6052 Discussion 11

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Translating Evidence Into Practice

Translating Evidence Into Practice Program Transcript

NARRATOR: Virtually all nursing research is conducted in the hopes of generating meaningful evidence that can improve health care outcomes and increase the quality of patient care. In this video, Doctor Kristen Mauk elaborates on the practice-related outcomes of her DNP project which examined the effective educational modules on nurses in a rehabilitation unit. In addition, Angela Boland, the Program Director of the rehabilitation unit where Doctor Mauk conducted her project, explains the initial challenges and lasting outcomes of the project for the nursing staff. And Michelle O'Connor, a registered nurse in the rehabilitation unit, describes her personal experience with the educational modules and how they impacted her practice.

KRISTEN MAUK: I think the whole education about being a change agent is really important to draw on. And knowing how to communicate with your administrators, your managers, whatever setting you happen to be working in, to see if they're willing to change. And how do you introduce that change.

I would say that one of the biggest barriers is working at an organizational level, whether it's within a college or a hospital setting, or a community setting, just to have people be willing to change or to listen to what you've discovered. I would see that as probably some of the major-- one of the major barriers that most of my students find is getting that entrance into initiating a change.

When I shared my a findings with the nurse manager and some of the staff, I did a PowerPoint presentation and I gave them a little copy of what the poster looked like. I think the way that they'll use some of that knowledge is seeing where their staff was maybe a little bit weaker in certain areas. And maybe they can do some more educating in the certain competencies that they weren't as strong in.

The intention, I believe, was to use it in orientation of new nurses. Which to me was great. If they could use all those modules we developed and they get a new nurse on, and she doesn't know much about rehab, and she can do the self- study modules. It was very cost effective, didn't cost the hospital anything extra. It was basically time that it took me to develop it. I think that's great.

Translating Evidence Into Practice

And I know that was the intention. And if we continue to have a relationship with them talking about what tools can they use, or additional education can they access from other organizations to get ready for certifying some of their nurses. They started looking at ways where they can better educate their staff.

And they were doing a great job of that anyway, but I think with the results of the project, I think they saw that more education might be needed. And that they had a motivation maybe to get certified because that would also require some more additional knowledge and background and things like that.

ANGELA BOLAND: As far as implementing the program itself, what I decided to do was have a unit-specific meeting and had Chris come and talk to the nursing staff in advance to let them know what we were doing, why we were doing it. To elevate their nursing practice, to enhance their ability as clinicians, to make it a better patient care experience for the individual for that patient, enhancing the quality of care.

And really getting the nursing staffs buy-in of, why am I going to do this extra 30 module? What is in it for me? Once they heard about the patient outcomes and it would impact that, and their confidence going into that room. Because in rehab you see such a variety of patients. It's a little bit ortho, it's a little bit neuro. You get such a variance in that.

But you have to become experts in all these little individual areas. And so to have that, these little learning modules, to really target these key areas, they bought in pretty darn quickly to go, somebody is going to come here and help us with that. And then I'm going to have this as a resource consistently.

So she came in and did that first unit meeting with the staff, and then she would come in every two weeks and drop off the first module. Staff again would take that first pre-test where they would assess what their knowledge base was. Then they read through the educational material. We did it at a nice pace for them.

Translating Evidence Into Practice

And the resource book to have, they could copy it, take it home. They can use it on their break, their lunch. There was no pressure in that. They could learn at their own pace, because each individual learner is different. So that was very nice for the staff.

And then they took that post-test. And they could really see what they thought they knew at the very beginning, and how much more they learned after spending the time in the module. And then they were beginning to talk amongst staff. In hey, I didn't know that, or you know what, this is a different way of thinking about it.

And it became a pride in the unit itself of really the rehab nurse piece. What's special about rehabilitation nurses. How are we different, what sets us apart. And being able to take those evidence-based practices and taking pride in that as they walk into that patient's room. That was a fantastic part to see that.

And then again with new staff that comes on we reference and use those resources. We keep them in the staff lounge so they can go in there as they need them. Sometimes it's xeroxing information to review with patients, to discuss with them. Discuss at team meetings, things, key areas, whether it be a bowel program, or dysphagia program. We show that with occupational therapy, physical therapy as well.

So it really has been a fantastic thing for us as a unit. And I do think it has helped separate us from our competitors and what we bring to the table. Which is that commitment to quality care, the commitment to evidence-based practice and patient outcomes. Making sure that patients that come to our facility, our program, really feel like they're getting the best. And how do you do that through education.

MICHELLE O'CONNOR: When I hired into the unit, it was made available to me that there were these modules based on the different departments of the rehabilitation. And being a new to the rehabilitation practice, it was very educational, beneficial for me to have these references. Say if I was working the off-shift and didn't have all the references of the therapy staff to go back to with questions, I could reference these very user-friendly modules.

Translating Evidence Into Practice

I like that they're broken down into different categories. Say I just want to look at skin, I don't have to flip through an entire whole dictionary on the entire rehabilitation spectrum. I can just get the small information that I need on that specific area. I feel that I'm more confident if a patient or a family member has a question regarding something that I'm not familiar with. I can go back and reference and speak to that, and even print out information to share with the patient or their loved ones.

KRISTEN MAUK: what advice would I give a master's prepared nurse to be a change agent and a leader? I would say make sure you've mastered something. Be the master of your area, whatever that is. If it's your clinical specialty or informatics or being an educator, make sure you've mastered something. Because when you get that master's degree, you better be the master of something because everyone will expect that of you.

So once you've mastered something, then I think you're in a position to lead. And things that help you be a leader are presenting at conferences, publishing your findings, publishing projects. Get out there, get involved in a national organization. Run for a position on the board of directors for your professional organization.

Those are the things that give other people trust in you that you are a leader. And they're not that hard to do. It might be a little scary, but it's not that hard to do. And I think once you establish yourself as an expert in whatever small area it is, then people begin to look to you for answers to their questions. And that is the best way to become a change agent.