Magnet Recognition Program® Request for Additional Documentation
Homestead Hospital
Homestead, FL
MGN20140102
NK2 Nurses disseminate the organization’s nursing research findings to internal and external audiences.
NK2a: Provide one example, with supporting evidence, of how clinical nurses disseminated to internal audiences knowledge obtained through the organization’s nursing research.
The documentation described the Best Practice Fair at Homestead Hospital as the venue for dissemination of nursing research to internal audiences. One research poster was mentioned in the document; however the document did not describe, with supporting evidence, the actual research and knowledge gained from the organization’s nursing research that was presented during the Fair.
Provide one example, with supporting evidence, of how clinical nurses disseminated to internal audiences knowledge obtained through the organization’s nursing research.
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A new example is presented below.
NAME OF INITIATIVE
SCALE – Skin Changes at Life’s End Educational Intervention for Intensive Care Unit (ICU) Nurses, Progressive Care Unit (PCU) Nurses, and Medical-Surgical Registered Nurses
BACKGROUND
At Homestead Hospital, clinical nurses have the opportunity to propagate knowledge obtained via research to internal audiences using a variety of avenues including shared governance councils, the annual Baptist Health South Florida, Inc. (BHSF) research conference, and the annual Homestead Hospital Best Practice Fair (BPF). The SCALE research project was one example of how multiple avenues were used to disseminate new knowledge gained through research to internal audiences.
Nursing Research
Homestead Hospital Clinical Nurses Sophie Boudreau, RN, from ICU/PCU and Rosa Filomeno, RN, from 3 South first developed and spearheaded SCALE in 2012, with the assistance of Nurse Scientist Maria Ojeda, ARNP. This was an area of interest for the investigators since Filomeno was the chair of the Wound Care Committee and Boudreau was a long-time member. Ultimately, they hoped that the knowledge gained by the clinical nurses on the principles of SCALE would help facilitate critical conversations regarding expected skin changes at life’s end among nurses, patients, and families. The specific goals of their research project were:
1. To increase staff’s knowledge regarding the concepts and principles associated with the development of pressure ulcers prior to death;
2. To increase the healthcare providers’ knowledge of the definition of SCALE and skin failure and its’ application in the healthcare setting; and
3. To measure the retention of SCALE by nursing staff over time.
The SCALE research project was a non-randomized, quasi-experimental, repeated measures study, using a convenience sample of RN working in the critical care (ICU), progressive care (PCU), and medical-surgical (MS3 and 3 South) units at Homestead Hospital. The project involved the delivery of an educational intervention based on the principles of SCALE proposed in the 2009 consensus statement on SCALE by an international team of clinical experts (Sibbad, Krasner, & Lutz, 2010).
A 9-item multiple-choice questionnaire was developed by the research team to assess RN knowledge of the principles of SCALE (scores ranged 0-9). The Homestead Hospital Wound Care Committee reviewed and approved the SCALE Knowledge Assessment Tool before it was administered to the clinical nurses. The investigators administered the knowledge questionnaire at 4 different points of time throughout the study: 1. Pre-education, 2. Immediately post-education, 3. Four weeks post-intervention, and 4. Eight weeks post-intervention.
Knowledge Obtained From Nursing Research
A total of 47 clinical nurses participated in the educational intervention. Pre-intervention knowledge scores averaged 7.57 for RN working in the ICU/PCU and 6.48 for RN on medical-surgical units; at 8-weeks post-intervention those scores had increased to 8.5 for RN in the ICU, and 8.2 for RN in medical surgical units. The results of repeated measures ANOVA indicated that:
1. Knowledge scores changed significantly between each administration period in both the ICU/PCU group and the medical-surgical RN group;
2. The ICU/PCU RN and the medical-surgical RN knowledge scores did not differ significantly from each other over time;
3. Knowledge increased significantly in both groups over time; and
4. Most of the increase in knowledge among participants occurred at the immediate post-intervention period but persisted over the 8-week period of the study.
The findings indicate that the educational intervention was effective at increasing knowledge of SCALE among RN working with critically-ill as well as those working with non-critically ill patients. In addition, the improvement in knowledge was successfully retained by both ICU/PCU and medical surgical RN over time.
Internal Dissemination
The knowledge gained through the successful implementation of the SCALE research project was subsequently shared with internal audiences on various occasions. Initially, the SCALE was featured as a poster presentation during the 8th annual Baptist Health South Florida, Inc. (BHSF) Research Conference at Parrot Jungle Island, Florida. The yearly conference provides a venue for BHSF staff to disseminate research findings to a largely internal audience of up to 300 attendees. Abstracts were submitted to a panel of internal experts including the Director of Nursing and Health Sciences Research Michelle Kirgan, RN and Nurse Scientists throughout the BHSF system, who make decisions regarding acceptance. Principal Investigator (PI) Filomeno presented the poster on April 12th, 2013 (NK2 01a BHSF Research Conference Acceptance Letter and Syllabus: Poster Presentation 15, page 35).
On April 17th, 2013, Co-PI Boudreau presented the findings of the SCALE project to the Homestead Hospital Wound Care Committee where additional plans for internal dissemination were discussed (NK2 02a Wound Care Committee Meeting Minutes 4/17/13).
Homestead Hospital also conducts an annual “Best Practice Fair” (BPF) to provide staff, particularly clinical nurses, additional opportunity to disseminate knowledge obtained through their research studies to internal audiences. The BPF provides an enjoyable and relaxing forum for nurses and other allied health professionals to share their research, evidence based practice (EBP) and performance improvement (PI) projects. All Homestead Hospital and BHSF staff members gets invited to participate and/or attend this free event.
The 2013 BPF accepted a total of 16 abstracts for poster presentations (8 PI, 7 EBP, and 2 research projects). It took place on August 20th, 2013 from 11 a.m. to 3 p.m. Poster sessions were held throughout the entire 4-hour period. The SCALE research project was featured on this occasion. Filomeno presented a professional poster which outlined the purpose, methods, results and implications associated with the project (NK2 03a SCALE Poster). A total of 52 people officially signed in; of those, 15% were from other entities. Homestead Hospital employees other than nurses also attended the fair, including physicians, social workers, registration personnel, operators and information technology (IT) staff. Visitors and family members were also seen visiting the area and reading the posters, even though they did not formally sign-in (NK2 04a 2013 BPF Sign-in Sheet and Flyer). The poster displays were kept overnight for the night staff to view.
Established in April 2015, Scholarly Commons is another platform for internal dissemination of research findings. It is a web-based institutional repository, maintained by the corporate Medical Library, which showcases and archives all scholarly output such as posters, lectures and papers. This site can be accessed by all employees via the intranet or internet (http://scholarlycommons.baptisthealth.net). The SCALE poster has been featured in the Scholarly Commons (NK2 05a Screenshot of SCALE Poster in Scholarly Commons).
PARTICIPANTS
Clinical nurses who were involved in the internal dissemination of knowledge obtained from the organization’s research are highlighted below.
Name/Credentials |
Title |
Department |
Role in the Team |
Rosa Filomeno, MSN, RN, CMSRN |
Clinical Nurse |
3 South |
PI and disseminated SCALE research results internally |
Sophie Boudreau, MSN, RN, CCRN, WCC |
Clinical Nurse |
ICU/PCU |
Co-PI and disseminated SCALE research results internally |
Maria Ojeda, DNP, PhD-c, MPH, ARNP, NP-C, |
Nurse Scientist |
Nursing and Health Sciences Research |
Mentored the PI and Co-PI in every step of the research and dissemination process; Chair of BPF Planning Committee |
Michelle Kirgan, MSN RN |
Director |
Nursing and Health Sciences Research |
Coordinated the BHSF annual conference |
Julie David, MSN, ARNP, ANP-BC |
Director |
Magnet Designation |
Provided fiscal support for printing of posters and BPF supplies |
Summary
Homestead Hospital supports an environment of inquiry by encouraging clinical nurses to conduct research. Furthermore, the organization has structures and processes in place to sustain clinical nurses in the internal dissemination of new knowledge obtained through nursing research.
Summary of Attachments/Hyperlinks/Evidences
NK2 01a BHSF Research Conference Acceptance Letter and Syllabus: Poster Presentation 15, page 35
NK2 02a Wound Care Committee Meeting Minutes 4/17/13
NK2 03a SCALE Poster
NK2 04a 2013 BPF Sign-in Sheet and Flyer
NK2 05a Screenshot of SCALE Poster in Scholarly Commons