Evidence-Based Practice & Research

Screen_shot_2011-05-09_at_4.04.18_PMThe Department for Research and Evidence-Based Practice (EBP) and the Research & EBP Council exist to foster a research and EBP program for the purpose of improving patient outcomes and transforming the practice environment.

This is accomplished through provision of education and support services for evidence-based innovation and primary research projects. Study design, conduction, data analysis, presentation and publication assistance is provided through mentoring. The educational courses offered provide nurses with the skills necessary for finding and implementing best practices. Education outreach to community nursing programs introduces students to EBP concepts and the evidence-based nursing practice environment at CVMC. By enabling hospital staff to embrace research and EBP, patients will receive exceptional care and clinical decision making will be advanced. 2010 program highlights are described below.

Screen_shot_2011-05-09_at_4.04.33_PMMagnet reviewers were highly complementary of the research and evidence-based nursing program during their site visit. Research and/or EBP were highlighted in the New Knowledge, Innovations and Improvements & Empirical Outcomes exemplars received by CVMC upon earning its 2nd Magnet redesignation in January 2010.

Ellen Minch, RN, ND, IBCLC, a lactation consultant on the Birthing Center, was featured in the magazine Military Spouse, January 2010.  In an article by Emily McKinley entitled Breastfeeding Basics: An interview with lactation consultant Ellen Minch on page 55, Ellen gives readers “the skinny on breastfeeding.”

The first Research and EBP Saturday Morning Clinic was held in February. Four interactive courses were offered with contact hour credit: Let’s Get Cooking with EBP, Searching the Literature, Appraising the Literature, and Grading the Evidence. Council members facilitated these educational activities, which they developed.

CVMC’s 1st Point-of-Care Nursing Research Team completed their research process in 2010. It sounds simple enough, research begins with an idea, but the process is involved and does not officially end until the study findings are published. The manuscript written by PACU and Day Surgery nurses, “The Impact of Music on the PACU Patient’s Perception of Discomfort,” was published in the April issue of The Journal of PeriAnesthesia Nursing1.

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Over the course of 2010 EBP week, 182 nurses, 29 NA/Techs, 14 MD/NP/CNM and 19 staff members in the RT/RPh/SW/Student category participated in activities beginning on Sunday and continuing through Friday. Council members conducted floor rounds with the “Who’s First”game for both day and night shifts.  “Who’s First,” like College Bowl, is a first-on-the-buzzer game, and prizes were ‘earned’ by correctly answering EBP questions.

This year’s Poster Session was open from 4:00 PM on the 20th through midnight of the 21st.  Lenoir-Rhyne University Senior Nursing Students (11) presented posters of their Quality Improvement Practicum Projects, and 4 CVMC nurses presented EBP Initiative Posters.  Over 125 persons viewed the poster presentations!  Apple Crisp samplers were served to those attending from 1100-1300 on Wednesday when the students and nurses were present to discuss their work.  These staff also received EBP Survival Kits.  CVMC nursing administrators served as poster judges, and awards were presented to the student projects earning highest scores.

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The nursing research team comprised of Day Surgery nurses, CRNAs and PACU nurses investigating aromatherapy for alleviation of postoperative nausea and vomiting due began the data collection phase of their research study in June. Experimental subjects are provided metered amounts of peppermint extract in concert with controlled breathing, while control subjects are coached in controlled breathing alone.

Wike_LisaThe 9th Annual Summer Institute on Evidence-Based Practice: Frontline Improvement–How to Do It, How to Lead It, How to Inform It, held in San Antonio in early July, focused on improving quality and safety in healthcare by translating evidence into practice. Lisa Wike, MSN, RN-BC, Practice Improvement Director, Medical-Surgical, presented her research on the effect of the Rapid Response Team (RRT) on mortality and nursing efficacy at CVMC. Wike stated, “one of the quotes I recorded from the conference was ‘If we continue to do what we’ve always done, we will get the results we have always gotten’ (Plesek, 2007).  As the current chair of the Research and Evidence-Based Practice Council, I hope to use some of the information learned from the conference to further promote research and EBP at CVMC.  We need to make it easy for direct care staff to obtain information on best evidence.  EBP should make the right choice easy to make.”   Also representing CVMC at the conference was Dr. Rebecca Tart with two poster presentations: a) Let’s Get Cooking with EBP, about the interactive course the Council developed to teach staff the EBP process and b) our point-of-care team approach to nursing research.

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The 2010 Research Theatre, which showcased the research talents of nurses at Catawba Valley Medical Center conducting studies at the point of care was convened in September. “Research Theatre was amazing,” according to Eddie Beard, Senior Vice-President for Patient Care and Chief Nursing Officer who reported Tony Rose, CEO, said, “Don’t ever let me miss another one of these again.”  Other comments included:

  • “The presentations were very impressive and inspiring – made me proud to work at CVMC!”
  • “I was totally impressed with the complexity of the research projects.  All presenters did a great job and obviously understood all aspects of their projects.”
  • “I thought it was great that the three research projects were at different points.”
  • “It is great to work in a place that encourages people to think and challenge the status quo.”

 

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The Birthing Center Nursing Research Team received approval of their study proposal from the IRB in September. These nurses will evaluate the effectiveness of alternative methods of dealing with labor pain in the subjects who volunteer to participate. The Coping with Labor Algorithm© will be used to guide the nurse researchers in the physiological and environmental alternatives offered to subjects, e.g. shower, massage, relaxing music, lighting, etc.

Beth Rudisill, MSN, RN-BC presented a poster, “Nursing Certification…Going Viral,” at the Nursing Management Congress 2010 in Grapevine, Texas held 22-26 September. This was a good networking conference, according to Rudisill. “Another poster presentation regarding patient satisfaction hit home with me. As a result we are addressing this in leadership rounds on Psychiatry Services now.” On each nurse leader’s assigned rounding day, he/she visits with patients admitted the previous day. This provides an opportunity for early recovery if a patient is not satisfied. Rudisill states that psychiatry patient satisfaction scores have increased since leadership rounding has been implemented.

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The ED Point-of-Care Nursing Research Team presented “How Do Temporal Artery Thermometers Measure Up,” results from their research, in both poster and podium format at the 2010 Emergency Nurses Association (ENA) Annual Conference in San Antonio in late September. Julie Carrigan, BSN, RN, CEN remarked, “I was overwhelmed at how many people were interested in our project.  Nurses from all over the country stopped by our poster to see the results because of issues in their practice with temporal artery thermometers.”  Ann Moore, MSN, RN-BC, CEN said, “we are very fortunate to have been provided this opportunity.  We returned excited to share insights about what we learned regarding sepsis, workplace violence, death of a young athlete and dealing with psychiatric patients in the ED.” CVMC’s ED Research Team was awarded “Best Research Poster,” one of two posters recognized for merit from among more than 100 poster abstracts accepted for presentation by the ENA.

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The North Carolina Organization of Nurse Leaders (NCONL) convened their inaugural research symposium 12 November 2010. “From Staff Nurse to Chief Nurse: Conducting Research at the Point of Care” was the symposium’s emphasis, and twenty CVMC staff traveled to WakeMed Health & Hospitals in Raleigh for the event.

Betty Easter, RN, CPAN provided a podium presentation on “How I Lead a Nursing Research Study.” From the staff nurse perspective, Easter described the process that PACU and Day Surgery followed to study the effect of music on postoperative patients’ pain. Being the first speaker after a carbohydrate-laden lunch would be daunting for most who might struggle to keep participants awake. However, Easter’s dynamic, genuine style garnered rapt attention from staff nurses and leaders alike. Her presentation was so well received that NCONL leaders have since been asked her to lead a panel discussion of staff nurses in the upcoming 2011 symposium.

In his presentation, “CNO Perspective: How I Support Point-of-Care Research”, Eddie Beard, MSN, RN, NEA-BC, summarized the structure and development of the Research and Evidence-Based Practice program at CVMC. He also highlighted his nurses’ research accomplishments from national presentation awards to manuscript publications. Beard stated “if nurses embrace research they are capable of transforming their own practice.”

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CVMC was also represented in the poster sessions. Feeding Readiness for Preterm Infants, an evidence-based practice project, led by Andrea Flynn, BSN, RNC and Lori McNeely, BSN, RNC received honorable mention in the EBP category. The Emergency Department Nursing Research Team’s temporal artery temperature study, presented by Julie Carrigan, BSN, RN, CEN, was an award finalist in the research poster category. A qualitative research study on the effects of the psychiatric unit’s environment on patient anxiety was accepted for presentation by Veronica McCray, BSN, RN-BC, Monique Robinson, BSN, RN-BC and Beth Rudisill, MSN, RN-BC, and Gail Settlemyre, BSN, RN, CPAN presented a poster describing the Let’s Get Cooking with EBP course developed by the Research & EBP Council.  Over 50 abstracts were submitted, but only 35 were accepted for presentation at the symposium.

A Patient Safety and Quality Healthcare: eNews alert dated November 17, 2010 featured CVMC’s suicide prevention initiative. The Editor’s Note, by Susan Carr, follows. The Joint Commission has issued Sentinel Event Alert #46: “A Follow-Up Report on Preventing Suicide.” The alert calls for non-psychiatric settings such as medical/surgical units and emergency departments to provide adequate screening and care for suicidal patients. For a resource on this topic see Bumgarner and Haygood (2009) in PSQH: “Suicide Prevention Outside the Psychiatry Department: A Bundled Approach.”   According to Susan Bumgarner, MSN, RNC, NEA-BC, Med/Surg Nurse Administrator, “the Suicide Prevention Bundle was huge team effort between the ED, CCU and Psychiatry Services, and the team approach continues with Kimberly Yates, MSN/MHA, RN, NEA-BC, Psychiatry Services Director, leading the Suicide Prevention Team.  Bumgarner recognized Greg Billings, MSN, RN, Van Haygood, MSN, RN, NE-BC and Beth Rudisill, MSN, RN-BC for their roles in disseminating the initiative.

References:

  1. Easter B, DeBoer L, Settlemyre G, Starnes C, Marlowe V, Tart RC. The Impact of music on the PACU patient’s perception of discomfort. J PeriAnesth Nurs. 2010;25(2):79-87.