Nursing Professional Development's Spirit of Inquiry Focus Areas.

An Association for Nursing Professional Development (ANPD) task force was charged with redesigning the association's small research grant process. One step in this process included identifying focus areas for the specialty's spirit of inquiry. Using input from a round table discussion with ANPD annual convention attendees, the Journal for Nurses in Professional Development Editorial Board, and the convention evaluation query, 10 spirit of inquiry focus areas were identified that align with the Nursing Professional Development Practice Model.

Evidence-Based Practice and U.S. Healthcare Outcomes: Findings From a National Survey With Nursing Professional Development Practitioners.

Nursing professional development (NPD) practitioners are integral to implementing evidence-based practice (EBP). Research was conducted to describe NPD practitioners' EBP beliefs and competencies, frequency of implementing EBP, and perceptions of organizational culture and readiness for EBP. Relationships among NPD practitioner characteristics and organization outcomes were explored. Findings indicate that NPD practitioners must develop personal competence in EBP, become engaged in shared governance, collaborate with others, and use quality metrics to demonstrate the effectiveness and value of NPD activities.

Nursing Professional Development Organizational Value Demonstration Project.

A common question nursing professional development (NPD) practitioners ask is, "How many NPD practitioners should my organization have?" This study examined correlations among facility size and structure, NPD practitioner characteristics and time in service, and organizational outcomes. Organizations with a higher rate of NPD full-time equivalents per bed had higher patient satisfaction with nurses' communication and provision of discharge instruction on their HCAHPS (Hospital Consumer Assessment of Healthcare Provider and Systems) scores.

The Strengths and Challenges of Implementing EBP in Healthcare Systems.

BACKGROUND: Multihospital healthcare system leaders and individual nurses are challenged to integrate standardized evidence-based practices that support continuous performance improvement in their systems. AIM: This study was undertaken to evaluate the strength of and the opportunities for implementing evidence-based nursing practice across a diverse 9-hospital system located in the mid-Atlantic region. METHODS: A cross-sectional survey of 6,800 registered nurses (RNs), with a 24% response rate, was conducted to learn about their attitudes, beliefs, and perceptions toward organizational readiness and implementation of EBP. RESULTS: Although respondents' beliefs about EBP were positive, they reported their ability to implement EBP as extremely low. More than one third (36%) of the respondents worked at two of the system's Magnet designated hospitals. Magnet RNs reported more resources and held more positive beliefs about their hospital's organizational readiness for EBP. Nurses who possess advanced nursing degrees, certification, and who serve in leadership roles were favorable toward EBP. Younger RNs with fewer years in practice were more likely to have positive beliefs toward EBP and embedding it into the organizational culture. LINKING EVIDENCE TO PRACTICE: Findings mirror previous research where nurses internationally favor EBP yet struggle with similar barriers for implementation. Strategies to link this evidence to action can be taken at local and global levels. Locally, transformational nurse leaders within each hospital can share the vision for implementing EBP and embrace Magnet principles. At the system level, transformational nurse leaders can collectively allocate resources to create a system-wide online EBP education plan with EBP competencies and tool kit to increase RN exposure to EBP and standardize practice. Globally, promoting free and accessible EBP massive open online courses (MOOC) and sharing best practices online and at international forums such as Magnet conferences will help to lead, educate, and mentor nurses with strategies to systematically increase EBP uptake.

Traditional classroom education versus computer-based learning: how nurses learn about pressure ulcers.

The goal of the Nurse Professional Development specialist is to utilize the most effective educational strategies when educating staff nurses about pressure ulcer prevention. More information is needed about the effect of computer-based learning and traditional classroom learning on pressure ulcer education for the staff nurse. This study compares computer-based learning and traditional classroom learning on immediate and long-term knowledge while evaluating the impact of education on pressure ulcer risk assessment, staging, and documentation.

Developing dual role nursing staff-clinical instructor: a partnership model.

Supported by visionary leadership, a unique strategic-academic partnership model was established with grant support between the University of Maryland School of Nursing, Baltimore, and 13 Maryland hospitals to prepare hospital-based staff nurses as clinical instructors. Participating hospitals gained masters' degree-prepared nurses able to lead the achievement of clinical and organizational goals. The schools of nursing gained additional access to clinical education resources to enable increased undergraduate enrollment.

Staging and defining characteristics of pressure ulcers using photographs by staff nurses in acute care settings.

PURPOSE: The aim of this study was to determine if a digital photograph obtained by a staff nurse in the acute care setting could be used to determine staging and wound characteristics of a pressure ulcer when viewed by a panel of wound experts as compared to a bedside assessment by a wound expert. SUBJECTS AND SETTING: One hundred digital photographs of pressure ulcers were obtained from 69 patients on general and critical care medical-surgical nursing units from 2 Magnet-designated hospitals belonging to a large Mid-Atlantic health care system. Four certified wound ostomy nurses (CWONs), 2 at each hospital site, identified patients with a pressure ulcer for bedside assessment and digital photography. METHODS: This multisite nonexperimental study compared bedside assessment of wound characteristics and staging of 100 pressure ulcers by the hospital CWON to assessment of the same wound by an expert panel of 3 CWONs via digital photography. This study examined 13 wound characteristics and a total score on the Bates-Jensen Wound Assessment Tool (BWAT) as well as the staging of a pressure ulcer using the National Pressure Ulcer Advisory Panel definitions. A nonprobability sampling plan used a convenience sample of 69 adult inpatients at the 2 hospitals to obtain photographs of 100 pressure ulcers. INSTRUMENT: : The BWAT, formerly the Pressure Sore Status Tool, was used by the bedside and expert panelists to assess the pressure ulcer characteristics. This tool assesses 13 wound characteristics from best to worst, using a modified Likert scale. Studies examining reliability and validity of the BWAT support it as an effective instrument. RESULTS: Interrater reliability among the hospital CWONs using bedside assessment and panelist CWONs using digital photography assessment for the BWAT 13 characteristics ranged from slight to fair agreement for skin color surrounding wound (κ range = 0.12-0.21, P ≤ .02) to fair to moderate agreement for necrotic tissue type (κ range = 0.37-0.60, P = .000). Only slight agreement for total BWAT score was found among on-site bedside CWONs and off-site expert panelist CWONs (κ range = 0.01-0.05, P ≤ .05). Results of the interrater analysis for staging of pressure ulcers had fair to moderate agreement (κ range = 0.39-0.58 (P = .000). CONCLUSIONS: The findings of this study indicate that a digital photograph alone cannot reliably convey the characteristics of a pressure ulcer. A digital photo, in combination with clinical information, may increase the accuracy of the assessment and documentation. Systems designed to provide digital photography wound measurements may improve consistency, along with the development of standardized education for examining digital photographs by wound experts.

Evidence-based practice process quality assessment: EPQA guidelines.

BACKGROUND: Nurses are increasingly engaged in evidence-based practice (EBP) processes to answer significant questions and guide nursing practice. However, there are no criteria to evaluate the rigor and quality of EBP projects, making the decision about whether to implement a recommended practice change questionable. AIM: The purpose of this study was to achieve consensus among nationally recognized EBP nurse experts on criteria that could be used to appraise the methodological quality of an EBP project as well as to serve as a guideline to plan for an EBP project. METHODS: A modified two-round Delphi method was used. Twenty-three nationally known EBP experts were invited by e-mail to participate in completing a web-based questionnaire. RESULTS: Items converged after two rounds (response rate [52% (n=12/23) for Round 1 and 35% (n=8/23) for Round 2]) and resulted in the development of the EBP Process Quality Assessment (EPQA) guidelines that include 34 items. IMPLICATIONS: The EPQA guidelines can be used to guide and evaluate the methodological quality of EBP projects. They can be used in practice settings to critically appraise an EBP project prior to translating recommendations into practice. Educators can use the EPQA guidelines as a rubric to evaluate student EBP projects. EPQA guidelines can be utilized in research to assess interventions and to build or improve EBP capacity.

An information technology infrastructure to enable evidence-based nursing practice.

The movement toward evidence-based practice (EBP) poses new organizational challenges to provide the necessary infrastructure to promote effective nursing interventions based on the best available evidence. The purpose of this article is to describe a collaborative effort between nursing and library services to provide readily accessible information at the bedside to support nurses using the best available evidence. In collaboration with nursing, the Health Services Librarian created an information resource titled "Research-based Nursing Practice: Finding the Evidence," which enables nursing staff to access the resources at the bedside without having to perform lengthy searches. Every known resource that will educate nurses in defining EBP to providing them with the links to Web sites, published articles, and all the information resources is included in the tool. Much has been written about building the organizational infrastructure to promote EBP and finding the filtered, synthesized research evidence, but to our knowledge, little has been published on building the information technology infrastructure, which will give nurses real-time access at the point-of-care to the research evidence. The research-based nursing practice system is helping bridge the gap between evidence-based resources and practice by compiling the literature in one place and making it easily and readily accessible.