Week 2-Evidence-Based Practice Process: The Johns Hopkins Nursing EBP Model – Flashcards

-Academic Center for EBP, 2009 -Starts with you going out and finding research instead of identifying an issue and then Q and THEN going out to find research -Could be organizational level change or individual

-Melnyk & Fineout-Overholt, 2011 -More focused on if they are ready for a change (step 0) -Big emphasis on organizational culture

-Titler et al, 2001 -team based

-Newhouse et al, 2005

-Rycoft-Malone at al, 2002

-Stetler, 2001 -OLDEST MODEL -Making sure you are using research -focused on individual level practice

1.) Identify the Practice Question 2.) Finding Evidence 3.) Translate Evidence into Practice

-Identification of a practice problem, issue or concern 1.) Recruit an inter-professional team 2.) Develop and refine the EBP Q 3.) Define the scope of the EBP Q & identify stakeholders 4.) Determine responsibility for project leadership 5.) Schedule team mtgs

*Knowledge-focused Triggers:* -Begins with an innovation or research finding -EX: ideas might emerge in a journal club or from attending a professional conference *Problem-focused Triggers:* -Begins with a perplexing or troubling clinical situation -EX: Increase in fall rate; Decrease in Pt. satisfaction

*Components for quantitative evidence* -*P*opulation -*I*ntervention -*C*omparison (not always specified) -*O*utcome -*T*ime (not always specified)

-P: Cancer pts receiving outpatient chemotherapy -I: hand massaging in addition to usual care -C: usual care alone -O: pt's self-reported levels of pain -T: immediately following chemotherapy treatment

-P: adolescents age 13-21 seen in ED -I: none -C: none -O: Prevalence of physical injuries as a result of teen dating violence -T: none

-Locating & appraising evidence to answer your practice question 6.) Search for internal and external sources of evidence 7.) Appraise the level and quality of each piece of evidence 8.) Summarize the individual evidence 9.) Synthesize overall strength and quality of evidence 10.) Develop a practice change recommendations

-Integrating evidence into practice 11.) Determine the fit, feasibility, and appropriateness of recommendations for the translation path 12.) Create an action plan 13.) Secure the support & resources necessary to carry it out 14.) Implement the plan 15.) Evaluate the outcomes 16.) Report outcome evaluation to stake-holders 17.) Identify the nest steps to continue and spread the implementation 18.) Disseminate the findings

*Research-related barriers:* -Availability of strong research evidence -Clinical practice implications *Nurse-related barriers:* -Education/skills -Attitudes *Organizational barriers:* -Financial support (time, resources) -Leadership