Nursing faculty focus on bringing best practices to bedside

Published on Monday, July 30, 2018

By: Alana Bowman

“Remember, systematic reviews are like cupcakes,” said Dr. Christian Pruett, assistant professor of nursing and director of instructional development and distance learning at the University of Mississippi School of Nursing.

His “students” are eight nursing faculty members, and they are taking a “train the trainer” course under the watchful eye of Dr. Kylie Porritt, senior research fellow at the Joanna Briggs Institute at the University of Adelaide in Australia. The school is preparing to educate faculty and students in the Doctor of Nursing Practice program on how to distill current research into informed practice – and to subsequently effect change in the quality of health care in Mississippi.

The nursing school was designated as the sixth Joanna Briggs Institute Centre of Excellence in the United States in April. The new Mississippi Centre for Evidenced-Based Practice is helping to advance the JBI concept that a pebble of knowledge can have a ripple effect of change in health care.

But let’s get back to cupcakes. Pruett points out that cupcakes are better than cake in that they are smaller, easier to manage, practical and satisfying in the moment – a lot like systematic reviews.

“If you go onto PubMed, there are millions of citations,” said Porritt. “Health professionals are busy. There is no way that someone in the clinical area is ever going to be able to read through that many papers and work out what they should be doing [on the floor or in the clinic].”

The JBI Collaboration provides tools for introducing evidence-based best practice standards into clinical care.

“Our students are learning basic evidence-based practice skills,” said Dr. Robin Christian, professor of nursing and a trainer for JBI since 2010. Christian was introduced to the institute during her studies at Texas Christian University where she earned a DNP degree. Through the JBI Comprehensive Systematic Review training program, students learn how to develop a clinical question, search literature, critically appraise the information they find and synthesize the evidence to answer the question that initiated the process.

Until now, Christian was the only local trainer in the process. The institute hosts only one “train the trainer” session per year in the Americas region which is made up of Canada, United States and Brazil. The nursing school is fortunate to have the training brought to campus so that faculty members could participate in the program without leaving the state. The school hopes to offer CSR training courses not just to DNP students, but also to clinicians across the state, to better affect positive change in Mississippi’s health care system.

“To have more people who can train is the better,” Porritt said. “It helps get message of evidence-based health care out further. It helps [the school], as well, to be able to train more students in the process of evidence-based health care.”

Porritt said that the school is a leader in the field of evidence-based health care within JBI and the Joanna Briggs Collaboration that is made up of Centres of Excellence around the world.

Two systematic reviews produced by the School of Nursing have been accepted, and 27 protocols, which are preliminary to the systematic reviews, have been approved.

“JBI has 11 different methodologies for systematic reviews. Most of ours are quantitative,” Christian said. “We are asking if one treatment is more effective than another.”

Topics range from decreasing wounds caused by a cervical collar when treating a trauma patient and home monitoring for infants with hypoplastic left heart syndrome to interventions for managing sleep disturbances in children with autism and the effectiveness of telehealth in a correctional facility.

“It's more than just grabbing a study here and a study there and trying to work out what best practices should be adopted,” Porritt said. The program teaches clinicians to follow a systematic approach of developing a protocol, doing a comprehensive search and critically appraising each paper. “You have a set inclusion criteria that relates to your particular question, then you do a formal process of data extraction and synthesis so that the findings you get at the end are valid and reliable.”

The JBI approach can be adopted for any health care discipline, not just nursing.

The institute offers more than a method of distilling data. It also serves as an easily accessible storehouse for that condensed data. Their clinical decision support tools provide databases to help clinicians at the point of care answer questions at the bedside, Christian said.

“One great thing about us becoming a Centre of Excellence is that we can offer that software to one clinical partner for free,” Christian said. “We've established an official partnership with University Hospital. Once we get that going, everyone will have access to those databases at the patient bedside. They can – on the fly – look up a systematic review that condenses a lot of research into a best practice.”

Now when a Medical Center nurse is wondering what the latest research is on the most effective frequency of wound re-dressing, the answer is only a few keystrokes a way. Having easy access to evidence-based best practices is one more step toward better patient outcomes and a healthier Mississippi.  

The School of Nursing will host CSR training the week of October 22, 2018. Those interested in taking part may call Robin Christian at (601) 984-6253 or email rchristian2@umc.edu. Of course, you’ll need to B.Y.O.C. – bring your own cupcakes.