AACN News—May 1999—Practice

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Vol. 16, No. 5, MAY 1999

Best Practice Network a Means to Sustainable Healthcare Improvement

How do we redesign and restructure a system as large, powerful and unwieldy as modern healthcare?

The Best Practice Network, a coalition of professional healthcare associations, is committed to the concept that many of the most creative and relevant approaches can and should arise from within the field—from the healthcare professionals who are most familiar with the challenges and best able to evaluate the effectiveness of proposed solutions. In addition, the Best Practice Network believes that researchers, administrators, managers, consultants and government officials will be most effective in stimulating meaningful and sustainable change when they partner with those on the front lines of healthcare delivery to create, apply, evaluate and refine new programs for healthcare improvement.

Toward these ends, the Best Practice Network seeks to stimulate the creative and scientific process that leads to the development of best practices in healthcare by encouraging a variety of activities and projects that result in healthcare improvement. These activities and projects are hosted and published on the Best Practice Network Web site at .

The Best Practice Network recently introduced an updated Project Guide and Application Kit, which offers assistance in determining the best Web site activity to showcase your project. The revised application kit is based on emerging models and evolving theories on the application of benchmarking for best practices in healthcare. The Project Guide and Application Kit can be downloaded directly from the Best Practice Network Web site or by calling (800) 899-2226 and requesting item #9011.

Projects and Activities
The Best Practice Network currently sponsors the following seven types of activities and projects that lead to healthcare improvement:
• Creative Solutions Discussion—an online discussion area where healthcare professionals post and respond to practical problems related to healthcare delivery.
• The Best Practice Incubator—an online workshop where best practice developers can post information about their projects in progress and request networking or mentoring support from other network participants.
• Everyday Innovations—an online showcase of creative-thinking and design skills as applied to practical workflow issues in healthcare.
• Poster Presentations—graphical presentations of creative healthcare improvements.
• Tools of the Trade—a compendium of protocols, guidelines, standards of care and clinical maps.
• Programs that Work—fully implemented programs that have positively impacted care delivery, dramatically improved operational efficiency or provided creative solutions to stubborn problems.

• Best Practices—fully implemented programs, benchmarked and tested, which meet or set new standards or introduce dramatic innovations in healthcare delivery.

Compedium of Improvement
When considered together, the activities and projects described represent a progression in the creative and the benchmarking processes as well as a progression in project scale and impact. The following chart, while relying upon broad generalizations, provides a snapshot of these activities and projects and how they compare.

Research, Creative Solutions Abstracts Invited for 2000 NTI

Abstracts on research studies, research utilization and creative solutions are being accepted for AACN’s 2000 National Teaching Institute™ and Critical Care Exposition, scheduled for May 21 through 25 in Orlando, Fla.
September 1, 1999, is the submission deadline. Presenters will receive a $75 reduction in NTI registration fees. All other expenses are the responsibility of the presenter, who can be either the first author or a designate of the author.
Following is information about the abstracts that will be accepted:

Research and Research Utilization
These abstracts can focus on any aspect of critical care nursing research including reports of research studies or reports of research utilization. Only abstracts of completed projects will be accepted.
Abstracts reporting research studies must address the purpose; background and significance; methods; results; and conclusions. Accepted abstracts will be designated either as an oral presentation or as a poster presentation.

Creative Solutions
These abstracts focus on specific strategies and practice innovations that are used by nurses to solve difficult, unique or interesting problems in patient care, nursing practice, nursing management, or nursing education. The creative solution must have been implemented, with outcomes evaluated. Abstracts must address the purpose of the project and description of the creative solution, as well as evaluation and outcomes.

To obtain abstract forms, call (800) 899-AACN (2226).

Practice Resource Network: How to Find an AP Graduate Program

QI am considering returning to school to pursue an advanced practice degree. Do you have any advice on how to begin investigating schools?

AAdvanced practice nursing is an area that is rapidly growing in response to a multitude of opportunities that are available. Sometimes returning to school can be an ominous prospect. However, there are some simple steps that can be taken to ease the decision-making process of selecting a school.

First, decide what type of advanced practice role interests you most. There are four advanced practice roles: clinical nurse specialist (CNS). nurse practitioner (NP), nurse anesthetist and nurse midwife. Resources are available to help you better understand each of these roles. For example, AACN’s Advanced Practice Work Group has developed both a fact sheet and a brochure to explains some of the similarities and differences of the CNS and NP roles. These tools are designed to give you a clearer understanding of the options available for improving patient care in an advanced practice role.

Once you have decided your focus, investigate which colleges and universities have programs that will provide the education you desire and will also fit into your lifestyle schedule.

If you have Internet access, you can find a link to a graduate school list from the AACN Web site at http://www.aacn.org. Click on the “Advanced Practice” area and then the “1999 Graduate School Listing” area. This will take you to the Petersons Web site, which provides an extensive list of schools that offer graduate-level nursing education, as well as other degrees. You can search this site by key word, institution name, location, academic area and professional degree.

This information is also published and can be purchased at most book stores.

Another option for locating a school is to select “Nursing Schools” within the “Professional Degree Programs” category. Here you will find an alphabetical listing of all the schools in the database. Selecting the school on which you would like more information will provide you with an overview of the school, the programs of study, application process and correspondence information. Then directly contact each school for additional information, applications and deadlines.

One of the many scholarships and grants AACN awards each year as part of its Circle of Excellence recognition program is an Educational Advancement Scholarship. This scholarship is available to AACN members who are completing a graduate degree related to nursing practice.

For more information about advanced practice and available resources, contact Advanced Practice Director Megan Whalen, RN, MS, at (800) 809-2273, ext. 333.

Geriatric Corner: Partnership Promotes Resources for Caring for Older Adults

AACN is collaborating with the John A. Hartford Foundation-Institute for Geriatric Nursing in a new program to promote best practices in the care of the older adult. This program, known as the Specialty Nursing Activities Partnership Program for Care of Older Adults, seeks to share institute resources with nurses who care for acute and critically ill older adults in the hope that together we can shape care for the elderly nationwide.

As part of this effort, the Institute for Geriatric Nursing has scheduled its Conference Resource Center for Nursing Care of Older Adults at AACN’s 1999 National Teaching Institute™ and Critical Care Exposition in New Orleans, La., this month. The goal is to assist AACN in providing informative learning experiences that are specifically related to geriatric care at our national conference. Included in the resource center are:
• Aging sensitivity materials, quizzes and games
• Geriatric nursing books and journals, and materials from geriatric organizations such as the National Institute on Aging, the Alzheimer’s Association, the Lighthouse, Gerontological Society of America, and the Geriatric Society of America

• User-friendly curricula and training materials
• Online access to gerontologic Web sites
• Gerontological nursing support to answer practice questions
If you are attending the NTI, please stop by and make the institute staff welcome.

Best Practices
Through the partnership, AACN and the Best Practices Network will provide information and learning opportunities that the institute has available to specialty nurses who are unfamiliar with the best practices in caring for older adults.
Following are some Web sites to visit:

John A. Hartford Foundation–Institute for Geriatric Nursing

The United Nations’ International Year of Older Persons 1999
http://www.hcoa.org/iyop (will officially end in September 1999)

Have you made changes in your practice because of information you have read in “Geriatric Corner”? Has the practical information provided on the care of the older adult been useful to you? Would you like to see a column similar to this one continue to appear in AACN News? Let us hear from you. Contact AACN Clinical Practice Specialist Justine Medina, RN, MS, CCRN, at (800) 394-5995, ext. 401; fax, (949) 448-5520; email, Justine.Medina@aacn.org.

Apply for a Nursing Research Grant

July 1, 1999, is the deadline for two nursing research grants that are available through AACN. Following is information about each grant.

Hewlett-Packard–AACN Critical Care Nursing Research Grant
This grant awards $30,000 for studies that are preferably related to the technological requirements of patient management in acute and critical care.

In addition, $2000 in travel expenses, an HP Vectra personal computer, HP LaserJet printer, and associated utility software is presented to the recipient of the grant. Eligible applicants must be AACN members and have an active RN license. The grant may be used to fund research that is associated with an academic degree.

Applications must be received by July 1, 1999. To obtain an application, call (800) 934-7372 or visit the Hewlett-Packard Web site at http://www.hp.com/go/healthcare. If you have additional questions, contact the Research Department at AACN, (800) 809-2273, ext. 335.

AACN Clinical Inquiry Grants
These grants provide up to $250 to support projects that will directly benefit patients and their families.

Funds will be awarded for projects that address one or more AACN research priority and that link to AACN’s vision of a healthcare system driven by the needs of patients and their families. To be eligible, the principal investigator must be an RN, an AACN member, employed in a clinical setting, and directly involved in patient care.

Applications must be received by July 1, 1999. To obtain an application, call (800) 899-AACN (2226).

For additional information about nursing research grants that are available from AACN, call (800) 899-AACN (2226).

Share Your Practice Ideas With Critical Care Nurse

Have you found a unique or resourceful solution to a problem related to your critically ill patients? Are you using an innovative approach in caring for these patients and their families? Share your successes with your colleagues through the “In Our Unit” feature in Critical Care Nurse.

Send your ideas to: Critical Care Nurse, 101 Columbia, Aliso Viejo, CA 92656; fax, (949) 362-2049; e-mail, critnurse@aol.com.

Vox Populi: Continuous IV Inotropic/Vasoactive Medication

Which nonconventional medication administration routes are used by nurses in your facility? Select all that apply.

Intrathecal 18.6%
Intraventricular catheters or ventriculostomy 10%3
Intrapleural catheter 9.3%
Chest tube 14.3%
Arterial line (other than normal saline and/or heparin for patency) 8.6%
Other 3.6%

If nurses administer medications via nonconventional routes, does your facility have written procedures or protocols outline the essential steps and considerations for this practice?

Yes 65.1%
No 4.8%
Don’t know 30.2%

Source: Volunteers in Participatory Sampling—a demographically representative sample of AACN members; 1998.

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