Table Of Content

SECOND SECOND EDITION SECOND EDITION US $99.95 EDITION EvidEncE-BasEd PE PracticE in action E vidEncE-BasEd rv ai The biggest barrier to effective evidence-based practice (EBP) is the failure Laura Cullen, DNP, RN, FAAN, d to effectively translate available knowledge, research, and clinical expertise is an Evidence-Based Practice c PracticE into action. This failure is rarely due to lack of information, understanding, Scientist at University of Iowa (UI) E or experience. In fact, it usually comes down to a simple lack of tools and Hospitals & Clinics and Adjunct absence of a clear plan to integrate EBP into care. Problem solved! Faculty at UI College of Nursing. t n Evidence-Based Practice in Action, Second Edition, is a time-tested, application- Kirsten Hanrahan, DNP, ARNP, i oriented resource for any EBP process model, and is organized based on The CPNP-PC, FAAN, is the Director in action cc Iowa Model Revised: Evidence-Based Practice to Promote Excellence in of Nursing Research and Evidence- Health Care. This book offers a proven, detailed plan to help nurses and Based Practice at UI Hospitals & EE healthcare professionals promote and achieve EBP implementation, adoption, Clinics and Adjunct Faculty at UI and sustained use. College of Nursing. - Throughout this practical, easy-to-use manual, the authors supply strategies, Michele Farrington, BSN, RN, i Comprehensive Strategies, B tools, and tips that show healthcare professionals how to apply and sustain PMGT-BC, is a Program Manager at n EBP in their setting. Inside are valuable recommendations on topic selection, UI Hospitals & Clinics and is certified a Tools, and Tips From literature searches, research and evidence review, implementation, and in pain management nursing. evaluation. New material in this second edition includes: a Sharon Tucker, PhD, APRN-CNS, s University of Iowa • PURPOSE and SEARCH for stating the EBP purpose and guiding PMHCNS-BC, NC-BC, FAAN, is the c search term identification Grayce Sills Endowed Professor in E Psychiatric-Mental Health Nursing, Hospitals & Clinics • EBP Evaluation Framework (KABOB) developed to capture Director of the Implementation t d actionable local data related to knowledge, attitudes, behaviors, Science Core of the Helene Fuld outcomes, and balancing measures Health Trust National Institute for i • Iowa Implementation for Sustainability Framework© with 75 EBP in the College of Nursing at The o Ohio State University, and Director implementation strategy specifications of the DNP Nurse Executive Track. n • Precision Implementation Approach® to drive decisions for selecting Stephanie Edmonds, PhD, MPH, RN, the most effective and efficient implementation strategies is a Nurse Scientist at UI Hospitals • Specific patient engagement tips and examples for every step & Clinics and Adjunct Faculty at UI Cullen of the EBP process and every implementation strategy College of Nursing. Hanrahan • Ways to de-implement practices that are not evidence-based, Farrington are ineffective, or are even harmful Tucker Edmonds Laura Cullen | Kirsten Hanrahan | Michele Farrington Sharon Tucker | Stephanie Edmonds www.SigmaMarketplace.org/SigmaBooks 9781948057950-Perfect.indd 1 6/27/22 11:50 AM Praise for Evidence-Based Practice in Action, Second Edition “ Building on extensive real-life experience with EBP, this expert team from University of Iowa Hospitals & Clinics provides vital guidance to clinicians at the cutting edge of care improvement. The advice is both practical and scientifically grounded. The authors detail an action-oriented and trustworthy framework that is connected to current advances in translational and implementation science. This book is sure to be a key resource for achieving scholarship in nursing practice.” –Kathleen R. Stevens, EdD, MS, RN, ANEF, FAAN Castella Endowed Distinguished Professor School of Nursing and Institute for Integration of Medicine & Science (CTSA) University of Texas Health Science Center San Antonio “ This second edition of Evidence-Based Practice in Action offers readers updated strategies to support EBP practice focused on hospital-based nursing. Packed with graphic tools and tips, it outlines a thoughtful, sys- tematic approach that will enhance nursing practice and support the use of EBP. The authors are experi- enced nurses with expertise in leading evidence-based practice change, and they have updated and infused this second edition with valuable new approaches.” –Anne Sales, PhD, RN Professor, Sinclair School of Nursing and Department of Family and Community Medicine University of Missouri Adjunct Professor, Department of Learning Health Sciences, University of Michigan Medical School Research Scientist, Center for Clinical Management Research, VA Ann Arbor Healthcare System Co-Editor-in-Chief, Implementation Science Communications “ I thought it was impossible to top the first edition of Evidence-Based Practice in Action, but the authors have done it! This new edition is essential for all who want to deliver evidence-based care. Beautifully organized, it is readable, practical, and user-friendly. Based on the Iowa Model and grounded in evaluation and implementation frameworks, this edition targets local needs and care contexts. I love the bulleted tips and key points, real-world examples, and tools at the conclusion of each chapter. Readers will, too!” –Kathleen C. Buckwalter, PhD, RN, FAAN Professor Emerita, University of Iowa College of Nursing Distinguished Nurse Scientist in Aging, Reynolds Center Oklahoma University Health Sciences Center, College of Nursing “ Evidence-Based Practice in Action, Second Edition, will continue to ensure high-quality, evidence-based care is implemented in healthcare systems across the country—and the world. It should also be a well-worn tool in every implementation scientist’s toolkit. The implementation strategies are laid out in the Iowa Imple- mentation for Sustainability Framework, followed by concrete definitions, specifications, evidence, and examples. As the field of implementation science continues to grow, this level of detail is critical for being able to specify, track, and test what works best to ensure that the evidence base is practiced and sustained.” –Heather Schacht Reisinger, PhD Professor, Department of Internal Medicine Associate Director for Engagement, Integration and Implementation Institute for Clinical and Translational Science, University of Iowa SECOND EDITION EVIDENCE-BASED PRACTICE IN ACTION Comprehensive Strategies, Tools, and Tips From University of Iowa Hospitals & Clinics Laura Cullen, DNP, RN, FAAN Kirsten Hanrahan, DNP, ARNP, CPNP-PC, FAAN Michele Farrington, BSN, RN, PMGT-BC Sharon Tucker, PhD, APRN-CNS, PMHCNS-BC, NC-BC, FAAN Stephanie Edmonds, PhD, MPH, RN Copyright © 2023 by University of Iowa Hospitals & Clinics, Department of Nursing Services and Patient Care, Office of Nursing Research & Evidence-Based Practice All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the copyright holder. Any trademarks, service marks, design rights, or similar rights that are mentioned, used, or cited in this book are the property of their respective owners. Their use here does not imply that you may use them for a similar or any other purpose. This book is not intended to be a substitute for the medical advice of a licensed medical professional. The author and publisher have made every effort to ensure the accuracy of the information contained within at the time of its publication and shall have no liability or responsibility to any person or entity regarding any loss or damage incurred, or alleged to have incurred, directly or indirectly, by the information contained in this book. The author and publisher make no warranties, express or implied, with respect to its content, and no warranties may be created or extended by sales representatives or written sales materials. The author and publisher have no responsibility for the consistency or accuracy of URLs and content of third-party websites referenced in this book. Sigma Theta Tau International Honor Society of Nursing (Sigma) is a nonprofit organization whose mission is developing nurse leaders anywhere to improve healthcare everywhere. Founded in 1922, Sigma has more than 135,000 active members in over 100 countries and territories. Members include practicing nurses, instructors, researchers, policymakers, entrepreneurs, and others. 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Suggested citation: Cullen, L., Hanrahan, K., Farrington, M., Tucker, S., & Edmonds, S. (2023). Evidence-based practice in action: Comprehensive strategies, tools, and tips from University of Iowa Hospitals & Clinics (2nd ed.). Sigma Theta Tau International. ISBN: 9781948057950 EPUB ISBN: 9781948057967 PDF ISBN: 9781948057974 First Printing, 2022 Publisher: Dustin Sullivan Managing Editor: Kristen Rempel Acquisitions Editor: Emily Hatch Production Manager: Carla Hall Development Editor: Kristen Rempel Project Editor: Todd Lothery Cover Designer: Michael Tanamachi Copy Editor: Todd Lothery Interior Design/Layout: Kim Scott, Bumpy Design Proofreader: Erin Geile Indexer: Larry Sweazy Ancillaries Editor: Jill Stanley Library of Congress Cataloging-in-Publication Data Names: Cullen, Laura, author. | Hanrahan, Kirsten, author. | Farrington, Michele, author. | Tucker, Sharon (Sharon JoAnn), author. | Edmonds, Stephanie, author. | Sigma Theta Tau International, publisher. Title: Evidence-based practice in action : comprehensive strategies, tools, and tips from University of Iowa Hospitals & Clinics / Laura Cullen, Kirsten Hanrahan, Michele Farrington, Sharon Tucker, Stephanie Edmonds. Description: Second edition. | Indianapolis, IN : Sigma Theta Tau International, [2022] | Includes bibliographical references and index. | Summary: “Evidence-based practice (EBP) is a process of shared decision-making between clinicians and patients based on research evidence, the patient’s experiences and preferences, and the clinician’s clinical expertise. We are now well beyond the Institute of Medicine (IOM) goal that 90% of healthcare be evidence-based by 2020 (IOM, 2010), and a gap persists. The need for EBP is more crucial than ever and must consider value-based care; patient preferences; diversity, equity, and inclusion; regulatory standards; costs; and implementation science. EBP in Action addresses the need for a clear EBP process along with precise, accurate, and effective selection of implementation strategies and resources to promote adoption and sustainability of EBP recommendations. In this book, we will inspire you to use the EBP process, think creatively, and engage patients in EBP co-design for improved outcomes”-- Provided by publisher. Identifiers: LCCN 2022021451 (print) | LCCN 2022021452 (ebook) | ISBN 9781948057950 (paperback) | ISBN 9781948057967 (epub) | ISBN 9781948057974 (adobe pdf) | ISBN 9781948057981 (kindle edition) Subjects: MESH: University of Iowa. Hospitals and Clinics. | Evidence-Based Nursing--methods | Models, Nursing Classification: LCC RT51 (print) | LCC RT51 (ebook) | NLM WY 100.7 | DDC 610.73--dc23/eng/20220617 LC record available at https://lccn.loc.gov/2022021451 LC ebook record available at https://lccn.loc.gov/2022021452 Additional Book Resources To download a free sample chapter and other book-related materials, visit the Evidence-Based Practice in Action, Second Edition, page in the Sigma Repository via this link or QR code. http://hdl.handle.net/10755/22479 To download University of Iowa Hospitals & Clinics’ tool templates, sign up via this link or QR code. https://uihc.org/new-book-evidence-based-practice-action Acknowledgments Foremost, the editors wish to thank colleagues at Univer- Thank you to the many patients and families who allowed sity of Iowa (UI) Hospitals & Clinics and abroad for their us to participate in their care, often when they were most creativity, collaboration, and commitment to patients and vulnerable. evidence-based healthcare. We are grateful to Kristen Rempel for her steadfast com- This work builds upon many years of partnership between mitment to shepherd this second edition through the visionary legends in nursing at UI Hospitals & Clinics and many growing pains of development and revision. We are UI College of Nursing. The very first evidence-based prac- thankful for her excellent editorial management and cre- tice (EBP) improvement at UI Hospitals & Clinics was led ative problem-solving. by Dr. Marita Titler in the mid-1980s. The formal partnership with the UI College of Nursing followed in 1989 under Special thanks to Kimberly Jordan for her administrative the leadership of Dr. Toni Tripp-Reimer, Dr. Kathleen assistance and office management and to Rosanna Seabold Buckwalter, and Dr. Geraldine Felton, and Sally Mathis for data, graphics, and innovative solutions. from UI Hospitals & Clinics Department of Nursing. We sincerely appreciate the many nurse leaders who have Our appreciation to the Sigma publishing team for their played key roles in building the culture, assisted our learn- patience and expertise as we navigated through this new ing, and offered mentoring that made this book possible. edition. We thank the many point-of-care clinicians who question And finally, we could not have completed this work with- practice and use EBP to improve outcomes. You are future out support from our wonderful families and friends. You healthcare leaders and innovators. keep us balanced, grounded, and grateful. About the Lead Authors and Book Editors Laura Cullen, DNP, RN, FAAN, is an Evidence-Based Michele Farrington, BSN, RN, PMGT-BC, is a Program Practice Scientist at University of Iowa (UI) Hospitals Manager at UI Hospitals & Clinics and is certified in pain & Clinics and Adjunct Faculty at UI College of Nursing. management nursing. Previously, Farrington served as a Cullen is known for her innovative educational programs study coordinator, EBP mentor, and staff nurse in pediat- and for supporting adoption of evidence-based practice rics. Farrington has tremendous experience and expertise (EBP) by point-of-care clinicians and teams. Her work has in pediatric oncology and EBP, leading or co-leading ini- led to the adoption of innovative and evidence-based prac- tiatives since 2003. Farrington’s work has been awarded tices; improved patient safety; improved patient, family, extramural funding, validating the strength of the proj- and clinician satisfaction; reduced hospital length of stay ects and impact on nursing care. Moreover, Farrington and costs; and the transformation of many organizations’ has authored numerous publications related to EBP proj- infrastructures to support EBP. She has served as the US ects and has given multiple local, regional, national, and representative on an international panel for Sigma Theta interna tional presentations. Farrington is actively involved Tau International Honor Society of Nursing. Her research in multiple professional organizations and is the ORL – endeavors include collaborations with engineers to incor- Head and Neck Nursing Media Review Column Department porate human factors in healthcare. She is an author of The Editor. Farrington is a recipient of the Nursing Excel- Iowa Model Revised: Evidence-Based Practice to Promote lence in Clinical Education Award, 100 Great Iowa Nurses Excellence in Health Care© and first author of the Iowa Award, Clinical Performance Improvement Award, Soci- Implementation for Sustainability Framework©. Cullen ety of Otorhinolaryngology and Head-Neck Nurses Honor has authored numerous publications and has given local, Award, and Ear, Nose and Throat Nursing Foundation Lit- regional, national, and international presentations. She erary Awards. co-authors a regular EBP column in the Journal of Peri- Anesthesia Nursing, is a member of the editorial board of Sharon Tucker, PhD, APRN-CNS, PMHCNS-BC, the American Journal of Nursing, and participates on the NC-BC, FAAN, is the Grayce Sills Endowed Professor in grant review panel for the DAISY Foundation™. Cullen has Psychiatric-Mental Health Nursing, Direc tor of the Imple- received numerous awards for her work and is a Fellow in mentation Science Core of the Helene Fuld Health Trust the American Academy of Nursing. National Institute for EBP in the College of Nursing at The Ohio State University (OSU), and Director of the DNP Kirsten Hanrahan, DNP, ARNP, CPNP-PC, FAAN, is the Nurse Executive Track. Prior to assuming these roles at Director of Nursing Research and Evidence-Based Prac- OSU, she served as the Director of Nursing Research, EBP, tice at UI Hospitals & Clinics, a Certified Pediatric Nurse and Quality at UI Hospitals & Clinics and Adjunct Faculty Practitioner, and Adjunct Faculty at UI College of Nurs- at UI College of Nursing. Tucker holds board certification ing. Hanrahan is well-versed in EBP and clinical research. as an APRN-CNS in psychiatric mental health nursing and Her research interests include pediatric pain, implementa- as an Integrative Nurse Coach. She is a change manage- tion, and IV management. She has consulted for a National ment expert and has cultivated research that has made Institutes of Health multi-site study and is co-founder of significant and sustained impacts on science and prac- the Distraction in Action© tool that helps parents learn tice in two areas: behavior change through mental health to be a distraction coach for their child during medical and wellness interventions and practice and organiza- procedures. Hanrahan recently served as site principal tional change through EBP implementation, training, and investigator for the US Clinician Wellbeing Study. She is tools. She partners with scientists across the country and an author of The Iowa Model Revised: Evidence-Based focuses on women and children, employees and worksite Practice to Promote Excellence in Health Care and the interventions for health, well-being, resilience, and mental Iowa Implementation for Sustainability Framework. She health. Tucker is a Robert Wood Johnson Executive Nurse has authored numerous publications and has given local, Fellows Program alumna and an elected Fellow of the regional, national, and international presentations. She American Academy of Nursing and National Academies has authored evidence-based guidelines and has imple- of Practice. She serves as Associate Editor for Worldviews mented multiple EBP changes in the clinical setting. Han- on Evidence-Based Nursing, publishes widely, and serves on rahan is a recipient of the 100 Great Iowa Nurses Award, regional and national boards. a participant in the Mayday Pain & Society Fellowship: Communicating Science & Improving Care Program, and a Fellow in the American Academy of Nursing.