Background/Significance

1. Stretching Resources to Bring Research to the Bedside: Redesigning Research Fellowships Wendy Tuzik Micek, PhD, RN1; Denise Angst, PhD, RN1/4, Josie Howard Ruben, MS, APN, AOCN5; Cheryl Lefaiver, PhD, RN1; Virginia Morse, PhD, RN2; Susan Okuno-Jones, DNP, RN4 1 Advocate Christ Medical Center, Oak Lawn, IL; 2Advocate Illinois Masonic Medical Center, Chicago, IL; 3Advocate Good Samaritan Hospital, Downers Grove, IL; 4Advocate Lutheran General Hospital, Park Ridge, IL; 5Advocate Support Center, Oak Brook, IL Title of Poster Doctors, Researchers, PhDs, etc… Department of Something, Advocate Lutheran General Hospital • Background/Significance • Research is important to clinical nursing practice, yet because patient care is the priority, conducting research in the clinical setting can prove challenging. • Closing the gap between research and practice has been important since the time of Florence Nightingale and searching for innovate ways to bring research into practice to improve quality, patient outcomes and safety is a priority for nursing leaders. • Research shows that many nurse clinicians have a positive view of nursing research but the barriers and influences to using research within nursing practice are many. • Lack of time, inadequate time to implement changes, lack of implementation support by other staff and lack of authority to change patient care were identified as significant barriers at Advocate Health Care using the BARRIERS Scale. • Few studies have been conducted on interventions to overcome these barriers. • Clinical Research Fellowships have been successfully implemented in a variety of practice settings and they provide paid time, didactic teaching, experiential learning experiences and access to research experts. • Advocate Nursing Research Council set out to develop an organizational strategy, a Nursing Research Fellowship, to overcome the identified barriers. • Expected Outcomes • By completion of the 4-month workshop period the nurse will: • Begin an IRB application or Evidence Brief • Construct a timeline for conducting the project • Provide monthly written updates quarterly • By completion of the 9-month post-workshop period the nurse will: • Submit an IRB application or complete an Evidence Brief • At the completion of the study the nurse will: • Disseminate the results with a written project summary to be featured on the Advocate Nurses online website and in professional journals Nursing Research Workshop Survey Participants self-rated their confidence level in their ability to perform 11 specific research-related activities pre and post completion of the Workshop Series using a 5-point Likert-type scale (Strongly Disagree, Disagree, Unsure, Agree or Strongly Agree). This modified survey is based on the Knowledge, Attitudes and Practices tool developed by Van Mullem et al (1999). Participation was voluntary and completion of the survey was anonymous. In addition, participants were also asked to provide feedback regarding the program through open-ended questions on a written evaluation form following each structured educational session. Results Results from the October 2008 through October 2010 Workshops were analyzed. Forty-seven participants completed both the pre and post survey. There was no significant difference in attendee characteristics between the years using Chi-square tests. Forty-six participants were female with the majority having a BSN degree (68%), employed full time (78%), completed nursing education over 10 years ago (59%), and employed in current position for over 5 years (51%). 71% of the participants were not members of a research council at their site. The Workshop Series has increased not only the participants’ research knowledge but the number of nurse initiated research projects. To date 18 studies have been approved by the IRB. Table 2 has a sample of the study titles. • Conclusion/Discussion • The Advocate Nursing Research Workshop Series provides an innovative example of professionalism and partnership in nursing research and EBP leveraged to enhance the knowledge and skills of nurses.Main findings were that the workshop: • sparkedinterestin and enthusiasm for nursing research and EBP among nurses at all levels throughout Advocate • demystifiednursing research and EBP • enhanced nurses’ confidence in their ability to search for, critique and utilize research in clinical practice • enhanced nurses’ confidence in their ability to develop and conduct nursing research • consolidated resources to strengthen nursing research and evidence-based nursing practice throughout the system • offered expert mentors to guide novice nurse researchers • provided personal and professional growth and recognition. • built a pool of APN research mentors who continue to foster an environment of clinical inquiry. • Implementations of Practice • Drawing upon the expertise of Research Council members as well as the research questions of staff nurses, clinical educators and managers, this workshop and mentoring initiative provides a foundation in nursing research education, support in the development of nursing research and EBP innovations, and a forum for exchanging ideas that that will serve to improve practice and contribute to nursing knowledge. • Next Steps • Continue the Advocate Nursing Research Workshop Series annually . • This education venue provides opportunity for staff to bridge the gap between research and practice. • A limitation of the workshop format does not allocate time for IRB completion and project implementation. Therefore, structured communication is essential to secure staffs ongoing engagement. • Recipe for Translating Research to the Bedside • Motivated and enthusiastic participants • Skilled research mentors • Organizational commitment • Transformational nursing leaders • Funding (a little can go a long way) • Course Materials • Participants are provided a: • Textbook • Burns, N. and Grove, S.K. (2007). Understanding nursing research: Building an evidence-based practice (4th Ed). Philadelphia, PA: Elsevier Inc. • Course binder • Book bag Program Development • A Fellowship proposal evolved into a Workshop Series because of limited funding. • The format enables nurses from across eight hospitals to participate instead of having to limit attendees. • Nurses receive protected release time for four months to develop a research proposal with structured education programs and mentoring. • Interested nurses complete a written application and participants are chosen through an on-site selection process which requires written approval from the applicant’s manager, director and site mentor. Methods • The Workshop Series consisted of 4 eight-hour structured educational sessions, as well as mentored and independent learning activities over a three-month period (Table 1). • The content design for each class was based on previous Advocate Health Care courses, the Clinical and Translational Research Methods summer intensive at University of Illinois at Chicago, a baccalaureate nursing program research course and external consultation based on the Clinical Scholar Model. • Purpose • The purpose of the Workshop is to increase the research activities of practicing nurses and generate meaningful clinical questions. • Specific objectives: • Foster professional growth and development of staff nurses at Advocate Health Care through the acquisition of research and/or evidence based practice (EBP) skills • Integrate research and EBP processes into clinical practice by skill building through development, implementation and evaluation of a clinically relevant project • Describe components of the research process and the relationship of these components to nursing excellence • Demonstrate selected research-related skills such as performing literature searches, critiquing research articles, developing an integrated literature review, preparing a project proposal and Institutional Review Board (IRB) application (as applicable) • Identify and utilize the research support services available in or leveraged through (e.g. faculty relationships) Advocate Health Care • Eligibility Criteria • Expressed interest in research and • other evidence in nursing practice • Director and Manager endorsement • BSN preferred but not required • Basic computer skills • Minimum 12 months employment at an • Advocate facility • Minimum 0.5 FTE status Nursing Research Workshop Survey For 11 of the 11 research activities, there was a significant (p <0.05) positive change from before to after the completion of the Nursing Research Workshop Series. References: Fink R, Thompson, CJ, Bonnes D. Overcoming barriers and promoting the use of research in practice (2005). JONA, 35(3), 121-129. Hutchinson, A.M. and Johnston, L. (2006). Beyond the BARRIERS Scale: Commonly Reported Barriers to Research Use. JONA, 36 (4), 189-199. Milne, D.J., Krishnasamy, M., Johnston, L. and Aranda, S. (2007). Promoting evidence-based care through a clinical research fellowship programme. Journal of Clinical Nursing, 16, 1629-1639. Pravikoff, D.S., Tanner, A.B., & Pierce, S.T. (2005). Readiness of U.S. nurses for evidence-based practice. The American Journal of Nursing, 105, 40-51. Rycroft-Malone, J., Harvey G, Seers K, Kitson A, McCormack B., & Tichen A. (2004). An exploration of the factors that influence the implementation of evidence in to practice. Journal of Clinical Nursing 13, 913-924. Turkel, M.C., Ferket, K., Reidinger, Gl., and Beatty, D.E. (2008). Building a Nursing Research Fellowship in a Community Hospital. Nursing Economics, 26(1), 26-34. Van Mullem, C., Burke, L., Dohmeyer, K., Farrell, M., Harvey, S., John, L. Kraly, C., Rowley, F., Severn, M., Twite, K., & Zapp, R. (1999).  Strategic planning for research use in nursing practice. Journal of Nursing Administration, 29 (12), 38-45. Acknowledgements The authors would like to thank fellow Council members Denise Angst, PhD, RN, Joal Hill, PhD, Victoria Koren, MLS, Cheryl Lefaiver, PhD, RN, Josie Howard Ruben, MSN, RN, and Linda Ryan, PhD, RN for their dedication, contributions, and creativity in designing and teaching the Advocate Nursing Research Workshop Series. We are grateful to the Chief Nurse Executives of Advocate Health Care for their ongoing support of nursing research and their financial commitment and to all the Workshop participants. Funding Support The Advocate Nursing Research Council thanks Aramark for the generous 2008 donation.