Evidence-Based Practice Improvement

Levin, Rona F.; Keefer, Jeffrey M.; Marren, Joan; Vetter, Mary Jo; Lauder, Bonnie; Sobolewski, Sally

doi:10.1097/ncq.0b013e3181b5f19f

Cited by 34 publications

(41 citation statements)

References 22 publications

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“…Dissemination of scientifically based best practices, including details of the journey, can increase quality of health care (Levin, Keefer, Marren, Vetter, Lauder & Sobolewski, 2009). Mancuso (2009) conducted a review of literature from 1991–2006 to identify psychometric properties of health literacy screening tools, noting that all articles and a majority of citations were from medical journals, not nursing journals.…”

Section: Discussionmentioning

confidence: 99%

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Improving Medication Management Among At-Risk Older Adults

Martin¹,

Kripalani²,

DuRapau³

2012

J Gerontol Nurs

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Low health literacy is common among Medicare recipients and affects their understanding of complex medication regimens. Interventions are needed to improve medication use among older adults, while addressing low health literacy. Community-dwelling older adults in this study were enrolled in an inner-city adult day center. They completed a baseline measure of health literacy, medication self-efficacy, and medication adherence. They were provided with a personalized, illustrated daily medication schedule (PictureRx™). Six weeks later, their medication self-efficacy and adherence were assessed. Among the 20 participants in this pilot project, 70% had high likelihood of limited health literacy and took an average of 13.2 prescription medications. Both self-efficacy and medication adherence increased significantly after provision of the PictureRx cards (p<0.001 and p<0.05, respectively). Al participants rated the PictureRx cards as very helpful in terms of helping them remember the medication’s purpose and dosing. Illustrated daily medication schedules improve medication self-efficacy and adherence among at-risk, community-dwelling older adults.

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Section: Discussionmentioning

confidence: 99%

“…The project followed The Evidence-Based Practice Improvement Model: problem description, formulation of the clinical question, review and appraisal of the literature for evidence, and development of the aim/goal for change (Levin et al, 2009). …”

Section: Methodsmentioning

confidence: 99%

Improving Medication Management Among At-Risk Older Adults

Martin¹,

Kripalani²,

DuRapau³

2012

J Gerontol Nurs

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“…7,10,58,61,89,148 Nevertheless, teams utilizing OLMs can choose among specific established methods to best identify where problems may be occurring and then initiate the search for solutions. 12,14,17,18,28,29,55,60,63,91,123,151,160 Plan-Do-Study-Act 39,115,119,122,132,149,167,173,177 It is imperative that the methods utilized for solution identification involve those who will implement the solutions at the frontline, thereby encouraging frontline ownership and a better chance of success.…”

Section: Developing Solutions That Fitmentioning

confidence: 99%

“…14,28,37,60,123,150,178,179 This is best accomplished within the plan-dostudy-act (PDSA) cycle. 14,28,37,60,123,150,178,179 This is best accomplished within the plan-dostudy-act (PDSA) cycle.…”

Section: Developing Solutions That Fitmentioning

confidence: 99%

Enhancing Learning, Innovation, Adaptation, and Sustainability in Health Care Organizations

Persaud

2014

The Health Care Manager

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The development of sustainable health care organizations that provide high-quality accessible care is a topic of intense interest. This article provides a practical performance management framework that can be utilized to develop sustainable health care organizations. It is a cyclical 5-step process that is premised on accountability, performance management, and learning practices that are the foundation for a continuous process of measurement, disconfirmation, contextualization, implementation, and routinization This results in the enhancement of learning, innovation, adaptation, and sustainability (ELIAS). Important considerations such as recognizing that health care organizations are complex adaptive systems and the presence of a dynamic learning culture are necessary contextual factors that maximize the effectiveness of the proposed framework. Importantly, the ELIAS framework utilizes data that are already being collected by health care organizations for accountability, improvement, evaluation, and strategic purposes. Therefore, the benefit of the framework, when used as outlined, would be to enhance the chances of health care organizations achieving the goals of ongoing adaptation and sustainability, by design, rather than by chance.

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“…Getting from that initial spark, the initial idea, to the implementation and dissemination of best practices may seem like a daunting task, but when approached in a systematic way, will yield promising outcomes. Levin et al (2010) discuss the first step in the EBPI Model as the description of the problem . Accordingly, clinical problems are uncovered by reviewing external literature and internal data sources.…”

mentioning

confidence: 99%

Describing the Problem for an Evidence-Based Practice Improvement Project: A Missing Ingredient

Burke

Levin

2010

Res Theory Nurs Pract

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C o-authoring this issue's evidence-based practice (EBP) column is particularly exciting for me because I am co-authoring it with one of my Doctor of Nursing Practice (DNP) students. This is a first because Pace just began its DNP program in fall 2008. Robert is a member of the first cohort. He and I have been dialoguing from his first semester in the program about EBP. At first he was reluctant to completely embrace this model of clinical decision making because he felt that it lacked elements of patient-centered care. After much conversation, reading, and reflection, his beliefs evolved and he began to see the interconnectedness of EBP, primary health care, and cultural competence (which happen to be the 3 Pillars for Pace's DNP Program).Readers of this column in RTNP may have realized how my thinking about the EBP paradigm has been evolving over the past few years. Previous columns in RTNP such as "EBP by Any Other Name is Still a Rose" ( Levin, 2008 ) and "Walk Before You Run" ( Levin, 2009 )-were instrumental in helping me hone my thinking into what has become the Evidence-Based Practice Improvement (EBPI) Model ( Levin et al., 2010 ), a model that merges the best of EBP and performance improvement (PI) into a simple and relevant model that may guide improvement efforts. EBPI was originally introduced as the model that students would use for their EBPI doctoral projects.After two semesters in which we were immersed in EBPI as a model for DNP projects, and after a course in evaluation in which the importance of stakeholder involvement in any organizational initiative was stressed, Robert came up with the idea that we need to include stakeholder interview data as an important component of problem description. Although the importance of stakeholder involvement has been emphasized in primary health care ( World Health Organization, 1978 ), public health initiatives (Centers for Disease Control, 1999), PI ( Langley et al., 2009 ), and evaluation ( Patton, 2008 ) literature, it has not become part and parcel of an EBP or EBPI framework. This column explores the notion of including stakeholder involvement as a stated and important component of any organizational improvement effort.

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Evidence-Based Practice Improvement

Cited by 34 publications

References 22 publications

Improving Medication Management Among At-Risk Older Adults

Improving Medication Management Among At-Risk Older Adults

Enhancing Learning, Innovation, Adaptation, and Sustainability in Health Care Organizations

Describing the Problem for an Evidence-Based Practice Improvement Project: A Missing Ingredient

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