Paper
Monday, November 14, 2005
Advancing Research and Clinical Practice Through Close Collaboration (ARCC): A Pilot Test of an Intervention to Improve Evidence-Based Care and Patient Outcomes in a Community Health Care Setting
Rona Faye Levin, PhD, RN1, Paula Scharf, PhD, RN2, MaryJo Vetter, MS, RN, NPC3, Bernadette Mazurek Melnyk, PhD, RN, CPNP/NPP, FAAN4, and Ellen Fineout-Overholt, PhD, RN4. (1) Center for Nursing Research, Clinical Practice and International Affairs, Lienhard School of Nursing, Pace University, Pleasantville, NY, USA, (2) Lienhard School of Nursing, Pace University, Pleasantville, NY, USA, (3) Education and Clinical Development, Visiting Nurse Service of New York, New York, NY, USA, (4) College of Nursing, Arizona State University, Tempe, AZ, USA
| Learning Objective #1: Discuss methods of implementing an EBP pilot study to test the effectiveness of the ARCC (Advancing Research and Clinical Practice through Close Collaboration) Model |
| Learning Objective #2: Describe the outcomes of a pilot study to evalute the ARCC Model |
The primary aim of this pilot study is to evaluate effects of an evidence-based practice (EBP) education program (ARCC) on nurse, physician, social worker, patient, and system outcomes. Secondary aims are to assess feasibility of design, determine preliminary relationships among variables, and establish reliability on new tools, i.e., Beliefs about EBP and EBP Implementation Scales. A two-group case comparative design enlists two nursing teams in the Long Term Home Health Care Program (LTHHCP) of the VNSNY, which will be randomly assigned to an ARCC or comparison group. The ARCC intervention consists of 4 one-hour presentations by an expert on EBP basics and an EBP mentor available onsite for consultation for 8 to 10 weeks to help nurses design and implement an EBP project. The comparison group will receive content on adult physical assessment comparable in length to the “EBP basics”. Physicians and social workers who work with participating nurses will be surveyed regarding their beliefs about EBP, collaboration between nurses and themselves, and EBP implementation. Outcomes for nurses are: beliefs about EBP, EBP implementation behavior, job satisfaction, group cohesion, collaboration, and turnover. System outcomes include adverse events (e.g., emergent care for wound infections) and will be collected from the VNSNY Outcomes website. Patient satisfaction will be measured by the Press Ganey survey. ARCC project specific patient outcomes will be determined when the experimental team designs their EBP project. Data on these outcomes will be collected via audits of VNSNY patient records. The study has IRB approvals. ANOVA with repeated measures will be applied to data. Descriptive statistics will provide data on the pattern of mean scores on all outcome variables. Effect sizes will be calculated for all outcome variables. Reliability coefficients will be calculated for all multiple item measures and Pearson's r will be calculated to determine relationships among variables.