Building a Foundation for Nursing Science….

A Unique Collaboration between Research & Practice

Tammy Cosman RN, MN, ACNP &

Karen Antoni RN, MHSc, ACNP

Objectives

Provide background information pertaining to nurses and research

Describe the evolution of the virtual Cardiac and Vascular Nursing Science Unit (CVNSU)

Highlight the impact of the CVNSU

Identify future directions

About Research & Practice…

Disconnect between research scientists and clinicians is well described

Scientists speak a foreign language, publish in different journals, and often present at different conferences than clinicians

Practice change is slow to follow published research findings ….may take up to 10 years! (Amsterdam, 2001)

A Slow Process Cleansing umbilical cords with alcohol

(Medves JM, 1997)

Pressure dressings post cardiac catheterization (Botti M, et al, 1998)

Nursing critically ill patients in supine position (Drakulovic MB, 1999; Dodek P, 2004)

Nurses & Evidence-based Practice Nurses reported their main source of practice

knowledge was through “social interactions” (Estabrooks, et al, 2005; Gerrish, et al, 2004)

17% of nurses said they never personally seek information from journal articles; 58% said that they never seek information from a research report

Primary barrier to the use of research in practice sited by nurses was the lack of value (Pravikoff, Tanner & Pierce, 2005)

Barriers Lack of Value

Organization perceptions of nurses involvement in researchLack of understanding

Lack of understandingElectronic databasesAbility to critique literature/knowledge of research

Difficulty accessing research materialsComputer access and skillsLibrary access

Presence of other goals with a higher priority Resources – monetary and human (mentorship)

(Pravikoff, Tanner & Pierce, 2005)

It started with intent … Relationships between key individuals

Communication and Timing

Research highly valued by individuals, within the program and the organization

Resources

Thoughtful selection of group members

Shared commitment to build nursing research capacity

Creation of the CVNSU

Goal was clear but the ‘how-to’ was not

Should we choose one geographical location,

given there were many units?

Determining the necessary infrastructure

Discussion about member skills & expectations

When should we engage others?

CVNSU Launch

Health Care is Knowledge Based

Explosion of Knowledge

Knowledge is Power

No One ‘Owns’ Knowledge

Mission Statement

To engage nurses in scientific

inquiry across the research

spectrum, from utilization to

generation of evidence.

Raising the Profile HHS Research Newsletter

Biennial Research Report

Seasons: Foundation publication

HHS Insider

Newsletter – Accomplishments at 6 months

Presentation to nursing class of 1951

Web page development

Educational Events

A need identified

“Evidence Based Health Care” course

Mentorship model

EBHC course members

Karen Antoni Pam Benoit

Tammy Cosman Leslie Gauthier

Pam Hewitson Lorene Long

Carol Mantle Kelly O’Halloran

Janina Sheasby Irene Travale

Marion Quirk

Presentations

Canadian Council of Cardiovascular Nurses – October 2005

Heart Rhythm Society, May 2006, Boston  International NP/APN Network Conference South Africa

Toronto Critical Care Medicine Symposium, October 2005

Innovations in Health Care Conference, April 2006, Toronto

Publications

Journal of Continuing Education in Nursing

Journal of Neuroscience Nursing

 

Healthcare Quarterly, Patient Safety Papers 

Abstract Submissions

Canadian Council of Cardiovascular Nurses

Vancouver, Canada - October 2006

American Heart Association

Chicago, USA, - November 2006

Nursing Research Day

Hamilton, Canada – October, 2006

Additional Achievements

Advanced Clinical/Practice Fellowship

- Registered Nurses Association of Ontario

Funding for Research study - HHS

Support for Nurses

Vision for the Future

CVNSU sponsored Journal club

Web site

FAQ sheet

Writing workshop

Dedicated administrative support

Linkages to other research experts

Core Committee

Dr. Heather Arthur Susan Gregoroff

Karen Antoni Tammy Cosman

Charlotte Daniels Leslie Gauthier

Sandra Ireland Kelly O’Halloran

Irene Travale

CVNSU Core Committee

Many thanks …Members of the CVNSU

Hamilton Health Sciences

Canadian Association of Advanced Practice Nurses

Clinical Nurse Specialist Interest Group

ReferencesAmsterdam EA, Lasletti I, Diercks D, et al. Reducing the knowledge/practice gap in the management of patients with cardiovascular disease. Rrev Cardiol 2001;5:12-15.

Botti M, Williamson B, Steen K, et al. The effect of pressure bandaging on complications and comfort in patients undergoing coronary angiography: a multicenter randomized trial. Heart Lung 1998;27:360-73.

Canadian Institute for Health Information, Workforce trends of Registered Nurses in Canada, 2004.

Dodek P, Keenan S, Cook D, et al. Evidence-based clinical practice guidelines for the prevention of ventilator-associated pneumonia. Ann Intern Med 2004;141:305-13.

ReferencesDrakulovic MB, Torres A, Bauer TT, et al. Supine body position as a risk for nosocomial pneumonia in mechanically ventilated patients: a randomized trial. Lancet 1999;354:1851-9.

Estabrooks CA, Rutakumwa W, O’Leary KA, et al. Sources of practice knowledge among nurses. Qualitative Health Research 2005;15(4):460-76.

Gerrish K, Clayton J. Promoting evidence-based practice: an organizational approach. Journal of Nursing Management 2004;12:114-123.

Medves JM, O’Brien BA. Cleaning solutions and bacterial colonization in promoting healing and early separation of umbilical cord in healthy newborns. Can J Public Health 1997:88:380-382.

Pravikoff DS, Taner AB, Pierce ST. Readiness of US nurses for evidence-based practice. AJN 2005;105(9):40-51.