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Strategy Submission

Empowering students to create a safer clinical environment utilizing Evidence Based Practice

Author:

Kimberly Silver-Dunker

DNP, RN

Title:

Assistant Professor

Coauthors:

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Institution:

UMASS Graduate School of Nursing Worcester

Email:

Kimberly.silver@umassmed.edu

Competency Categories:

Evidence-Based Practice, Patient-Centered Care, Quality Improvement, Safety

Learner Level(s):

Graduate Students, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN

Learner Setting(s):

Classroom, Clinical Setting

Strategy Type:

Paper Assignments

Learning Objectives:

Upon completion of this activity the students will be able to:

 1) Assess the needs of hospitalized patients and identify a clinical problem to evaluate the most current evidence-based practice.

 2) Identify strategies to improve quality of care and patient safety by planning evidence-based practice plan.

 3) Demonstrate quality patient care in clinical by integrating current evidence into their nursing practice.

Strategy Overview:

Evidence Base Practice

Students will have experiential clinical learning that will require them to collaborate and work together as a team to identify an evidence-base practice issue in the clinical setting.  They will then assess the literature to further identify the evidence to support best clinical nursing practice. (Knowledge, Skills, Attitudes)

Quality Improvement

Students will identify a clinical practice issue on their unit. They will formulate interventions to improve the quality of care based on evidence-based practice. The students will prepare a presentation and paper on this topic. (Knowledge, Skills, Attitudes). 

Safety

Students will identify how current evidence improves the delivery of care to patients and results in increased patient safety. (Knowledge, Attitudes). 

 Patient Centered Care

Students will discuss in their presentation and paper how the integration of evidence-based practice promotes a more patient-centered environment. (Knowledge, Attitudes)

 

Evidence Based Practice Paper Activity

 Students will divide into groups of 3 or 4 students within a clinical group.  While at clinical, they will identify a clinical problem (see examples below). 

They are instructed to utilize the clinical health care environment to explore and discuss their topic in the clinical setting. Students will collaborate with their clinical faculty regarding the unit’s policy and procedures and current practice guidelines for their topic.  It will be is critical for students to be organized at the beginning of their clinical experience so that they can focus on their Evidence-Based Practice project.

Students will compare the unit’s policies and current evidence on their topic, and will prepare a group presentation following a grading rubric (see attached).  They will then, synthesize the evidence and present current information about their topic and discuss the impact on the safety of their patients, the quality of care delivered, and how to make the care they give more patient centered care.

Lastly, the students will individually prepare and write an APA formatted evidence based practice paper emphasizing best practices within their topic.  This paper must include a minimum of 3 nursing articles written within the past 5 years as well as integration of a least one QSEN competency within the evidence based paper.

           

Topic Examples:

  1. Pain Assessment, Management (ex. acute, post-operative pain vs. versus chronic Pain) and patient centered care
  2. Falls prevention in the hospital and patient centered care
  3. Medication errors and medication reconciliation increase safety
  4. Nursing Report and handoffs including nursing and physician SBAR (Situation, Background, Assessment, Recommendation) Communication
  5. Hand hygiene use of antimicrobial soap versus alcohol-based hand rubs- best evidence based practice
  6. Preventing Pressure Ulcers and Turning Practices to enhance quality improvement
  7. Quiet hours and noise level on patient units and patient centered care
  8. Electronic documentation at the bedside and bar code scanning.  How does it improve nursing care and patient safety?
  9. Infection of central line and blood stream best evidence base practice.
  10. Social Media dangers and (Facebook © , email, Twitter ©) impact of HIPPA and safety of patient information.

Submitted Materials:

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Additional Materials:

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Evaluation Description:

The evaluation methods for grading include a rubric for the presentation and the paper that are attached. Both of the grading rubrics included in the course syllabus for the paper and presentation. Students will receive a grade for both the paper and group presentation. They will be allowed to submit a draft prior to the presentation to receive feedback from the instructor.  All clinical faculty will be present for the presentation. The learning objectives will be met by the delivery of presentation according to the rubric, providing the audience with current evidence-based practice and best practice guidelines (see rubric).  Students will formulate a meaningful paper grounded in evidence from the literature (see rubric). Anecdotal information: This assignment was utilized in a graduate level program with pre-licensure nursing students.  This integrated cogitative and psychomotor competencies from three pre-licensure nursing courses; (1) medical-surgical nursing theory (2) medical-surgical nursing clinical, and (3) nursing concepts course.  The integration of assignments between three courses enhanced students’ ability to translate theory into practice.  The assignment could be utilized in a variety of settings including: adult medical surgical, maternal child, pediatrics, mental health, and leadership courses. Feedback from this assignment has been positive. Students were able to identify the correlation between current evidence and the impact of this information on the quality and safety of their nursing care while facilitating a more patient centered environment.  Thus connecting the clinical environment and course or theory component.  It has helped the students see the correlation between theory and clinical, and increased their awareness of evidence based practice and topics in nursing. This exercise has bridged the clinical practice environment with theory. As a result, adjunct part-time faculty have reported becoming more involved in guiding the students in their discovery of evidence base practice, safety, quality improvement, and creating a more patient-centered environment while at clinical.
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