Clinical Scholars Program

North Memorial Clinical Scholar

Program

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Project Coordinators

• Dean of HSSH and the Graduate School at St. Catherine University (Penny Moyers)

• Associate Dean of the HSSH at St. Catherine University (Alice Swan)

• Director of Nursing Research at North Memorial Medical Center (Patty Finch-Guthrie [at the time of the Project])

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Vision

Vision: To create active and vibrant interprofessional learning teams to change practice using evidence.

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Team Composition

• North Memorial nurse clinical scholars (6 nurses)

• North Memorial nurse clinical mentors (5 advanced practice nurses)

• St Catherine University interprofessional faculty and students (12 faculty and 13 students: Holistic Health, OT, PT, Nursing, RT, and Library & Information Science)

• Occupational therapy students and faculty were on 4 of the 5 teams

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Team Steps

• Formulate an evidence-based project question • Search for and select evidence• Appraise and synthesize the evidence• Develop a practice change project in conjunction

with stakeholders• Use principles from implementation science to

conduct practice change• Evaluate the process and outcomes of the change

project

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Interprofessional Team Principles• Every member of the team contributes to the

work of the project

• Every member of the team has something to learn from and something to teach each other

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Program Components• 8 topic modules & materials for all participants

– Overview of evidence-based practice, – Asking the question, – Searching the literature, – Appraising the literature, – Developing a plan for implementation of a change, – Evaluation of the change result, and – Leadership for creating change.

• Mentoring materials for mentors– One-minute mentoring updates– Evidence-based practice class– Mentoring meetings & workshops

Project OnePopulation: Trauma patients are a major focus for North Memorial and have significant pain issues.

• Issue: Identified that if staff had more interventions available to manage pain, their patients would be more comfortable.

• Study area: Staff wanted to incorporate complimentary therapy options into their routine practice.

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Team One

TProject TwoPopulation: Patient post angioplasty. • Issue: Staff cannot immediately remove the sheath

in the groin that was used to thread balloon into the heart because of the significant blood thinning medications.

• Study Area: The most common complaint for pain is severe back pain. The question was whether positioning, other then being flat on the back, could relieve the pain as well as protect the site from bleeding problems.

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Project Three

• Population: Patients who are on ventilators and who are receiving sedation to manage their respiratory issues.

• Issue: The sedation makes it difficult to determine if the patient is comfortable or is having pain that is going untreated and unrecognized.

• Study Area: Wanted to identify different methods for assessing pain.

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Team Three

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Project Four

• Population: Patients with chronic pain• Issue: These patients often do not receive

assessment and intervention for chronic pain during an acute hospitalization for another or related problem.

• Study area: Wanted to create a guideline for chronic pain management during an acute hospitalization.

Team Four

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Project Five

• Population: Post-operative patients.• Issue: Nausea and vomiting.• Study Area: Wanted to use aromatherapy to

decrease symptoms and decrease medications that are often ineffective, but create significant side-effects.

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Team Five

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Measurement of Program Outcomes Analysis In Progress• Evidence-based practice

attitudes, beliefs, and knowledge pre- and post-course for those on the clinical teams. (Preliminary analysis completed)

• Interprofessional teaming beliefs and attitudes of team members pre- and post- clinical scholar team project.

• Qualitative data of team member experience on the clinical scholar teams.

• Analysis Completed• Project outcomes• Mentor qualitative experience• Number of publications &

Presentations.

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Project Outcomes

Team Project Title Sample Intervention Outcomes Team 1 Aromatherapy

and Abdominal Pain and Anxiety in the ED

n = 33 Control = Jojoba Intervention = Mandarin Intervention = Lavender

1. No age or gender difference between groups

2. Females had greater anxiety and pain

3. Mandarin group had a larger decrease in pain compared to control and lavender

4. No difference in anxiety Team 1 Aromatherapy

and Pain and Anxiety for Trauma Patients

n =56 Control = Jojoba Intervention = Lavender Intervention = Marjoram

1. No age or gender difference between groups

2. Males more frequently chose lavender over marjoram

3. Marjoram users had a greater decrease in pain

4. No difference in anxiety Team 5 Aromatherapy

as a pre-surgical intervention to prevent nausea and vomiting

n =70 Control = Jojoba Intervention = Combination of Ginger and Lavender

1. Only two patients in the sample experienced vomiting

2. Intervention group had lower mean values of nausea

3. Difference was not statistically significant

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Project Outcomes

Team Project Title Sample Intervention Outcomes Team 2 Back pain post

angioplasty 6-month project 25 chart audits

Literature review Recommendations

1. Chart audit indicated patients had significant pain

2. Pain related to the time on bed rest

3. Recommendations to decrease bed rest time from 6 to 4 hours based on criteria

Team 3 Assessment of pain in the ventilated, sedated patient

Implementation of the Behavioral Pain Scale

1.

Team 4 Chronic Pain Knowledge and Beliefs

Survey of Staff’s knowledge and beliefs

1. Development of a survey 2. Survey reliable and tested for

face validity

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Outcomes for Positive Mentoring of Mentors

Mentor Supports

Inspire

Support

Invest

Teach

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Preliminary Analysis of Beliefs and Implementation• Sample:

– Faculty, students, mentors, and scholars– n = 15

• No Significant changes in frequency of using EBP in practice

• Significant differences in the Belief about EBP– I am clear about the steps in EBP

• t = -2.582, df = 14, p =.022– I believe that I can search for the best evidence to answer

a clinical question in a timely manner• t = -2.201, df = 14, p = .045

– I know how to implement EBP sufficiently enough to make a practice change• t= -2.485, df = 14, p=.026