NK5: Describe and demonstrate how the organization disseminates knowledge generated through nursing research to internal and external audiences.

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1 1 NK5: Describe and demonstrate how the organization disseminates knowledge generated through nursing research to internal and external audiences. Findings generated from research studies conducted by nurses external to Riverside and by Riverside Medical Center nurses are disseminated in a variety of ways to internal and external audiences. A description of the dissemination of research conducted outside of the hospital will be included; this topic has been described in previous NK sources of evidence. The structures and processes used to disseminate research generated by Riverside Medical Center nurses will also be described. Dissemination of Research Generated by Nurses External to the Hospital As described in previous NK sources of evidence, dissemination of research conducted outside of the hospital is disseminated via staff meetings such as the Patient Care Council (PCC), department meetings, and Patient Care Forum (our monthly meeting of nursing leaders), and Unit-Based Councils (UBCs). UBCs Riverside s unit-based councils are department specific committees of five to seven staff nurses and in some cases, other members of nursing units, who review current research-based policies, identify practice-related issues, and utilize scholarly literature reviews to support initiatives aimed at changing and improving nursing practice and patient care. Academic Nursing Degree Programs Riverside nurses who are enrolled in BSN, MSN, and DNP programs are also exposed to research findings generated by others, and have used external research in written assignments and in discussions with classmates and Riverside nursing peers. Riverside has provided financial assistance for these nurses through our Tuition Reimbursement program and our Nursing Excellence program, as explained in SE sources of evidence. Educational Programs Another method for internal dissemination of nursing research that has taken place outside of Riverside is through educational programs, such as the Research/No Research class (see NK4 for an explanation of the class). Other educational programs such as Lunch and Learns presented by nurses and physicians include research-based practice information. The Nursing Research Journal Club is another educational medium for disseminating research findings generated by others. This educational offering was developed by the

2 2 Evidence Based Practice/Research (EBPR) Council and was designed as a way for nurses to learn the research process and apply research findings to their own practice. The journal club is set up to mimic a traditional Book Club structure where nursing staff meet to discuss the importance of research findings that are pertinent to Riverside nursing practice. The open forum structure allows nurses at all levels of care to share thoughts on nursing research and to ask questions or review research processes they may not understand. The outcome is a growing number of Riverside staff who are learning not only the content presented in research articles, but also how to critically evaluate the design of research projects and their relevance to nursing practice. Deborah. Kleszynski, RN, staff nurse from 2 Medical/Surgical, has described the benefits of the research journal club. Deb explained, The article chosen for the September 2009 Journal Club described a study involving nurses health risks based on night shift work. Deb noted this article opened her eyes to questionable research processes. She stated, The article s sample group consisted of day shift nurses and compared the health risks with nurse s who worked both day and night shifts; the nurse s who worked only nights was not part of the sample. The discussion at Journal Club revolved around how Riverside could duplicate the study with an improved design to produce more accurate results. Riverside nurses and nurses from outside of the hospital, who are enrolled in academic nursing degree completion programs, develop and present educational programs that include research findings. One example is an educational series for nurses in Obstetrics. One RN, BSN student, a non-riverside nurse enrolled in an MSN program at Governors State University, presented a series of educational programs on obstetrical care. Topics included preterm labor and delivery, pregnancy-induced hypertension, gestational diabetes, and physical changes in pregnancy. Dr. Stephen Hermes, specialist in geriatrics, and Margaret Ondrey, RN, MSN, APN, Medical-Surgical and Palliative Care Clinical Nurse Specialist for Riverside, present a series on Elder Care. Elder Care is a growing specialty with implications for nurses in all hospital areas. Research findings related to topics such as assessment of dementia are essential to improving our care of this growing segment of the United States population. Dissemination of educational programs is accomplished via flyers posted on units, announcements at committee and council meetings, and in newsletters such as the Nursing News at Riverside. The newsletter is also a medium utilized by nursing staff to disseminate research-generated knowledge to internal audiences, both nursing and ancillary. The newsletter is organized by Barb Hamilton, RN, Manager of the 4 th Rehabilitation Unit. It is distributed to nursing staff six to eight times a year via and posting on nursing units. The newsletter is used as a medium to communicate ongoing research throughout the organization. The newsletter contains information regarding policy changes, information on new procedures, monthly calendar of Continuing Education opportunities, and general reminders.

3 3 The nursing newsletter also includes articles from ancillary areas such as the rehabilitation services department. The September 2009 issue included a review of a research article from the American Journal of Nursing on the impact of hourly rounding on patient satisfaction. After reviewing this article and reviewing additional research on the outcomes of hourly rounding, nursing leaders convened a group of nurses to implement hourly rounds in all inpatient areas. This is an example of how Riverside nurses use research generated by others to develop quality improvement and evidence-based practice (EBP) projects. Below is an excerpt from the September 2009 Nursing News at Riverside, which demonstrates how information on research-based endeavors and outcomes is provided to nurses in all areas.

4 4 Dissemination of Knowledge Generated by Riverside Nurses to Internal and External Audiences As described in previous NK sources of evidence, nurses from two departments have been involved in conducting original research studies. The Special Procedures Lab (SPL) study was a two-part study with a pilot and full study. Both of these studies have been completed and were described in NK4EO. The Mental Health Unit (MHU) study is still in progress. Both studies will be used to describe

5 5 and demonstrate the methods the organization used to disseminate knowledge generated through research to internal and external audiences. Internal Dissemination Information from Riverside-generated research is shared internally through a variety of ways, using the same methods described above. In addition, internal dissemination includes poster presentations at the annual Nursing EBP/Research Fair, which have been held in 2008 and Riverside s EBPR Council sponsors the fair, which has been held in the main lobby of the hospital on the afternoon of our annual Nursing Excellence Celebration. (The Celebration is a dinner and short program honoring Riverside nurses for their participation in shared governance councils such as the PCC and UBCs, as preceptors for RNs who are new to the organization, as nursing leaders, and as recipients of national certifications and degrees in the past year.) UBCs prepare posters for the fair to depict and explain their quality improvement, EBP, and/or research projects. Riverside staff, leaders, and physicians walk through the lobby every day, making the hospital lobby an excellent place for internal dissemination of poster projects. In addition, persons external to the hospital attend the poster fair. Patients, visitors, and nursing students and instructors also view the posters. Our CEO and President, Phil Kambic visits every poster and talks to RNs about their projects. For the 2009 poster fair, the EBPR Council prepared an abstract booklet that provided the names and type of every project; names of UBC members; and project purpose, background, design, measures, results, and conclusions. Copies of the booklet were available to all poster fair visitors, including visitors internal and external to the hospital. During the fair, posters are judged on specific criteria. Judges for the past two years have included our CNO, Dave Duda, RN, MSN; our Vice President of Nursing Services, Deena Layton, RN, MSN; our Vice President of Perioperative and Procedural Services; our Director of Patient Safety/Employee Health, Phil Crouch, RN, MSN; or our Director of Quality Improvement, Mary Schore, RN, MSN. Prizes are awarded to winning posters for the Best Clinical Outcome, the Best Unit Collaboration, and the Best Overall Project winners and criteria for each award follows: Award Best Clinical Outcome: 2 Med/Surg (EBP) Criteria Able to identify clinical problem Able to use evidence to change a practice Statistical data that supported the outcome Best Unit Collaboration: E.D. (Quality >90% staff participation Participation to include: o choosing of topic/project

6 6 Improvement and Peer Review) Best Overall Project: MHU (Research) o collection of data o interpretation of data o literature search o communication of findings o design of poster Well designed topic Able to communicate topic Relevant to practice: cost effective and positively impacts patient Organized concise description of steps taken Poster Fair awards in 2009 were announced during the Nursing Excellence Celebration event. Each UBC received a framed certificate demonstrating participation and awards for 2008 and The framed certificates were hung in each nursing unit. There is room on the certificates for participation and award recognition stickers for future projects. Like the poster fair abstract booklets, the certificates are displayed for internal and external recognition. External Dissemination Methods to disseminate research findings from Riverside nurses may include reports, posters, and presentations. Publication in nursing journals is a goal for 2010 and External dissemination of research findings includes reports prepared by investigators for Riverside Medical Center s Institutional Review Board (IRB). IRB members are comprised of professionals from the community and hospital representatives. For example, findings from the SPL research pilot and full studies were disseminated via reports to the IRB and were shared with the IRB by Vicki Haag, RN, MSN, Magnet Coordinator, a hospital representative to the IRB. Plans are in place to convert the SPL full study into a poster, which will be submitted to upcoming local, state, and national conferences. Findings from Riverside nursing EPB and quality improvement projects were also disseminated at national and state conferences, as described in NK4. External dissemination of the MHU research project was accomplished in a poster presentation at the 17 th Annual EBP Conference at the University of Iowa Hospitals and Clinics on April 22 and 23, Melinda Cockrell, RN, BSN, represented the MHU UBC at the conference. Representatives for the other 3 posters were Judith Rivard, RN, 5ICU; Jenny Rogers, RN, BSN, 2 nd Medical/Surgical; and Gail Stewart, RN, and Lisa Bodemer, RN, Home Health Care. The award winning posters from Riverside Medical Center s 2009 EBPR Poster Fair were professionally-printed on three-by-four foot posters by a local vendor.

7 7 MHU Poster and MHU Abstract Submission: The Impact of Forced Abstinence from Smoking During Hospitalization on Future Smoking Behavior (Research Project) 2 Medical /Surgical Poster and 2 Medical/Surgical Abstract Submission: Implementation of Walking Rounds (EBP) 5ICU Poster and 5ICU Abstract Submission: Healthy Hearts: An Initiative to Reduce the Incidence of Sternal Wound Infections for Open Heart Surgery Patients (EBP) E.D. Poster and E.D. Abstract Submission: Combating Contaminated Urine Cultures (Quality Improvement and Peer Review) Home Health Care Poster and Home Health Care Abstract Submission: Development of a Care Pathway for Pulmonary Rehabilitation for Home Health Patients (EBP) Outcomes The poster demonstrating the MHU UBC s research project won the 2010 Marita G. Titler Conduct Research Award for the outstanding poster presented at the University of Iowa Hospitals and Clinic National Evidence-Based Practice Conference on April 23, Eileen Krach, RN, BSN, 2 nd Medical/Surgical Manager, accompanied staff nurses and/or team leaders from MHU, 2 Med/Surg, 5ICU, and Home Health Care to the Iowa conference. We learned that Riverside Medical Center was one of only two hospitals that had the most posters four accepted at the conference. Eileen reported nurses from other hospitals noticed Riverside had a lot of posters these comments arose during conversations and networking at the conference. After the conference, a nursing administrator from a downstate hospital in Illinois called Jenny Rogers to ask about our implementation of walking rounds shift report. According to Gail and Lisa, several nurses from Thailand were very interested in the Home Health Care project and spent significant time discussing their project. These comments and observations demonstrate growing external recognition of Riverside as a hospital that supports nurse-led quality improvement, EBP, and research efforts to improve outcomes. Summary Dissemination of findings from research generated by nurses outside of Riverside and by Riverside nurses is currently accomplished through meetings, newsletters, reports, poster fairs, and state and national conferences. Internal audiences have included Riverside nursing staff and nursing leaders, IRB hospital representatives, physicians, and ancillary staff. External audiences have been IRB community members, nursing students and instructors, patients, visitors, and nurses from other national and international healthcare organizations. As Riverside s nurses become more experienced in conducting research, we will continue to submit study findings

8 to external audiences via poster fairs, conferences, and seminars. Our future goal is to submit research findings to professional nursing journals. 8

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