Teaching evidence-based practice piece by PEACE

Teaching evidence-based practice (EBP) to nurse practitioner (NP) students creates a challenge. Practicing NPs are frequently called upon to develop EBP protocols and therefore, must be proficient in defining clinical problems, retrieving and appraising evidence, implementing protocols to change practice based on evidence, and evaluating the practice changes. A new faculty team integrated the constructivist approach using the PEACE framework to rebuild the EBP course. Course modules corresponded to each letter of the PEACE framework: problem identification, evidence retrieval, appraisal of evidence, changing practice or conducting more research, and evaluation. Students collaborated with a non-nursing professional as part of the college’s commitment to interprofessional learning. Following the PEACE framework, students created an evidence-based poster of a proposed clinical practice change. Feedback from faculty and students was positive. Areas for improvement included eliminating redundancy in module content, standardizing all grading rubrics, and adding more virtual sessions for student/faculty interaction.

End-of-Life Care in Acute Hospitals: Practice Change Reported by Health Professionals Following Online Education

Providing quality care for those dying in hospital is challenging for health professionals who receive little training in this. “End of Life Essentials” (EOLE) was developed to address gaps in health professionals’ knowledge, skills and confidence in end-of-life care via the provision of online learning modules and practice resources. This study aimed to determine whether respondents could describe clinical practice change as a result of module completion. Deidentified data were collected between October and November 2018 from learners registered for the online learning modules. Both quantitative and qualitative data were extracted and analysed. The survey design and conduct were reviewed, and ethical approval was obtained. Although the response rate was very low, results from n = 122 learners show improvements in knowledge, skills, awareness and confidence as a result of the undertaking of the learning modules. Two thirds self-reported practice changes (71%, n = 59) following the education, with “communication” cited most commonly (n = 19). The findings suggest that the EOLE education modules can help to improve end-of-life care by increasing health professionals’ awareness of good practice as well as their knowledge, skills and confidence. Online learning has also been reinforced as an appropriate forum for end-of-life education. Following education, implementing what has been learned occurs more easily at a personal level rather than at a team and organisational level. Barriers to and enablers of clinical practice change in hospital are described, including the fact that the organisation may not be responsive to changes or have the relevant resources to support change.

A multimodal, interprofessional training program on chemotherapy safety for nurses and pharmacists: Development and preliminary evaluation.

266 Background: Chemotherapy is a high-volume, high-risk clinical intervention that requires interprofessional clinical teams. With increased demand for chemotherapy, a record number of newly-approved drugs, and health system cuts to professional development, we sought to develop and deliver an evidence-based educational program for nurses and pharmacists on safe handling of hazardous drugs, management of oncology emergencies, extravasations, oral oncolytic therapy, and promoting clinical practice change. Methods: After mail and web-based recruitment activities, selected participants completed pre-workshop online modules. Live workshops included a blend of faculty-led interactive sessions and four simulations to reinforce content. Post-simulation debriefing sessions clarified concepts and identified participant action plans for clinical practice change. Attendees have access to lecture videos, handouts, resources, and a discussion board. Applying Kirkpatrick’s framework, we assessed participant confidence to meet program objectives before and after the workshop, a 27-item knowledge assessment before and after the workshop, and satisfaction with specific learning activities on a 5-point Likert scale. Results: To date, faculty have led two workshops. 266 nurses and 72 pharmacists applied and we accepted 77 (29%) and 30 (42%), respectively. Participants' change scores in confidence to meet program objectives increased from pre- to post-workshop (range 0.51-1.00). Knowledge scores increased between pre- and post- workshop (16.3 vs. 18.76, p < .01). Overall satisfaction was high across all content areas (range 4.76 - 4.98). Nearly all participants (n = 104, 97.2%) reported they were extremely satisfied with the program. Conclusions: An interprofessional education program with online modules, in-person interactive sessions, and simulation activities is a promising strategy to deliver chemotherapy safety content to practicing oncology nurses and pharmacists. Future efforts include recruiting a more diverse pool of participants, and expanding the program to include advanced practice providers.

Promoting Higher Quality of Care Through Education of Pediatric Residents on the Medical Home Model

The objective of this project was to present educational modules to pediatric residents and to assess if the modules improved residents’ understanding of the patient- and family-centered medical home model. Eighteen residents participated in 3 separate training sessions taught by fellow residents, which covered a total of 5 modules. Pretests and posttests were administered for each module. All modules showed improved scores from pretest to posttest, but only one module showed statistically significant improvement. The modules also incorporated discussion sessions that led to clinical practice change. These results revealed that resident-administered education using predeveloped modules can be effective in increasing knowledge related to the medical home model and in changing resident clinical practice.

Colostrum Swabbing as an Infection Prevention Strategy: A Retrospective Study

Critically ill neonates are prone to healthcare-associated infection (HAI) due to an immature immune system and need for multiple invasive diagnostic and treatment procedures. The purpose of this retrospective study was to determine the effectiveness of oral swabbing of colostrum as an intervention to provide immunity and decrease the incidence of neonatal HAI, particularly central line–associated bloodstream infection (CLABSI). The research study was informed by specific Caritas Processes, which are part of Watson’s Theory of Human Caring. Medical record audits were conducted for infants before, during, and after a 6-month pilot period for the clinical practice change of oral swabbing with colostrum, and data indicated the practice are safe, feasible, and effective in reducing CLABSI in critically ill neonates.