1. Enhancing Knowledge About Evidence-Based Practice Using Nursing Grand Rounds
Jennifer Kitchens, MSN, ACNS-BC, CVRN, RN
Bonnie Kruszka, DNP, MSN, CPN, FNP, NP-C, ENP-BC, RN
Margie Hull, M.Ed., MSN, ACNS-BC, CDE, RN
Lenora Maze, MSN, CNRN, RN

2. Purpose
To implement and evaluate evidence-based practice (EBP) nursing Grand Rounds as a clinical education strategy to address nurses’learning needs

3. Significance
Implementation of EBP into nursing clinical practice has been shown to improve patient outcomes
Delivery of care based on nursing expertise, patient preference & best available evidence (research)
Current research highlights the struggle experienced by RNs to use and implement research findings in clinical practice
Online learning methods have been adopted by many healthcare facilities
Needs assessments identified that nurses preferred interactive learning for some content
Examined ways to translate concepts to the daily practice of nursing
Other disciplines have used grand rounds as a teaching method to promote interaction and engagement

4. Background
Several interventions already implemented to advance EBP knowledge
Implemented Strategies:
Formulation of a EBP/Research Council with a “burning question link”
Administration and evaluation of Academic Center for EBP Evidence-Based Practice Readiness Inventory Report
Development of electronic online learning modules
Journal Clubs
Critical appraisals of topics
Facility needs assessments identified preference for interactive learning with some content
Needs assessments identified that nurses preferred interactive learning with some content (especially with unfamiliar content and abstract concepts)

5. Implement practice change
Iowa Model of EBP
Ask clinical question
Search the literature
Appraise evidence
Implement practice change
Evaluate
Used adaptation of the Iowa model as a conceptual framework for development of program
Ask the clinical question: Are nursing grand rounds an effective teaching method that engages the audience and promotes participation interaction?
Literature search: effectiveness in medical discipline, little attention in the nursing literature
Appraise evidence: effective teaching method in residency programs and community hospitals
Implemented practice change: developed ebp grand rounds
Evaluated effectiveness: results were favorable
(Titler et al., 2001)

6. Background (Cont.)
Examined additional ways to translate EBP concepts to daily practice of nursing
Effectiveness, processes and outcomes in nursing Grand Rounds received little attention in the literature
However, other disciplines have used Grand Rounds as an effective teaching method to promote interaction and engagement

7. Objectives of EBP Grand Rounds
Describe the use of evidence-based practice as an important process needed for quality care and optimal patient outcomes including:
Sources of evidence
Definition of EBP
EBP process and clinical nursing examples
List resources to find and evaluate evidence to support nursing practice with limited resources, time, and experience including searching for evidence and subject-specific databases
Case example EBP project

8. Implementation Prioritizing and integrating topics
Developing an EBP presentation
Coordinating nursing contact hour process
Designing handouts
Advertising
Acquiring media technology
Cultivating a learning environment
Engaging participation
Analyzing evaluation data
Disseminating findings

9. Evaluation
Meeting program objectives, methods and presenter effectiveness
A pre- and post EBP readiness survey was administered
A 5-point Likert scale was used to score meeting program objectives, methods and presenter effectiveness and the EBP survey
Scores: 1 being most negative and 5 being most positive

10. Outcomes
There were 8 duplicate nursing Grand Rounds sessions offered at various times/locations (0.5 nursing contact hour each)
Total attendance = 46 nurses
The mean evaluation scores were positive: meeting program objectives 4.53; methods effectiveness 4.76; presenter effectiveness 4.81

11. EBP Survey Results Survey Item Pre Mean Post Mean 4.68 4.98 4.62 4.91
Important to share ideas with colleagues
4.68
4.98
Importance of EBP to practice
4.62
4.91
Aware of sources of health care information
3.47
4.37
Comfort level in using EBP
3.64
Ability to identify clinical problem/EBP question
3.45
4.24

12. Interpretation
The EBP nursing Grand Rounds was an effective clinical education strategy to address the learning needs of nurses

13. Implications
Use Grand Rounds as an additional method to educate nurses
Evaluation of nursing EBP adoption
Dissemination of findings

14. References
Agee, N., Komenaka, I.K, Drachman, D., Bouton, M.E., Caruso, D.M., & Foster, K.N. (2009). The effectiveness of grand rounds lectures in a community-based hospital. Journal of Surgical Education, 66(6), doi: /j.surg
Armola, R., Brandeburg, J., & Tucker, D. (2010). A guide to developing nursing grand rounds. Critical Care Nurse, 30(5), doi: /ccn
Bohman, D.M., Ericsson, T., Borglin, G. (2012). Swedish nurses’ perception of nursing research and its implementation in clinical practice: a focus group study. Scandinavian Journal of Caring Sciences. Advance online publication. doi: DOI:  /j
Mjid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y., Chnag, Y., Mokhtar, I. (2011). Adopting evidence- based practice in clinical decision making: nurses’perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3),
Myint, P.K., & Sabanathan K. (2005). Role of grand rounds in the education of hospital doctors. Hospital Medicine, 66,
Richmond, D.E. (1985). The educational value of grand rounds. New Zealand Medical Journal, 98,
Schmidt, N.A. & Brown, J. M. (2014).  Evidence Based Practice for Nurses: Appraisal & Application (3rd ed.).   Boston, MA: Jones & Bartlett Learning.

15. Q & A

16. Contact Information
Jennifer Kitchens
Margie Hull
Clinical Nurse Specialist Acuity Adaptable
Diabetes Clinical Nurse Specialist, CDE
Bonnie Kruszka
Lenora Maze
Family Nurse Practitioner
Clinical Nurse Specialist, Critical Care & Neuroscience
Marian University Adjunct Faculty