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“Perspectives:
Implementation of
strategies to adopt and
integrate evidence-based
Teresa Moreno Casbas
Unidad de Investigación en Cuidados de Salud (Investén-isciii)
Instituto de Salud Carlos III
practice (EBP) in nursing.
What are we doing?”
Nursing and Healthcare Research Unit
(Investén-isciii)
Ministry of Economy, industry
and Competitiveness
Investén-isciii
Strategic planning Capacity
building Research
consultation services
Evidence-based practice and
Knowledge transfer
Research and innovation
Institute of Health
Carlos III
Organization
Main objetives
Research
Implementation
Synthesis and Dissemination
• Supporting healthcare professionals on methodology to conduct
reasearch projects
• Promoting training and dissemination of research methodology and
evidence-based practice
• Participating in clinical trials, systematic reviews and clinical
practice guidelines aimed at the area of healthcare service providers
• Investén-isciii is involved in national and international healthcare
research projects, such as:
Healthcare an health services research
Centre of excelence for the Joanna Briggs Institute
Coordinating a nationalwide Implementation Project for the Good
Practice Guidelines in Centres Comitted to Excellence in Care, in
collaborating with the Registered Nurses Association of Ontario
(RNAO)
Member of the “Healthy Aging and Frailty Network” (CIBERFES)
Investén-isciii has coordinated and participated in several Health
European projects, such as RN4CAST
Expertise
Brazil measures 8.5 million square kilometers. Spain stays at 504,000
• Brazil could fit 17 times Spain and only in the Amazon three
• Brazil have 206.101.000 inhabitants in 2016) and Spain 46.468.102
The Spanish National Healthcare System
NHS funded by taxes Decentralized to regional autonomies Universal coverage Free Access Very wide range of publicly covered services Co-Payment in pharmaceutical products Services provided mainly in public facilities Interterritorial Board to coordinate policies
17 autonomous communities 2 autonomous cities (Since 1978)
The Spanish National Healthcare System
“Perspectives:
Implementation of
strategies to adopt and
integrate evidence-based
Teresa Moreno Casbas
Unidad de Investigación en Cuidados de Salud (Investén-isciii)
Instituto de Salud Carlos III
practice (EBP) in nursing.
What are we doing?”
The fact to incorporate nursing knowledge into clinical practice has to do
with the availability of good quality research results, but also with the
attitudes of professionals to adopt new practices and with the willingness and opportunity of institutions and policy
makers to implement them
Aim: Influence the adoption of Best Practice Guidelines in Spanish health institutions, in order
to promote excellence in practice and better patient outcomes
Strategy: International network of Best Practice
Spotlight Organizations (BPSO)
Investén-isciii/Collaborating centre of JBI as Host
organization in Spain
To improve the quality of care at the local, national and international level
Variability
Evidence transfer
Continuous improvement
Decision making
Patients satisfaction
Costs
Team building
Stop interventions without effect
Research gap
Programa de Guías de Práctica Clínica
Why RNAO?
August 2010
Agreement between RNAO and Investén-isciii: Spanish BPSO Host • Spanish translation guidelines • BPSO Host
Nursing Research and Healthcare Unit (Investén-isciii)
Belonging to the Institute of Health Carlos III
• International scope • EBP objectives
Traslation (2010)
Dissemination and call (2011)
Implantation and evaluation
(2012-2014)
Second cohort
Sostenibility (2015-2017)
RNAO Best practice guidelines
•34 Clinical guidelines • 7 Healthy Work Place
Environment Guidelines
On-line access / Social Network/ Information
Sessions
44 candidates
Proposal
34 candidates
Evaluation
8 institucions
competitive calls for proposals
Implantation – 3 years • Training • Operationalization • Evaluation / Feed-back •Accreditation BPSO
• Implantation of new guidelines
•New calls (2nd cohort)
Centros Comprometidos con la Excelencia en Cuidados
www.evidenciaencuidados.es
Best Practice Guidelines are
now available in several
languages:
French / Français
Chinese / 最佳作业指引中文 版
Italian / Italiano
Japanese/ ベストプラクティス・ガイドライン
Spanish / Español
Spanish Best Practice Spotlight organization® project
• Press release
• Mailing to the Health Centers in Spain
• Publication of a paper at a Nursing Scientific Journal
• Dissemination at Website (www.evidenciaencuidados.es)
• Annual International Nursing Research Conference
General Information
Declaration of interest
Applications submission
Publication selected
institutions
Spanish Best Practice Spotlight
organization® project
1
2
3
4
Nursing Best Practice Guidelines
Woman Abuse: Screening, Identification and Initial Response
Supporting Clients on Methadone Maintenance Treatment
Enhancing Healthy Adolescent Development
Adult Asthma Care Guidelines for Nurses: Promoting Control of Asthma
Promoting Asthma Control in Children
Breastfeeding Best Practice Guidelines for Nurses
Client Centred Care
Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease
Caregiving Strategies for Older Adults with Delirium, Dementia and Depression
Screening for Delirium, Dementia and Depression in Older Adults
Promoting Continence Using Prompted Voiding
Prevention of Constipation in the Older Adult Population
Crisis Intervention
Assessment and Management of Foot Ulcers for People with Diabetes
Prevention of Falls and Fall Injuries in the Older Adult
Supporting and Strengthening Families through Expected & Unexpected Life Events
Assessment and Device Selection for Vascular Access
Primary Prevention of Childhood Obesity
Ostomy Care & Management
Assessment and Management of Pain
Risk Assessment and Prevention of Pressure Ulcers
Assessment and Management of Foot Ulcers for People with Diabetes
Assessment and Management of Stage I to IV Pressure Ulcers
Assessment and Management of Venous Leg Ulcers
Integrating Smoking Cessation into Daily Nursing Practice
Stroke Assessment Across the Continuum of Care
Establishing Therapeutic Relationships
Healthy work environments
Collaborative Practice Among Nursing Teams Guideline
Developing and Sustaining Nursing Leadership
Embracing Cultural Diversity in Health Care: Developing Cultural Competence
Preventing and Managing Violence in the Workplace
Professionalism in Nursing
Workplace Health, Safety and Well-being of the Nurse Guideline
BPG Translated into Spanish
OSI Donostialdea
G.A.I de Alcázar de San Juan
Hospital Universitario Puerto Real
Consorcio HUAV-HSM Facultad de Lleida
Área de salud de Menorca: Hospital Mateu Orfila
y Centros de Salud de AP
OSI Debabarrena
Hospital Valle del Nalón
Complejo Hospitalario de Navarra
Centro de Salud José María Llanos
Hospital Doctor José Molina Orosa
Complejo Hospitalario Universitario de Granada
Hospitales de SierrallanaTres Mares
G.A.P. Del Bierzo. Centro de Salud Ponferrada II
Hospital de Medina del Campo
Complejo Hospitalario Universitario de Albacete
Hospital Clínico San Carlos
Hospital Rafael Méndez de Lorca y Universidad de Murcia
Hospital Universitario Vall d’Hebron
1st BPSO Cohort
2nd BPSO Cohort
Platform in Spain. CarEvID ®
+
http://www.evidenciaencuidados.es/bpso/attachments/article/26/Libro_ideas_2012-2014_FINAL_1.pdf
Evidence Based
Nursing
Nursing sensitive indicators
CarEVID
National Network
BPSO
Sustainability and growing
up
Transforming care through the
knowledge!
The Iceberg Illusion: What People See Vs What They Don’t
Esta obra está bajo una licencia Creative Commons Reconocimiento-Nocomercial-CompartirIgual 4.0 Internacional
Unresolved problem
Inpatients who sleep at
night less than 300
minutes (5 hours) have a
fourfold increase in
mortality
An impatient wakes up 3-
6 times during the magic
hours (0h-6.30h)
1. Gómez Sanz, Carmen. Calidad del sueño de los pacientes ingresados en una unidad de cuidados intensivos. Enfermería Intensiva 2013; 24(1):3-11.
2. Medina Cordero, A., Feria Lorenzo, DJ, Oscoz Muñoa, G. Los conocimientos sobre el sueño y los cuidados enfermeros para un buen descanso. Enfermería
Global 2009; 8 (3).
3. Costa Shíntia Viana da, Ceolim Maria Filomena. Factors that affect inpatients' quality of sleep. Rev. esc. enferm. USP [Internet]. 2013 Feb
[cited 2016 July 13]; 47(1): 46-52
CAUSES OF SLEEP
DISRUPTION
lighting
Noise Fear and worries
Pain or fatigue
Nursing interventios
Daytime naps
Room temperature
Uncomfortable bed
To empower health
professionals, leading by
nurses, asking them to
change their routines using the
recommendations proposed
by the evidence
Raise awareness of the
institutions, professionals,
patients and caregivers
“MIRÍADA DE
CUIDADORES”
ADHESION COMMITMENTS
Health institution teams
Health professionals
Patientes and caregiver
11th of July 20916 -
21st of April
3120
PROFESSIONAL HEALTH COMMITMENT
“Cuidadores
del sueño”
PATIENTS AND CAREGIVER COMMITMENTS
RECOMMENDATION
To create a quiet setting in the "magic hours"
Twitter: @sueno_on
#cuidamoselsueño
Instagram: @suenon117
Facebook: SueñOn
Youtube: SueñOn Investén
Abstract deadline
3rd of June 2017
http://www.isciii.es/investen
http://investigacionencuidados.es
http://www.evidenciaencuidados.es
http://www.recursosencuidados.es