San Francisco VA Health Care System

Leonides Penaflor discusses ways to create a more comfortable clinical environment for women Veterans affected by Military Sexual Trauma seeking healthcare at VA clinics. She is one of 14 nursing fellows who put theory into practice as they presented ways to improve patient care during their capstone project presentations at the conclusion of a newly-launched evidence-based practice education and fellowship program offered at the San Francisco VA Medical Center.

As the charge nurse at the San Francisco VA Medical Center’s Women’s Clinic, Leonides Penaflor, R.N., noticed that some female Veterans seeking health care felt uncomfortable being treated by male practitioners. Recognizing that some of these women suffered from military sexual trauma (MST) and that interactions with males in a medical setting could potentially conjure negative reactions, Penaflor sought to implement a system where such patients would be assigned a female practitioner and, thus, creating a safer environment for the patient.

Penaflor is one of 14 nursing fellows who put theory into practice as they presented ways to improve patient care during their capstone project presentations at the conclusion of a newly-launched evidence-based practice education and fellowship program offered at the San Francisco VA Medical Center (SFVAMC).

Piloted in November 2017, the program was developed by SFVAMC Oncology Clinical Nurse Specialist Deborah Burgoon, MSN, APRN, AOCN, and UCSF’s Director for Nursing Research and Innovation Mary Foley, R.N., Ph.D., with the intent to inspire nurses to find ways to improve patient care quality, safety, outcomes and costs in a clinical setting using evidence-based practice. Evidence-based practice is defined as the integration of clinical expertise, patient values, and the best research evidence into the decision-making process for delivering patient care.

Fellows – all of whom work at SFVAMC – attended one eight-hour workshop each month where they learned about the fundamental principles of evidence-based practice – how to conduct a scientific literature search, identify a clinical practice problem, implement a pilot project, evaluate the project, and disseminate findings. Topics included using the proper body mechanics in using transport gurneys; identifying and preventing sepsis; increasing access to rural Veterans with movement disorders; and shortening stays for post-operative patients, among others. Five SFVAMC nurses served as coaches for the fellows, providing mentorship and project guidance. The fellows presented their findings to their peers and key stakeholders on May 4 at SFVAMC. Nine fellows submitted abstracts of their projects for the June 29 VISN Nursing Research Conference in Palo Alto.

“The nurses were engaged and enthused,” said Burgoon. “This offered them an opportunity outside of their clinical work to focus and learn about how to identify, analyze and solve a practice problem. It allowed them to ask the question, ‘Why do we do the things we do, and how can we improve?’”