Building Evidence Based Practice in the Community:

1. Building Evidence Based Practice in the Community: A Collaborative Faculty-Student Model

2. 18th Annual Nursing Research Congress • Authors: • Daryl Canham, EdD, RN, BC • Marian Yoder, EdD, RN • Phyllis Connolly, PhD, APRN, BC • Chia-Ling Mao, PhD, RN, C

3. IOM Environment Changes (2003) & NMCs • Applying evidence to health care delivery • Using information technology • Aligning payment policies with quality improvement • Preparing the workforce

4. Nurse Managed Centers • PURPOSES: • Provide nursing services for medically underserved, multicultural clients • Arena for community health nursing educational experiences for students • Opportunity for faculty and student research regarding outcomes of nursing care

6. Omaha System in NMCs • BSN students easily develop understanding of system • Framework for evidence based practice • Facilitates documentation and information management

7. Omaha System • Developed by the VNA of Omaha, Nebraska • Community focused documentation system • 3 Components • Problem Classification Scheme (Environmental, Psychosocial, Physiological, Health Related Behaviors) • Intervention Scheme (Categories andTargets) • Problem Rating Scale (Likert type scale to rate changes) • Knowledge • Behavior • Status

8. Research Questions • Are client outcomes improved when measuring pre and post outcome ratings based on the Omaha System for specific problems? • What are the most frequently occurring health problems of older adults and persons with serious mental illness living in the community? • What nursing interventions are used most frequently in academic nurse managed centers?

9. Findings from Persons With Psychiatric/Mental Health Problems Living in the Community

10. Table 1. Mean score and Results of paired t-test of Omaha System Outcome Ratings Note: ** Statistically significant difference between pre and post ratings, p≤ .05.

11. Table 2. Most Frequently Identified Omaha Problems, Interventions and Related Targets Note: HTGC: Health Teaching, Guidance, and counseling TP: Treatment & Procedure; SUR: Surveillance

12. Findings: Adult Elder Population • Multi-ethnic population (Caucasian, Hispanic, Asian/Pacific Islander, African American) N=134 • 50-99 years; 71% female • Intervention Target Examples: • NMS function: exercises, safety, mobility/gait training, positioning • Pain: signs/symptoms physical, med. Action, relaxation techniques, coping skills, medical care

13. Table 3 ADULT ELDERS: 5 MOST FREQUENT HEALTH PROBLEMS Mean Score and Results of paired t-test of Omaha System Outcome Ratings Knowledge Behavior Status Note: * Statistically significant difference between pre and post ratings p< .05

14. Outcomes of the Faculty-Student Collaborative Model • Developed a plan for research and a protocol for data collection • Students actively participated in data collection and client care • Analyzed data to determine populations’ problems, nursing interventions, and client/population outcomes • Utilized data for program (curriculum & service) improvements and identifying strategies for more effective client care

15. Summary • Use of data from the Omaha System in the Nurse Managed Centers provides internal benchmarks for continuous improvement and building of evidence based teaching and practice (Connolly, Mao, Yoder & Canham, 2006).

16. Thank you for the opportunity to share our research with you! The authors wish to thank their colleagues at SJSU School of Nursing for their support

17. Contact Information • Daryl Canham, EdD, RN, BC San Jose State University, School of Nursing One Washington Square San Jose, CA 95192-0057 Email: canham@son.sjsu.edu