RESUMEN
Faculty to teach and mentor doctoral nursing students are and will continue to be in short supply. Coupled with ever-increasing resource-constricted educational environments, doctoral programs are challenged to provide high-quality education with limited resources. The Nursing Education Exchange (NEXus) is a viable solution to help meet that challenge. This article presents an overview of the origins and evolution of NEXus, financial considerations, and basic steps for joining NEXus, along with 4 exemplars. NEXus has continued to grow since its inception in 2007. In 2015, the number of NEXus schools reached 20, with 11 schools offering both doctor of philosophy and doctor of nursing practice courses. Currently, NEXus offers over 160 courses, organized into 14 clusters such as gerontology and chronic illness. Recently, a collaboration between the National Hartford Centers of Gerontological Nursing Excellence and NEXus was formalized. This collaboration prepares faculty to address an aging population. In summary, in an era of increased demand for doctoral prepared nurses, a lack of qualified doctoral nursing faculty, and limited financial resources, the NEXus collaborative provides a model for optimal resource sharing.
Asunto(s)
Conducta Cooperativa , Educación a Distancia/organización & administración , Educación de Postgrado en Enfermería/organización & administración , Docentes de Enfermería/provisión & distribución , Enfermería Geriátrica/educación , Relaciones Interinstitucionales , Curriculum , Educación a Distancia/economía , Educación a Distancia/métodos , Educación de Postgrado en Enfermería/economía , Enfermería Geriátrica/organización & administración , Humanos , Estudiantes de EnfermeríaRESUMEN
There is a need for bedside nurses to disseminate the results of evidence-based practice quality initiatives to a wider audience through publications in peer-reviewed journals. Barriers to publication are common and include lack of time, skills, experience, confidence, and tangible support. This article describes the structured approach, timeline, writing activities, and coaching guidance used to support the publication of 12 quality improvement articles in 1 nursing journal.
Asunto(s)
Enfermería Basada en la Evidencia/normas , Personal de Enfermería en Hospital/normas , Garantía de la Calidad de Atención de Salud/normas , Enfermería Basada en la Evidencia/educación , Enfermería Basada en la Evidencia/métodos , Humanos , Difusión de la Información/métodos , Periodismo/normas , Mentores , Personal de Enfermería en Hospital/educación , Edición/normas , Garantía de la Calidad de Atención de Salud/métodos , Autoeficacia , Apoyo Social , Desarrollo de Personal/métodos , Desarrollo de Personal/normasRESUMEN
Hawaii's innovative statewide evidence-based practice program facilitates practice change across multiple health care systems. The innovation eliminated duplicative efforts and provided resources, was compatible with the values of health care organizations, and had experience with a pilot program. Interpersonal and mass media communication promoted and embedded the practice change. Users included nurse champions with multidisciplinary team members. The rate of adoption varied across projects and, although resources seemed to be a major determinant of successful institutionalization, there does not seem to be a predictable pattern of successful project implementation.
Asunto(s)
Práctica Clínica Basada en la Evidencia , Hawaii , Conocimientos, Actitudes y Práctica en Salud , Humanos , Personal de Enfermería/psicología , Poder PsicológicoRESUMEN
Fever is a significant contributor to secondary brain insult and management is a challenge for the neurocritical care team. The absence of standardized guidelines likely contributes to poor surveillance and undertreatment of increased temperature. A need for practice change was identified and this evidence-based practice project was initiated to compile sufficient evidence to develop, implement, and evaluate a treatment guideline to manage fever and maintain normothermia in the neurocritical care population. Ongoing education, inclusion in staff annual competency, and staff update on compliance performance is essential to maintain and sustain the practice change achieved through this project.
Asunto(s)
Regulación de la Temperatura Corporal , Fiebre/complicaciones , Humanos , Hipotermia Inducida , Relaciones Enfermero-Paciente , Estados UnidosRESUMEN
Despite the Institute of Medicine's goal of 90% of all practice being evidence-based by 2020, educational and practice institutions are not on target to achieve this goal. Evidence-based practice is one of 5 core elements of the Army Nurse Corps' patient care delivery system and a key focus of the Hawaii State Center for Nursing. In order to increase evidence-based practice (EBP), a civilian-military partnership was formed to include healthcare organizations in the state, optimize resources, and share strategies for successful practice changes statewide. The partnership has been successful in meeting each of these goals using national EBP competencies and Bloom's taxonomy as a guide. The article presents a discussion regarding the history, processes, and outcomes of this partnership.
Asunto(s)
Competencia Clínica , Conducta Cooperativa , Enfermería Basada en la Evidencia , Relaciones Interinstitucionales , Enfermería Militar/educación , Curriculum , Hawaii , Humanos , Estados UnidosRESUMEN
BACKGROUND: Establishing system-wide evidence-based nursing practice requires the support of senior leadership as well as adherence to a model that is sensitive to the challenges of practice change. OBJECTIVE: The purpose of this study was to establish a level of skill and knowledge among Army, Navy, and Air Force nurses to develop, to implement, and to evaluate best evidence-based practices (EBPs) for improved patient care. METHODS: Using the Iowa Model to guide their work, nurses from the Air Force, the Army, and the Navy joined efforts to establish EBP as a standard of nursing practice at four different military healthcare facilities in Hawaii: one tertiary medical center and three clinics on the island of Oahu. With the support of senior leadership at all four sites, four nurse researchers and a project director facilitated the work of advance practice nurses and staff nurses. RESULTS: Twelve different EBP projects were developed, implemented, and evaluated over 18 months by more than 50 nursing personnel across the three branches of service on Oahu. The result was a positive contribution to patient care throughout the healthcare system, affecting all areas of military nursing practice. Supporting goal was the improvement in the attitudes of nurses about research and their skills in applying evidence to their practice by way of a year-long internship program. Also influenced was the development of a foundation for evidence-based clinical and administrative military nursing decision making in the Pacific. CONCLUSION: A successful EBP program requires (a) consistent long-term vision and support from senior leadership; (b) resources such as trained personnel, finances, and time; and (c) structured approach to create an environment that facilitates the process. However, the success of an EBP program relies heavily on each nurse's commitment to change designed to improve nursing care for patients.
Asunto(s)
Enfermería Basada en la Evidencia/organización & administración , Implementación de Plan de Salud/organización & administración , Relaciones Interinstitucionales , Enfermería Militar/organización & administración , Enfermería Basada en la Evidencia/educación , Hawaii , Humanos , Enfermería Militar/educación , Modelos Teóricos , Evaluación de Procesos y Resultados en Atención de SaludRESUMEN
The purpose of this study was to describe Operation Iraqi/Enduring Freedom and Operation Desert Storm/Shield deployment experiences from the perspectives of 39 Army Medical Department personnel using a qualitative method in 2004. Thematic content analysis revealed themes from data collected during twelve focus groups. The themes with the most discussion that transcended across wars, branches, echelons of care, and grade were leadership and readiness concerns, followed closely by safety issues. The majority of discussion was about deficiency needs during deployment and the data suggests that problems experienced during deployment are timeless and are not unit-specific; issues were strikingly similar across the two wars, as well as across the varying AMEDD roles and types of medical units. Therefore, the findings of this study may be generically applicable to deployed AMEDD personnel with the potential to alter current policy regarding leadership, readiness, and safety for future AMEDD deployments.
Asunto(s)
Adaptación Psicológica , Medicina Militar/normas , Personal Militar , Psicología Militar , Estrés Psicológico , Adulto , Femenino , Grupos Focales , Guerra del Golfo , Humanos , Irak , Guerra de Irak 2003-2011 , Kuwait , Liderazgo , Masculino , Investigación Cualitativa , Seguridad , Estados UnidosAsunto(s)
Actitud del Personal de Salud , Enfermería Militar/organización & administración , Personal de Enfermería/psicología , Selección de Profesión , Educación Continua en Enfermería , Humanos , Satisfacción en el Trabajo , Enfermería Militar/educación , Rol de la Enfermera/psicología , Personal de Enfermería/educación , Personal de Enfermería/organización & administración , Selección de Personal , Estados UnidosRESUMEN
CONCEPTUAL FRAMEWORK: The Academic Center for Evidence-based Practice (ACE) Star Model was used to implement an evidence-based clinical practice guideline (CPG) in order to decrease ventilator-associated pneumonia (VAP) incidence rates and ventilator days. The goal was to interrupt person-to-person transmission of bacteria and bacterial colonization using low-cost, evidence-based strategies to prevent VAP. DISCOVERY: Two geographically proximate medical centers, inclusive of five intensive care units located in the southwestern region of the United States had significant variations in their VAP rates. EVIDENCE SUMMARY: Using the U.S. Preventive Services Task Force grading criteria, the results of 69 studies were used to establish a clinical practice guideline to prevent ventilator-associated pneumonia. TRANSLATION: A clinical practice guideline was developed for the prevention of VAP and included five nursing activities: (a) head-of-bed elevation; (b) oral care; (c) ventilator tubing condensate removal; (d) hand hygiene; and (e) glove use. The effect of the CPG, inclusive of an educational intervention, was measured using an observational, prospective, quasi-experimental design. INTEGRATION: A multidisciplinary education team developed a self-learning packet, educational materials, and storyboards for the staff as dissemination strategies. Strategies also included e-mail, one-on-one teaching with clinicians, and feedback on guideline adoption and VAP rate reports. EVALUATION: Observation data were collected to evaluate adoption of the CPG while caring for 106 ventilated patients. VAP rates changed at both hospitals although the change was not statistically significant. Additionally, the ICU length of stay declined at both facilities, causing cost savings. DISCUSSION: These results support the idea that adoption of evidence-based practices contributes to decreased VAP rates. For a successful program, ICU leaders should emphasize strategies that routinize adoption of evidence-based CPGs.