Postbaccalaureate Nurse Residency: EBP in Action

Abstract

It is no secret that health care in the United States is in need of reform. Great attention has been paid over time to the problems of errors in medical and nursing practice, cost vs quality, and evidence needed to improve patient outcomes. We like to think that health care in the United States is well advanced, but we have yet to tackle significant problems that have plagued our country for so many years. Transformation is certainly the theme of the day! We have a long way to go to heed the call made by Florence Nightingale in 1863 when she stated, while admitting to the full extent the great value of hospital improvements of recent years, a vast deal of suffering, and some at least of the mortality, in these establishments is avoidable (p. 7). Evidence-based practice (EBP) is critical to changing our evolving health care delivery and reimbursement systems. Examining how nursing faculty are incorporating EBP in the curriculum for student nurses and how clinically based nursing professionals are using EBP are essential to understanding how nursing will contribute to improved patient outcomes. The Health Professions Report (2003) describes the shortcomings of today's health professions, citing much-needed competencies related to the provision of patientcentered care and the employment of EBP. How is EBP used in nursing education and service? How are nursing faculty transforming curricula? Is nursing service taking the important steps in the clinical setting so that professional nurses and other members of the health care team formulate and apply evidence in their practice? The Postbaccalaureate Nurse Residency program at Westchester Medical Center (WMC) serves as an example of how academic and practice partners are approaching these kinds of questions. The Postbaccalaureate Nurse Residency Program grew out of an interest in improving patient care by providing additional training and support to new baccalaureate graduates. The goal of the program is to develop competent professionals to provide patient care leadership at the bedside ( Commission on Collegiate Education [CCNE], 2008 , p. 6). The curriculum developed through a partnership of the University HealthSystem Consortium (UHC) and the American Association of Colleges of Nursing (CCNE, 2009 ). The program is based on partnerships between accredited acute care hospitals and at least one accredited academic nursing program. The residency builds on the The Essentials of Baccalaureate Education for Professional Practice (American Association of Colleges of [AACN], 2008). During the program, nurse residents develop skills in decision-making, EBP, clinical leadership, and lifelong career planning as they advance their commitment to professional nursing The Lienhard School of (LSN) has worked for several years to ensure that baccalaureate nursing graduates have a strong foundation in EBP. While curriculum reform was initiated in the graduate Family Nurse Practitioner Program, this was soon followed by the undergraduate program. Baccalaureate didactic coursework is framed within an EBP context, and numerous clinical opportunities throughout the program extend that focus. The 2008 AACN Essentials for Baccalaureate Education for Professional Practice lists as its third essential Scholarship for Evidence- Based Practice. The LSN undergraduate curriculum has been revised to be consistent with the revised Essentials , and has as one of its expected student learning outcomes, Apply nursing theory and research in an evidence-based approach to nursing practice. Likewise, in the Nurse Residency program at WMC, EBP is an important basis for advancing safe, quality patient care. Introduced to nurse residents during their orientation period, the concept of EBP is a thread discussed throughout their year-long program. The EBP curriculum at the University and Medical Center reinforces and guides the nurse residents through developing and presenting a final EBP project. …