A Model for Evidence Based Practice by June

A Model for Evidence Based Practice by June Larrabee and Mary Ann Rosswurm Ferris State University NURS 501 Juline Lloyd, Rachel Peltier, Jill Slade and Carrie Vasquez

Objectives � Understand the basis of Rosswurm and Larrabee’s Evidence-Based Practice Model � Discuss the nursing paradigm concepts as related to the model � Explain the analysis of the model � Understand the effect that the model has on current research � Describe how the model can be used in current practice � Recognize the correlation of this nursing model to nursing practice

Overview • Assess • Link • Synthesize • Design • Implement/Evaluate • Integrate/Maintain (Larrabee & Rosswurm, 1999)

Model Definitions of the Paradigm Concepts � Person � Environment � Health � Nursing (Tourville & Ingalls, 2003)

Analysis of Model Criteria Larrabee/Rosswurm Accuracy Written in 1999 -Still relevant today Complexity Simple-Linear, provides order Scope Broad- Can be used for many health related issues Acceptance Accepted by many Socio. Cultural Significant to humanity-Focuses on improved patient care (Dudley-Brown, 1997)

Model in Practice Promoting Evidence-based Practice: Implementing the American Stroke Associations Acute Stroke Program Darina Kavanagh Phyllis Connolly Jayne Cohen Setting Goals Larrabee/ Rosswurm Purpose

How Research Reflects the Theory Rosswurm/ Hospital implementation Larrabee 1. Assess Study of 30 subjects 2. Link Preprinted order sets 3. Synthesize Interventions based on evidence 4. Design Team formed to design change 5. Implement Nurse managers and educators, ED physician and neurologist 6. Evaluate Outcomes measured (Kavanagh, Connolly & Cohen, 2006)

PRE Outcomes POST 22% CT < 50 minutes 66% 0 TPA < 180 min 74% 72% Lipid profile 70% 95% Antithrombotic medication 100% 78% Dysphagia screen 71% 100% A-fib patients discharged with anticoagulation medication NA 100% Smoking cessation advice 66% 27% Discharge home 29% 71% Diabetic patients discharged on diabetes medication 100% (Kavanagh et al. , 2006)

Organization Collaboration Continued Assessment Focused Outcomes

Model in Practice

Model in Practice Continued…

Theory and Practice: A Correlation Theory Wisdom Practice

Support of Theory and Practice Nursing Knowledge Practice Theory

References Dudley-Brown, S. L. (1997). The evaluation of nursing theory: A method for our madness. International Journal of Nursing Studies, 34(1), 76 -83. � Kavanagh, D. , Connolly, P. , & Cohen, J. (2006). Promoting evidence-based practice: Implementing the american stroke association's acute stroke program. Journal of Nursing Care Quality, 21(2), 135 -142. � Larrabee, J. H. Model for evidenced-based practice change [Personal web page]. Retrieved from http: //junehansenlarrabee. info/evidence-based-practicemodel. html �

References � Nightingale, F. (1859). Notes on nursing. London: Harrison and Sons � Rosswurm, M. A. , & Larrabee, J. H. (1999). A model for change to evidence-based practice. Image-the Journal of Nursing Scholarship, 31(4), 317– 322. � Tourville, C. , & Ingalls, K. (2003). The living tree of nursing theories. Nursing Forum, 38(3), 21– 30, 36.