Paper
Wednesday, July 13, 2005
An Evidence-Based Performance Improvement Project
Deborah J. Kenny, RN, PhD, LTC, US, ANC, Nursing Research Service, Walter Reed Army Medical Center, Washington, DC, USA and Maggie L. Richard, RN, PhD, CDR, NC, USN, National Naval Medical Center, Bethesda, MD, USA.
Aims/Objectives: The purpose of this project is to intensively train a core group of Advanced Practice Nurses (APNs) from two military treatment facilities (MTFs) in the Washington, DC area: 1) to utilize a performance improvement process and research methodology to implement evidence based practice guidelines; 2) to examine the process of translating knowledge into practice; and 3) to examine differences in nurses' perceptions of the environment, personal innovativeness, and research utilization in the organizational culture. Design: A prospective, descriptive research design was employed to develop and implement evidence-based practice guidelines Population, Sample, Setting, Years: Nursing personnel from two MTF's in the Greater Washington, DC area. Methods: The Iowa Model of Evidence-Based Practice guided the process. Doctorally prepared team leaders established Multidisciplinary Teams comprised of BSN and APN nurses from both facilities. Topic areas were identified and evidence from literature reviews was graded using recommendations from the Agency for Healthcare Research and Quality; and the US Preventive Services Task Force (USPSTF). Metrics were used to measure nursing knowledge, practice compliance and documentation both pre- and post-implementation. Analysis: Outcomes will be measured on several levels (unit, nurse, patient, organization) to determine overall adoption (and adaptation as necessary) of the guidelines, consistency of practice, and continuous evaluation of the implementation process. Comparisons of professional and paraprofessional staff were made to determine diffusion of the new practice as a part of the organizational culture. Implications: Long term objective: Adapt the EBP guidelines to other facilities throughout the military healthcare system. The guidelines will be posted on the TriService Nursing Research Program Resource Center website for general public use and adaptation. This project is expected to enhance the quality of patient care and outcomes and support nurses in having evidence based practices. Funding: This project is funded through the TriService Nursing Research Program.