensitive care.

12
Examples of EBP
  • Use of evidence-based standards from professional
    organization
  • Use of research to guide protocols
  • Institute for Healthcare Improvement (IHI)
    bundles
  • Specifics
  • Safe patient handling
  • Falls prevention
  • Pressure ulcer prevention
  • Restraint free environments

13
Integration of QI, EBP, and NR
QI
Met
Not Met
EBP
Evidence
No Evidence
NURSING RESEARCH
14
If in doubt.
  • Ask the experts
  • Nurse researchers/scientists
  • Quality Management
  • Institutional Review Board
  • Advance Practice Nurses
  • Affiliated faculty

15
Strategies to ensure differentiation
  • Educational seminars, including
  • Grand Rounds (evidence based case study analyses)
  • Webinars
  • Reinforcement/Education at the bedside
  • Documentation
  • EBP Fact Sheets
  • Website
  • Use of tools (Rating, differentiation, such as
    Kring, p. 167)
  • Journal Clubs (in person, on line)

16
Additional Strategies
  • Establish reasonable budget (as separate FCP or
    line items) for research
  • Start with basic education for staff Research
    process, protection of human subjects, sharing
    your findings enhance all staff nurses ability
    to evaluate research using their selected tool
  • Assist staff with verbalizing how research is
    systematically reviewed and used for evidence
    based practice focus on enculturation of
    research and EBP
  • Articulate, and develop further, relationship
    with academic affiliates and own research staff,
    including MDs, regarding staff developing
    research skills/mentoring
  • Facilitate attendance at research and EBP
    conferences.
  • Assist with local research and EBP conferences

17
Preparing the workforce involves developing
competencies in QI, EBP, informatics,
patient-centered care, and interdisciplinary
collaboration.(Newhouse, p. 435)
18
Magnet Requirements Educational
  • List continuing education programs (classroom or
    electronic) and the number of nurses completing
    each during the past 24 months. Do not include
    orientation or inservice education. Include
    programs covering
  • Research, including protection of human subjects
  • Evidence-based practice
  • Application of ethical principles
  • Quality improvement
  • Data and information analysis competencies

19
Evidence Based Practice SOE
  • Describe and demonstrate
  • The structure(s) and process(es) used to evaluate
    existing nursing practice, based on evidence
  • The structure(s) and process(es) used to
    translate new knowledge into nursing practice.
  • How translation of new knowledge into nursing
    practice has affected patient outcomes.

20
Research SOE
  • Provide annual report (research efforts and
    presentations could be included here)
  • Provide a budget summary for most recent fiscal
    year, actual to budget, for nursing education,
    conference attendance, and research

21
Research SOE (cont.)
  • The institutions policies, procedures (including
    IRB) and processes that protect the rights of
    participants in research (NK 2)
  • The credentials or related experience of all
    external experts and other resources used to
    develop and/or improve the infrastructures,
    capacities, and processes for evidence-based
    practice and research (NK4 and NK 4EO)

22
Research SOE (Cont.)
  • Describe and demonstrate
  • Consistent membership and involvement by at least
    one (1) nurse in the governing body responsible
    for the protection of human subjects in research,
    and that a nurse votes on nursing-related
    protocols.
  • The structure(s) and process(es) used by the
    organization to develop, expand, and/or advance
    nursing research.
  • Nursing research studies from the past 2 years,
    ongoing or completed, generated from the
    structure(s) and process(es) above. Provide a
    table including
  • Study title
  • Study status
  • Principal investigator name(s)
  • Principal investigator credential(s)
  • Role(s) of nurses in the study
  • Study scope (internal to a single organization,
    multiple organizations within a system
    independent organizations collaboratively)
  • Study type (replication-yes or no qualitative,
    quantitative, or both). Select one (1) completed
    research study and respond to the four (4)
    criteria listed in the guidelines provided.

23
References
  • ANCC Manual, 2008
  • Newhouse, R. (October, 2007). Diffusing
    Confusion between Evidence Based Practice,
    Quality Improvement and Research. Journal of
    Nursing Administration. Vol 37. No. 10, 432-435.
  • Kring, D. (June, 2008). Research and Quality
    Improvement Different Processes, Different
    Evidence. MED/SURG Nursing. Vol. 17, No. 3,
    162-169.
  • Reinhardt, A, and Ray, L. (February, 2003).
    Differentiating Quality Improvement from
    Research. Applied Nursing Research. Vol 16, No.
    1, 2-8.

24
Questions? Contact Regina Taylor, MN, RN,
ACNS-BC Regina.taylor_at_va.gov 404-321-6111. ext.
6487
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