Evidence Based Practice Scholar Program, 2007
The vision of the Nursing Research Practice Council (NPRC) is to create a culture of inquiry that empowers nurses at all levels to examine their professional practice and use evidence to improve the quality of patient care. Today, nursing research and other sources of evidence guide and impact the quality of care we provide to our patients and families. At CHOC, nurses are empowered to ask critical questions in the spirit of looking for opportunities to improve nursing care and patient outcomes.
The Nursing Practice Research Council held a retreat to discuss Evidence Based Practice, and the membership in attendance selected the IOWA Model as the theoretical basis for projects, as well as the PICO method for generating EBP questions. Melnyk’s 7-levels of evidence was selected as the method for rating the evidence.
The NPRC also wrote a definition of evidence-based practice that is consistent with our beliefs and practices. Evidence-based practice is a dynamic process of integrating research, credible sources of knowledge, clinical expertise, patient & family preferences and values to achieve optimal patient outcomes, enhance nursing practice, and manage health care costs.
We then launched the inaugural Evidence-Based Practice Scholars Program. The curriculum for the Evidence-Based Practice scholarship program has been developed as a six month guided experience to change practice based on the evidence in the literature.
A one day exploratory session was held on May 29, 2007. Ten applications were received and seven scholars were selected to begin the program, and five scholars completed the program.
The Scholars represent the continuum of care and diverse topics of clinical practice. Here are the Scholars and their PICO questions, which is the focus of their EBP projects.
Donna Bigani, RN, Staff Nurse, Medical Surgical Unit - 4
Among pediatric medical surgical patients, does checking blood pressure every 12 hours on a stable patient compared to checking blood pressure every 4 hours result in increased patient/family satisfaction and promotion of sleep?
On August 14, 2008, Donna presented her findings during Clinical Grand Rounds. Nurses and other practitioners attended the three sessions held that day and asked questions about how less frequent vital signs might be incorporated into practice. Click here for Pediatric Blood Pressure Monitoring presentation
Poster Presentation: Pediatric Blood Pressure Monitoring
Ana Cardona, RN, Staff Nurse, Medical Surgical Unit – 4
Among pediatric patients with teeth, does the use of American Academy of Pediatric Dentistry (AAPD) clinical guidelines by health care providers compared to those who use standard dental care result in reduced risk of dental caries, improved dental hygiene practices, and increased dentist referral?
Ana presented at clinical grand rounds January 9, 2009. Click here for presentation.
Connie Carcel, RN, Educator, Breathmobile
Among hospitalized pediatric patients with asthma, does a formalized asthma educational program for patients and their parents by a trained asthma nurse educator compared to traditional hospital discharge education result in increased knowledge of asthma and its triggers, increased adherence to daily medication management and/or rescue plan, decreased ED visits, increased school attendance, and increased quality of life?
Title of the Abstract that has been accepted for Poster Presentation:
"The Impact of Certified Asthma Educators (AE-C) on Provider Pediatric Hospital Discharge Planning".
This poster will be presented at the American College of Allergy, Asthma and Immunology - Annual Scientific Meeting on November 7 & 8, 2009.
Connie is to present clinical grand rounds on January 9, 2009. Click here for presentation.
Tammy Fogel, RN, Staff Nurse, Oncology
Among pediatric immunocompromised patients with Vancomycin Resistant Enterococcus (VRE), does the use of gloves alone for isolation when there is no direct patient contact compared to the use of standard isolation therapy (gloves, gowns) result in a decreased risk of the spread of VRE?
Tammy has been actively working to educate families on the need to follow isolation procedures. She has also been working to reinforce current policy and procedure at CHOC related to isolation and VRE. This is significant as Tammy had been an advocate for discontinuing isolation practices related to VRE until the review of the evidence indicated that isolation was the best practice to ensure quality and safety in care.
Lori MacLean, RN, Staff Nurse, Oncology
Among hospitalized pediatric patients, does treatment with mind body techniques such as assisted relaxation, guided imagery, or hypnosis when compared with the standard treatment of distraction or medication alone result in a hospitalization experience of improved comfort and less distress?
On August 14, 2008, Lori presented her findings during Clinical Grand Rounds. Nurses and other practitioners attended the three sessions held that day and asked questions on how to incorporate this care into practice. Click here for presentation.
All of the scholars presented their findings at a poster viewing held at CHOC during June 2007. The viewing was held for nursing leaders, scholars nursing and medical leadership supporters, mentors, and family/friends. The scholars were available to answer questions on the findings.
Evidence Based Practice Scholar Program, 2008
Dr. Vicki Bowden, Associate Professor, Assistant Director of Undergraduate Programs at Azusa Pacific University will mentor the scholars. She has been a leader in applying evidence to pediatric practice; she co-authored the second edition of Pediatric Nursing Procedures published by Lippincott and Williams.
On September 22, 2008, nurses wishing to apply for year two of the scholars program gathered to learn more about the program and evidence-based practice. The applicant materials were reviewed and six scholars were selected via a competitive process. They were selected based upon well-prepared proposals, demonstrating a high standard necessary for completion of the projects.
Tammy Anderson, RNC, Staff Nurse, NICU
Topic: The Positive Benefits of Neonatal Developmental Care
Marie Arpa, RN, PHN, Staff Nurse, Medical Surgical Unit
Topic: Acetaminophen vs. Ibuprofen for Fever Reduction
Deanne Beck BSN, RN CPON, Staff Nurse, Oncology Intensive Care
Topic: What is the Most Effective Method to Administer Cyclosporine IV to Oncology Patients
Jane Dean, RN, Staff Nurse, Pediatric Intensive Care Unit
Topic: The Effectiveness of Sliding Sheets to Move Patients
Ron Mascio, RN, CPN, Charge Nurse, Medical Surgical Unit
Topic: Benefits of a Primary Care Model in Pediatric Medical Surgical Unit
Wanda Rodriguez, RN, CPN, Staff Nurse, Medical Surgical Unit
Topic: Heparin vs. Saline for Peripheral Intravenous Locks
Wanda's poster was accepted for presentation at the Annual Society of Pediatrc Nurses (SPN) National Conference April 30-May 2, 2010 in Pensacola, FL
Finally, on October 23, 2008, Elyse McClean, 2006-2008 Fellow, and Lori MacClean, 2007 Scholar, did an oral presentation at the local Sigma Theta Tau, Odyssey Conference on the establishment of the Nursing Research Fellowship and Evidence-Based Practice Scholars programs. This conference was attended by local nursing faculty and practitioners. Those in attendance gained an appreciation for the level of expertise CHOC is looking for in nursing graduates as we continue to provide the highest level of quality, safe care based upon the best evidence. CHOC not only continues to contribute to the body of knowledge related to pediatric evidence, but we are using our research findings in combination with other evidence to change pediatric practice.