Ch. 6 4205 Evidence-Based Practice, Advocacy, & Bill of Rights - PowerPoint PPT Presentation

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Ch. 6 4205 Evidence-Based Practice, Advocacy, & Bill of Rights

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Ch. 6 4205 Evidence-Based Practice, Advocacy, & Bill of Rights Presented by Pamela Roberts, MSN RN * * * * * * * * * * * * * * * * * * * * * * * * * * * * EBP Defined ... – PowerPoint PPT presentation

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Title: Ch. 6 4205 Evidence-Based Practice, Advocacy, & Bill of Rights


1
Ch. 6 4205Evidence-Based Practice, Advocacy,
Bill of Rights
  • Presented by
  • Pamela Roberts, MSN RN

2
EBP Defined
  • The process of providing clinically competent
    care, supported by the best scientific evidence
    available, such as outcomes research and expert
    advisers.

3
EBP Characteristics
  • Framework for clinical practice
  • Considers internal and external influences on
    practice
  • Encourages critical thinking
  • Judicious use of evidence for broad-based
    thinking
  • Numerous studies cited

4
Critical Thinking and EBP
  • Translating theory to practice
  • Posing answerable questions
  • Broad-based critical thinking
  • Analysis, synthesis, interpreting, and drawing
    conclusions

5
Using Evidence-Based Practice
  • Asking the right questions
  • Why was the research done, what setting was used?
  • Applying innovation to practice
  • Innovation is originality
  • Evaluating the effect of predetermined outcome
  • Was success achieved?
  • How were the results disseminated?
  • Disseminated dispersed, distributed

6
Why are we using Evidence-Based Practice?
  • Increased rate of information distribution
  • You can google anything you want on the internet
  • Nontraditional
  • EBP moves away from tradition. This is the way
    weve always done it. Well, maybe that way has
    been wrong all these years
  • Decision making based on comprehensive body of
    knowledge
  • Patient care improvement
  • Implementing the Fallen Star program has
    decreased the rate of falls
  • Conscientious use of current best evidence in
    making decisions about nursing care
  • By educating clients based on whats current

7
Why use EBP?
  • Efficacy
  • The ability to reach the desired result
  • Efficiency
  • Desired result timely with minimal effort
  • Effectiveness
  • The ability to produce the desired result

8
The Nurses Role in EBP
  • Active in the evolution of EBP in the
    organization
  • Promote ways to systemize evidence at the bedside
  • Remained enlightened about the use of EBP
  • We do CEUs, take classes, read articles and what
    not

9
How do we use EBP?
  • Translating evidence into practice
  • PET
  • P Practice question
  • PICO
  • E - Evidence
  • T Translation
  • Are the changes in practice feasible? If so,
    actions are taken to put the change into
    practice, this is when a plan is developed

10
PICO for practice question
  • Patient, population, or problem
  • Intervention
  • Comparison with other treatments
  • Outcomes

11
Searching for Evidence
  • PubMed (MEDLINE)
  • CINAHL (The Cumulative Index to Nursing and
    Allied Health Literature)
  • The Cochrane Library

12
CINAHL
  • EBSCO
  • 2700 nursing, allied health, biomedical, and
    consumer health journals
  • ANA and NLN journals
  • Various depths of coverage
  • References dissertations, books, standards of
    practice, legal cases, critical pathsetc.

13
MEDLINE (PubMed)
  • Produced by the National Library of Medicine
  • Premier source for biomedical literature
  • 5000 journal with 300 nursing specific
  • Evidence-based filters in clinical queries

14
The Cochrane Library
  • A collection of seven databases
  • Contains evidence summaries and synthesizes
    reviews
  • Reviews are based on the best available
    information in health-care interventions
  • Structured to minimize bias
  • Good evidence-based source

15
Search tips
  • Use controlled vocabulary for keywords and
    phrases
  • Use AND, OR, and NOT
  • Ex Clinical competence AND
  • Intravenous therapy

16
More search tips
  • Think of alternative spellings such as tumour,
    behaviour, gynaecology American vs. British)
  • Use limits such as age, date of publication, and
    language

17
Reviewing the search
  • Has it been reviewed? If so by whom?
  • Why was it published?
  • Has it been cited?
  • Who wrote it?
  • Who sponsored the research?
  • When was it published?

18
Advocacy
Workplace
Patient
Whistle-Blowing
Professional
19
Advocacy
  • Advocacy is the foundation and essence of nursing
    and nurses have a responsibility to promote human
    advocacy
  • Advocacy is helping people grow and self
    actualize
  • Nurses must advocate for themselves, clients,
    family members, subordinates, and their
    profession

20
Goals of the Advocate
  • Inform
  • Autonomy (enhance this)
  • Respect
  • To respect the decisions of others, even if you
    dont agree with it.

21
How Nurses Can Act as Advocates
  • Helping others make informed decisions
  • Cultural and ethnic diversity and sensitivity
  • Directly intervening on behalf of others
  • Continuing care of DNR client

22
Advocating for Clients
  • Clients needs and goals are paramount
  • Advocate the distribution of resources
  • Leadership must be willing to take risks
  • Time out procedures (right pt, right site, right
    surgery)
  • DNRs
  • Ethics Committee for Staff
  • Must be willing to accept conflict

23
Bills of Rights
  • Passed by the National League for Nurses and
    American Hospital Association in the 1960s
  • Privacy law primarily protects the rights of the
    patient
  • Guide professional practice

24
Subordinate Advocacy
  • What is it?
  • The manager helps subordinates resolve ethical
    problems and live with the solutions at the unit
    level
  • Like if you have a problem on E5, you should try
    to solve the problem and live with the
    consequences on E5

25
PromotingSubordinate Advocacy
  • Staff needs, (listen to)
  • Empower staff
  • Promote autonomy (for the nurses)
  • Face challenges (and solve problems together)
  • Go to bat for the staff (when needed)

26
Workplace Advocacy
  • Manager insures safe, growth oriented environment
  • Occupational health and safety must be assured

27
Internal vs. External Whistle-Blowing
  • Internal whistle-blowing
  • Within the organization, reporting up the chain
    of command
  • External whistle-blowing
  • Reporting outside the organization, such as the
    media or an elected official
  • Public awareness has increased
  • People are more likely to complain when they feel
    wronged
  • Nurses must act individually or collectively

28
Professional Advocacy
  • Leader-managers also must be advocates for the
    nursing profession
  • Professional duty is assumed by entering the
    profession of nursing
  • Speak out on consumer issues, continuing and
    expanding attempts to influence legislation, and
    increasing membership on governmental health
    policy-making boards and councils
  • Speak out on staffing issues
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