Strengthening Health Research

Capacity of Nurses – The Need for Evidence Based

Practice

Dr. Shareen Swastika Ali ( BDS,PGDETT,MPH)

Health Research Officer Ministry of Health

Health Research

• Research is systematic and rigorous amount process of enquiry which aims to describe health phenomena with an aim to contribute to scientific body of knowledge. It aims to improve health, health outcome and health services.

Health Research Capacity

• improve the ability of health personnel to conduct research, to use results effectively, and to promote demand for research

Evidence Based Practice

• is an approach which tries to specify the way in which professionals or other decision-makers should make decisions by identifying such evidence that there may be for a practice, and rating it according to how scientifically sound it may be. Its goal is to eliminate unsound or excessively risky practices in favor of those that have better outcomes.

Health Research Capacity in the Pacific

• Are we doing research and applying it to our work ?

Health Research Capacity in the Pacific

• WHO –Western Pacific Advisory Committee and Health Research Council of the Pacific : Mapping of the PIC’S Research Capacity

• 3- 6 October 2007 in Nadi reviewed current status of health research in the pacific

Health Research Capacity in the Pacific

• Why are we not applying EBP at our workplaces??

1. Apprehension2. Do not have the knowledge3. Lack skills4. No incentive 5. Lack encouragement 6. Funding7. Infrastructure 8. Translation 9. Research culture10. Leadership

Health Research Capacity in the Pacific

The Challenge

• There is an urgent need to develop and use evidence informed policies and health services to address priority health issues

• What is the best way to get timely, effective, affordable and sustainable health services in place for Pacific Peoples

Health Research Capacity in the Pacific

The Problem

• Our current approach will achieve

too little too late.

• So how can we do better

Health Research Capacity in the Pacific

What can be done?

Build pacific partnership which links bilaterally research to training

Role of Global and Regional and Regional Organizations

Role of Global and Regional and Regional Organizations

1. Coordinate activities through conferences and workshops

2. Facilitate training

3. Disseminate knowledge and research outputs

Pacific Health Research Committee

• Reducing inequality and improve health status of Pacific peoples

• Develop and strengthen our internal processes and systems

• Foster engagement with Pacific Research Communities and Pacific Peoples

Pacific Health Research Committee

Vision

Optimal health for Pacific Peoples through promoting and funding health research

Pacific Health Research Committee

Mission

Discovering Pacific Health Solutions through Research

Pacific Health Research Committee

What does it do?

• Strengthening capacity and capability of Pacific health research workforce

• Offer scholarships for Pacific peoples in health and research

• Promote Pacific health Research

• Develop Pacific Research policy

Guidelines for Research on Pacific Peoples

• Relationship

Positive relationship to be developed with the community

• Respect

For the culture, values and beliefs

• Cultural Competency

Know your culture and the impact it has on others

Guidelines for Research on Pacific Peoples

• Meaningful Engagement

Collaboration should be from the beginning

• Reciprocity

Mutual relationships to be developed

• Utility

Output should benefit Pacific Peoples

Guidelines for Research on Pacific Peoples

• Rights Informed Consent Procedures• Balance Both parties should benefit • ProtectionPacific peoples • Capacity building Learning opportunities for Pacific Peoples

Evidence Based Nursing

• Within the nursing profession, it is expected that new information in the form of research findings will be incorporated constantly and knowledgeably into nursing practice.

• The staff nurse is a critical link in bringing research-based changes into clinical practice

Evidence Based Nursing

Isn't new: it's what we have been doing for years

Each nurse must care enough about her own practice to want to make sure that it is based on the best possible information

15 years ago, someone said that nursing should be renamed to a research based profession

Evidence Based Nursing – Gaps

• Time constraints• No access to literature• Lack of training in information seeking and

critical appraisal • A professional ideology that emphasizes

on practical rather than intellectual knowledge

• A work environment that does not encourage information seeking

Evidence Based Nursing – Gaps

We have learned that it is not sufficient to give nursing students a few lectures on the

process of doing research and then expect them to use that knowledge

throughout their careers in an ongoing process of gathering and interpreting research evidence and implementing

findings.

Evidence Based Nursing – Gaps

In a study of health agencies in Ontario, Canada, Mitchell et al found that only 35% of small hospitals (<250 beds) had nursing research journals in their libraries; 38% of health agencies based change in nursing practice on the research process; 15% implemented research utilization programs for staff nurses; and 97% wanted assistance in teaching their nursing staff about research utilization.

Evidence Based Nursing

• "cookbook" nursing and a disregard for individualized patient care

clinical expertise should be balanced with the risks and benefits of alternative treatments for each patient

Evidence Based Nursing – Gaps

• there is an over-emphasis on clinical trial and systematic reviews in evidence-based health care

Maybe impractical in clinical practice

Evidence Based Nursing – Situational Analysis

EBN is gaining wider popularity• Increasing number of nursing conferences

with evidence based themes

• Journals that feature evidence based , best practices in health care

• Increasing in subscription to nursing journals

Evidence Based Nursing Journals

• Journal of Advanced Nursing

• Western Journal of Nursing Research

• Evidence Based Nursing

• HINARI website

Evidence Based Nursing – Continuing Education

In United States a study was done to evaluate nursing practice 5 years post graduation.

Faults • Contaminated wounds• Misuse of gloves• Failed to wash hands• Decreased wound caring• Privacy not provided

How Qualified is Qualified?

Evidence Based Nursing – Continuing Education

After CE was provided…

• Renewed interest in work

• Greater team work

• Registration in online education

• Quality of clinical practice increased, with more supervised care

The End