Issue link: https://ahint.epubxp.com/i/619494
Evidence-based practice (EBP) enhances healthcare quality, reduces costs and improves patient-centric outcomes. 1 Heart failure (HF) nurses are urged to use current research evidence to ensure valued patient outcomes and the highest quality care. Clinical decisions are to be based on the best obtainable evidence and must be continually reviewed. To function from an EBP perspective, HF nurses need to be aware of how to introduce, create, measure and evaluate EBP. Two organizational models that provide a framework for nurses in the application of EBP are the Iowa Model and the Advancing Research and Clinic Practice through Close Collaboration (ARCC) Model. 2 The Iowa Model has been used extensively in clinical research programs, focusing on knowledge and problem- focused triggers, which leads nurses to question current practices and whether care can be improved through use of research. 2 The ARCC Model provides a systematic approach to appraise, apply and disseminate evidence, and facilitates integration of research into clinical practice. 2 By including research in daily clinical decision making, HF nurses can achieve sustained outcomes. 1 The EBP process encompasses a spirit of inquiry, including asking clinical questions, seeking the best evidence, analytically evaluating the evidence, integrating the evidence, evaluating the outcomes based on the evidence and disseminating the results. 1 By nurturing a spirit of inquiry, HF nurses consistently ask questions regarding the care they provide to patients, the outcomes achieved and the evidence to support this care. Finding the best evidence in the published literature is reliant on developing a clinically focused question that can be searched in the available literature. The population, intervention, comparison and outcome (PICO) format can frame a specific research question and facilitate an effective literature search. 1 HF nurses can critically appraise the evidence by asking if the information is valid and reliable, and examine how it best answers their questions, as well as integrate the evidence by implementing clinical decisions in their daily practice using clinical expertise. When evaluating the outcomes, HF nurses should ask if the effect has clinical or statistical significance and if the results are relevant and answer the PICO questions. Disseminating outcomes can be accomplished by sharing the results with colleagues at facility clinical practice councils, leadership meetings, research conferences and EBP committee meetings. Results may also be published in peer-reviewed publications and presented at professional organization annual meetings, 3 such as the AAHFN Annual Meeting. Facility-Level Support/Funding HF nurses may also explore their own facility resources for nurse-led projects and internal research funding resource opportunities or get involved in local nursing research committees. To meet the Institute of Medicine (IOM) goal for 2020, 90 percent of healthcare decisions are evidence-based, concentrated efforts and will be essential to enhance and sustain EBP in nursing practice. 1 Heart failure nurses must continuously update their knowledge and provide care from an EBP-approach. Embracing EBP can empower HF nurses in their daily care of patients and it is crucial in furthering professional nursing practice. Explore your resources and be agents of change! References 1. Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: a guide to best practice. Philadelphia, PA: Lippincott Williams & Wilkins; 2011. 2. Doody CM, Doody O. Introducing evidence into nursing practice: using the IOWA model. Br J Nurs. 2011;20(11):661-664. 3. Toolkit for evidence-based practice (EBP), Indiana University Health System Evidence-Based Practice Steering Committee (type of study design table – Evidence-based answers to clinical questions for busy clinicians workbook – cite). 4. Heart failure: early recognition, and treatment of the patient at risk for hospital readmission. In: evidence-based geriatric nursing protocols for best practice. Agency for Healthcare Research and Quality website. http://www.guideline.gov/content.aspx?id=43926. June 24, 2013. Updated August 6, 2013. Accessed August 31, 2015. 5. Foster J. Resources for researchers at your fngertips (literally). Clin Nurs Spec. 2015;29(2):71-72. NURSING RESEARCH RESOURCES — BE AN AGENT OF CHANGE Linda Rohyans, RN, MSN, CNS, CHFN • Editorial Board Member Indiana University Health, Indianapolis, IN E D I T O R I A L B O A R D C O L U M N Major Databases with the Best Primary Evidence for Clinical Nursing Inquiries 3,4 Agency for Healthcare Research and Quality (AHRQ) ahrq.gov/clinic/epcix.htm Cumulative Index to Nursing and Allied Health Literature (CINAHL) ebscohost.com/cinahl Cochrane Database of Systematic Reviews thecochranelibrary.com/view/0/index.html MEDLINE ncbi.nlm.nih.gov/pubmed National Guideline Clearinghouse — guideline.gov Nursing OVID ovid.com/webapp/wcs/stores/servlet/ProductDisplay?storeld 2 0 | T H E C O N N E C T I O N • W I N T E R 2 0 1 6