Paper Presentations: Stephanie Schulte’s “Teaming Up with Nursing to Put Evidence into Action at an Academic Medical Center”

First, the abstract:

Teaming Up with Nursing to Put Evidence into Action at an Academic Medical Center
Michigan, 11:00am-11:50am
Presenter: Stephanie J. Schulte, Assistant Professor, Education & Reference Services Coordinator, OSU Health Sciences Library, Columbus, Ohio
Authors:

  • Stephanie J. Schulte, Assistant Professor, Education & Reference Services Coordinator, OSU Health Sciences Library
  • Susan Bejciy-Spring, Director, Nursing Evidence Based Practice and Standards, The Ohio State University Health System
  • Jill Niese, Manager, Nursing Evidence Based Practice and Standards, The Ohio State University Health System

Evidence in Action (EIA) Rounds is a clinical nursing initiative at The Ohio State University Health System that provides unit-based interactive forums to assist nurses in exploring best practices in the management of a selected patient. Facilitators of EIA Rounds include two health system nurse leaders in evidence based practice (EBP) and a nursing liaison librarian. Facilitators team up with unit nurses caring for the patient to define evidence-based practice, use an evidence-based approach to answer clinical questions, and explore the best available evidence related to a specific patient. Using nursing sensitive indicators and the Iowa Model of Evidence Based Practice as a guide, the facilitators review details of the case and note clinical questions from the care team, search appropriate internal and external resources for evidence, and return to discuss their findings. The evidence, or lack thereof, is placed in the context of the selected patient. Gaps in policies and procedures and evidence from the research literature are all discussed in a non-punitive manner. If gaps are identified, the EBP nurse leader facilitators have the authority and means to revise policies or create new policies if needed. This presentation will explore the librarian’s role in this unique collaboration aimed at putting best practices into action. It will also discuss the outcomes and challenges encountered in the process.

What follows are my notes from Stephanie’s awesome talk on her experience working with staff nurses in “Evidence in Action Rounds.” (Disclaimer: I took these on my 1st gen iPod Touch.  I’ve tried to clean them up somewhat.  If the presentations get posted at some point, we’ll be sure to link to them!  And if you attended the session and want to add anything, please feel free to do so in the comments!)

At Stephanie’s institution:

  • Culture of EBP
  • various nursing practices and positions and programs to support.
  • Clinical practice guidelines committe (Stephanie is on).
  • Lots of educational initiatives.

Stephanie provides nursing CME support.

“Evidence in Action” (EIA) nursing rounds:

  • A way to integrate internal & external best practices
  • These are non-punitive, which needs to be made very clear because there is some fear.
  • How it works: nurse leader identifies a unit to work with through staff nurse contacts.
    • Day 1: nurse leader and librarian meet with unit manager, who identifies a patient. Together they create clinical questions while looking at chart, using indicators. EBP nurse leader and librarian “divide and conquer” to search the literature.
    • Day 2: return with results, review indicators etc, with the unit nurses. Go over answers to the clinical questions and the resources used.  Usually there are still lots of gaps at the end – these can be addressed through policy changes etc.

EIA tools:

  • Nurse sensitive indicators
  • Iowa model of EBP: forming a question, forming a team (top half of model)
  • Johns Hopkins nursing EBP scale

How she got involved:

  • Result of construction, she had to get out of the space which provided an excuse to get out on the floors.
  • Contacted the director of EBP.

Example: “The power of 1”: one patient can influence the care of many.  Nephrostomy tube example led to policy change and a poster with the nurses involved.  The poster is being presented at national nursing conference!

Challenges:

  • Scheduling!! Turnaround time for searches is FAST.