NURS 6052 Week 1 Essay Discussion
Nursing Research and Evidence-Based Practice
In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care.NURS 6052 Week 1 Essay Discussion
Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).
To prepare:
Consider a recent clinical experience in which you were providing care for a patient.
Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?NURS 6052 Week 1 Essay Discussion
What questions have you thought about in a particular area of care such as a procedure or policy?
Review Chapter 2, pages 36—39 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.
Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.
Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.
By Day 3
Post an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days using one or more of the following approaches:
Ask a probing question, substantiated with additional background information, and evidence.NURS 6052 Week 1 Essay Discussion
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Validate an idea with your own experience and additional sources.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional strategies for addressing barriers to EBP based on readings and evidence.
Evidence-based nursing is one approach that may enable nurses to manage the explosion of new literature and technology and ultimately may result in improved patient outcomes.
Nursing students spend a great deal of clinical preparation time designing care plans, reviewing psychophysiology, and memorizing pharmacologic interactions. Although these activities are useful, they cannot be the only methods of preparing students for nursing practice.
Sole reliance on textbooks and expert faculty knowledge does not promote the critical thinking skills that nurses must have to survive in the current fast paced clinical settings. Students must learn to develop independent, evidence-based methods of clinical decision making. Both medical and nursing professionals have explored this change in healthcare practice, research and knowledge development, a paradigm shift called “evidence based practice”.
Evidence based practice (EBP) “involves an ability to access, summarize, and apply information from the literature to day-to-day clinical problems”. Evidence based practice “requires an emphasis on systematic observation and experience and a reliance on the research literature to substantiate nursing decisions.” Evidence based practice allows practitioners to meet a daily need for valid information about clinical situations.NURS 6052 Week 1 Essay Discussion
Evidence based practice allows nurses to enrich their clinical training and experience with up to date research. With the large amount of research and information that exists in nursing, learning the skills of evidence based practice allows nurses to search for, assess, and apply the literature to their clinical situations.
As healthcare institutions become ever more complex and our focus on patient experience expands, nurses are leading and participating in research studies, evidence-based practice (EBP) projects, and quality improvement (QI) initiatives with a goal of improving patient outcomes. Research, EBP, and QI have subtle differences and frequent overlap, which can make it a challenge for nurses to identify the best option to investigating a clinical problem.
The first step is a comprehensive review of the literature with a medical librarian. This informs about the problem, what evidence has been reported, and what gaps exist in our knowledge of the problem. Then, synthesize the relevant literature and decide how best to proceed based on the outcome of the literature review, experience with previous projects, available resources, and staff time and effort.
Quality Improvement
QI projects typically don’t involve extensive literature reviews and are usually specific to one facility. The purpose of QI projects is to correct workflow processes, improve efficiencies, reduce variations in care, and address clinical administrative or educational problems. An example is assessing and implementing urinary catheter removal policies with a goal of removing catheters within a defined time frame.NURS 6052 Week 1 Essay Discussion
Evidence-Based Practice
EBP integrates the best available research evidence with clinical expertise and patient values to improve outcomes. The process involves asking a relevant clinical question, finding the best evidence to answer it, applying the evidence to practice, and evaluating the evidence based on clinical outcomes. An example is implementing a new evidence-based clinical practice guideline at an institution to reduce or prevent chemotherapy extravasation for patients receiving vesicant therapy.
Research
If a literature review identifies gaps, you may conduct a study to generate new knowledge or to validate existing knowledge to answer a specific research question. Human subject approval is necessary before conducting a research study. An example is a randomized controlled trial of two skin care regimens for patients receiving external-beam radiation therapy.
Nurses at all levels of care will be involved in asking and answering focused clinical questions with a goal of improving patient outcomes. It is important to be familiar with the similarities and differences between research, EBP, and QI. Each is an excellent method to improve clinical outcomes.NURS 6052 Week 1 Essay Discussion