2.50
Hdl Handle:
http://hdl.handle.net/10755/164281
Category:
Abstract
Type:
Presentation
Title:
CNS Driven Process to Promote Evidence Based Practice
Author(s):
George, Elisabeth L.; Tuite, Patricia K.; Chelluri, Lakshmipathi; Shearn, Daniel
Author Details:
Elisabeth L. George, PhD, RN, CCRN, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA, email: nacnsorg@nacns.org; Patricia K. Tuite, MSN, RN, CCRN; Lakshmipathi Chelluri, MD, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; Daniel Shearn, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
Abstract:
Purpose: The purpose is to explain a clinical nurse specialist (CNS) led innovative strategy to promote a culture of evidence based practice (EBP) in the intensive care (ICU). Significance: Basing nursing practice on evidence is a goal of health care, but the literature identifies numerous challenges to implementing and sustaining EBP. Design: An initial focus is developing an organizational culture that supports the process for nursing EBP. The CNS has the skill to lead this change and improve patient outcomes. Methods: The process described was implemented in a tertiary center with 152 ICU beds, in 8 specialty units with diverse patient populations and varying needs. The CNS led the development and implementation of a Rules of Evidence (ROE) Committee for ICU. The goal of the committee is to use evidence to improve the care in the critical care (CC) population. The committee included: CC physician, nursing representatives from each ICUs, respiratory therapist, CC nurse administrator, and school of nursing faculty. Ad-hoc members added to a multi- disciplinary approach (pharmacist, engineer, enterostomal therapist, informatics specialist) and attended meetings based on project need. EBP projects were identified from a literature review. The CNS led the initial projects involving the committee representatives in all stages of the process. Unit representatives were key in disseminating EBP protocol information to staff. Findings: EBP protocols have been implemented with ongoing monitoring. Comparisons measures of pre-intervention to current outcome demonstrate improvements: 1) ventilator associated pneumonia decrease from 8 to 5 (rate/1000 ventilator days), 2) average mechanical ventilation days decreased from 7.4 to 6.8 (days), 3) head of bed elevation > 30 increased 30 % to 99%, 4) daily sedation interruption compliance increased 0% to 75%, and 5) blood conservation methods have been introduced in all units. Conclusions: This innovative approach improved patient outcomes and also provided a method to educate staff on EBP. The committee representatives have become advocates for EBP and serve as innovators for change and EBP on their units. Implications for Practice: The CNS driven project can be initiated to provide staff with skill in EBP to create change. The next goal is to have the committee representatives identify and lead the EBP projects with assistance from the CNS.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2008
Conference Name:
Clinical Nurse Specialists: Leaders in Clinical Excellence
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Atlanta, Georgia, USA
Description:
Conference theme: Clinical Nurse Specialists: Leaders in Clinical Excellence, held March 5 - 8 at the Westin Peachtree Plaza in Atlanta, Georgia
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleCNS Driven Process to Promote Evidence Based Practiceen_GB
dc.contributor.authorGeorge, Elisabeth L.en_US
dc.contributor.authorTuite, Patricia K.en_US
dc.contributor.authorChelluri, Lakshmipathien_US
dc.contributor.authorShearn, Danielen_US
dc.author.detailsElisabeth L. George, PhD, RN, CCRN, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA, email: nacnsorg@nacns.org; Patricia K. Tuite, MSN, RN, CCRN; Lakshmipathi Chelluri, MD, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; Daniel Shearn, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/164281-
dc.description.abstractPurpose: The purpose is to explain a clinical nurse specialist (CNS) led innovative strategy to promote a culture of evidence based practice (EBP) in the intensive care (ICU). Significance: Basing nursing practice on evidence is a goal of health care, but the literature identifies numerous challenges to implementing and sustaining EBP. Design: An initial focus is developing an organizational culture that supports the process for nursing EBP. The CNS has the skill to lead this change and improve patient outcomes. Methods: The process described was implemented in a tertiary center with 152 ICU beds, in 8 specialty units with diverse patient populations and varying needs. The CNS led the development and implementation of a Rules of Evidence (ROE) Committee for ICU. The goal of the committee is to use evidence to improve the care in the critical care (CC) population. The committee included: CC physician, nursing representatives from each ICUs, respiratory therapist, CC nurse administrator, and school of nursing faculty. Ad-hoc members added to a multi- disciplinary approach (pharmacist, engineer, enterostomal therapist, informatics specialist) and attended meetings based on project need. EBP projects were identified from a literature review. The CNS led the initial projects involving the committee representatives in all stages of the process. Unit representatives were key in disseminating EBP protocol information to staff. Findings: EBP protocols have been implemented with ongoing monitoring. Comparisons measures of pre-intervention to current outcome demonstrate improvements: 1) ventilator associated pneumonia decrease from 8 to 5 (rate/1000 ventilator days), 2) average mechanical ventilation days decreased from 7.4 to 6.8 (days), 3) head of bed elevation > 30 increased 30 % to 99%, 4) daily sedation interruption compliance increased 0% to 75%, and 5) blood conservation methods have been introduced in all units. Conclusions: This innovative approach improved patient outcomes and also provided a method to educate staff on EBP. The committee representatives have become advocates for EBP and serve as innovators for change and EBP on their units. Implications for Practice: The CNS driven project can be initiated to provide staff with skill in EBP to create change. The next goal is to have the committee representatives identify and lead the EBP projects with assistance from the CNS.en_GB
dc.date.available2011-10-27T11:45:26Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:45:26Z-
dc.conference.date2008en_US
dc.conference.nameClinical Nurse Specialists: Leaders in Clinical Excellenceen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationAtlanta, Georgia, USAen_US
dc.descriptionConference theme: Clinical Nurse Specialists: Leaders in Clinical Excellence, held March 5 - 8 at the Westin Peachtree Plaza in Atlanta, Georgiaen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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