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TOWARD REFLECTIVE PRACTICE

EBP summit in the Andes

by R. Terry Olbrysh

Ellen Fineout-Overholt, director, Center for the Advancement of Evidence-Based Practice, Arizona State University, and Dean Bernadette Melnyk, ASU College of Nursing & Healthcare Innovation, join Colombian Minister of Health Francisco Raul Restrepo and Maria Iraidis Soto Soto, executive director, Colombian Association of Faculties of Nursing (ACOFAEN), at the Latin American EBP Leadership Summit in Bogotá.

The mountains around Bogotá, Colombia, were shrouded in a cool, foggy mist when the Latin American Evidence-Based Practice (EBP) Leadership Summit convened in late May. However, the fog and rain did nothing to dampen the enthusiasm or obscure the purposes of 40 health care and nursing education leaders who had come together from Argentina, Ecuador, Panama and Colombia.

Arizona State University (ASU) College of Nursing & Healthcare Innovation and the Colombian Association of Faculties of Nursing (Asociación Colombiana de Facultades y Escuelas de Enfermería, or ACOFAEN) sponsored the EBP summit. The purposes of the intensive program were to determine priorities for advancing EBP in Latin America and to formulate a plan to accomplish this goal. It was the first EBP program of its kind to be held in Latin America, according to Bernadette Melnyk, ASU dean and Distinguished Foundation Professor in Nursing.

The genesis for the summit occurred during an EBP workshop conducted by ASU in collaboration with the ACOFAEN at the 10th Regional Research Colloquium, held in Buenos Aires, Argentina, in late 2006. Maria Iraidis Soto Soto, executive director of the Colombian Association of Faculties of Nursing, organized the workshop and, together with Dean Melnyk and Ellen Fineout-Overholt, director of ASU’s Center for the Advancement of Evidence-Based Practice (CAEP), discussed how to advance EBP in Latin America. Melnyk and Fineout-Overholt suggested hosting an EBP leadership summit to further efforts across all of Latin America and, through the planning and collaboration of all three nurse leaders—Melnyk, Fineout-Overholt and Soto Soto—the summit became reality.

To prepare for the event, Soto Soto and the CAEP team at ASU worked together to conduct a survey of nursing and health care leaders in Latin America to determine 1) perceived priorities for moving evidence into practice and 2) clinical areas in which more evidence is needed.

Colombian Minister of Health Francisco Raúl Restrepo, a medical doctor, opened the summit with a presentation on the importance of EBP for improving the quality and safety of health care in Latin America, emphasizing the role of nursing. Dean Melnyk discussed evidence-based strategies that are working in the United States to advance EBP. Soto Soto presented results of the survey that had been conducted to serve as the foundation for the summit and to facilitate the work of making recommendations to advance EBP. Melnyk and Fineout-Overholt facilitated the full-day program.

After formal presentations, participants divided into four small groups to discuss and present outcomes on the following subjects: 1) priorities to accelerate transfer of research findings into clinical practice, 2) priorities and strategies for synthesizing research, 3) priorities for research areas in which evidence does not exist, and 4) barriers to advancing EBP in Latin America and potential solutions for overcoming them.

After reconvening, summit participants determined the following priorities based on the work of the task groups: 1) Advance evidence-based knowledge and practice, 2) establish EBP nursing technique in Latin America, 3) encourage continuous education, 4) integrate EBP as a foundational curriculum in nursing schools, and 5) establish groups for mentorship and education.

Summit attendees identified the following steps to begin implementing evidence-based health care in Latin America, taking into consideration that commitment to EBP must begin at personal, national and international levels: 1) Communicate widely the summary of the task force reports; 2) support a second summit; 3) take part in national colloquia and Pan American Health Organization programs; 4) establish a Latin American center to advance EBP; 5) designate ASU College of Nursing & Healthcare Innovation as a key partner to provide support for development of activities related to evidence-based nursing; 6) facilitate the work by conducting in-person and/or virtual meetings for summit participants in 2008, with one of those meetings being the biannual Research Colloquium or the annual Iberian-American Education Conference; and 7) strengthen evidence-based implementation by preparing practitioners of the discipline.

In response to a needs assessment by Latin American nursing educators and other health care leaders, CAEP has developed a strategic plan that encompasses the following priorities: 1) Establish a Latin American consortium/collaborative center for advancement of EBP, 2) advance EBP knowledge and skills of nurses and nurse faculty members with assistance of ASU College of Nursing & Healthcare Innovation, and 3) assist collaborative members with implementing evidence-based guidelines and measuring guidelines developed by ACOFAEN.

Bernadette Melnyk

Ellen Fineout-     Overholt

Melnyk was pleased with the international collaboration demonstrated at the summit. “It is so exciting, as it provides us with the opportunity to assist nurses and other health care providers in advancing evidence-based care for the ultimate purpose of improving quality of care and patient outcomes in Latin America,” said the ASU nursing dean. “The lessons we have learned in advancing EBP in the United States since the late 1990s will help us to more rapidly speed translation of research findings into clinical practice in the form of EBP in countries throughout Pan America.”

Fineout-Overholt commented on the common bond she had observed at the summit among nurses from the five countries involved: “There was a shared passion to improve patient outcomes among the nursing faculty and health care leaders,” she said. “I considered the differences among the group—language, culture, resources—and then it occurred to me, nurses are nurses no matter where they work or what level of resources they have. They want to provide the best care for their patients. There really is a global connection to improve care through EBP.”

Kay Jarrell, clinical assistant professor of nursing at ASU, perhaps was in an ideal position to provide a personal perspective on the summit. The previous week, she had worked with Fineout-Overholt in facilitating an EBP workshop for dialysis nurses in Santiago, Chile, and she attended the summit in Colombia as an observer.

“I was struck by the intensity of the group,” she noted. “I have taken EBP for granted, as our College of Nursing & Healthcare Innovation has been saturated with the concept since Ellen and Bernadette came aboard a couple of years ago. Here I was in a classroom hundreds of miles from ASU where nurses were thirsting for the knowledge I was exposed to every day.”

Jarrell also observed that health care in the four countries represented by summit participants is not as technologically advanced as in the United States because of lack of resources. “As a result, nurses are challenged to develop strategies to promote health and prevent complications in order to improve client care,” Jarrell added. “It is imperative that they have access to research, ability to synthesize research and put it into practice. Their patients’ lives depend on it. This is not an academic exercise; it is a nursing responsibility.”

“We are grateful to Dean Melnyk and Dr. Fineout-Overholt for their contributions to advancing evidence-based practice and sharing their knowledge at the summit,” said Maria Iraidis Soto Soto on behalf of ACOFAEN. “In particular, we found great value in their discussion of qualitative studies in EBP and look forward to holding a second summit during 2008.”

Fineout-Overholt said the most important next steps include development of an electronic mailing list of all summit participants, finalization of leadership for the Latin America EBP initiative, and plans for the next summit.

“We are very pleased with the progress made at the summit in advancing EBP in Latin America,” Dean Melnyk said. “It will now be important to sustain the momentum created by the first summit and continue to work with these countries intently and consistently in advancing EBP.”

The summit was conducted as part of a technical cooperation agreement between ASU College of Nursing & Healthcare Innovation and Pan American Health Organization, which also serves as the Regional Office for the Americas of the World Health Organization. RNL

R. Terry Olbrysh, MA, APR, is editor of ASU Nursing, a semiannual publication of Arizona State University College of Nursing & Healthcare Innovation.

Continuing nursing education: The following course is offered by the Honor Society of Nursing, Sigma Theta Tau International: Clinical Scholars at the Bedside, by Alyce A. Schultz, RN, PhD, FAAN.