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Transcript of QAH HospitalPortsmouth Hospitals NHS Trust9/11/2015Page 1 Stepping up to Evidence Based Practice -...
QAH HospitalPortsmouth Hospitals NHS Trust 04/19/23 Page 1
Stepping up to Evidence Based Practice - Ideas into Action 5
Debra Ugboma
January 2010
Implementing Evidence Based Practice and Change
QAH HospitalPortsmouth Hospitals NHS Trust
Objectives
Ensure you have appraised the evidence in the context of your own clinical setting
Identify local factors that may affect the outcomes of applying the findings
Revisit some of the barriers to implementing EBP Identify personal and team influences over care and change Discuss the value of action plans and Gantt charts
What do I need for this session:– Your evidence summary– Your ideas for your plan of action– Worksheet 5
QAH HospitalPortsmouth Hospitals NHS Trust Page 304/19/23
Stepping up to EBP..
Ideas into action
Getting involved in audit
Implementing EBP dissertations
Evidence from others/policy etc.
Questioning care, responding to feedback
Structured EBP projects
Projects into publication!
Active involvement in research
QAH HospitalPortsmouth Hospitals NHS Trust Page 404/19/23
A PHT Model?
Implementers
(drivers)
Consultant NursesPDNsSpecialist NursesMasters educated clinical staff (facilitators/sponsors)
Learning and
Development
Department (supporters)
Practice Links Clinical CareKnowledge/Expertise
“Permission”
Higher Education Links Scholarship Development
Resources Skills
Development
Clinical ManagersMulti-professional Team
QAH HospitalPortsmouth Hospitals NHS Trust
Context
Have you appraised the findings – and answered your question – in the context of your own clinical environment?
Have you considered all the comments and issues raised from team discussions about the proposed change?
Is this a multi-professional issue? It usually is, and so do not forget to consult others and work collaboratively.
These are important before moving further forward
QAH HospitalPortsmouth Hospitals NHS Trust
Embracing change..
Think about a previous change implemented in your clinical area?
Undertake the activity on worksheet 5 (questions 1-3)
QAH HospitalPortsmouth Hospitals NHS Trust
Who will Lead, Facilitate and Support?
What will each need from the other?
QAH HospitalPortsmouth Hospitals NHS Trust
The Lead…
Clarify role and responsibilities as the lead Identify any educational/information/skill needs for staff – how
will you convey the message and information and develop skills Plan the change – Action plan or Gantt chart Be realistic in your time-scale and what you want people to do Consider how you are going to evaluate the change and feed-
back to staff and into care/practice You must enthuse, drive, keep positive and keep momentum
going Where are you going to get your support from and what form
does this need to take?
QAH HospitalPortsmouth Hospitals NHS Trust
The Facilitator
Clarify role and responsibilities Usually adds “weight” to a project Provide expertise and support planning/implementation May help with information sharing and developing skills and
knowledge Connections and networking Problem solving Enthuse, drive, keep positive and keep momentum going Regular structured “catch ups” with lead
QAH HospitalPortsmouth Hospitals NHS Trust
The Supporter
Clarify role and responsibilities Usually “hands-off” in relation to project (there for the lead and
facilitator rather than clinical team) Resource for Lead and Facilitator Provide a corporate/global perspective May support global or resource issues/initiatives Enthuse, drive, invigorate, keep positive and keep momentum
going Structured “catch ups” with Lead and Facilitator – clinical
supervision/action learning models?
QAH HospitalPortsmouth Hospitals NHS Trust
Top tips.. What works
Small incremental changes Talking Involving staff and “taking them with you” Regular reminders and updates The right tone Doing and role modelling Positive attitude…but… Being realistic Knowing it will not be perfect initially Feedback, encouragement, reward (cakes!)
QAH HospitalPortsmouth Hospitals NHS Trust
Awareness, Agreement, Adoption, Adherence (Pathman,1996 cited in Friedman et al 2009)
Awareness
AgreementAdoption
Adherence
QAH HospitalPortsmouth Hospitals NHS Trust
Final word about audit and evaluation
Evaluation or audit of change is important Not always about tick lists! Choose most appropriate audit and evaluation method. Try to use validated tools or get help with designing audit tools Keep it as simple as possible
Helps to evaluate achievement of EBP Helps to identify further actions Feeds back into EBP cycle
QAH HospitalPortsmouth Hospitals NHS Trust
What if we need money or resources for our EBP project?
If your EBP change is significant, and requires money or resources you will need to discuss this with your line manager in the first instance
You can apply for money through some professional or charitable organisations e.g:– The Florence Nightingale Foundation travel scholarships:
http://www.florence-nightingale-foundation.org.uk/scholarships.htm
– The Foundation of Nursing Studies “putting patients first programme”: http://www.fons.org/ahcp_pffunding.asp
– The Learning and Development Team can help you with some of these aspects as any application needs thought and care
You may need to write a business plan if there are significant financial implications for the Trust (discuss with your Operational Manager)
QAH HospitalPortsmouth Hospitals NHS Trust
Start your plan..
At the end of this session, try drafting your plan for implementing EBP. Try it in an action plan or Gantt chart format?
QAH HospitalPortsmouth Hospitals NHS Trust
It’s a wrap for us and a beginning for you!
These five presentations have hopefully helped to steer you through aspects of the EBP process
Our aim is to set you off on the road to continued and on-going EBP
Please keep in touch about your current and future projects…
For further information contact:Learning and Development TeamDebbie Knight, Deputy Head of Nursing and Midwifery Education
and Practice [email protected]
QAH HospitalPortsmouth Hospitals NHS Trust Page 1704/19/23
Resources
Case studies for change/developing practice: http://www.rcn.org.uk/development/practice/clinical_governance/case_studies#ebp
Fish! Motivational ideas. Fish! A remarkable way to boost morale and improve results. Stephen Lundin, Harry Paul and John Christiensen.
Foundation of Nursing Studies – Networking and Sharing: http://www.fons.org/ns_projects.asp?sub=sub2
Intute – helping you find the best websites for study and research: http://www.intute.ac.uk/cgi-bin/browse-keyword.pl?jacs=nmap&id=31462
PHT Governance and clinical audit: http://pht/Departments/ClinicalAudit/default.aspx
PHT Leadership and Management Courses e.g. Managing and leading for the first time, Practical project management: http://phtlearningzone.org.uk/index.php?page=lm