Promotion of Evidence Based Practice: Surgical Nursing

Evidence Based Nursing

Promotion of Evidence Based Practice: Surgical Nursing Journal Club

Department of Surgery Pamela Youde Nethersole Eastern Hospital

Lui KL, Lau KY, Fung PW, Tang CN


Introduction • Healthcare practice is increasingly focused on

delivering care that is based on empirical evidence or research findings published in the literature.

• As the primary providers of patient care services, nurses develop guidelines, protocols, and procedures in our individual practice settings based on research evidence.

• As nurses we care for patients everyday and perform interventions that should stimulate questions about the evidence supporting our practice

2


Evidence based practice begins with…..

• A Spirit of Inquiry – An ongoing curiosity about the best evidence to guide clinical

practice – It involves nurses who routinely ask questions about their

clinical practice while care is being delivered to patients

(Melnyk, Fine-overholt, Stillwell & Williamson, AJN 11/2009)


Nursing Inquiry • Why am I doing a treatment this way? • Is there any evidence to support this practice? • Are these the best outcomes we can achieve? • Can an intervention be done more efficiently or

cost-effectively? • Can we improve patient or nurse satisfaction?


Three Forms of Nursing Inquiry


EBP is an Explicit Process: • Identifying a focused practice question • Identifying the best evidence to answer the

question (uses research and other types of evidence)

• Critically appraising the evidence • Applying the evidence to practice • Evaluating the practice change • Disseminating the findings


Our current situation • Numerous literatures have suggested that

staff nurses have difficulty in interpreting research articles because of the complexity, academic, and statistical language.


The benefits of a journal club • Critical appraisal skills are developed • Participants keep update of current nursing

literature • Research & evidence-based practice are

developed • The needs of continuing nursing education are

met • Presentation skills are developed • Academic debate is stimulated

Bowles, et.al 2013


• The implementation of a journal club is one approach to help nurses integrate research findings into clinical practice and provide evidence-based care.

• In January 2016, the Surgical Nursing Journal Club was established which aims in both educating nurses and improving clinical practice.


Our Team Members • Facilitator Team

– Mr. LUI Ka Lok, Gilbert, NC (Urology)

– Mr. CHEUNG Yee Sing, Leo, APN (Colorectal CCM)

– YIP Mei Lin, Jessie, APN (Breast)

– Mr. TSE On Ho, Ronald, APN (Vascular)

– Mr. SHE Hoi Fan, Alex, APN (Surgery)

– Mr. CHUNG Pak Ho, Gary, APN (Surgery)

– Ms. LO Ka Man, Karman, APN (Surgery)

• Management Team – Ms. LAU King Yim, Kara,

DOM – Ms. FUNG Siu Yin, WM – Ms. TANG Wai Ngun, WM – Ms. FUNG Po Wan, Maria,

WM – Ms. FUNG Siu Kin, WM – Ms. SO Wai Ling, WM – Ms. LOK Mei Ling, Priscilla,

WM – Mr. POON Chi Sing, Eric,

WM


Evidence-based Practice


Objective • To consolidate the evidence based nursing

(EBN) & surgical nursing care through journal sharing & literature appraisal.

• To disseminate the learning outcomes by sharing the journal & literature appraisal results with other readers.


Characteristics of successful journal clubs

• Held at regular intervals • Held at a set time convenient for the members • Attendance register is held • The attending nurses share common clinical

interests • A nominated chair to chair the meeting & guide

members in choosing of journal articles • The papers are read in good time before the

meeting • Food is available at the meeting

13 Bowles, et.al 2013


Methodology • The journal club held once every quarter & all

nursing staff of surgical department were encouraged to join.

• Senior nursing staffs who had acquired basic EBN knowledge such as completion of EBN training / workshop were recruited as facilitators.

• Each surgical ward takes turns to assign a presenter to prepare one journal article related to surgical nursing practice for pre-reading & present in the journal club under the guidance of the facilitator.


15


Methodology • Facilitators gave comments, provide

guidance to facilitate discussions and compilation of the final appraisal report.

• The appraisal report had been posted up in our department training website for dissemination as critical appraisal topics (CATs).


Result • From January 2016 to December 2017,

Seven journal clubs had been held. • A total of 143 nursing staff attended the

journal club and completed the questionnaire.


Topic Presented Date Presenter Facilitator Speaker Topics

27.1.2016 URO team Gilbert Lui, NC(Uro) APN Winnie Yeung Can normal saline be used to fill the balloon of a Foley catheter? The experience of a prospective randomized study in China

11.5.2016 E10 ward Jessie Yip, APN(Breast) E10 RN Chan Ching Ching Cryotherapy is Effective on Post Op Laparotomy Incision for Pain Control

27.7.2016 F10 ward R Tse, APN(Vascular) F10 RN Eric Fung Influence of Aspirin Therapy in the Ulcer Associated with Chronic Venous Insufficiency

7.12.2016 B8 ward Gary Chung, APN(B8)

B8 RN Tracy Kung A prospective randomized trial comparing transurethral prostatic resection and clean intermittent self-catheterization in men with chronic urinary retention

29.3.2017 A8 ward WY Tan, APN(A8) A8 RN Yeung Tsz Yan Bariatric Surgery verus Conventional Medical Therapy for Type 2 Diabetes

5.7.2017 E8 ward Karmen Lo, APN(E8) E8 RN Lam Chun Ki E8 RN Lee Siu Ho Max

Effective of Chewing Gum against Postoperative Ileus after Pancreaticoduodenectomy – A Randomized Controlled Trial

4.10.2017 D8 ward Leo Cheung, Colorectal CCM

D8 RN Hui Ka Ying A RCT evaluation a new 2L PEG solution plus ascorbic acid vs 4L PEG for bowel cleansing prior to colonoscopy



20


21


22


23


24


25


26


0

1

2

3

4

5

6

Q1Do you agree that thelectures have achievedtheir stated objectives?

Q2 Do you agree thelecture contents are

adequate?

Q3 Do you agree thatthe speakers have

enhanced your learningon their lectures?

Q4 Do you agree thatthe lecture duration is

appropriate?

Q5 Do you agree thatthe lecture are useful?

Q6 Do you agree thatyou are satisfied with

the lectures as a whole?

Overall result

Overall result


Conclusion • The feedbacks from participants provided solid

evidence in supporting the journal club. • Establish of journal club can improve our nursing

staff’s ability to – critically evaluate published research; – encourage them how to make presentation; – promote evidence-based practice; – familiarize nurses with research; – have impact on changes in nursing practice and indicate

the multi-role of surgical nurses in delivery of professional performance in both clinical care and academic advancement.


Conclusion • Although day-to-day working environment is

challenging, continuous learning opportunities should always be provided for enriching staff competence, confident under sharing and learning which ultimately benefit patient with quality and safety.


Acknowledgement • Dr. C. N. TANG, COS, Department of Surgery,

PYNEH • Ms. K. Y. LAU, DOM, Department of Surgery,

PYNEH


Thank You!

Documents

Promotion of Evidence Based Practice: Surgical Nursing