RESEARCH Roundtable - Improving the CARE of MOMS and Babies through EVIDENCE-BASED PRACTICE Initiatives

Purpose for the program:  

Providing patient care based on evidence is a priority for healthcare organizations.  One of the most challenging aspects of creating and sustaining a culture of excellence is reducing the barriers of evidence based practice for nurses at the bed side. Research Roundtable, an innovative strategy between an urban healthcare system and a baccalaureate nursing program to promote research and evidence based practice, is one successful initiative.  The purpose of the program is to identify clinical problems that can be investigated through the evidence based practice (EBP) process. The program format includes workgroups comprised of staff nurses, nursing students, advanced practice nurse facilitators, and nurse faculty consultants. 

Proposed change:  

Three projects that have resulted in practice change (analgesia for IV insertion for laboring women, neonatal intensive care lighting and body positioning for gavage feeding for neonates) will be outlined.  Practice changes include offering analgesia prior to all IV insertions, cycled lighting to induce distinct patterns of rest-activity in preterm infants and left side-lying to prevent gastroesophageal reflux.

Implementation, outcomes and evaluation:  

Projects: EBP fact sheets were developed to assist in staff education and practice change implementation.   Analgesia protocol was approved through interdisciplinary committees and functions as a nursing order for all patients requesting medication prior to IV insertion.  Outcomes: 95% of patient surveys demonstrate effective pain control with analgesia use; decreased need for anti-reflux medication despite an increase in preterm infants; decreased crying/longer sleep cycles .

Program: Pre- and post-test data demonstrate improved skills in the EBP process and overall program evaluations are consistently positive.  Nurses demonstrate an increased understanding of the research process, the ability to ask appropriate questions and the ability to critically appraise literature in an effort to improve patient care and provide best practice.  Participants function as resources and drivers of examination of practice and change at the unit level. Many have participated in interdisciplinary health teams to further projects into implementation and evaluation phases. 

Implications for nursing practice:  

The impact of research roundtable is evident at the individual, unit and organizational levels.  The program has positively impacted patient outcomes, nursing practice and professional development and has provided opportunities to collaborate and network with other healthcare institutions.  It has played an integral role in promoting a shift in organizational culture to embrace clinical inquiry and to recognize EBP as an expectation rather than the exception for practice change.

Keywords:

Evidence-Based Practice

Knowledge Translation

Quality Outcomes