Evidence-Based Practice in Daily Nursing Care

Friday, 16 July 2010: 8:50 AM

Margo Jansen, RN1
Anja van der Tempel, RN1
Jolanda Maaskant, MSc, RN1
Hester Vermeulen, PhD2
1Department C, Academic Medical Center - University of Amsterdam, Amsterdam, Netherlands
2Amsterdam Center for Evidence Based Practice, Academic Medical Center to the University of Amsterdam, Amsterdam, Netherlands

Learning Objective 1: describe a model and infrastructure to systematically approach the implementation of EBP.

Learning Objective 2: descibe how knowledge gaps can be identified and narrowed by implementing the “nursing staff file meeting” within an organization.

Purpose and target audience
Working with Evidence Based Practice (EBP) can improve quality of care. However, within organizations an infrastructure to systematically support nurses to implement EBP often is lacking. We offer nurse executives and educators a strategy to move from opinion-based to evidence-based nursing care.
A model for implementing EBP was developed by the quality department in cooperation with the nursing directors. Key element is the “nursing staff file meeting”. This meeting, in which active discussion and critical thinking based on real life patient cases is the starting point, enables nurses to recognize and formulate clinical uncertainties, questions and ideas on optimal care. At the end of the discussion, questions are presented in a Patient Intervention Comparison Outcome-format (PICO). One nurse reviews the evidence in order to answer the PICO and prepares an evidence-based recommendation, herewith supported by an EBP-expert. This recommendation will subsequently be incorporated in teaching programs and existing protocols. In addition to the “nursing staff file meeting” an education program was developed with EBP courses on different levels.  

Measurement of improvement
In total 95 file meetings are organized on 10 different wards. The identified clinical problems have resulted in circa 90 PICO’s that can be grouped in 4 themes; (a) pain, (b) infections, (c) feeding and (d) excretions. Based on these subjects 15 evidence-based recommendations are written, 18 are still in progress and 7 protocols are revised. More than 200 nurses are trained.

The “nursing staff file meeting” is an innovative way for healthcare organizations to improve the quality of care by the implementation of EBP. When facilitated in terms of dedicated time and education, all steps of EBP can be performed resulting in evidence-based nursing care.