Penn Medicine Center for Evidence-based Practice, Philadelphia, PA, USA.
Penn Presbyterian Medical Center, Associate Professor of Geropsychiatric Nursing, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
Worldviews Evid Based Nurs. 2019 Feb;16(1):4-11. doi: 10.1111/wvn.12346. Epub 2019 Feb 3.
In 2006, our healthcare system created a hospital Evidence-based Practice Center (EPC) to support the local delivery of high-quality, safe and high value patient care. Since then, the importance of healthcare staff work life has also been highlighted, and together these four elements form the Quadruple Aim framework. Synergistic to this Aim, the Magnet program promotes and recognizes organizational nursing excellence.
To examine the EPC's work to inform nursing policy and practice in support of the goals of the Quadruple Aim framework and Magnet designation.
Methods used included the following: (1) descriptive analysis of the hospital EPC's database of rapid reviews; and (2) administration of a 40-item electronic questionnaire to nurses who requested an EPC review during fiscal years (FY) 2015 and 2016.
Of 308 rapid reviews completed in the EPC's first 10 years, 59 (19%) addressed nursing topics. The proportion of reviews relevant to nursing increased from 5% (2/39) in the center's first 2 years to 44% (25/60) in FY 2015-2016. The majority of nursing reviews (39/59) examined processes of care. Of 23 nurses eligible to participate in the survey, 21 responded (91%). Nurses with administrative or managerial responsibilities requested 70% of reviews; clinical nurse specialists and bedside nurses requested 17% and 9%, respectively. Reviews were used to support clinical program development (48%), provide clinical guidance (33%), update nursing policies or procedures (24%) and develop training and curricula (24%). Nurses were satisfied with the hospital EPC reviews (mean; 4.7/5), and 95% indicated they were likely to request a future review.
A dedicated hospital EPC in partnership with nursing offers a unique mechanism for promoting a culture of evidence-based practice. Nurses at all organizational levels use the services of a hospital EPC to inform nursing policy and practice and are highly satisfied with the process, supporting the Quadruple Aim and Magnet designation.
2006 年，我们的医疗体系建立了一个医院循证实践中心（EPC），以支持提供高质量、安全且高价值的患者护理。从那时起，医护人员的工作生活质量也得到了强调，这四个要素共同构成了四重目标框架。与此目标相辅相成的是，磁性计划促进和认可组织内护理的卓越表现。
研究 EPC 在制定循证政策和实践方面的工作，以支持四重目标框架和磁性认证的目标。
使用的方法包括：（1）对医院 EPC 的快速审查数据库进行描述性分析；（2）在 2015 财年和 2016 财年期间，向请求 EPC 审查的护士发放了一份 40 个问题的电子问卷。
在 EPC 的前 10 年中完成了 308 项快速审查，其中 59 项（19%）涉及护理主题。与护理相关的审查比例从中心成立的头 2 年的 5%（2/39）增加到 2015-2016 财年的 44%（25/60）。大多数护理审查（39/59）检查了护理流程。有 23 名护士有资格参与调查，其中 21 名做出了回应（91%）。有管理或管理职责的护士要求进行 70%的审查；临床护理专家和床边护士分别要求 17%和 9%。审查用于支持临床项目的发展（48%）、提供临床指导（33%）、更新护理政策或程序（24%）和开发培训和课程（24%）。护士对医院 EPC 审查非常满意（平均 4.7/5），95%的护士表示他们可能会要求进行未来的审查。
与护理合作的专门医院 EPC 为促进循证实践文化提供了独特的机制。各级组织的护士都利用医院 EPC 的服务来为护理政策和实践提供信息，并对该过程非常满意，这支持了四重目标和磁性认证。
