The detailer may be from inside or outside the provider’s organization, and the information may be tailored to address site-specific barriers (Avorn & Soumerai, 1983; Davies et al., 1995; O’Brien et al., 2007; Sohn et al., 2004; Titler et al., 2002). The terms academic detailing and educational outreach are used interchangeably (Box 16-1). By using the longer cuffs the automatic monitors did not reinflate to get a blood pressure reading. INTRODUCTION. These longer cuffs have nearly eliminated the use of the thigh cuff for upper arm measurements. The project director relied on the nurse manager for assistance with scheduling meetings, taking minutes, and providing follow-up on issues. Nursing Outlook, 49(6), 272-279. The challenge for clinicians is to identify a model that guides practice and also promotes successful translation and implementation of evidence-based practice (Block et al., 2012; Cullen et al., 2012; Dolezal et al., 2011). The desired process was to select the correct size blood pressure cuff in order to have the most accurate readings. Iowa City: Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics. Research demonstrates the importance of leadership in use of clinical practice guidelines, but the development of leaders and the skills they require are less clear. – The increasing use of clinical guidelines, development of health care standards. Several studies have been conducted comparing forearm readings with upper arm readings. A guide to best practice (2nd ed.). The Evidence-Based Practice Implementation Guide (Figure 16-1) was developed to assist nurse leaders with planning and use of effective implementation strategies that advance stakeholders (both people and systems) through a process of diffusion: creating awareness and interest, building knowledge and commitment, promoting action and adaptation, and integrating and sustaining use (Cullen & Adams, 2012). Planning for implementation requires use of effective implementation strategies across phases of adoption. A number of strategies have good evidence and are particularly effective. Nasogastric tube placement in pediatric and neonatal patients. Clinicians tend to buy into the need for the practice change when there is a strong evidence base, the topic addresses an identified need, data demonstrate an opportunity for practice improvement within the clinical area, and the practice change offers a relative advantage. Journal for Nurses in Staff Development, 25(6), 278-284, quiz 285-286. The Iowa Model of evidence-based practice to promote quality care. As Outlined in the Literature* Despite national and international policy and research agendas, provision of evidence-based care does not meet expectations (Burns, 2012; An understanding of evidence-based practice and related concepts requires requisite knowledge of a variety of terms. Budgeting, Productivity, and Costing Out Nursing. You can disseminate knowledge by communicating the information directly to fellow practitioners, publishing in peer-reviewed journals or professional newsletters, or … With the rise of obesity, the use of the forearm to measure blood pressure is becoming more prevalent. Blood pressure has been described as a powerful, consistent, and independent risk factor for cardiovascular and renal disease (Pickering et al., 2005). Over 94% of the patients questioned agreed that the longer blood pressure cuffs caused less pain then using a cuff that was the wrong size. • Case study NCSBN continually adds to the body of knowledge surrounding evidence-based nursing. Localizing or adapting practice recommendations to fit the local setting and culture is an essential step in the process, often using the role of the opinion leader and team of local experts (Doumit et al., 2007; Titler, 2008). Strategies include, but are not limited to: © Copyright 2020 Canadian Nurses Association. The results demonstrated satisfaction for both the staff (pre = 2.75; post = 3.56; scale: 1 to 44) and patients (pre = 3.35; post = 3.4) with the appropriate size cuff. • Team work • State the desire to make the change systematic and with minimal impact on workload (e.g., standing orders to make the process easy for the clinicians) Using the evidence-based practice process to answer clinical and operational questions can be challenging. (2001). The National Health and Nutritional Examination Survey showed that the prevalence of obesity has increased in the United States from 22.9% in 1994, to over 30% in 2000, and 35.7% in 2010 (Centers for Disease Control and Prevention, 2012a). Related There is now a rising expectation by consumers as well as in regulatory standards that evidence-based knowledge be used in health care. One in three U.S. adults has hypertension (Centers for Disease Control and Prevention, 2012b). Translational research includes testing the effect of interventions aimed at promoting the rate and extent of adoption of evidence-based practices by nurses, physicians, and other health care providers and describing organizational, unit, and individual variables that affect the use of evidence in clinical and operational decision making (Titler, 2004; Titler & Everett, 2001). Although “best practice” and “evidence-based practice” are sometimes used interchangeably, the extent that best practices are evidence-based is often unclear. Translational research is often used interchangeably with implementation science.Implementation science includes scientific investigations that support movement of evidence-based, effective health care approaches from clinical knowledge into routine use; testing strategies to promote uptake and use of innovations; and explaining factors that promote and hinder use of scientific knowledge in health care delivery (Eccles & Mittman, 2006; Greenhalgh et al., 2005; Rubenstein & Pugh, 2006; Titler, 2007). Guidelines are systematically developed, they link the evidence with health outcomes (benefits and harms), and they continue to require subjective judgments when making decisions for use (Institute of Medicine, 2011a; Woolf & Atkins, 2001). An emphasis on use of evidence-based practice includes the application of the best available evidence and also represents a desire to improve patient outcomes with a consideration for patient values and preferences when making patient care decisions. • The cuff bladder length should be at least 80% of arm circumference and the width should be at least 40% of upper arm length setting to provide information about the evidence-based practice. • Role-model the change Image: Journal of Nursing Scholarship, 31(4), 317-322. (2001). • Match the practice change with the equipment available This project addresses blood pressure monitoring for obese patients (Dole & Griffin, 2009). Nurses report patients being more satisfied (pre = 2.2; post = 3.0). Despite national and international policy and research agendas, provision of evidence-based care does not meet expectations (Burns, 2012; Jablonski & Ersek, 2009; Randall et al., 2010; Revello & Fields, 2012; Scales et al., 2011; Schmaltz et al., 2011; Williams et al., 2005), and a continuing gap exists between the conduct and application of research findings. The project director worked with the project team, advanced practice nurse from nursing evidence-based practice, and a health sciences librarian to identify applicable evidence. Use evidence-based implementation strategies to promote and sustain the change. This paper describes useful strategies for teaching evidence-based practice in an undergraduate nursing research course. Recommendations ( Prior et al., 2010 ) large upper arm readings strategies for occupational health Nursing Workplace! And patients to measure blood pressure on the obese arm in an outpatient setting and to... 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