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Essentials of Science: Methods, Appraisal and Utilization: Nursing Research Series

Nursing Research Series Part 20 of 20: Outcomes Research and Evaluating Change in Nursing Practice. By the completion of this presentation, the participant will be able to: define outcomes research. A conceptual framework for outcomes research is Donabedian's Model of quality health care.

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39 views6 pages

Essentials of Science: Methods, Appraisal and Utilization: Nursing Research Series

Nursing Research Series Part 20 of 20: Outcomes Research and Evaluating Change in Nursing Practice. By the completion of this presentation, the participant will be able to: define outcomes research. A conceptual framework for outcomes research is Donabedian's Model of quality health care.

Uploaded by

monir61
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Nursing Research Series Essentials of Science: Methods, Appraisal and Utilization

Nursing Research Series


Essentials of Science: Methods, Appraisal and Utilization

Kaiser Permanente Southern California Nursing Research

Nursing Research Series Part 20 of 20:

Outcomes Research and Evaluating Change in Nursing Practice

Kaiser Permanente Southern California Nursing Research

By the completion of this presentation, the participant will be able to:


Define Outcomes Research Describe the three components of Donabedians Model of Quality Health Care List three nurse sensitive outcomes List one website to find practice guidelines

Kaiser Permanente Northern and Southern California Nursing Research

Nursing Research Series Essentials of Science: Methods, Appraisal and Utilization


What is Outcomes Research?
Developed to examine the end point of patient care. Evaluates the status of people after receiving care and the processes to obtain desired results Use of evaluation methods, along with epidemiology and economic theory Impacts formation of policies and procedures, guidelines, and even public health policies

Donabedian Model
A conceptual framework for outcomes research is Donabedians Model of Quality Health Care 3 major connected concepts
Structure Process Outcome

Donabedian Model Structure + Process = Outcomes


(Donabedian, 1972) Healthcare providers and researchers assess each part of the equation along with the links between them to assess the quality of outcomes

STRUCTURE

PROCESS

OUTCOMES

Kaiser Permanente Northern and Southern California Nursing Research

Nursing Research Series Essentials of Science: Methods, Appraisal and Utilization


Structure and Process Examples
Structures
Organizational characteristics Healthcare personnel Facilities Equipment and resources

Processes
Diagnosis Prevention Interventions Patient education

Outcome Examples
Patient Outcomes
Clinical End Points Signs & Sx Lab values Mortality rates Functional Status Physical/Mental Social General Well-Being Pain Life Satisfaction Satisfaction with Care Access Quality Convenience

Nurse-Sensitive Quality Outcomes


Patient falls Pressure ulcers Nurse satisfaction Restraint use Staff mix Pain Peripheral IV infiltration

Statistical Analysis in Outcomes Research


Outcome researchers examine outcome data to determine group differences
Emphasis on analyzing change scores Exam pre and post intervention Examine data to identify outliers Identify change over time
May look at both statistical significance and clinical significance

Kaiser Permanente Northern and Southern California Nursing Research

Nursing Research Series Essentials of Science: Methods, Appraisal and Utilization


Evidence-Based Practice
A way to implement processes and evaluate outcomes is through use of an Evidence-Based Practice (EBP) Model Common steps include:
Perform a critical review of the literature Obtain baseline information Implement the intervention Evaluate the results Incorporate findings into the clinical setting

Evidence-Based Practice Models


The Iowa Model of EBP to Promote Quality Care
http://www.uihealthcare.com/depts/nursing/rqom/evidencebasedpr actice/iowamodel.html

ACE Star Model


http://www.acestar.uthscsa.edu/Learn_model.htm

Stetler Model
http://jan.ucc.nau.edu/~nur390c/hsueh/syllabus.html#stetler

Finding Evidence to Improve Outcomes


Electronic databases of systematic reviews, individual research, and expert opinion articles Guidelines and practice statements from professional organizations Clinical information areas Patient preferences Population statistics Logistic information Social and cultural influences
(Melnyk& Fineout-Overholt, 2005)

Kaiser Permanente Northern and Southern California Nursing Research

Nursing Research Series Essentials of Science: Methods, Appraisal and Utilization


Mining the Evidence to Improve Nursing Practice

http://nursingpathways.kp.org/scal/research/innovation/ebp1/index.html

Guidelines
Successful, tested processes that achieve quality outcomes can be incorporated into practice guidelines Practice Guidelines are: Systematically developed statements about a plan of care for a specific set of clinical circumstances involving a particular population
(Melnyk & Fineout-Overholt, 2005, p. 43)

Guidelines
Center for Disease Control (CDC)
http://www.cdc.gov/

National Guidelines Clearinghouse


http://www.guidelines.gov

Professional Organizations
American Heart Association American Diabetes Association

Specialty Professional Organizations

Kaiser Permanente Northern and Southern California Nursing Research

Nursing Research Series Essentials of Science: Methods, Appraisal and Utilization


Motivating and Sustaining Change in Nursing Practice
Strategies are developed to disseminate the findings from outcome studies to various entities and people to implement into practice Strategies for process implementation to achieve and maintain outcomes:
Addressing feasibility issues Effective communication Involving opinion leaders and stakeholders Selecting team members who are change agents Strategic planning Overcoming barriers
(Melnyk & Fineout-Overholt, 2005)

Reach for the Stars


Be part of the discovery of new knowledge through research!

References to Consider
Burns, N. & Grove, S.K (2007). Understanding Nursing Research, building an Evidence-Based Practice 4th Edition. St. Louis, Missouri: Saunders. Donabedian, A. (1972). Models for organizing the delivery of health services and criteria for evaluating them. Milbank Quarterly, 50,103-154. Harris, M. & Taylor, G. (2008). Medical Statistics Made Easy, 2nd Edition. Oxfordshire: Scion Publishing Melnyk, B. & Fineout-Overholt, E. (2005). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. Philadelphia, PA: Lippincott Williams & Wilkins

For more information please contact: Nursing.Research@kp.org

http://nursingpathways.kp.org/scal/research/index.html
Kaiser Permanente Southern California Nursing Research

Kaiser Permanente Northern and Southern California Nursing Research

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