Resources
Research essentials Implementing findings from clinical projects to influence practice IMPLEMENTING AND evaluating findings from clinical projects is an essential part of ensuring that care is based on the best available evidence and is responsive to local needs and settings. The ‘plan’, ‘do’, ‘study’, ‘act’ (PDSA) cycle (Figure 1) is one framework for planning projects and improving services. Identifying strategies and planning the implementation of project findings are essential to a project’s success. Active dissemination through educational packages and training are more likely to bring about change in practice, but a combination of strategies appropriate for the setting will maximise the effect. ■■ Inform and involve All professionals affected by the changes should be involved and informed about the progress of a project. Use newsletters/regular meetings to provide updates. Plan a project launch and try to obtain sponsorship for refreshments. ■■ Supporting paperwork If required, ensure documentation is produced on time and in line with local guidelines. ■■ Dissemination Ensure the final report is clear and well written. Circulate a one-page summary of the main findings to key players and display summaries on noticeboards. ■■ Support of project champions Foster allies who can act as champions. ■■ Clinical audit meetings Timetable a regular slot to discuss the project at clinical audit meetings for timely review of outcomes and an ongoing update of evaluation. ■■ Education and training Training sessions/ workshops are essential to implement change and plan ahead. Build into existing training schedules/events. Consider online resources for easy access to training.
Figure 1 The Plan, Do, Study, Act cycle ■ Plan local implementation of the project. ■ Share innovations across organisations. ■ Ongoing monitoring/review/ update.
Act ■ Review information/analyse data obtained. ■ Has the problem/ question been solved? ■ Summarise findings.
Study
■ Identify the problem/formulate a question. ■ How will the problem be addressed? (Who? What? Where? When?) ■ What information/data are required? ■ How will information/data be collected and by whom? ■ Set clear timescales. Plan
Do
■ Carry out the plan. ■ Review and monitor progress (timescales).
(Adapted from NHS Institute for Innovation and Improvement 2008)
■■ Presentations Disseminate project findings at local and national conferences. The success of a project depends on three factors: Table 1 shows how the PDSA cycle enabled a regional children’s hospital to develop, implement and evaluate an electronic monitoring system to support the existing early warning score (EWS): ■■ Plan The project was developed in response to best practice guidance in recording physiological observations in acutely ill patients (National Institute for Health and Care Excellence 2007). ■■ Do It had a clear goal: to implement an electronic EWS. An operational group of nurses and doctors, managers and technical staff was established. ■■ Study The first stage involved undertaking a pilot study of commercially available electronic EWS systems. ■■ Act Patient safety and better clinical outcomes for patients could be achieved
by using Patientrack; this system enables staff to review electronic observation records from a central area, supports clinical decisions, and improves the legibility and accuracy of documentation. Children’s nurses said that the system allows them to spend more time at the bedside, rather than telephoning colleagues to escalate concerns. References National Institute for Health and Care Excellence (2007) Acutely Ill Patients in Hospital. Clinical Guideline 50. NICE, London. NHS Institute for Innovation and Improvement (2008) Quality and Service Improvement Tools. Plan, Do, Study, Act (PDSA). tinyurl.com/pdsa-cycle Sandström B et al (2011) Promoting the implementation of evidence-based practice: a literature review focussing on the role of nursing leadership. Worldviews on Evidence-Based Nursing. 8, 4, 212-233.
Michael McNamee, education development practitioner, Central Manchester Foundation Trust, and Joanna Smith, senior lecturer children’s nursing, University of Huddersfield
Table 1 Factors that affect project implementation Individual
Organisation
Culture
Clinical governance Systems that ensure NHS organisations improve quality of services and safeguard high standards of care.
Skills of project leader: ■■ Role model ■■ Support ■■ Good communicator
Value placed on innovation and project development
Value placed on evidence-based practice
Individual attitudes and beliefs of staff
Resources, time and support for project leaders
Pro-active or re-active response to change
Clinical effectiveness The extent to which clinical interventions do what they are intended to do. Delivering clinical effective care depends on practice being informed by the best available evidence and monitoring changes through clinical audit. 12 November 2014 | Volume 26 | Number 9
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Geek speak
(Adapted from Sandström et al 2011)
NURSING CHILDREN AND YOUNG PEOPLE
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Research essentials Implementing findings from clinical projects to influence practice IMPLEMENTING AND evaluating findings from clinical projects is an essential part of ensuring that care is based on the best available evidence and is responsive to local needs and settings. The ‘plan’, ‘do’, ‘study’, ‘act’ (PDSA) cycle (Figure 1) is one framework for planning projects and improving services. Identifying strategies and planning the implementation of project findings are essential to a project’s success. Active dissemination through educational packages and training are more likely to bring about change in practice, but a combination of strategies appropriate for the setting will maximise the effect. ■■ Inform and involve All professionals affected by the changes should be involved and informed about the progress of a project. Use newsletters/regular meetings to provide updates. Plan a project launch and try to obtain sponsorship for refreshments. ■■ Supporting paperwork If required, ensure documentation is produced on time and in line with local guidelines. ■■ Dissemination Ensure the final report is clear and well written. Circulate a one-page summary of the main findings to key players and display summaries on noticeboards. ■■ Support of project champions Foster allies who can act as champions. ■■ Clinical audit meetings Timetable a regular slot to discuss the project at clinical audit meetings for timely review of outcomes and an ongoing update of evaluation. ■■ Education and training Training sessions/ workshops are essential to implement change and plan ahead. Build into existing training schedules/events. Consider online resources for easy access to training.
Figure 1 The Plan, Do, Study, Act cycle ■ Plan local implementation of the project. ■ Share innovations across organisations. ■ Ongoing monitoring/review/ update.
Act ■ Review information/analyse data obtained. ■ Has the problem/ question been solved? ■ Summarise findings.
Study
■ Identify the problem/formulate a question. ■ How will the problem be addressed? (Who? What? Where? When?) ■ What information/data are required? ■ How will information/data be collected and by whom? ■ Set clear timescales. Plan
Do
■ Carry out the plan. ■ Review and monitor progress (timescales).
(Adapted from NHS Institute for Innovation and Improvement 2008)
■■ Presentations Disseminate project findings at local and national conferences. The success of a project depends on three factors: Table 1 shows how the PDSA cycle enabled a regional children’s hospital to develop, implement and evaluate an electronic monitoring system to support the existing early warning score (EWS): ■■ Plan The project was developed in response to best practice guidance in recording physiological observations in acutely ill patients (National Institute for Health and Care Excellence 2007). ■■ Do It had a clear goal: to implement an electronic EWS. An operational group of nurses and doctors, managers and technical staff was established. ■■ Study The first stage involved undertaking a pilot study of commercially available electronic EWS systems. ■■ Act Patient safety and better clinical outcomes for patients could be achieved
by using Patientrack; this system enables staff to review electronic observation records from a central area, supports clinical decisions, and improves the legibility and accuracy of documentation. Children’s nurses said that the system allows them to spend more time at the bedside, rather than telephoning colleagues to escalate concerns. References National Institute for Health and Care Excellence (2007) Acutely Ill Patients in Hospital. Clinical Guideline 50. NICE, London. NHS Institute for Innovation and Improvement (2008) Quality and Service Improvement Tools. Plan, Do, Study, Act (PDSA). tinyurl.com/pdsa-cycle Sandström B et al (2011) Promoting the implementation of evidence-based practice: a literature review focussing on the role of nursing leadership. Worldviews on Evidence-Based Nursing. 8, 4, 212-233.
Michael McNamee, education development practitioner, Central Manchester Foundation Trust, and Joanna Smith, senior lecturer children’s nursing, University of Huddersfield
Table 1 Factors that affect project implementation Individual
Organisation
Culture
Clinical governance Systems that ensure NHS organisations improve quality of services and safeguard high standards of care.
Skills of project leader: ■■ Role model ■■ Support ■■ Good communicator
Value placed on innovation and project development
Value placed on evidence-based practice
Individual attitudes and beliefs of staff
Resources, time and support for project leaders
Pro-active or re-active response to change
Clinical effectiveness The extent to which clinical interventions do what they are intended to do. Delivering clinical effective care depends on practice being informed by the best available evidence and monitoring changes through clinical audit. 12 November 2014 | Volume 26 | Number 9
iStock
Geek speak
(Adapted from Sandström et al 2011)
NURSING CHILDREN AND YOUNG PEOPLE
Downloaded from RCNi.com by ${individualUser.displayName} on Dec 05, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
