1. Getting ready, Getting Started
18/02/2019
Getting ready, Getting Started
Stepping up to Evidence Based Practice - Ideas into Action 2
Debra Ugboma
January 2010

2. 18/02/2019
Objectives
Consider personal, team and environmental issues influencing EBP
Undertake a SWOT analysis of your clinical area (in relation to EBP)
Identify strategies to address weaknesses or threats
Discuss how opportunities and strengths can be maximised
Begin thinking about ideas for action..
What do I need for this session:
Paper/pen for SWOT
Worksheet 2

3. What is Evidence Based Practice (EBP)
18/02/2019
Page 3
What is Evidence Based Practice (EBP)
“Doing right things right” (Muir Gray, 2009 p41)
“.. the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patient/clients (Sackett et al 1996 p 71-72)
“Practice supported by a clear, up-to-date rationale, taking into account the patient/clients preferences and using your own judgement. If we practice EBP then we are set to give the best possible care” (Aveyard and Sharp, 2009 p4)

4. Stepping up to EBP.. Active involvement in research
18/02/2019
Stepping up to EBP..
Active involvement
in research
Projects into publication!
Structured EBP projects
Implementing
EBP dissertations
Evidence from others/policy etc.
Getting involved in audit
Ideas into action
Questioning care, responding to feedback

5. 18/02/2019
A PHT Model?

6. Identify some of the things you think you need to integrate
18/02/2019
Identify some of the
things you think
you need to integrate
EBP into everyday
working life?

7. 18/02/2019
Now undertake a SWOT analysis of your clinical area in relation to EBP?
Strengths
Opportunities
Weaknesses
Threats

8. Weaknesses and Threats… What gets in the way of EBP?
18/02/2019
Weaknesses and Threats… What gets in the way of EBP?
Competing/higher priorities for time
work and home
Skill
finding and appraising literature
research too complex
Access
too much information
poor quality information
Library/IT/Computer resources
Aveyard and Sharp, 2009

9. Weaknesses and Threats.. What gets in the way of EBP?
18/02/2019
Weaknesses and Threats.. What gets in the way of EBP?
Leadership/organisational culture/implementing change
managers have other priorities
no clear/strategic direction
knowledge of EBP doesn’t result in changed behaviour
Role modelling
role models out of date/poor practice – students influenced more by practice educators than evidence
challenging practice of others is difficult
ritualistic practice is alive and well
Relevance
some problems too complex to be answered by research
research doesn’t always take into account holistic/individualised care
“cook book” approach doesn’t always work
Aveyard and Sharp, 2009

10. Did you identify “lack of time” on your SWOT analysis?
18/02/2019
Did you identify “lack of time” on your SWOT analysis?
To get you started, identify at least 6 “sessions of time” over the next 6 months for EBP activities and your own development
Protect this time!
Complete question 1 of worksheet 2 and consider
different ways to incorporate EBP into your
(or your teams) role/daily work rather than
as an add-on e.g. weekly at the end of hand-
over, discuss a care issue and continue to
use time to drive it forward.
Try further activities:

11. Tackling weaknesses and threats…
18/02/2019
Tackling weaknesses and threats…
What preparation do YOU need before getting started?
Do you have a current Athens password – if not, re-set via the library website:
What can you read (see resources)?
Can you identify a potential supporter/facilitator? This will likely be clearer once you have identified a project/topic, but have some ideas.
Do you need to hone/learn any skills? If these are library focussed, suggest doing this linked to a specific search.

12. 18/02/2019
Opportunities…
Keep articles/guidelines/evidence available to read when you have time
Agree with each other that you will ask each other why you approach a task in a particular way
Ask students to talk about what they are learning – maybe bringing in lecture notes/references
Consider attending a clinical conference – these are often great places to get ideas and “jump start” you into action
Get staff talking about what is important to them – what are their “bug bears”
Start to identity your potential “implementers” or lead for projects

13. Take a look at your opportunities and strengths…
18/02/2019
Take a look at your opportunities and strengths…
What can you do to embrace them and let them surface?
Who else can you involve?
What can you do to maximise their impact?
Complete questions 2 and 3 of worksheet 2

14. Getting involved in clinical audit
18/02/2019
Getting involved in clinical audit
Audit can be a great starting point for EBP
It can help generate questions
It may help identify care issues that “matter” or that staff feel strongly about
You might get involved in auditing national guidelines (tools often available)
Think about the audit cycle…

15. Getting involved in clinical audit…
18/02/2019
Getting involved in clinical audit…
What audits are undertaken in your clinical area?
Which audits have a nursing or midwifery focus?
How is the audit cycle organised in your area?
What is your role in audit?
How can you increase your involvement in audit, or lead a particular audit cycle?
Can you identify one aspect of care that is not currently audited, that you think could benefit from audit?
For more information about audit, contact your local lead or within PHT:

16. Generating your care/EBP question… Ideas into Action
18/02/2019
Generating your care/EBP question… Ideas into Action
Preparing the environment and staff…
Getting involved in audit…
Getting ready for EBP…
Helps generate ideas and questions.
Do you have a question or idea?
Whose idea was it?
How did it come about?

17. 18/02/2019
Help is out there…
PHT Learning and Development Team:
PHT Clinical Audit:
PHT Library Clinical Outreach: and
RD Learning - Putting evidence into practice (free 5 day course)
Foundation of Nursing Studies – great for ideas about projects, sharing information etc.

18. before you attend/undertake the next session (3)
18/02/2019
Making a start…
Complete the sections on the “do one thing” page on
worksheet 2
Try them out before the next session. How did it go?
Begin talking with your team about your/some “ideas for action”
What is important to them, what care issue would they like to review or address
Identify at least one “idea for action”
before you attend/undertake the
next session (3)

19. 18/02/2019
Resources
Aveyard H and Sharp P A beginners guide to evidence based practice in health and social care. Maidenhead: Open University Press
Craig JV and Pearson M 2007 Evidence-based practice in nursing In: Craig JV, Smyth RL (Eds) 2007 The Evidence-Based Practice Manual for Nurses, Edinburgh: Churchill Livingston Elsevier
Department of Health – Governance and National Clinical Audit:
Foundation of Nursing Studies (useful for project ideas and guidance for developing practice):
Guidance with SWOT -
Library
Tagney J, Haines C 2009 Using evidence-based practice to address gaps in nursing knowledge. British Journal of Nursing Vol 18 (8):