Empowering Nurses for System-wide Application of an Evidence-Based Practice Model for Seven Nurse Sensitive Quality Indicator Initiatives

Tuesday, 19 November 2013: 10:40 AM

Cheryl Christ-Libertin, MS, CPNP-PC
Center for Professional Practice, Akron Children's Hospital, Akron, OH
Lisa A. Aurilio, MSN, MBA, RN, NEA-BC
Akron Children's Hospital, Akron, OH

Learning Objective 1: Identify leadership strategies to provide a structure and process for implementation of evidence-based practice to impact patient outcomes for nurse sensitive quality indicators.

Learning Objective 2: Describe the benefits of experiential learning to sustain and spread evidence-based practices.

Nurse leaders have an essential role in promoting evidence-based practice (EBP) and quality improvement (QI). Frontline nurses benefit from experiential learning and mentoring in EBP and QI for exemplary patient outcomes, reduced healthcare costs, increased reimbursement, and recognition of quality nursing care. An EBP coordinator mentored teams in a literature search of the Cochrane Review Database, National Guideline Clearinghouse, CINAHL, and PubMed. The teams synthesized and weighed. A CNO demonstrated transformational leadership in engaging frontline nurses, interdisciplinary staff, and parents to develop and sustain exemplary nurse sensitive quality indicator (NSQI) outcomes. Seven teams formed with a focus on NSQI most relevant to pediatrics. Teams formed charters defining background, purpose, importance, scope, deliverables, and metrics. Nurse executives provided resources to overcome implementation barriers and empower frontline staff to drive system change. Members attended a full-day workshop and received individual and group mentoring. Teams meet regularly to develop and implement best practices applying an EBP model. Teams evaluated understanding of evidence-based bundles or best practices through pre- and post-test following mandatory education modules and unit level monitoring of adherence to the bundles. Unit level monitoring provides the opportunity for non-punitive reinforcement of education to hard wire changes into practice. Tracking and analyzing NSQI data at the unit and organizational level provides the definitive outcome measure of the effectiveness of the initiative. Organizational outcomes include exemplary NSQI outcomes compared to internal trends and national benchmark statistics, two national awards for low catheter-associated blood stream infection rates and NDNQI Quality Excellence Award for Pediatric Hospitals, Magnet re-designation with 10 exemplars for outcomes, and federal funding to spread and sustain patient safety processes through Ohio Solutions for Patient Safety collaborative. Team member outcomes include membership on national advisory panels and manuscript teams to disseminate processes and outcomes for replication.