Design For Change Proposal : Implementing Hourly Rounding

According to Long and Harrison (1997), (as cited by Nursing and Health Sciences, 2003), evidenced base nursing is the process of systemically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions. Nurses carry out a variety of activities to obtain, recover, and develop the patient’s health and well being. Evidence-based practice helps nurses provide high quality patient care based on research and knowledge rather than because “this is the way we have always done it,” or based on traditions, myths, hunches, or most commonly based on the advice of co-workers. The challenge for nurses is to implement the best intervention and practice informed care by the evidence. Evidence-based practice positions nurses to be a significant influence on health care decisions and a partner in improving quality care. Nursing interventions and processes informed by the best evidence are critical to realizing health-care improvements and cost savings.

The learning process during this course (Advanced Nursing Research: NURS 5301) has been quite a lot. We dealt with the importance of research and evidence-based practice (EBP) in nursing and it has being quite revealing and extensive in contents. The course contents and assignments were in-depth and time-consuming, mostly the literature review paper nevertheless they were informative and educative. The course promotes critical thinking and judgment, more so, the materials and assignments were based on how clinicians will be able to identify a need for change in the current practice and ask the right questions, which in turn generate research that will lead to EBP.

During my associate degree program and my bachelor degree in nursing, I have read several evidence-based practice articles and research. However, I still feel I need to strengthened more this area of nursing. According to Balis & Hayes (2016), “Nurses in clinical practice identify the problems in need of investigation and collaborate with researchers from nursing and other disciplines, who design studies to address the identified problems and collect and analyzed the data” (p. 194). I am committed to seek more knowledge through reading more evidence-based practice nursing articles and studies in order to make the best decision and judgment for my patients and

Nursing research is utilized to support evidence-based nursing practice; its evolution began with the work of the Lady with the lamp Florence Nightingale. According to Polit & Beck, (2017) nursing research embodies widespread arrays of systematic inquiry utilized in guiding nursing practice, quality and safety of populations’ health and improvement in care provided.

Continuing education is important for nurses to remain competent and facilitate quality care. Education based on research is crucial in making practice changes and research based on tried and true evidence will influence these changes. The Johns Hopkins Nursing Evidence-Based Practice Process is evidence-based and consists of eighteen steps that are performed in three phases. The phases are practice question, evidence, and translation. (Dearholt & Dang, 2012) and it came about through collaboration between clinical nurses and nursing faculty. “The strength of the Johns Hopkins model is its reliance on a strong academic-collaboration as a foundation for mutual benefit.” (Houser, 2015, p. 465). A Magnet designated institution has a responsibility to contribute to the education of nurses using research based evidence to make practice guidelines.

Understanding that research is evidence for nursing practice consists of knowing that nursing knowledge is the main source

Among the biggest challenges in the implementation of evidence-based practice in all sectors of healthcare is lack of knowledge among the care-givers. Research based nursing practice is a new concept lasting barely a century making nurses still skeptical about adopting the approach and depending on their knowledge. Studies have indicated that nurses, mostly novice nurses have little knowledge, if any on the concept of evidence-based nursing practice (Warren & McLaughlin 2016). This research recommended that nurses needed to include research training and adequate conditions and resources to enable them to implement EBP as

Nurses are educated and trained on the development and use of evidence based research. Evidence based research is therefore incorporated into the daily routine of nursing care than expected.

Evidence-based practice is a problem-solving approach that integrates systematic search for, and critical appraisal of, relevant evidence to answer a burning clinical, educational or administrative question. In today’s Magnet Monday, I will further explain this approach, why it is important to us at Parkview and how our clinical nurses are making great strides to improve clinical outcomes through evidence-based practice.

There was in increase in falls over the first quarter of the year so the question was why and how to decrease the number of falls on the unit? After reviewing the data and conducting research on falls a quality improvement team decided on a plan, which was to hourly round on the patients. In essence, education was provided to the patient and family about what hourly rounding and why it is occurring. Overall, hourly rounding did decrease the fall rates on the unit and improved patient safety. Another issue identified on the unit was an increase in percutaneous endoscopic gastrostomy tube (PEG) being pulled out by patients. Therefore, a plan was put into place for patients with PEG tube to wear an abdominal binder and have a stat lock place

Filling the gaps between research and practice is very important. This issue has always existed and this is one of biggest challenges facing nursing students. The availability of information is increasing. However, it is difficult to find evidence and apply it to nursing practice. The results of research should be feasible and a higher level of evidence should be provided to bridge the research-practice gap. It will require two-way communication between researchers and practitioners, or education for both researchers and practitioners. Through communication or education, researchers can develop more feasible interventions and provide more scientific evidence. Providers should be able to identify the best

With healthcare continually changing, does one ever stop to think why changes are being made, or if changes made are necessity? Wouldn’t it be easier to continue nursing the way everyone is used to? The answer is, no! Changes in health care are brought upon with the idea of implementing safer, more efficient, and patient friendly techniques. This is all due to research that is done and then introduced into clinical practice. Where does the research come from? The answer is, through research utilization. This process consists of five steps before reaching the final step of introing the new research into clinical practice. (Zerwekh & Garneau, 2015).

I believe that nursing should be based on a continuum which includes; research, practice, and theory. As the professional nurse role has evolved each of these concepts collectively define the profession. “New knowledge is generated and effective interventions are developed through nursing science, new avenues for implementation, dissemination, and sustainability must also be considered” (Grady & Gough, 2015, p.518). Theory provides the foundation on which nursing as a profession is built. The ability to generate and apply theory defines the legitimacy of the profession (McCrae, 2012, p.222). Practice provides specific examination and experience that is important to the role of the nurse. Research is imperative to the advancement of care and

The nursing practice is directed to provide qualified and safe care, and remarkable is the fact that the skills and abilities of the nurses have their foundational basis in strong scientific knowledge as a standard for the purposes of care of the patients. Nurses are committed to the best care and responding to the challenges of the actual healthcare system, “Nurses are increasingly engaged in evidence-based practice (EBP) processes to answer significant questions and guide nursing practice” (Lee, 2013).

I do agree your topic, ''hourly rounding". Hourly rounding can prevent patients from falls, timely meet the various needs of patients, and increase patients’ satisfaction. However, how to efficient implement the hourly rounding is an important issue. The ratio, the level of work and patients’ condition may affect its implementation. Therefore, it has the necessity of research.