Paper
Thursday, July 12, 2007
Knowledge-Based Nursing Initiative: Translating Evidence into Practice
Beth Ann Swan, PhD, CRNP, FAAN1, Norma M. Lang, PhD, RN, FAAN, FRCN2, Elizabeth C. Devine, PhD, RN, FAAN2, Amy Coenen, PhD3, Tae Youn Kim, PhD, RN2, and Mary Hagle, PhD, RN4. (1) Jefferson School of Nursing, Thomas Jefferson University, Jefferson College of Health Professions, Philadelphia, PA, USA, (2) College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA, (3) International Classification for Nursing Practice Programme, International Council of Nurses, Milwaukee, WI, USA, (4) Center for Nursing Research, Aurora Health Care, Milwaukee, WI, USA
| Learning Objective #1: Describe the ACW “Knowledge-Based Nursing” Initiative (KBNI) created to accelerate and expand the use of knowledge and evidence in nursing practice through intelligent technology. |
| Learning Objective #2: Discuss the ACW knowledge discovery process that leads to embedding evidence into the nurse workflow of clinical decision support systems at the point of care.
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TITLE: Knowledge-Based Nursing Initiative: Translating Evidence Into Practice
The “Knowledge-Based Nursing” Initiative (KBNI) is a leading edge partnership among Aurora Health Care, Cerner Corporation, and University of Wisconsin-Milwaukee College of Nursing (ACW) to accelerate and expand the use of knowledge and evidence in nursing practice through intelligent technology. Variation in the quality of nursing care across countries, clinical settings, and populations is widely recognized. KNBI identifies, defines, facilitates and improves nurses’ direct contributions to patient outcomes through the enhanced use of evidence based clinical care using intelligent clinical information systems.
This Initiative uses a structured process for knowledge discovery that defines criteria for a phenomenon of concern (POC), search, analysis, evaluation, and synthesis of referential evidence. Evidence is gathered from a variety of sources and translated into specific patient assessments, nursing judgments/diagnosis about the problem, nursing interventions and outcomes. The evidence is then synthesized into referential recommendations. This referential knowledge is then translated into action items for practice. The action items are then embedded into the workflow of the clinical information systems application structure that provides decision support to nurses at the point of care.
This presentation will describe and discuss each step in the structured knowledge discovery process using the phenomenon of concern – risk for delirium - as an exemplar from referential evidence to actionable decisions by nurses at the point of care. Evidence about risk for delirium related to: 1) patient assessment of risk for delirium, 2) problem identification of risk for delirium, 3) nursing interventions for risk for delirium, and 4) nurse-sensitive outcomes of risk for delirium have been translated and embedded in a clinical information system at the point of care.