President Valarie Howard EdD RN opened the 2013 INACSL conference at the Paris Hotel in Las Vegas. This annual event hit another record high for attendance with nursing simulation champions coming from around the World. The key take away for me was learning about a new mentorship program the organization is development to connect the community to one another. More about this to follow tomorrow after the committee meeting.
Dr. Bernadette Mazurek Melnyk PhD, CPNP, FNAP then provided the keynote address “Nothing Happens Unless First a Dream”. Dr. Melnyk is the Dean, Associate VP for Health Promotion and the University Chief Wellness Officer at Ohio State University. She quickly reminded the audience that those who encounter a medical error will have a 5-15% chance of death or permanent disability – as over 200,000 patients die this way every year with such wasteful healthcare spending costing the healthcare system 1.2 trillion dollars annually.
Siting a lack of real world setting research Dr. Melnyk suggested that out of 10,093 articles screened only 50 reported patient outcomes for 3,221 trainees and 16,742 patients. For the past fifteen years, Dr. Melnyk has traveled the globe to teach others about evidence-based practices in education and urges all nursing simulation champions that are engaging in future research to explore the patient-outcomes “so what factors” that will end up affecting the healthcare system right now. The recommendation here is to utilize some form of quality assurance program to demonstrate that the “strength of the evidence plus the quality of the evidence equals the confidence to act”, which is crucial for evidence-based practices. But what does it take for clinicians to develop and promote EBP within their programs in a world “routed in tradition” (such as daily changing of iv dressings, perineal shaves before child birth, or mayonnaise for head lice). She reminded us that no one was calling to implement her COPE NICU training program until after she published a “so what” clinical trial which demonstrated a cost savings of $5000 per infant and an average 8 day shorter LOS. After this “so what” real world study Dr. Melnyk said “the phone never stopped ringing” with clinicians looking to to improve outcomes for patient care.
Her key take away is the consideration to add so what outcomes factor for research and simulation program development designed at directly affecting patient outcomes through evidence-based approaches. She further stresses that healthcare administrators must understand that they must encourage and reward clinicians for evidence-based practice research in-order to continue to improve patient care outcomes. Key strategies for those implementing EBP include:
- Using the best evidence available
- Inspire a spirit of clinical inquiry
- Reinforce the steps of EBP in simulations
- Role model EBP in all simulations and discuss benefits
- Build randomized clinical trials that show translations from simulation to pt care
You can get connected with more EBP information by reading Worldviews on Evidence-Based Nursing, edited by Dr. Melnyk!