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October 6, 2016

Dr.Rs/nsg forum/workshop/RGUHS/18.1.08

October 6, 2016

Dr.Rs/nsg forum/workshop/RGUHS/18.1.08

Introduction
Definitions of terms
Quality management
Historical development
Evidence based practice
Conclusion
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There is no quality with out

an evidence ;
Quality and evidence go

hand in hand.
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A thing / Things

helpful informing a
conclusion or judgment

Something that

furnishes proof.

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Nursing is a nurturative , generative, and

protective profession.
Preventive care is a part of nursing
practice of every nurse.
Nurses value independence and self
respect.
They are guided by ethical and
humanitarian philosophy in which ;
EVERY human being deserve respect
regardless of racial ,social, cultural, sexual,
economic, and religious or other factors.
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It is degree of excellence.

It is subjective way of expression


according to each ones perception
and it is fundamentally relational.
( Websters dictionary )
Quality is a measure determining
what the best is shall be the
key to competitiveness.
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It is also a methodology and a

way of promoting peoples active


participation

based

on

the

involvement and responsibility of


each individual working towards
common vision.

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In quality management ,
Quality control is a prime element of
the management of nursing service.
It is a system for evaluation of the
total effort, which include the
evaluation of management process and
the practice of nursing.
Quality Assurance and quality
improvement are essential elements .
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Is the process by which Nurses make clinical


decisions using ;

The best available research evidence


Their clinical expertise,

and

Patient preferences

in the context of available resources .


( DiCensoA, Cullum N,Ciliska D.)
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Is the integration of
best research
evidence with
clinical expertise
and patient values.
( Sackett D 2000)
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Involves the use of best

evidence to justify particular


teaching or curricular
interventions considering the
needs of individual learners ,
the professional judgment of
nurse educators ,
and the resource costs of
the interventions.
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Is a process of finding

, appraising , and
applying scientific
evidence to the
treatment and
management of health
care .

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In order to make a start in

the quest for evidence based


practice nurse managers ,
educationalists ,researchers
and clinical practitioners
must all play an active part.
Simple strategies can help to
prepare nurses such as role
modeling and reflection on
action.(Walsh & Ham, 1997).
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Evidence based practice movement

was founded by Dr. Archie


Cochrane, a British epidemiologist .
In 1972 , Cochrane published a

land mark book that criticized the


medical profession for not
providing rigorous reviews of
evidence.
Died in 1988.
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Cochrane Collaboration

was launched in England in


1992.
1993 Cochrane

collaboration was founded.


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The term Evidence Based

Medicine ( EBM) describes a


clinical learning strategy that
was developed by faculty at
McMaster medical school in
the 1980s

Evidence Based Medicine

disseminated to the medical


community in the early 1990s

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Applies methods derived

from clinical epidemiology to


clinical decision making .
Over the last decade, other

medical professions adopted


an evidence based approach.
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Nursing research began to focus

on clinical issues in the mid 80s.

The national institute for

nursing research was formed in


1986.

Many new journals emphasize

nursing research

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In recent years , the

international society for


nursing research ,has
greatly increased its
capacity to support and
disseminate nursing
scholarships.
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McMaster University in Ontario,

Canada has developed extensive


resources in teaching and
implementing evidence based in
nursing and other disciplines.
In the past few years a number of

countries including UK, Canada , New


zealand Australia and others , have
created centers for evidence based
nursing.
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Bridge the gap between knowledge

and practice
Provide a sound method for making

clinical decisions
To make education less vulnerable to

political ideology ,conventional wisdom


, folk lore , and wishful thinking
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Evidence Based practice is

not new, It is what we have


been doing for years
Evidence Based nursing

lead to cook book nursing


and a disregard for
individualized patient care.
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There is an over emphasis on

Randomized Control
Trials( RCT) and systematic
reviews in Evidence Based
health care.

Requires too much time to be

routinely employed in real life


practice setting.

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Evidence Based practice is the

mindless application of population


studies to the treatment of the
individual.
It takes the results of studies of
large groups of people and tries to
apply them to individual.
There is often great difficulty in

getting access to the evidence and


in conducting effective searches to
identify the best evidence.

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The conduct and utilization of

research in nursing (CURN)


project.
The CURN project was designed

to develop and test a model for


using Research based knowledge
in clinical practice settings.
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The stetler model of


research utilization
applies research
findings at the
individual practitioner
level.
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The Lowa model of research


in practice infuses
research into practice to
improve the quality of care
,and is an out growth of
Quality Assurance Model
Using Research(QAMUR)
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Ask the burning

clinical question
Collect the most

relevant and best


evidence
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Integrate all evidence with

ones clinical expertise


,patient preferences, and
values in making a practice
decisions or change .
Evaluate the practice

decision or change.
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Clinical question should be asked in PICO

format
P Population
I - Intervention/s
C- Comparison
O Out come/s
Example:
In teenagers (p), how effective Depo Provera
( Intervention) versus oral contraceptives
( Comparison) in the prevention of pregnancy
( Out come)
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Begin with systematic reviews or

meta analyses

Evidence based clinical guide lines


Eg: Dove soap, Washing powders,

Face creams,

Medications etc which means

everything needs proof

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Are nursing educators are walking the

walk in terms of Evidence Based


practice?
Are nursing education strategies and

curricula based on the best evidence?


Does nursing education have a specific

body of knowledge that is used as


Evidence Based practice?
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Do nurse educators use clinical judgment in

adopting recommended practices to their


particular situations , curriculum or students?
In which way are student values considered

in the development of curricula and teaching


strategies?
What are the implications of implementing

evidence based practice in nursing


education?
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Increased interest in Evidence

Based nursing practice and


participating in the generation of
research.
Enhanced critical thinking skills

through the development of


knowledge , experience , and
competencies.
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Increased motivation to continue

professional growth and


development by participating in
life long learning.
The desire to become better

consumers of research findings.


Increased desire to pursue

graduate studies in nursing.

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Fostering communication skills

specific to nursing research.


Creating mentored

opportunities to practice
research process.
Promoting enduring pattern of

research use.
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Accessibility of research findings.


Anticipated outcomes of using

research .

Organizational support to use

research.

Support from others to use

research.

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According to Capez and Morehouse


(2004)

Total Quality Management refers to


A management process and set of
disciplines that are coordinated to
ensure that the organization
consistently meets and exceeds
customers requirements .
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TQM engages all divisions ,

departments ,

And levels of the organizations.


Top management organizes all of

its strategy and operations around


customer needs and;

Develops a culture with high

employee participation.

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To assure high quality nursing care,


or education ;
Information about structure ,
Nursing process,
And patient/Student out comes
Must be continuously fed back to
the Nurses /Teachers at all levels
of organizational hierarchy.

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