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2 Implementing and Evaluating of an Evidence Based Nursing into Practice Prepared By Dr. Nahed Said El nagger Assistant Professor of Nursing H UMM AL- QURA UNIVERSITY FACULTY OF APPLIED MEDICAL SCIENCES NURSING DEPARTMENT

3 Implementing and Evaluating of an Evidence Based Nursing into Practice Lecture No. 11

4 Learning Outcomes: Define implementation. Identify how to implement the best evidence in clinical practice (changes). State the general and specific approaches to implement the best evidence in clinical practice (change). Identify evaluation. Differentiate between efficacy and effectiveness. Discuss how to evaluate the progress and the effect of implementation for the best evidence in clinical practice.

5 What Is the Implementation? Translation of research into practice and where changes takes place.

6 best evidence in clinical practice How to implement the best evidence in clinical practice ? Developing a dissemination and implementation strategy: The guidelines have been developed and activities required to prepare staff identified. Inform and motivate practitioners for the practice change.

7 Implementing & Evaluating the best evidence in clinical practice by: Pilot study demonstration. Pilot study demonstration. Evaluate process & outcomes. Evaluate process & outcomes. Decide to adapt, adopt, or reject practice change. Decide to adapt, adopt, or reject practice change.

8 How to integrate & maintain the best evidence in clinical practice? Communicating recommendations to stakeholders. Communicating recommendations to stakeholders. Staff education on changes in practice. Staff education on changes in practice. Integrating changes into standards of practice. Integrating changes into standards of practice. Monitoring the process & outcomes. Monitoring the process & outcomes.

9 What are the general approaches to implement the best evidence in clinical practice ( change)? Educational approaches. Epidemiological Stances. Marketing of a product, information or strategies. Behavioral change. Social interactions'. Moving from individual to organizational approaches.

10 What are the specific approaches to implement the best evidence in clinical practice ? Realistic goals and time frames have been set. Resources are sufficient. Opportunities have been taken to pilot changes where possible. The manager/ coordinator role is enabled to fulfill required activities. continue

11 What are the Specific approaches that managing change? (cont.) Review dates for guidelines’ implementation and for the guidelines themselves have been set. Existing initiatives within the trust which can support the change. The attitudes and beliefs of groups, to guide the targeting and presentation of information.

12 What is the evaluation? Impact of the change is measured. Assess variables (health outcomes, efficiency, cost or satisfaction)

13 OUTCOMES MANAGEMENT Efficacy : Efficacy : The results of an intervention applied under ideal conditions (RCT). The results of an intervention applied under ideal conditions (RCT). Effectiveness : Effectiveness : The results of an intervention applied in the real world; fewer controls; lack of random assignment. The results of an intervention applied in the real world; fewer controls; lack of random assignment.

PROBLEM STATEMENT There is an increase in requests for nursing staff to administer unfamiliar anesthetic and sedative agents in the ICU area for procedures which affect patient care and staffing.

PROBLEM STATEMENT Nursing staff will have guidelines for administration of analgesic drugs during procedures and extended patient treatment and for care of such patients in the critical care area. Nursing staff will have guidelines for administration of analgesic drugs during procedures and extended patient treatment and for care of such patients in the critical care area.

16 Synthesize the best evidence by: Searching literature related to major issues. Searching literature related to major issues. Critiquing &weighing the evidence. Critiquing &weighing the evidence. Assessing the feasibility, benefits, and risks. Assessing the feasibility, benefits, and risks.

17 Design practice change by: Defining the proposed change. Defining the proposed change. Identifying needed resources. Identifying needed resources. Planning an implementation process. Planning an implementation process. Defining outcomes. Defining outcomes.

18 Outcome Indicators: Data collected on administration of approved drugs by ICU practitioner nurse (e.g., frequency). Data collected on administration of approved drugs by ICU practitioner nurse (e.g., frequency). Anecdotal reports from staff on administration of approved drugs. Anecdotal reports from staff on administration of approved drugs. No negative patient outcomes with non-approved drugs. No negative patient outcomes with non-approved drugs.

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