November 16, 2018

In the United States there are up to 400,000 unintended patient deaths every year. Additionally, receiving healthcare is the third leading cause of death in the country. The Institute of Medicine established a goal that by 2020, 90 percent of all healthcare decisions would be evidence based. Today, only 30 percent of decisions are evidence based, which has led to patients receiving roughly 55 percent of the care that they require when entering the current healthcare system.

In an effort to bridge the gap, the Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare at The Ohio State University College of Nursing has launched the first and only globally recognized professional evidence-based practice certificate of added qualification (EBP-C). The goal of earning the EBP-C is to demonstrate the expertise that a holder uses evidence to make decisions that improve healthcare for not only patients and their families, but also healthcare providers and their practitioners. Upon completion of the CAQ, healthcare professionals in education or practice will be awarded an EBP certificate of added qualification for a period of five years.

“EBP will help us reach the Quadruple Aim in healthcare,” said Bernadette Melnyk, PhD, RN, APRN-CNP- FAANP, FNAP, FAAN, executive director of the Fuld Institute for EBP, vice president for health promotion, chief wellness officer, dean and professor in the College of Nursing. “Evidence-based practice increases healthcare quality and safety, decreases costs and empowers clinicians to be freely engaged and excited when they come to work every single day.”

Healthcare professionals are experiencing increased levels of burnout and dissatisfaction with their jobs. Evidence-based practice is a strategy to assist healthcare providers in meeting the Quadruple Aim. The Quadruple Aim focuses on creating better outcomes for patients, improving the patient experience, lowering costs and improving the overall clinician experience.

The EBP-C demonstrates expertise in EBP and denotes that the successful applicant has completed the required education component. While EBP may have the most immediate impact with practitioners and clinicians, educating future healthcare professionals is an important long-term outcome. In an effort to improve the future of healthcare overall, the Fuld Institute for EBP is working to imbed evidence-based practice as part of every curriculum as this is how today’s students will practice as tomorrow’s professionals.

“A certificate of added qualification in evidence-based practice demonstrates that the holder is an expert in EBP,” said Cindy Beckett, PhD, RNC-OB, LCCE, CHRC, LSS-BB, director of the evidence-based practice certificate programs in the Fuld Institute for EBP and assistant professor in the College of Nursing. “Each person that obtains this certificate of added qualification can lead and mentor integration of best practice changes to positively impact individual and organizational goals.”

Visit the Fuld Institute for EBP to learn more and apply for the EBP-C program.

June 27, 2018

On Sept. 13 and 14, 2018, the College of Nursing’s Office of Innovation and Strategic Partnerships will be hosting the fourth annual Healthcare Innovation and Entrepreneurship Workshop. The event will take place at The Longaberger Alumni House at The Ohio State University, located at 2220 Olentangy River Road, Columbus, Ohio. All are welcome, and this event may be of special interest to Ohio State faculty and staff, College of Nursing alumni, the Wexner Medical Center staff, healthcare and business professionals and research and innovation peers. 

This two-day workshop will provide an overview of important business fundamentals and tips on how to integrate innovation and entrepreneurship principles into practice. Attendees will learn from experts on how to develop a business plan, start and manage a small business, pitch ideas, understand legal considerations for business ventures and more. There will also be a number of renowned speakers at the event, including College of Nursing Dean Bernadette Melnyk, PhD, RN, APRN-CNP, FAANP, FNAP, FAAN. 

Registration for the event is now open. Fees paid in person before Sept. 1 are $325 and increase to $375 after Sept. 1. The price for past participants and Ohio State students is $125. Those with an osu.edu or osumc.edu email, or those who refer a colleague who registers at the full rate, will receive a $25 discount. The registration cost includes breakfast and lunch both days, parking fees, shuttle access from many local hotels and a happy-hour reception on the first day.

The deadline to register is Sept. 7, 2018. To learn more and register for the event, go to www.go.osu.edu/startup. Send any questions to Tim Raderstorf, chief innovation officer, at raderstorf.3@osu.edu.

December 21, 2017

A statement from the directors of the Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare at the College of Nursing at The Ohio State University: 

Last week, a report was issued that claimed officials at the Centers for Disease Control and Prevention were instructed to refrain from using the phrases “evidence-based” and “science-based” in its 2018 budget documents. Whether this claim is completely accurate or not, it provides a tremendous window of opportunity to educate the public and policy makers on the importance of evidence-based healthcare. 

The United States spends more money on healthcare than any western country, yet ranks 37th in health outcomes. One key reason for this ranking is that many healthcare systems and clinicians across the U.S. do not consistently use the evidence generated from science to implement evidence-based practice (EBP). Instead, care is often based on tradition (e.g., “That’s the way we do it here”) or on outdated, non-science-based information. Findings from a strong body of research indicate that evidence-based or science-based healthcare enhances the quality and safety of care, reduces healthcare costs, and improves population health outcomes. However, it often takes years or even decades to translate findings from science into real-world clinical settings to improve patient care and outcomes.

Embracing EBP as a culture is long overdue in American healthcare. Healthcare environments are under enormous pressure. Medical errors, the third leading cause of death in the U.S., result in 200,000 to 400,000 deaths every year. Healthcare costs continue to escalate, and there is still a tendency to deliver too much care instead of the right evidence-based care. Eliminating “evidence-based” and “science-based” from our language will set us back decades and jeopardize the health of Americans.

At the Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare at The Ohio State University, we will continue to use the best evidence from science to advance evidence-based care and health policy to ensure the highest quality of safe care, which the people of our great country deserve. 

Provided by Executive Director Bernadette Melnyk, PhD, RN, FAANP, FNAP, FAAN, and Senior Director Lynn Gallagher-Ford, PhD, RN, DPFNAP.

Listen to College of Nursing Dean Melnyk discuss the word ban and EBP on WOSU Radio's All Sides with Ann Fisher, on Tuesday, Dec. 19  

More about Melnyk:

Melnyk serves The Ohio State University as vice president for health promotion, university chief wellness officer, dean and professor of the Ohio State College of Nursing, professor of pediatrics and psychiatry of the Ohio State College of Medicine and executive director of the Helene Fuld Health Trust National Institute for Evidence-based Practice (EBP) in Nursing and Healthcare. The Fuld Institute for EBP was founded at Ohio State in 2016 with a $6.5 million grant from the Helene Fuld National Health Trust. Melnyk is a world-renowned expert in EBP and intervention research, the author of over more than 300 publications, co-editor of five books, including Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice and Implementing EBP: Real World Success Stories. She also serves as the editor of the journal Worldviews on Evidence-based Nursing.

More about Gallagher-Ford:

Gallagher-Ford, senior director of the Fuld Institute for EBP, director of the Transdisciplinary Clinical Practice at the Fuld Institute for EBP, clinical associate professor at the College of Nursing at The Ohio State University, has 30 years of experience in maternal and child health nursing in roles that range from bedside clinician to chief nursing officer. She co-authored a book on implementation of EBP competencies in healthcare and has published multiple EBP studies. She serves as assistant editor of Worldviews on Evidence-Based Nursing.

October 13, 2017

Leaders, academicians, researchers and expert clinicians will convene in Columbus, Ohio, Oct. 18-20, to share the latest research and recommendations for improving healthcare quality, safety and costs through evidence-based practice (EBP) and launch the recently-funded Helene Fuld Health Trust National Institute for EBP in Nursing and Healthcare.

 

Evidence-based practice (EBP) is a problem-solving approach that integrates the conscientious use of best evidence in combination with a clinician’s expertise and patient preferences to make healthcare decisions. Incorporating the use of EBP in healthcare settings can improve patient outcomes and save on costs. The Ohio State University College of Nursing is an internationally-recognized hub for EBP, which will be advanced thanks to a $6.5 million grant from the Helene Fuld National Health Trust to form the new institute. The Fuld Institute for EBP will expand the college's reach to translate research findings into real world clinical settings at a faster pace and equip nurses as well as other clinicians with the EBP skills needed to transform health and improve lives throughout the world.

 

The two-day conferencebeing held at the Hilton Columbus at Easton, is preceded by a reception at the Ohio Union on Oct. 18. The reception also celebrates the Wednesday afternoon “Expert Forum,” which features leaders from 40 national organizations and federal agencies who will gather to discuss best practices and devise action strategies for accelerating EBP throughout the nation. Their recommendations and tactics will be presented in a special panel discussion on the first day of the conference. Click here for the full conference agenda.

 

A complementary live stream offered by The Ohio State University College of Nursing is available on Thursday, Oct. 19, 2017 from 9-11 a.m.

To access the live stream, click here.

 

Topics and speakers during this live stream event will include:

9-9:10 a.m.

Welcome & introductions

Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN

Vice President for Health Promotion

University Chief Wellness Officer

Dean and Professor, College of Nursing

Executive Director, the Helene Fuld Health Trust National Institute for EBP

Professor of Pediatrics and Psychiatry, College of Medicine

The Ohio State University

 

9:10-10 a.m.

Keynote: The State of EBP throughout the U.S.: Hot-off-the-press findings from the national competency study

Bernadette Mazurek Melnyk

 

10-10:15 a.m.

Recovery break

 

10:15-11 a.m.

Plenary session: EBP Expert Forum panel

Moderated by:

Lynn Gallagher-Ford, PhD, RN, DPFNAP, NE-BC, FAAN

Director, the Center for Transdisciplinary Evidence-based Practice

Clinical Associate Professor, College of Nursing

Senior Director, the Helene Fuld Health Trust National Institute for EBP

The Ohio State University

July 19, 2016

Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN, dean of The Ohio State University College of Nursing, was recognized as a 2016 Champion of Healthcare by Columbus Business First.

 

The publication named Melnyk, vice president for health promotion and chief wellness officer at Ohio State, as its 2016 Healthcare Educator & Advocate, a name that honors an individual for efforts toward creating and improving awareness among consumers about healthcare issues that affect specific groups or the community at large.

 

Melnyk was credited in her nomination for the College of Nursing’s recent rise in U.S. News & World Report rankings and for her efforts to improve patient access to effective care, including the opening of Ohio State Total Health and Wellness Primary Care Center located at University Hospital East, as well as her role in the national Million Hearts Initiative.

 

Melnyk has more than 25 years of research and teaching experience in the field of healthcare systems and nursing. She is also an internationally renowned expert in evidence-based practice (EBP), intervention research, child and adolescent mental health and health and wellness  and is a frequent keynote speaker at national and international conferences.

 

Columbus Business First's Champions of Healthcare program honors central Ohio medical professionals who are raising the region's quality of life through dedication to patient care, innovations in research and technology and outstanding healthcare management.

July 01, 2016

Registration is now open for the Innovation and Entrepreneurship Workshop for Health Professionals being held at the Ohio Union on The Ohio State University campus, Sept. 22 and 23. This is the second workshop for entrepreneurs hosted by the Ohio State College of Nursing’s Academy for Continuing Education and Lifelong Learning (AcCELL).

 

The two-day workshop provides an overview of important business fundamentals for anyone with an interest in starting a business, be it clinically-based or otherwise. Sessions include developing a business plan, pitching your ideas, raising capital and creating a marketing strategy, as well as practical methods for guarding patient data and complying with HIPPA regulations.

 

“This is a dynamic time in the delivery of healthcare, and innovative leaders will guide changes to benefit patients and other healthcare providers,” said Tim Raderstorf, MSN, RN, chief innovation officer at the College of Nursing. “We want to provide educational experiences that give nurses and other healthcare providers the confidence and tools to decide if starting their own business is the right choice for them.”

 

Raderstorf reports that at least four innovative companies have been directly influenced by leaders who participated in the inaugural Innovation Workshop held in 2015. Jen O’Brien, CNP, opened a unique internal medicine practice that provides personalized care in a spa-like setting.

 

“The Innovation and Entrepreneurship Workshop was a fantastic learning and preparation opportunity for me,” said O’Brien. “The workshop enabled me to solidify my vision and work out the mechanics of my start-up.”

 

Two nursing students have developed a line of comfortable clothing and accessories for nurses called NursSwag, and provide a 10 percent give-back to charity. Two other participants now offer different types of business coaching. Amelia Roberts, BSN, RN, is now a successful social media coach, assisting small businesses with brand awareness.

 

Joyce Dillon, RN, MN, BCC, is a consultant and facilitator, who works with practitioners and entrepreneurs in the health and wellness industry to help them gain clarity for their business ventures.

 

“I think attending the entrepreneurial workshop helped me to refocus and rebrand my business and identify the niche of health and wellness,” said Dillon. “It jump-started my research in developing a holistic, sustainable model … and was very helpful in launching my business.”  

 

Registration information is available at accell.osu.edu/entrepreneur-innovation-workshop.

February 01, 2016

New study reveals one reason why many hospitals continue to struggle with quality, safety and costs

 

Editor's note: Read this fact sheet on what you should know about evidence-based practice (EBP) and what it means to patients. 

 

As hospitals across the country continue to feel pressure to improve patient outcomes and reduce costs, a new study published today in Worldviews on Evidence-Based Nursing reveals one reason why many organizations continue to fall short.

 

A research team led by Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN, dean of the College of Nursing at The Ohio State University, surveyed 276 chief nurse executives across the United States to gauge how highly EBP ranks as a priority in their institution. Findings from multiple studies support the idea that evidence-based care results in higher quality care care, improved population health, better patient experience and lower costs, often referred to as the “Triple Aim” of healthcare.

 

Despite this fact, data from the survey revealed that the implementation of EBP among chief nurses and their hospitals is relatively low. Additionally, many of the hospitals involved in the study reported poor scores on key performance measures, such as falls and pressure ulcers.

 

“We found that a substantial percentage of hospitals were not meeting national benchmarks for quality and safety,” explained Melnyk, who also serves as Ohio State’s associate vice president for health promotion and chief wellness officer. “As you look at explanations for why 30 [to] 40 percent of these hospitals aren’t meeting benchmarks on key quality indicators­—one key explanation is the low level of evidence-based practice happening in those hospitals.”

 

EBP is an approach to decision making in healthcare that brings together evidence from research, a clinician’s expertise and patient preferences and values to drive the best patient care and outcomes. However, application of EBP is not the norm. For example, children with asthma continue to be treated with nebulizers in many emergency rooms across the U.S. even though numerous studies have indicated better outcomes and fewer hospitalizations when children are given a bronchodilator with a metered-dose inhaler and spacer.

 

“When patients get evidence-based care, they have 28 percent better outcomes. That’s a big deal,” said the study’s co-author Lynn Gallagher-Ford, PhD, RN, DPFNAP, NE-BC. “When they don’t get evidence-based care, those outcomes go away. There’s a public perception that this is what hospitals are already doing, and the sad news is, many are not.”

 

Gallagher-Ford directs Ohio State’s Center for Transdisciplinary Evidence-based Practice (CTEP), which works with organizations to effectively implement EBP in both clinical and academic settings.

 

While most chief nurses who participated in the survey said they believe in the value of EBP, more than half of them reported that evidence-based care is practiced in their organization “not at all” or only “somewhat.” When asked to list their organization’s top three priorities, quality and safety ranked first and second. Evidence-based practice was ranked among the lowest. These results cast doubt on the Institute of Medicine’s goal that 90 percent of healthcare decisions will be evidence-based by 2020.

 

The study points to a lack of understanding as the root problem.

 

“The chief nurses we surveyed reported that they planned to focus on EBP as soon as they had a handle on quality and safety. That’s the disconnect—leaders think EBP is a competing priority when in reality, EBP is the exact mechanism that needs to be integrated in order to achieve and sustain quality and safety,” explained Gallagher-Ford, also noting that this misconception likely exists among other hospital leaders, not just nurses.

 

Researchers say that without leadership support and engagement, it’s nearly impossible for an organization to successfully sustain a culture of EBP. Many hospitals stop at some EBP education of front-line staff and fail to create leadership champions who can help create an environment of success.

 

The study also revealed that nearly half of the chief nurses surveyed were unsure of how to measure patient outcomes, a statistic Melnyk and her team find concerning.

 

“To me, this finding signifies a real gap in the preparation of nurse leaders,” said Melnyk, co-editor of the widely-used book Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice and editor of the top-ranked journal Worldviews on Evidence-based Nursing. “If we’re graduating nurses with graduate and doctoral degrees who have not mastered EBP, and a part of that is measuring outcomes of evidence-based practice changes, then we’re not going to have nurse leaders with that knowledge and skillset. And, if these leaders don’t have those EBP skills, how are they going to be able to create the culture and infrastructure that’s needed for their staff to practice evidence-based care in a consistent manner?”

 

Melnyk stresses the importance of patients asking for EBP when they receive healthcare services. She says patients should ask their provider for the evidence behind the care, medications or treatments they are receiving. If patients are not satisfied with the answers given, they should seek out a nurse practitioner or physician provider who does deliver evidence-based care.

 

Researchers emphasize that until hospitals can rally leadership to support investment in EBP education, infrastructure, job description changes, accountability and cultural changes across all disciplines, quality, safety and patient outcomes will continue to suffer.

 

The study was conducted in 2014 and received funding from Elsevier Clinical Solutions. “Discovering the barriers to EBP is important in order for providers to deliver EBP as a standard of care,” said Michelle Troseth, RN, MSN, DPNAP, FAAN, Elsevier’s chief professional practice officer and one of the researchers who contributed to the study. It was published by The Honor Society of Nursing, Sigma Theta Tau International (STTI).

 

Other researchers who contributed to the study are Bindu Koshy Thomas, MEd, MS, The Ohio State University College of Nursing; Kathy Wyngarden, RN, MSN, FNP; and Laura Szalacha, EdD, University of Arizona.

 

About The Ohio State University College of Nursing

 

The Ohio State University College of Nursing is the world's preeminent college known for accomplishing what is considered impossible through its transformational leadership and innovation in nursing and health, EBP and unsurpassed wellness. As part of the largest health sciences campus in the United States, the College of Nursing offers seven innovative academic programs. The college's graduate nursing programs are among the top five percent in the country, according to the U.S. News and World Report, while its online graduate program is ranked fourth and its RN to BSN program is ranked seventh as part of Ohio State's ranking for online bachelor's programs. Annual college enrollment is approximately 1,950 students. The college celebrated its centennial in 2014. 
 

About Elsevier

 

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health and technology professionals, empowering them to make better decisions, deliver better care and make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions, such as ScienceDirectScopusElsevier Research Intelligence and ClinicalKey, and publishes more than 2,500 journals, including The Lancet and Cell, and more than 33,000 book titles, including a number of iconic reference works. Elsevier is part of RELX Group plc, a world-leading provider of information solutions for professional customers across industries. 


About STTI

 

The Honor Society of Nursing, Sigma Theta Tau International (STTI) is a nonprofit organization whose mission is advancing world health and celebrating nursing excellence in scholarship, leadership and service. Founded in 1922, STTI has more than 135,000 active members in more than 90 countries. Members include practicing nurses, instructors, researchers, policymakers, entrepreneurs and others. STTI’s roughly 500 chapters are located at approximately 700 institutions of higher education throughout Armenia, Australia, Botswana, Brazil, Canada, Colombia, England, Ghana, Hong Kong, Japan, Kenya, Lebanon, Malawi, Mexico, the Netherlands, Pakistan, Portugal, Singapore, South Africa, South Korea, Swaziland, Sweden, Taiwan, Tanzania, Thailand, the United States, and Wales. More information about STTI can be found online at www.nursingsociety.org.
 

 

June 02, 2015

The Ohio State University College of Nursing and medical device company Welch Allyn have joined forces on new research aimed at improving the delivery of patient care.

 

The project will examine how patient physical evaluations are conducted and how the process can be improved, given the changing healthcare landscape and its growing emphasis on primary care and prevention. As a supplier of diagnostic equipment to patient-care facilities and emergency departments, Welch Allyn is interested in understanding the physical assessment workflow, including the challenges and needs associated with this process in primary- and emergency-care settings. The ultimate goal will be to improve the healthcare delivery process for both providers and patients alike.

 

“Given our shared vision of transforming healthcare and improving health outcomes, it seemed natural to partner with Welch Allyn in this exciting endeavor,” said Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN, university chief wellness officer, vice president for health promotion and dean of the College of Nursing at Ohio State. “This relationship serves as a leading example of our college’s commitment to improving patient care through innovative education, research and evidence-based clinical practice. And, because nurses, nurse practitioners and physicians are all on the frontlines of care, their input is crucial to the success of this project. Interprofessional teams delivering care result in improved health outcomes, so including each discipline makes for more valuable feedback overall.”

 

Research is being conducted on the Ohio State campus. The College of Nursing will also provide research expertise and evidence reviews on relevant topics, as well as secure clinicians for interviews to be conducted by the Welch Allyn team of engineers, usability and technology experts, and marketing executives. Once enough feedback is gathered, the teams will work together to develop new concepts to improve the physical-exam process.

 

“For 100 years Welch Allyn has been committed to delivering practical innovations that help doctors and nurses provide better care for their patients,” said Sal Strods, senior director of advanced technology and sensors. “As healthcare continues to undergo rapid transformations, we must be ready to provide clinicians with the right equipment to help meet further challenges. Our partnership with The Ohio State University College of Nursing will allow us to learn first-hand the challenges physicians, nurses and patients face in this changing industry. Unlike other partnerships, this agreement is extremely interactive, allowing clinicians to guide the Welch Allyn team on what they need most to help improve patient care. Basically, products will be modeled by clinicians for clinicians.”

 

“This relationship greatly supports our college’s goal of fostering collaborative entrepreneurial initiatives with local, national and international partners to improve healthcare and health outcomes, as well as enhancing the experience for both providers and their patients,” added Melnyk.


 

About The Ohio State University College of Nursing

 

The Ohio State University College of Nursing is the world’s preeminent college known for accomplishing what is considered impossible through its transformational leadership and innovation in nursing and health, evidence-based practice and unsurpassed wellness. As part of the largest health sciences campus in the United States, the College of Nursing offers seven innovative academic programs. The college’s graduate nursing programs are among the top five percent in the country, according to U.S. News and World Report, while its online graduate program is ranked 6th and its RN to BSN program is ranked 8th as part of Ohio State’s ranking for online bachelor’s degree programs. Annual college enrollment is approximately 1,950 students. The college celebrated its centennial in 2014.


 

About Welch Allyn, Inc.

 

Since 1915, Welch Allyn has brought a unique perspective to developing diagnostic solutions by combining pragmatic knowledge with a visionary spirit of innovation and ongoing improvement. As a leading global manufacturer of physical examination instruments and accessories and EMR-connected vital signs and cardiac monitoring solutions, the company has a steadfast commitment to delivering superlative medical products, services and solutions that help healthcare professionals provide better care for their patients. Welch Allyn is headquartered in Skaneateles Falls, New York, and employs more than 2,600 people in 26 different countries. Visit www.welchallyn.com for more information. Like us on Facebook and follow us on Twitter and LinkedIn.

August 29, 2012

A new national survey of more than 1,000 registered nurses suggests that serious barriers, including resistance from nursing leaders, prevent nurses from implementing evidence-based practices (EBP) that improve patient outcomes.

 

When survey respondents ranked these barriers, the top five included resistance from nursing leaders and nurse managers - a finding that hasn’t been reported in previous similar studies - as well as politics and organizational cultures that avoid change.

 

When asked what would help them implement evidence-based practice (EBP), respondents reported education, access to information and organizational support among their top five needs.

 

EBP refers to making decisions about patient care that are based on the best evidence produced by well-designed clinical research. Numerous studies have suggested that evidence-based care of patients can reduce patient complications and decrease healthcare costs by as much as 30 percent.

 

Overall, a little more than half of respondents reported that EBP was consistently used in their organization, but only about one-third said their colleagues consistently used these practices.

 

The respondents with more education tended to have more confidence in implementing EBP. However, the longer nurses had been working in healthcare, the less interested they were in learning more about EBP.

 

“This was a distressing finding,” said Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN, dean of the College of Nursing, chief wellness officer at The Ohio State University and lead author of the study. “And it’s a huge problem. The average age of nurses is 47, and they were educated at a time when evidence-based practice was not well integrated into educational programs. As a result, many nurses are practicing the way they were taught or steeped in tradition of the healthcare system in which they work. When new graduates who have learned to take an evidence-based approach to care are meeting these nurses in real-world settings, they encounter this prevalence of a ‘this is the way we do it here’ culture.”

 

Melnyk said the findings indicate the need for widespread cultural change in healthcare settings and a new direction in nursing education, where many current faculty tend to emphasize teaching rigorous research methods and critique of existing research rather than how to put research findings to use in clinical practice settings. She also said consumers should feel empowered to ask whether they are receiving evidence-based care.

 

The study is published in the September issue of the Journal of Nursing Administration.

 

Examples of care that are not based on evidence are not that hard to find, noted Melnyk, a longtime consultant with health systems on implementation of EBP and a former member of the U.S. Preventive Services Task Force. It’s not uncommon for children suffering from asthma attacks to receive a drug to open their airways with a nebulizer in an emergency room, when research has shown that using a metered-dose inhaler with a spacer instead leads to fewer side effects, less time in the emergency room and lower likelihood for hospitalization. And patients with depression typically receive an antidepressant prescription and nothing else despite research-based evidence that cognitive behavior therapy is more effective than medicine for mild to moderate depression.

 

The Institute of Medicine (IOM) issued a report in 2003 calling for health professional education programs to include evidence-based care among five core competencies. The IOM has set a goal that 90 percent of all patient-care decisions be based on evidence by 2020.

 

A survey of nurses in 2005 conducted by a different research group suggested that the profession wasn’t ready then to adopt evidence-based care.

 

“Now, in 2012, they believe in it and they’re ready for it,” said Melnyk, associate vice president for health promotion at Ohio State. “But there are so many barriers that continue to exist in our healthcare and educational system.

 

“Another disconcerting finding in our survey was that a substantive number of nurses said their leader or manager is resistant to evidence-based practice," Melnyk said. "What I’ve seen as a consultant is a lot of leaders and managers will say they want their clinicians to deliver evidence-based care, but they don’t walk the talk. If leaders do not role model evidence-based decision-making, and they are not providing tools, education and resources for their clinicians to get the knowledge and skills they need to consistently implement this, it’s probably not going to happen nor will it be sustained.”

 

Melnyk and colleagues solicited potential participants via emails sent to 20,000 randomly selected members of the American Nurses Association. Of those, 1,015 members completed the survey.

 

The survey contained questions about the state of EBP from each respondent’s perspective as well as two open-ended questions: what one thing prevents respondents from implementing EBP in daily clinical care, and what one thing would help them the most to implement this care.

 

Respondents' ages ranged from 21 to 79 years, and 93 percent were female. Nearly 56 percent held master’s degrees or higher, and 44 percent had earned a bachelor’s, associate degree or diploma. The average number of years in nursing practice was 24, representing a range of zero to 52 years. Almost 47 percent worked in community hospitals, and 23 percent practiced in academic medical centers. A quarter of respondents described themselves as nurse educators.

 

While 46.4 percent of respondents agreed that findings from research studies are routinely implemented to improve patient outcomes at their institution, more than three-quarters, 76.2 percent, indicated that it was important for them to receive more education and skills building in EBP. Fewer than a third of respondents reported that mentors were available in their healthcare settings to help them learn more about how to adopt these practices.

 

Nurses working in hospitals with magnet designation, awarded by the American Nurses Credentialing Center for excellence in nursing, were more likely to report the adoption of evidence-based care at their institutions, plenty of educational opportunities to gain skills in this care and organizational cultures that supported the use of evidence in delivering care.

 

As for her own educational institution, Melnyk said that when she arrived at Ohio State one year ago, she held workshops on EBP with faculty “so we made sure we were talking the same language and were committed to integrating this even further throughout our curriculum. It is being strengthened all the time.”

 

The college has also launched a Center for Transdisciplinary Evidence-based Practice to facilitate the implementation and sustainability of EBP throughout Ohio State’s healthcare system as well as others' across the country.

 

“Educational programs are behind on this. Many tend to still teach students at the bachelor’s and master’s levels the rigorous process of how to do research versus how to use the research that’s being produced and get it into the real-world setting at a much faster pace,” Melnyk said. “Unless we have some drastic changes in both our clinical practice environment as well as our education systems, it’s going to be a long haul until every clinician in this country consistently delivers evidence-based care.”

 

Co-authors of the study include Ellen Fineout-Overholt, PhD, RN, FNAP, FAAN, of East Texas Baptist University; Lynn Gallagher-Ford, PhD, RN, DPFNAP, NE-BC, of Ohio State’s College of Nursing; and Louise Kaplan, PhD, MN, ARNP, of the American Nurses Association.

 

About The Ohio State University College of Nursing

 

The Ohio State University College of Nursing is the world’s preeminent college known for transforming health and transforming lives through innovative academic programs and research that improves outcomes and evidence-based clinical practice. We exist to revolutionize healthcare and promote the highest levels of wellness in diverse individuals and communities throughout the nation and globe. The College of Nursing is part of the largest health science campus in the nation that is comprised of seven health sciences colleges, including dentistry, medicine, nursing, pharmacy, optometry, public health and veterinary medicine. Please visit us at www.nursing.osu.edu.

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