The Genesis of a Consortium to Promote Excellence in Nursing through Evidence-Based Practice

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The Genesis of a Consortium to Promote
Excellence in Nursing through Evidence-Based
Practice

• Caroline E. Brown, DEd, WHNP, CNS
• Associate Professor, San Diego State University
• Evidence-Based Practice/Research Liaison UCSD
  Medical Center
• Laurie Ecoff, MS, RN
• Director, Research, Education, Professional
  Practice
• Sharp Memorial Hospital

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RecognitionSpecial thanks and recognition to the
members of the consortium and their institutions
for the program resources

• Judy Davidson, Scripps Mercy
• Son Chae Kim, Point Loma Nazarene University
• Kathy Klimpel, Rady Childrens Hospital
• Danielle McCallion, Sharp Grossmont

• Diana Rodriguez, San Diego Unified Schools
• Barbara Rose, VA San Diego Healthcare System
• Tanna Thomason, Sharp Memorial
• Mary Wickline, UCSD Medical Library

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Formation of the Group

• Partnership formation current partners
• UCSD Medical Center
• Sharp HealthCare System (5 Hospitals)
• VA San Diego Healthcare System
• Rady Childrens Hospital
• Scripps Mercy Hospital Scripps Chula Vista
  Hospital
• San Diego Hospice
• Point Loma Nazarene University
• San Diego State University

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Consortium Purpose

• To foster networks for mutual sharing, innovative
  thinking and creative problem-solving to move
  evidence-based practice initiatives into clinical
  realities.
• To inspire clinical excellence through the
  promotion of evidence-based practice as a
  community norm.
• To test a novel approach to infuse evidence-based
  practice through interagency partnerships within
  a community.

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Our Vision

• To inspire clinical excellence through the
  promotion of evidence-based practice.

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Our Mission

• To foster networks for mutual sharing, innovative
  thinking and creative problem-solving to move
  evidence-based practice initiatives into clinical
  realities.
• To test a novel approach to infuse evidence-based
  practice through interagency partnerships within
  a community.
• To promote expertise in evidence-based practice
  through workshops and other learning
  opportunities.
• To disseminate our experiences and our outcomes.

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Theoretical Framework

• Rodgers Theory of Diffusion of Innovation
• Organization Change Theory
• Evidence-based Practice Models
• Iowa model
• Rosswurm and Larrabee
• Five As model, Hayward Evidence-based
  Information Cycle

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Clinical Partners

• Lead Faculty
• Logistic Support
• Identification of
• Stakeholders
• Participants

Academic Partners
Descriptive Research Winter 2006
Clinical Partners
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Clarification of Interagency Roles

• Lead Faculty to be drawn from
• Participating Clinical Partners
• Participating Academic Partners
• Logistic Support
• Coordination of programs
• Support for clinical projects
• Institutional commitment
• Identification of stakeholders and participants
• Advance practice nurses
• Staff nurses

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Determining Funding Structure

• Developed a budget
• Complete 2 request for proposals
• Sharp funding proposal submitted May 06 (awarded)
• UCSD proposal submitted May 06 (awarded)
• In-kind support from each participating entity
• Proposal developed for the Nursing Leaders.

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Budget
What Who When When Cost
Phase I Phase I Phase I Phase I Phase I
Evaluation of EBP Nursing Initiative on Nursing Knowledge of EBP Pre-test/post-test Intranet based surveys (Barriers and EBPQ) Survey of registered nurses September 2006 September 2007 1. Web based survey 300 per institution 2. Salaries to complete survey ______ RNs x _____ (minutes to complete) x ______ (average hourly rate) _________________ 3. Data analysis 8 hours per institution x 150/hour 1200 Total Phase I _____________ 1. Web based survey 300 per institution 2. Salaries to complete survey ______ RNs x _____ (minutes to complete) x ______ (average hourly rate) _________________ 3. Data analysis 8 hours per institution x 150/hour 1200 Total Phase I _____________
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Phase II Phase II Phase II Phase II
EBP Practicum Note Curriculum will be structured such that institutions may send mentors only for partial days. Curriculum differentiated by fellow and mentor competencies. Mentor and Fellow dyad January June 2007 Research Day Fall 2007 Non-salary Books ______/participant Printing and duplicating ________ Food __________ (institution to take turns with breakfast and snacks) Total non salary ___________ Fellows Classroom 48 hours (six days), plus wrap up day/graduation and research day (2007) 16 hours. Practicum days 48 hours (six days). Total hours 112 x ______ (average hourly rate) _______ (per fellow) Mentors Time commitment based on level of participation in practicum. Classroom time only _____ of specialists x 64 (classroom hours) x ________ (average hourly rate) ________ Total salary costs ___________
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Progress to Date

• Descriptive Research Study
• Institute Program development and implementation
• Program evaluation
• Fall Collaborative Research Conference Planning

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Descriptive Research Study

• Purpose of this research was to explore nursing
  knowledge, attitudes, and perceived barriers to
  practicing evidence-based practice at four
  hospital systems in Southern California with the
  secondary aim to explore the variations between
  hospital systems collaborating in the EBP
  consortium.
• Descriptive, prospective, correlational
  non-experimental design
• Data collection completed 12-2006 to 01-2007
• Data analysis complete
• Presentation Preparation for a podium
  presentation at Joanna Briggs International
  Conference

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Development and Implementation of the Institute
for EBP

• Provide theory and experiential learning
  opportunities for the advanced practice/staff
  nurse dyads to implement a clinical practice
  project
• Annual cycle ending with the Fall Evidence-Based
  Practice Conference
• First Cycle January 2006 through September 2007
• Second Cycle March 2008 through November 2008
  (tentative)
• Application process created and revised

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Adopting
Advancing
Consortium Model for Evidence-Based Practice
2007 EBP model by Caroline E. Brown Laurie
Ecoff The Consortium for Nursing Excellence,
San Diego Adapted from Robert Hayward,
Evidence-based Information Cycle Rosswurm and
Larrebbe, 1999 Rogers, 1995
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Institute Content

• Day 1 Assessing Asking
• Primer on Evidence-Based Practice
• Getting Started with EBP Asking Clinical
  Questions
• Panel Discussion with EBPI graduates
• Day 2 - Acquiring
• The Nature and Levels of Evidence
• Finding the Best Evidence Searching Literature
  and Databases

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Institute Content

• Day 3 Appraising
• Critical Appraisal of the Evidence
• Making Sense of the Numbers- Finding and
  Understanding Research Results
• Day 4 - Applying Moving Ahead Making your
  Project a Reality
• Defining the Change in Practice- Protocol
  development
• Defining and Measuring outcomes
• Integration of Clinical expertise and Population
  perspectives
• Change Strategies
• Protecting Human Subjects

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Institute Content

• Day 5 Analyzing
• Nuts and Bolts of Managing Data
• Sustaining change
• Day 6 - Advancing Disseminating your project
• Discovering audiences to share finding with
• Creating Posters and presentations

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Institute Website

• A website was created for the consortium and to
  update participants about the Institute.
• The URL is http//nursing.sdsu.edu/inr/consortiu
  m.php

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Collaborative Research Day

• Morning sessions will include
• A graduation celebration for the Fellows and
  Mentors
• Presentation of exemplar projects by
  fellow-mentor dyads
• Keynote address on Nurse Innovators by Kathy
  Malloch, RN, PhD
• Afternoon sessions will include
• research presentations from San Diego area
  university faculty, students, and recent
  graduates
• Keynote address on Evidence-Based Leadership by
  Kathy Malloch

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Next Steps

• Partnership clarification
• Delineate responsibilities and reaffirm contacts
• Determine funding structure
• Continued exploration
• Program development
• Refinement of curriculum based on evaluation
  findings
• Program administration logistics
• Defining the group as an entity

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For more information

• Caroline E Brown cbrown_at_mail.sdsu.edu
• Laurie Ecoff laurie.ecoff_at_sharp.com