Description
Unformatted Attachment Preview
1
Create a 5-10 minute video of yourself, as a presenter, in which you will propose an
evidence-based plan to improve the outcomes the patient in the provided case study,
and examine how remote collaboration provided benefits or challenges to designing and
delivering the care.
Expand All
Introduction
As technologies and the health care industry continue to evolve, remote care, diagnosis,
and collaboration are becoming increasingly more regular methods by which nurses are
expected to work. Learning the ways in which evidence-based models and care can
help remote work produce better outcomes will become critical for success. Additionally,
understanding how to leverage EBP principles in collaboration will be important in the
success of institutions delivering quality, safe, and cost-effective care. It could also lead
to better job satisfaction for those engaging in remote collaboration.
Professional Context
Remote care and diagnosis is a continuing and increasingly important method for
nurses to help deliver care to patients to promote safety and enhance health outcomes.
Understanding best EBPs and building competence in delivering nursing care to remote
2
patients is a key competency for all nurses. Additionally, in some scenarios, while you
may be delivering care in person you may be collaborating with a physician or other
team members who are remote. Understanding the benefits and challenges of
interdisciplinary collaboration is vital to developing effective communication strategies
when coordinating care. So, being proficient at communicating and working with remote
health care team members is also critical to delivering quality, evidence-based care.
Preparation
Before beginning this assessment, it would be helpful to review the following media
activity to examine another example of remote collaboration:
● Vila Health: Remote Collaboration on Evidence-Based Care.
You may also wish to review Selecting a model for evidence-based practice changes.
[PDF] and Evidence-Based Practice Models, which help explain the various
evidence-based nursing models.
Scenario
Review the case study in the Assessment 04 Supplement: Remote Collaboration and
Evidence-Based Care [PDF]
Download Assessment 04 Supplement: Remote Collaboration and Evidence-Based
Care [PDF]
resource. You will use this case study as the focus for this assessment.
Instructions
3
For this assessment, you are a presenter! You will create a 5–10-minute video using
Kaltura or similar software. In the video:
● Propose an evidence-based care plan that you believe will improve the safety
and outcomes of the patient in the case study presented in the Assessment
04 Supplement: Remote Collaboration and Evidence-Based Care [PDF]
● Download Assessment 04 Supplement: Remote Collaboration and
Evidence-Based Care [PDF]
● resource. Add your thoughts on what more could be done for the patient and
what more information may have been needed.
● Discuss the ways in which an EBP model and relevant evidence helped you
to develop and make decisions about the plan you proposed
● Wrap up your video by identifying the benefits of the remote collaboration in
the scenario, as well as discuss strategies you found in the literature or best
practices that could help mitigate or overcome one or more of the
collaboration challenges you observed in the scenario.
Be sure you mention any articles, authors, and other relevant sources of evidence that
helped inform your video. Discuss why these sources of evidence are credible and
relevant. Important: You are required to submit an APA-formatted reference list of the
sources you cited specifically in your video or used to inform your presentation. You are
required to submit a narrative of all your video content to this assessment and to
SafeAssign.
The following media is an example learner submission in which the speaker
successfully addresses all competencies in the assessment.
4
● Exemplar Kaltura Reflection.
○ Please note that the scenario that the speaker discusses in the
exemplar is different from the Vila Health scenario you should be
addressing in your video. So, the type of communication expected
is being model, but the details related to the scenario in your
submission will be different.
Make sure that your video addresses the following grading criteria:
● Propose your own evidence-based care plan to improve the safety and
outcomes for a patient in the provided case study.
● Explain the ways in which you used an EBP model to help develop your plan
of care for the client.
● Reflect on which evidence you found in your search that was most relevant
and useful when making decisions regarding your care plan.
● Identify benefits and strategies to mitigate the challenges of interdisciplinary
collaboration to plan care within the context of a remote team.
● Communicate in a professional manner that is easily audible and uses proper
grammar, including a reference list formatted in current APA style.
Refer to Using Kaltura as needed to record and upload your video.
Note : If you require the use of assistive technology or alternative communication
methods to participate in this activity, please contact [email protected] to
request accommodations. If, for some reason, you are unable to record a video, please
5
contact your faculty member as soon as possible to explore options for completing the
assessment.
Additional Requirements
Your assessment should meet the following requirements:
● Length of video: 5-10 minutes.
● References: Cite at least three professional or scholarly sources of evidence
to support the assertions you make in your video. Include additional properly
cited references as necessary to support your statements.
● APA reference page: Submit a correctly formatted APA reference page that
shows all the sources you used to create and deliver your video. Be sure to
format the reference page according to current APA style. Submit a narrative
of all of your video content.
Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that
you may refer to it as you complete the final capstone course.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in
the following course competencies and scoring guide criteria:
● Competency 2: Analyze the relevance and potential effectiveness of evidence
when making a decision.
○ Reflect on which evidence you collected that was most relevant
and useful when making decisions regarding the care plan.
6
● Competency 3: Apply an evidence-based practice model to address a
practice issue.
○ Explain the ways in which you used the specific evidence-based
practice model to help develop the care plan identifying what
interventions would be necessary. This requires a particular
evidence-based model, such as the Johns Hopkins, Iowa, Stetler,
or other.
● Competency 4: Plan care based on the best available evidence.
○ Propose your evidence-based care plan to improve the safety and
outcomes for the Vila Health patient with a discussion of new
content for the care plan.
● Competency 5: Apply professional, scholarly communication strategies to
lead practice changes based on evidence.
○ Identify benefits and propose strategies to mitigate the challenges
of interdisciplinary collaboration to plan care within the context of a
remote team.
○ Communicate via video with clear sound and light, and include a
narrative of video content.
○ Provide a full reference list that is relevant and evidence-based
(published within five years), exhibiting nearly flawless adherence
to APA format.
7
Remote Collaboration and Evidence-Based Care
Scoring Guide
NON-PERFO
DISTINGUIS
CRITERIA
RMAN
BASIC
PROFICIENT
HED
CE
Describes an
Proposes
Proposes
propos
eviden
your
your
e an
ce-bas
own
eviden
eviden
ed
eviden
ce-bas
ce-bas
care
ce-bas
ed
improve
ed
plan,
ed
care
the safety
care
but the
care
plan to
plan to
releva
plan to
improv
improv
nce to
improv
e the
e the
the
e the
safety
safety
Vila
safety
and
Health
and
Health
and
outco
patient
outco
patient
outco
mes
Propose your
evidence-b
ased care
plan to
and
outcomes
for the Vila
Does not
8
with a
mes
or how
mes
for the
discussion
for the
the
for the
Vila
Vila
plan
Vila
Health
Health
would
Health
patient
patient
improv
patient
with
.
e
with a
new
outco
discus
conten
mes is
sion of
t
absent
new
added.
or
conten
Notes
unclea
t for
areas
r.
the
in
care
which
plan.
further
of new
content for
the care
plan.
inform
ation
or data
could
have
been
useful
in
9
develo
ping
the
plan.
Identifies an
Explains the
Explains the
explain
EBP
ways
ways
the
model
in
in
ways
and
which
which
in
lists
you
you
specific
which
the
used
used
evidence-b
you
ways
the
the
used
in
specifi
specifi
the
which
c
c
specifi
you
eviden
eviden
c
use
ce-bas
ce-bas
help
eviden
the
ed
ed
develop
ce-bas
specifi
practic
practic
ed
c
e
e
practic
eviden
model
model
e
ce-bas
to help
to help
Explain the
ways in
which you
used the
ased
practice
model to
the care
plan,
Does not
10
identifying
model
ed
develo
develo
what
to help
practic
p your
p your
develo
e
care
care
p the
model
plan,
plan.
care
to help
identify
Notes
be
plan,
develo
ing
ideas
necessary.
identify
p the
what
for
ing
care
interve
how to
what
plan.
ntions
evaluat
interve
would
e the
ntions
be
positiv
would
necess
e
be
ary.
benefit
necess
Uses a
s to
ary.
particul
patient
ar
outco
the Johns
eviden
mes.
Hopkins,
ce-bas
interventio
ns would
This
requires a
particular
evidence-b
ased
model,
such as
Iowa,
ed
model,
such
as the
11
Stetler, or
Johns
other.
Hopkin
s,
Iowa,
Stetler,
or
other.
Lists which
Reflects on
Reflects on
reflect
eviden
which
which
on
ce you
eviden
eviden
which
collect
ce you
ce you
eviden
ed that
collect
collect
that was
ce you
was
ed that
ed that
most
collect
most
was
was
ed that
releva
most
most
was
nt and
releva
releva
most
useful
nt and
nt and
releva
when
useful
useful
making
nt and
making
when
when
decisions
useful
decisio
making
making
Reflect on which
evidence
you
collected
relevant
and useful
when
Does not
12
regarding
when
ns
decisio
decisio
the care
making
regardi
ns
ns
decisio
ng the
regardi
regardi
ns
care
ng the
ng the
regardi
plan.
care
care
plan.
plan.
plan.
ng the
care
Discus
plan.
ses the
rationa
le or
criteria
that
was
used
to
determ
ine
releva
nce
and
13
usefuln
ess.
Identify benefits
Does not
Identifies
Identifies
Identifies
identify
benefit
benefit
benefit
benefit
s or
s and
s and
s or
propos
propos
propos
propos
es
es
es
e
strateg
strateg
strateg
strateg
ies to
ies to
ies to
ies to
mitigat
mitigat
mitigat
mitigat
e the
e the
e the
e the
challen
challen
challen
challen
ges,
ges of
ges of
nary
ges of
but not
interdis
interdis
collaborati
interdis
both,
ciplinar
ciplinar
ciplinar
of
y
y
y
interdis
collabo
collabo
collabo
ciplinar
ration
ration
the context
ration
y
to plan
to plan
of a
to plan
collabo
care
care
and
propose
strategies
to mitigate
the
challenges
of
interdiscipli
on to plan
care within
14
remote
care
ration
within
within
team.
within
to plan
the
the
the
care
context
context
context
within
of a
of a
of a
the
remote
remote
remote
context
team.
team.
team.
of a
Discus
remote
ses
team.
how
interdis
ciplinar
y
collabo
ration
could
be
better
levera
ged to
improv
e
outco
15
mes in
future
care
situatio
ns.
Communicate
Does not
Does not
Communicate
Communicate
comm
comm
s via
s via
unicate
unicate
video
video
profes
via
with
with
sionall
video
clear
clear
light, and
y in a
or
sound
sound
include a
well-or
video
and
and
ganize
is
light
light.
d
difficult
and
Conten
presen
to hear
does
t
tation
and
include
deliver
and
see,
a
y is
does
but
narrati
focuse
not
does
ve of
d,
include
include
video
smoot
via video
with clear
sound and
narrative of
video
content.
16
a
a
conten
h, and
narrati
narrati
t.
well-re
ve of
ve of
hearse
video
video
d.
conten
conten
Include
t.
t.
sa
narrati
ve of
the
video.
Video
presen
tation
is
betwee
n 5 to
10
minute
s.
17
Provide a full
Does not
Provides
Provides a
The reference
provid
referen
referen
list is
ea
ce list
ce list
from
referen
that is
that is
releva
ce list
not
releva
nt and
of
releva
nt and
eviden
releva
nt
eviden
ce-bas
nt
and/or
ce-bas
ed
and/or
eviden
ed
(publis
eviden
ce-bas
(publis
hed
ce-bas
ed with
hed
within
ed
several
within
five
source
APA
five
years)
s
errors.
years)
source
(publis
source
s,
hed
s,
exhibiti
adherence
within
exhibiti
ng
to APA
five
ng
flawles
format.
years).
nearly
s
flawles
adhere
s
nce to
reference
list that is
relevant
and
evidence-b
ased
(published
within five
years),
exhibiting
nearly
flawless
adhere
18
nce to
APA
APA
format.
format.
Communication
The resources below explore communication in health care:
● Ratna, H. (2019). The importance of effective communication in healthcare
practice. Harvard Public Heath Review, 23.
https://harvardpublichealthreview.org/23-article-ratna/
○ This article discusses the importance of communication in
healthcare by presenting approaches to communication as well as
discussing barriers.
● Cayley, W. (2018). Four evidence-based communication strategies to
enhance patient care. https://www.aafp.org/fpm/2018/0900/p13.html
○ This article presents four difference evidence-based strategies to
approach patients and communicate with patients.
Evidence-Base Practice Models and Examples of Application
The resources below explore EBP models and examples of their application:
● NewsRx. (2017, Jul 07). Nursing – evidence-based nursing; studies from
University of Iowa add new findings in the area of evidence-based nursing
19
(Iowa model of evidence-based practice: Revisions and validation). Health &
Medicine Week.
○ This article examines the Iowa model for EBP. The specific
example in which the model is presented is oncology nursing, but
there are valuable lessons to learn about applying evidence-based
models to nursing practice no matter what your personal focus
might be.
● Indra, V. (2018). A review on models of evidence-based practice. Asian
Journal of Nursing Education and Research, 8(4), 549-552.
○ In this paper, review on models of evidence-based practice is
discussed.
● Cacchione, P., Jayakumar, K., Lavenberg, J., Leas, B., Mitchell, M., Mull, N.,
& Umscheid, C. (2019). Impact of a hospital evidence-based practice center
(EPC) on nursing policy and practice. Worldviews Evid Based Nurs, 16(1),
4-11.
○ This article examines evidence-based practice center work to
inform nursing policy and practice.
● Chan, E., Glass, G. F., & Phang, K. N. (2020). Evaluation of a hospital-based
nursing research and evidence-based practice mentorship program on
improving nurses’ knowledge, attitudes, and evidence-based practice. The
Journal of Continuing Education in Nursing, 51(1), 46-52.
○ This article presents nine nurses in an acute hospital in Singapore
that participated in a mentorship program throughout 2015. The
20
evidence-based practice questionnaire was used to measure the
program’s effectiveness. This article examines how using an
evidence-based model can help in the implementation of care
guidelines.
● Gawlinski, A., & Rutledge, D. (2008). Selecting a model for evidence-based
practice changes. [PDF]. AACN Advanced Critical Care, 19(3) 291-300.
https://www.kau.edu.sa/Files/0004020/Subjects/EBP%20Changes%20project
.pdf
○ This website explains the various evidence-based nursing models.
● Springer Publishing. (n.d.). Evidence-Based Practice
Models.https://connect.springerpub.com/content/book/978-0-8261-2759-4/ba
ck-matter/bmatter1
○ This website also explains the various evidence-based nursing
models.
Technology and Telehealth Resources
The resources below explore technology and telehealth resources:
● Peters, M. D. J. (2018). Engaging nurses and midwives with evidence-based
healthcare. Australian Nursing and Midwifery Journal, 25(11), 24.
○ This article discusses future national public hospital funding and
healthcare reform. Australia’s healthcare sector and nursing and
midwifery professional practice must be supported by the
collection, sharing, linkage, analysis, implementation, and
21
evaluation of high quality data and evidence from research as well
as expert and consumer sources.
● RHIhub. (n.d.). Telehealth use in rural healthcare.
https://www.ruralhealthinfo.org/topics/telehealth
○ This online resource repository could be helpful in examining ways
in which telehealth care is delivered, as well as how you might
blend evidence-based care delivery to telehealth patients.
● van Houwelingen, C. T. M., Ettema, R. G. A., Kort, H. S. M., & ten Cate, O.
(2017). Internet-generation nursing students’ view of technology-based health
care. Journal of Nursing Education, 56(12), 717-724.
○ This article presents the results of a study that examined the views
of younger first-year nursing students with regard to a variety of
technologies.
● Vila Health: Remote Collaboration on Evidence-Based Care.
○ This media simulation will provide the context for your Assessment
4.
Theory and Decision Making
The resources below explore theory and decision making:
● Barret, D. (2017). Rethinking presence: A grounded theory of nurses and
teleconsultation. Journal of Clinical Nursing, 26(19/20), 157-159.
○ The article presents a potential evidence-based and theory
approach to delivering effective remote patient care.
22
● Nibbelink, C. W., Brewer, B. B. (2018). Decision-making in nursing practice:
An integrative literature review. Journal of Clinical Nursing, 27(5/6), 917-928.
○ This literature review examines the various ways that
decision-making strategies, and the evidence that informs though
strategies, are demonstrated in practice.
Program Resources and Library Resources
Writing Resources
A variety of writing resources are available in the NHS Learner Support Lab, linked in
the courseroom navigation menu. Access these resources to help you better
understand and improve your writing.
APA Style and Format
Capella University follows the style and formatting guidelines in the Publication Manual
of the American Psychological Association, known informally as the APA manual. Refer
to the Writing Center’s APA Module for tips on proper use of APA style and format.
Library Resources
Access the following library resources:
● BSN Program Library Research Guide.
○ The library research guide will be useful in guiding you through the
Capella library, offering tips for searching the literature and other
references for your assessments.
● Databases A-Z: Nursing Health Sciences.
23
○ This is a list of the library databases that are relevant to nursing
and health sciences.
● Evidence-Based Practice in Nursing Health Sciences.
○ Library guide to EBP-related topics with a focus on nursing and
health sciences.
● Find Scholarly Peer-Reviewed Sources.
○ Guide to help you more efficiently locate scholarly and
peer-reviewed resources.
● Get Critical Search Skills.
○ This guide offers a five-step approach to improving your research
search effectiveness.
1
AACN Advanced Critical Care Volume 19, Number 3, pp.291–300 © 2008, AACN
Selecting a Model for Evidence-Based
Practice Changes
A Practical Approach
Anna Gawlinski, DNSc, RN, FAAN Dana Rutledge, PhD, RN
ABSTRACT
Evidence-based practice models have been developed to help nurses move evidence into practice. Use of
these models leads to an organ- ized approach to evidence-based practice, pre- vents incomplete
implementation, and can maximize use of nursing time and resources. No one model of evidence-based
practice is
present that meets the needs of all nursing envi- ronments. This article outlines a systematic process that
can be used by organizations to select an evidence-based practice model that best meets the needs of
their institution. Keywords: evidence-based practice models, evidence-based practice, models
Factors related to patient safety, quality, and evidence-based practice (EBP) are driving changes
in healthcare. Nurses are interested in how to move good evidence into practice to optimize
patients’ outcomes; thus, nurses may benefit from understanding more about EBP models. These
2
models have been developed to help nurses conceptualize moving evidence into practice. They can
assist nurses in focusing efforts derived either from clinical problems or from “good ideas” toward
actual implementa- tion in a specific practice setting. Use of EBP models leads to systematic
approaches to EBP, prevents incomplete implementation, promotes timely evaluation, and
maximizes use of time and resources.
This article describes a systematic process for organizations to use as a template for choosing an
EBP nursing model. Strategies for involving staff nurses and clinical and administrative leaders are
discussed. Finally, a summary of key EBP nursing models is presented.
Creating Structures or
Forums for Discussions
The first step in selecting a model is to estab- lish a structure or a forum in which presentations and discussions can occur about various EBP models, their advantages and disadvan- tages,
and their applicability to organizational needs. Several possible strategies include:
• use of an existing nursing research commit- tee in which selection of an EBP model is added to
annual goals and activities;
• formation of an EBP council, with an initial task of selecting an EBP model;
• appointment of a task force charged with selecting an EBP model;
• use of an educational event to increase knowledge about EBP models while facili- tating the
selection of a model appropriate for the organization; and
• use of a focus group process to select an EBP model consistent with the philosophy, vision, and
mission of the organization.1
3
Anna Gawlinski is Director, Evidence-Based Practice, and Adjunct Professor, Ronald Reagan University of California, Los Angeles
Medical Center & University of California, Los Angeles School of Nursing, 757 Westwood Plaza, Los Angeles, CA 90095
([email protected]).
Dana Rutledge is Professor, Department of Nursing, California State University Fullerton; and Nursing Research Facilitator, Saint
Joseph Hospital, Irvine, California.
291
GAWLINSKI AND RUTLEDGE
AACN Advanced Critical Care
Any of these strategies could help “set the stage” for an organization to choose an EBP model. For
example, the authors used an existing nursing research committee/council to begin the process of
selecting an EBP model in 2 different settings. In a third hospital, a multidisciplinary EBP council
took on the task of selecting an EBP model. Regardless of the structure or the forum used, a
thoughtful and systematic process is helpful.
Composition of the Committee
or the Group
The second step to identifying an EBP model is to carefully consider appropriate members of the
committee or the group. Administrative and clinical leaders such as nurse managers, clinical nurse
specialists, and nurse educators should be represented, as should interested staff nurses. Staff
nurses who are clinical resources in their units, share an interest in improving patient care, or are
curious about research are likely members. The educational level of the committee members should
reflect that of nurses within the department or the institution and will most commonly include
nurses with associate, bachelor’s, and master’s degrees. In addition, members should repre- sent the
various clinical units/departments or specialties within the institution.
4
Involvement of persons with special expert- ise in research or EBP, such as a nurse researcher or
faculty member from a local unit, hospital, or school of nursing, may be especially helpful. These
persons may be internal or external to the organization and have valuable expertise in EBP nursing
models. They can function as active members or as consultants. A librarian member may also be
useful in retrieving needed publications to evaluate selected models.
The evaluation process and the number of EBP models that are considered can influence the
desirable number of committee members. For example, at one institution (a university academic
hospital), the nursing research council selected 7 EBP nursing models for review and evaluation.
Table 1 lists the mod- els and shows the criteria used to evaluate them. These 7 models were chosen
for evalua- tion either because they were commonly men- tioned in publications about EBP nursing
models or because they were identified by committee members. At another institution (a
community hospital), the nursing research council selected 4 EBP nursing models to evaluate on the basis of council members’ knowl- edge of the models’ utility and potential fit with the
organization.
Involvement of all committee members in the evaluation process is vital. Using a process where 2 or
3 persons volunteer to review and present 1 to 2 EBP nursing models can get all members involved.
Staff nurses can be paired with administrative or clinical leaders in teams of 2 to 3 persons. All
committee members can then participate in the process of evaluating models by attending
presentations about each model and actively participating in discus- sions. By having small groups
present each model, the workload is divided among group members. The more people involved in
the process, the greater the need for coordination and oversight by the chairperson.
Organizing the First Meeting
5
Once the group has been selected, the next step is to organize the first meeting so that clear
communication about the roles and responsibilities of team members can occur. The chairperson or
the leader can survey the group members to determine the optimal date, time, and comfortable
location for this meet- ing. Because of the nature of the work involved in selecting a model, 2 hours
is an optimal duration for meetings. An agenda should accompany the meeting invitations and
initially will include items such as discussions of the purpose and goals of the committee and the
roles and responsibilities of committee members (Table 2). Providing a brief reading assignment
that gives an overview of EBP models and should be completed before the first meeting is advisable.
The chairperson can request committee members who are already knowledgeable about EBP
models to highlight parts of the reading assignment at the first meeting to promote discussion. The
chairper- son should also collaborate with unit leaders to ensure that staff nurses have appropriate
release time for meetings.
Roles and Responsibilities of Committee or Members
At the first meeting, roles and responsibilities of the members for reviewing, presenting, and
evaluating each EBP model should be addressed. Assignments and due dates are determined to
ensure steady progress. For example, a member can elect to work in a small group to review the
literature on an EBP
292
VOLUME 19 • NUMBER 3 • JULY–SEPTEMBER 2008 SELECTING A MODEL FOR EBP CHANGES
Table 1: Evaluation Criteria and Scoring for 7 Models of Evidence-Based Practice Changesa
Evaluation Criteria for EBP Model
Purpose of Project: Evaluation and selection of an EBP model for the Nursing Department of Ronald Reagan University
of California, Los Angeles Medical Center.
6
1.
Search, retrieve, and synthesize the current literature describing EBP models to help staff nurses use EBP
concepts and apply them in clinical practice.
2.
Recommend the adoption of a specific EBP model for use by UCLA nurses.
Scoring system: 0 not present; 1 present/yes; 2 highly present/yes
Criteria
1.
Concepts and organization of model are clear and concise
2.
Diagrammatic representation of the model allows quick assimilation of concepts and organizes the steps in the
process of EBP changes
3.
The model is comprehensive from beginning stages through implementation and evaluation of outcomes
4.
The model is easy to use when concepts are applied to direct EBP changes and practice issues in clinical settings
5.
The model is general and can be applied to various populations of patients,
EBP projects, and department initiatives and programs
6.
The model can be easily applied to typical practice issues as evidenced with practice scenario or in published
literature
Models
Total
EBP Model:
EBP Model:
EBP Model:
EBP Model:
EBP Model:
7
Comments
Strengths: Weaknesses: Strengths: Weaknesses: Strengths: Weaknesses: Strengths: Weaknesses: Strengths: Weaknesses:
aUsed with permission from the Evidence-Based Practice Program, Nursing Department at Ronald Reagan University of California, Los Angeles Medical
Center, Los Angeles, California.
293
GAWLINSKI AND RUTLEDGE
AACN Advanced Critical Care
Table 2: Example of Agenda Items for the First Evidence-Based Practice Committee or Group Meeting
Welcome and introduce members
Review agenda
Discuss the goals of the committee
Discuss roles and responsibilities of committee members
Select models for evaluation
Discuss the process for presenting and evaluating evidence-based practice models
Make assignments and schedule
Identify resources and forms
Identify strategies to communicate ongoing committee work to the department
Open discussion of other items
Plan for next meeting
8
model. Work teams should be assigned a pres- entation date to present details of the reviewed EBP
model to committee members. Presenta- tions of each EBP model may take 30 to 45 minutes and
might include information on the history and development of the EBP model (who, what, when,
where, and how), revision of the model over time, overall concepts in the EBP model, the process
and flow of the EBP model, and publications describing how the model guided EBP changes in
other facilities.
Each presentation of an EBP model can be followed by 10 or 15 minutes for group mem- bers to
raise questions and discuss specific aspects of the EBP model. After the presenta- tion and
discussion, group members could review an example of how the EBP model might be applied in a
realistic practice scenario that requires consideration of a practice change (Table 3). Group
members could then use the EBP model under discussion to address the practice issue. Depending
on the group’s size, this work can be done in small groups, with each small group slated to report
back to the larger group its opinion about how the model “worked.” It is recommended that groups
break into smaller groups of 2 or 3 persons to “rate” the models’ applicability on the basis of
predetermined criteria (Table 4). Criteria for evaluating the applicability of the EBP model
should include clarity of the EBP model con- cepts and diagrammatic representation, appli- cability
of the EBP model to clinical practice issues for diverse patient care situations in the institution, ease
and user-friendliness of the EBP model, and the ability of the EBP model to pro- vide direction for
all phases of the EBP process.
Table 1 shows an example of an evaluation tool that can be used by committee members when
reviewing each EBP model. After the evaluation instrument is administered and scored, committee
members can compare and contrast the ratings, strengths, and weaknesses for addressing the
practice scenarios, and potential adoption by the institution for each model is reviewed.
9
The use of a structured process provides members with little or no background in evalu- ating an
EBP model to learn about EBP models and have greater participation and support in the evaluation
process. The link of the EBP model to practice is clear when the practice sce- nario is used.
Members increase their knowl- edge and skills in using EBP models for practice changes and
become champions for the adop- tion of a model within the organization.
Finally, the ongoing work of the committee should be communicated through forums such as mass
e-mails, newsletters, posters, nursing grand rounds, and other continuing education programs.
Such communication helps dissemi- nate the process used in selecting a model for the organization,
while inviting others to par- ticipate via comments and feedback.
Summary of Selected
EBP Nursing Models
A number of EBP models have been devel- oped; many appear very different from each other.
Some of these models are more useful in some contexts than others, and each has advantages and
disadvantages. The following steps or phases are common to most models:
●
Identification of a clinical problem or poten- tial problem
●
Gathering of best evidence
●
Critical appraisal and evaluation of evidence; when appropriate, determination of a
potential change in practice
●
Implementation of the practice change
●
Evaluation of practice change outcomes,
both in terms of adherence to processes and planned outcomes (eg, clinical, fiscal,
administrative)
10
294
VOLUME 19 • NUMBER 3 • JULY–SEPTEMBER 2008 SELECTING A MODEL FOR EBP CHANGES
Table 3: Sample Practice Scenario for Evaluating Applicability of Models for Evidence- Based Practice
Changesa
Scenario for Application of Evidence-Bas