Evidence-Based Practice in Advanced Practice Nursing: Utilizing the Ottawa Model of Research Use

Introduction

Advanced practice nursing (APN) encompasses a range of roles and responsibilities, including nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives. These roles require the integration of evidence-based practice (EBP) to enhance patient outcomes, improve healthcare delivery, and contribute to the overall effectiveness of the healthcare system. A prevalent issue in APN is the challenge of translating research findings into clinical practice. This paper will review the Ottawa Model of Research Use as a framework for addressing this concern in advanced practice nursing.

Literature Review: Issues in Evidence-Based Practice in Advanced Practice Nursing

Numerous studies highlight barriers to implementing evidence-based practice within advanced nursing roles. Common issues include:

1. Knowledge Gap: Many advanced practice nurses report feeling inadequately trained in research methodologies and EBP principles, leading to uncertainty about how to apply research findings to clinical decision-making (Melnyk et al., 2014).

2. Organizational Barriers: Healthcare organizations may lack the necessary infrastructure, such as access to databases and support for continuous education, which hinders the ability of nurses to engage with current research (Caldwell et al., 2010).

3. Time Constraints: APNs often face heavy workloads that limit the time available for reviewing literature and applying findings to practice (Cummings et al., 2016).

4. Resistance to Change: Some healthcare professionals may resist adopting new practices or changing established routines, which can be a significant barrier to implementing EBP (Rycroft-Malone et al., 2016).

Selected Theory: The Ottawa Model of Research Use

The Ottawa Model of Research Use (OMRU) is a comprehensive framework designed to facilitate the use of research evidence in practice. It was developed to address the gap between knowledge generation and knowledge application, aiming to create a systematic approach for integrating EBP into clinical settings (Graham et al., 2006).

Relevance to Advanced Practice Nursing

The OMRU is particularly relevant to advanced practice nursing for several reasons:

– Focus on Context: The model emphasizes the importance of context, recognizing that organizational culture, clinician characteristics, and patient preferences significantly influence research utilization.

– Multi-level Approach: It considers various levels of influence—from individual practitioners to organizational policies—allowing for a more holistic understanding of barriers to EBP.

– Emphasis on Collaboration: The model encourages collaboration among stakeholders, including researchers, clinicians, and administrative leaders, fostering an environment conducive to evidence-based practices.

Context for Evidence-Based Practice

In the context of advanced practice nursing, the OMRU can provide a structured approach to address the identified barriers to EBP. By recognizing that these barriers often stem from both individual and organizational factors, APNs can implement strategies that target these areas effectively.

For instance, using the OMRU framework, an advanced practice nurse might collaborate with their healthcare organization to establish regular training sessions on research methodologies and literature review techniques. Additionally, creating a mentorship program could help bridge knowledge gaps by pairing experienced clinicians with those less familiar with EBP.

Application of the Ottawa Model of Research Use

The OMRU can be utilized as a framework for guiding evidence-based practice in several ways:

1. Assessment of Barriers: APNs can conduct assessments to identify specific barriers within their practice environment using the multi-level approach outlined in the model. This will help target interventions effectively.

2. Implementation Strategies: By employing research-supported strategies like audit and feedback mechanisms or educational workshops, practitioners can enhance their skills in utilizing research findings.

3. Evaluation of Outcomes: The model encourages ongoing evaluation of EBP initiatives. APNs can measure the impact of implemented strategies on patient outcomes and refine them accordingly based on feedback and results.

4. Fostering a Culture of Inquiry: The OMRU promotes collaboration and communication, which can help create a culture that values inquiry and encourages continuous learning among nursing staff.

Unique Insights Offered by the OMRU

The Ottawa Model of Research Use provides unique insights by highlighting the importance of context in implementing EBP. Unlike other models that may focus solely on individual behaviors or knowledge deficits, the OMRU comprehensively addresses organizational factors that can either facilitate or impede research use.

This holistic perspective allows advanced practice nurses to develop tailored strategies that resonate with their specific practice environments. By fostering an understanding of how individual actions are influenced by broader organizational structures, APNs can advocate for systematic changes that support evidence-based practices.

Conclusion

In summary, the Ottawa Model of Research Use serves as an effective framework for addressing the challenges faced by advanced practice nurses in implementing evidence-based practice. By focusing on contextual factors and promoting collaboration among stakeholders, this model offers a comprehensive approach to bridging the gap between research and clinical application. Through its application, APNs can enhance their capacity for evidence-based decision-making, ultimately leading to improved patient outcomes and more effective healthcare delivery systems.

References

– Caldwell, M., Hurst, R., & D’Aurora, T. (2010). Barriers to evidence-based practice: A qualitative study of nurse practitioners. Journal of Nursing Management, 18(6), 650-659.
– Cummings, G. G., Hayduk, L., & Estabrooks, C. A. (2016). The impact of organizational context on research utilization in nursing: A systematic review. Nursing Leadership, 29(2), 20-41.
– Graham, I. D., Logan, J., Harrison, M. B., Straus, S. E., Tetroe, J., & Caswell, W. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26(1), 13-24.
– Melnyk, B. M., Fineout-Overholt, E., & Giggleman, M. (2014). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Jones & Bartlett Learning.
– Rycroft-Malone, J., Wilkinson, J., & Burton, C. R. (2016). A realistic evaluation of change management interventions in health care settings: The role of context in determining effective implementation strategies. Implementation Science, 11(1), 12.