enhancing nurse residentsâ•Ž transition to practice
TRANSCRIPT
Lehigh Valley Health NetworkLVHN Scholarly Works
Patient Care Services / Nursing
Enhancing Nurse Residents’ Transition to PracticeThrough an Evidence-Based Practice Project: TheVolunteer Partners Walking ProgramTamara L. Burket MSN, ACNS-BC, GCNS-BC, CCRN, FGNLALehigh Valley Health Network, [email protected]
Follow this and additional works at: http://scholarlyworks.lvhn.org/patient-care-services-nursing
Part of the Nursing Commons
This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact [email protected].
Published In/Presented AtBurket, T. L., (2015, October 29) Enhancing Nurse Residents’ Transition to Practice Through an Evidence-Based Practice Project: TheVolunteer Partners Walking Program. Presented at Research Day 2015, Lehigh Valley Health Network, Allentown, PA.Burket, T. (October, 22, 2014). Enhancing Nurse Residents' Transition to Practice Through an Evidence-Based Practice Project: TheVolunteer Partners Walking Program. Poster session presented at the 2014 PONL Nursing Leadership Conference, Gettysburg, PA.
•Patientsarenotconsistentlyambulated,oftenresultinginmissedcareopportunities.
•Duringanaveragestay,apatientspends73%-83%oftheirtimelyinginbed.causing5%lossofstrengthperday.
•34-50%ofelderlypatientsinanacutemedicalsurgicalsettinglosefunctionforreasonsunrelatedtotheprimarydiagnosis,includingtheeffectsofbedrest.
Background Outcomes
Process1List of ‘walkers’ created daily2Registered Nurse (RN) deems patients appropriate for
volunteer walking program
Frequent,earlyambulationisprovento:Increase•levelofconsciousness(LOC)•functionalindependence•numberofpatientsdischargedtohomevs.skillednursing
facility/rehabilitativecareImprove•respiratoryfunction•cardiovascularfitness•overallpsychologicalwell-beingDecrease•lengthofstay
6/15/2014 - 7/15/201435trainedvolunteerpartnerslogged116hours,walking47patientsatotalof26,136feetor4.95miles.
Cost Savings
•Identifyproblem•DevelopPICOquestion•Completeliteraturesearch•Buildevidencetable•Disseminatefindings
Whileorientationcentersonclinicalcompetencyandacclimationtoanorganization,anurseresidencyprogram(NRP)focusesonprofessionaldevelopment,transitionintopractice,androlesocialization.Throughaseriesoflearningandworkexperiences,graduatenursestransitionintoleadersatthebedside.Animportantcurriculumobjectiveistoincorporateresearchbasedevidencetoimproveorimpactpatientoutcomes.Nurseresidentsaredividedintosmallcohortsoftheirpeerstoworkthroughcompletionofanevidencebasedpractice(EBP)project.TheprojectsaresupportedbyanEBPfacilitator,anexperienced,clinicallycompetentmaster’spreparednursewhocommitstoinvestinginthenurseresidents’professionaldevelopment.UsingTheIowaModelofEvidence-BasedPracticetoPromoteQualityCareasaguide,EBPFacilitatorscoachresidentsovera12monthperiod.CompletinganEBPprojectwithinthefirstyearofhireallowsthenurseresidenttoexperiencemakinganimpactonclinicalpracticeearlyintheircareer.ThisposterillustratesaNRPEBPproject-“TheVolunteerPartnersWalkingProgram.”
0
$12,760
$29,580
0
5000
10000
15000
20000
25000
30000
35000
Volunteer Partner Technical Partner Registered Nurse
$
Problem Focused Triggers
1. Risk Management Data 2. Process Improvement Data 3. Internal/External Benchmarking Data 4. Financial Data 5. Identification of Clinical Problem
Knowledge Focus Triggers
1. New Research or Other Literature 2. National Agencies or Organizational Standards
and Guidelines 3. Philosophies of Care 4. Questions from Institution Standards Committee
Consider Other
Triggers
NO
Form a Team
Assemble Relevant Research & Related Literature
Critique & Synthesize Research for Use in Practice
Is there A Sufficient Research
Base?
NO YES
Pilot the Change in Practice 1. Select Outcomes to be Achieved 2. Collect Baseline Data 3. Design Evidence-Based Practice
(EBP) Guideline(s) 4. Implement EBP on Pilot Units 5. Evaluate Process and Outcomes 6. Modify the Practice Guideline
Conduct Research
Base Practice on Other Types of Evidence 1. Case Reports 2. Expert Opinion 3. Scientific Principles 4. Theory
Institute the Change in Practice Continue to Evaluate Quality Of Care and New Knowledge
Is Change Appropriate
For Adoption in Practice
NO YES
YES
Disseminate Results
Monitor and Analyze Structure, Process, and Outcome Data
• Environment • Staff • Cost • Patient and Family
Is this Topic A Priority For the
Organization
Reprinted with permission from Marita G. Titler, PhD; RN, FAAN, University of Iowa Hospitals and Clinics. Copyright © 2008. Source: Pediatr Nurs 2010 Jannetti Publications, Inc.
The Iowa Model of Evidence-Based Practice to Promote Quality Care
Patient Criteria for Volunteer Walking Program
•PatientIndependently: –Sits&standsupright –Useswalker/cane –PushesIVpump •Normotensive •Steady,notfirsttimeoutofbed •Notinisolation •Needsapartnertobeencouragedtowalk
3Trained Volunteer Partners round hourly: •Ambulatequalifyingpatients •Offercomfortitems(headphones,toiletries,pillows,blankets) •Clearhallwaysandpatientroomsof
clutter •Stockhandgel,glovesand
incontinencesupplies •Engageinotherdutiesasrequested
PurposeDevelopandimplementasafeandefficientprogramtopromoteopportunitiesforpatientambulationutilizingthevolunteerworkforceascaringpartners.
© 2014 Lehigh Valley Health Network
The Iowa Model of Evidence-BasedPractice to Promote Quality Care
References:1. Drolet,A.,DeJuilio,P.,Harkless,S.,Henricks,S.,Kamin,E.,Leddy,E.,&Williams,S.(2013).Movetoimprove:thefeasibilityofusinganearly
mobilityprotocoltoincreaseambulationintheintensiveandintermediatecaresettings.PhysicalTherapy,93(2),197-207.doi:10.2522/ptj.20110400.2. Fleck,S.,Bustamante-Ara,N.,Ortiz,J.,Vidán,M.,Lucia,A.,&Serra-Rexach,J.(2012).ActivityinGEriatricacuteCARe(AGECAR):rationale,design
andmethods.BMCGeriatrics,1228.doi:10.1186/1471-2318-12-28.3. Inouye,S.K.,Acampora,D.,Miller,R.L.,Fulmer,T.,Hurst,L.D.,&Cooney,L.M.(1993).TheYalegeriatriccareprogram:amodelofcaretoprevent
functionaldeclineinhospitalizedelderlypatients.JournaloftheAmericanGeriatricsSociety,4,1345–52.
Lehigh Valley Health Network, Allentown, PA
Enhancing Nurse Residents’ Transition to Practice Through an Evidence-Based Practice Project: The Volunteer Partners Walking Program
Savingsfor29FourHourShiftsforVolunteerPartnersVersusSkiledCaregivers
NursingServices TherapyServices
VolunteerServices
PatientCentered
Care
MagnetTMSince2002