Tuesday, 14 July 2009: 12:00 AM
Learning Objective 1: describe a comprehensive framework for EBP infusion using a relevant metaphor that aids continual evaluation.
Learning Objective 2: report the experience of using the EBP framework to educate nurses in a Balkan cultural exchange program.
Over the past decade, war and economic upheaval have left the Balkan countries struggling to provide adequate health care to its citizens. In an effort to improve health care delivery, a large grant-based health education and cultural exchange program sponsored by the Bureau of Educational and Cultural Affairs, U.S. Department of State and the University of Arizona Health Sciences Center was developed to support physicians, nurses, and engineers in that area of the world toward improving health practice. In response to an assessment of nursing and physician education, ten selected Balkan nurses visited the
Magnet-designated University Medical Center in
Tucson,
Arizona and were given structured curricula on the establishment of telemedicine networks, e-libraries, and video conferencing for development of their health care infrastructure and virtual educational and practice support. Their curricula included evidence-based practice knowledge (EBP) but crafting presentations was difficult because acquiring content does not guarantee fundamental practice change. A comprehensive EBP framework was developed including domains, elements and levels in order to reach the best clinical behaviors and optimal patient outcomes. This framework led to finding the metaphor substate for evaluation that had relevance for our Balkan guests.
Infusion of evidence-based practice is a daunting task that requires continued vigilance and evaluation no matter what the environment. Enthusiasm for EBP is developed at the individual and unit levels but implementation support must occur at the managerial and administrative levels for change to be sustained. Technology can accelerate the process but EBP ultimately becomes a human endeavor for critical and reflective thinking. Collaboration reinforces the context but communication provides the nexus. Without continuous evaluation, EBP infusion can be derailed at the next trendy initiative. Having a framework that can be tailored to an country’s nature and culture allows for continued evaluation which is essential for making EBP a reality.
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