Perspectives: Implementation of strategies to adopt and integrate evidence-based practice (EBP) in nursing. What are we doing? Teresa Moreno Casbas Unidad de Investigación en Cuidados de Salud (Investén-isciii) Instituto de Salud Carlos III
Nursing and Healthcare Research Unit (Investén-isciii)
Organization Ministry of Economy, industry and Competitiveness Institute of Health Carlos III Investén-isciii Strategic planning Capacity building Research consultation services Evidence-based practice and Knowledge transfer Research and innovation
Main objetives Research Synthesis and Dissemination Implementation
Expertise Supporting healthcare professionals on methodology to conduct reasearch projects Promoting training and dissemination of research methodology and evidence-based practice Participating in clinical trials, systematic reviews and clinical practice guidelines aimed at the area of healthcare service providers Investén-isciii is involved in national and international healthcare research projects, such as: Healthcare an health services research Centre of excelence for the Joanna Briggs Institute Coordinating a nationalwide Implementation Project for the Good Practice Guidelines in Centres Comitted to Excellence in Care, in collaborating with the Registered Nurses Association of Ontario (RNAO) Member of the Healthy Aging and Frailty Network (CIBERFES) Investén-isciii has coordinated and participated in several Health European projects, such as RN4CAST
Brazil measures 8.5 million square kilometers. Spain stays at 504,000 Brazil could fit 17 times Spain and only in the Amazon three Brazil have 206.101.000 inhabitants in 2016) and Spain 46.468.102
The Spanish National Healthcare System NHS funded by taxes Decentralized to regional autonomies Universal coverage Free Access Very wide range of publicly covered services Co-Payment in pharmaceutical products Services provided mainly in public facilities Interterritorial Board to coordinate policies 17 autonomous communities 2 autonomous cities (Since 1978)
The Spanish National Healthcare System
Perspectives: Implementation of strategies to adopt and integrate evidence-based practice (EBP) in nursing. What are we doing? Teresa Moreno Casbas Unidad de Investigación en Cuidados de Salud (Investén-isciii) Instituto de Salud Carlos III
The fact to incorporate nursing knowledge into clinical practice has to do with the availability of good quality research results, but also with the attitudes of professionals to adopt new practices and with the willingness and opportunity of institutions and policy makers to implement them
Aim: Influence the adoption of Best Practice Guidelines in Spanish health institutions, in order to promote excellence in practice and better patient outcomes Strategy: International network of Best Practice Spotlight Organizations (BPSO ) Investén-isciii/Collaborating centre of JBI as Host organization in Spain
Programa de Guías de Práctica Clínica To improve the quality of care at the local, national and international level Variability Patients satisfaction Evidence transfer Team building Decision making Continuous improvement Stop interventions without effect Costs Research gap
Why RNAO?
August 2010 Nursing Research and Healthcare Unit (Investén-isciii) Belonging to the Institute of Health Carlos III International scope EBP objectives Agreement between RNAO and Investénisciii: Spanish BPSO Host Spanish translation guidelines BPSO Host
Traslation (2010) Dissemination and call (2011) Implantation and evaluation (2012-2014) Second cohort Sostenibility (2015-2017) RNAO Best practice guidelines 34 Clinical guidelines 7 Healthy Work Place On-line Environment access / Social Guidelines Network/ Information Sessions competitive calls for proposals 44 candidates Training Proposal Implantation 3 years 34 candidates Evaluation 8 institucions Operationalization Accreditation BPSO Evaluation / Feed-back Implantation of new guidelines New calls (2nd cohort)
Centros Comprometidos con la Excelencia en Cuidados www.evidenciaencuidados.es
Best Practice Guidelines are now available in several languages: French / Français Chinese / 最佳作业指引中文版 Italian / Italiano Japanese/ ベストプラクティス ガイドライン Spanish / Español
Spanish Best Practice Spotlight organization project Press release Mailing to the Health Centers in Spain Publication of a paper at a Nursing Scientific Journal Dissemination at Website (www.evidenciaencuidados.es) Annual International Nursing Research Conference General Information 1 Publication selected institutions 4 Spanish Best Practice Spotlight organization project Declaration of interest 2 Applications submission 3
BPG Translated into Spanish Nursing Best Practice Guidelines Woman Abuse: Screening, Identification and Initial Response Supporting Clients on Methadone Maintenance Treatment Enhancing Healthy Adolescent Development Adult Asthma Care Guidelines for Nurses: Promoting Control of Asthma Promoting Asthma Control in Children Breastfeeding Best Practice Guidelines for Nurses Client Centred Care Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease Caregiving Strategies for Older Adults with Delirium, Dementia and Depression Screening for Delirium, Dementia and Depression in Older Adults Promoting Continence Using Prompted Voiding Prevention of Constipation in the Older Adult Population Crisis Intervention Assessment and Management of Foot Ulcers for People with Diabetes Prevention of Falls and Fall Injuries in the Older Adult Supporting and Strengthening Families through Expected & Unexpected Life Events Assessment and Device Selection for Vascular Access Primary Prevention of Childhood Obesity Ostomy Care & Management Assessment and Management of Pain Healthy work environments Risk Assessment and Prevention of Pressure Ulcers Assessment and Management of Foot Ulcers for People with Diabetes Collaborative Practice Among Nursing Teams Guideline Assessment and Management of Stage I to IV Pressure Ulcers Developing and Sustaining Nursing Leadership Assessment and Management of Venous Leg Ulcers Embracing Cultural Diversity in Health Care: Developing Cultural Competence Integrating Smoking Cessation into Daily Nursing Practice Stroke Assessment Across the Continuum of Care Preventing and Managing Violence in the Workplace Establishing Therapeutic Relationships Professionalism in Nursing Workplace Health, Safety and Well-being of the Nurse Guideline
Hospital Valle del Nalón Hospitales de SierrallanaTres Mares OSI Donostialdea G.A.P. Del Bierzo. Centro de Salud Ponferrada II Hospital Doctor José Molina Orosa Hospital de Medina del Campo Hospital Universitario Puerto Real G.A.I de Alcázar de San Juan OSI Debabarrena Complejo Hospitalario Universitario de Albacete Centro de Salud José María Llanos Hospital Clínico San Carlos Complejo Hospitalario Universitario de Granada Complejo Hospitalario de Navarra Consorcio HUAV-HSM Facultad de Lleida Hospital Universitario Vall d Hebron Área de salud de Menorca: Hospital Mateu Orfila y Centros de Salud de AP Hospital Rafael Méndez de Lorca y Universidad de Murcia 1 st BPSO Cohort 2 nd BPSO Cohort
Platform in Spain. CarEvID
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http://www.evidenciaencuidados.es/bpso/attachments/article/26/libro_ ideas_2012-2014_final_1.pdf
Evidence Based Nursing Nursing sensitive indicators CarEVID National Network BPSO Sustainability and growing up Transforming care through the knowledge!
The Iceberg Illusion: What People See Vs What They Don t
Esta obra está bajo una licencia Creative Commons Reconocimiento-Nocomercial-CompartirIgual 4.0 Internacional
Unresolved problem Inpatients who sleep at night less than 300 minutes (5 hours) have a fourfold increase in mortality An impatient wakes up 3-6 times during the magic hours (0h-6.30h) 1. Gómez Sanz, Carmen. Calidad del sueño de los pacientes ingresados en una unidad de cuidados intensivos. Enfermería Intensiva 2013; 24(1):3-11. 2. Medina Cordero, A., Feria Lorenzo, DJ, Oscoz Muñoa, G. Los conocimientos sobre el sueño y los cuidados enfermeros para un buen descanso. Enfermería Global 2009; 8 (3). 3. Costa Shíntia Viana da, Ceolim Maria Filomena. Factors that affect inpatients' quality of sleep. Rev. esc. enferm. USP [Internet]. 2013 Feb [cited 2016 July 13]; 47(1): 46-52
CAUSES OF SLEEP DISRUPTION lighting Noise Nursing interventios Pain or fatigue Fear and worries Daytime naps Room temperature Uncomfortable bed
To empower health professionals, leading by nurses, asking them to change their routines using the recommendations proposed by the evidence Raise awareness of the institutions, professionals, patients and caregivers MIRÍADA DE CUIDADORES
ADHESION COMMITMENTS Health professionals Health institution teams Patientes and caregiver
PROFESSIONAL HEALTH COMMITMENT Cuidadores del sueño 11th of July 20916-21st of April 3120
PATIENTS AND CAREGIVER COMMITMENTS RECOMMENDATION To create a quiet setting in the "magic hours"
Twitter: @sueno_on #cuidamoselsueño Instagram: @suenon117 Facebook: SueñOn Youtube: SueñOn Investén
http://www.isciii.es/investen http://investigacionencuidados.es http://www.evidenciaencuidados.es http://www.recursosencuidados.es Abstract deadline 3rd of June 2017 mmoreno@isciii.es