Evidence-Based Practice: A Case Study

Evidence based practice has been seen as far back as the 1700s and there is even some evidence tracing back to Ancient Egypt. (Dillard, 2017) The first randomized control test for EBP was in 1747 by James Lind. (Dillard, 2017) Lancaster used a sailing voyage to test the theory that scurvy could be prevented in sailors by use of citrus juice. The results from his experiment were dramatic but were not published for another 7 years. Even after it was published it took another 40 years before ships implemented having citrus juice for sailors. (Dillard, 2017) One of our most prominent figures in nursing, Florence Nightingale, is credited with evaluating and then changing practice standards in our field. (Brower, 2017) One of her greatest examples was implementing the change of using hot water with soap instead of just cold

According to Warren et al. (2016), numerous barriers exist for implementation of evidence-based practice (EBP) within hospitals. In a study conducted evaluating the strengths and opportunities for implementing EBP in hospitals, lack of autonomy, lack of leadership support, and lack of inclusion in clinical practice decisions, were noted as the top barriers to the implementation of EBP (Warren, et al., 2016). The study revealed that while the majority of respondents’ beliefs

Evidence-based practice is the practice of making clinical decisions based off the best available research evidence coupled with the nurse’s own expertise, while also taking into account, the patient’s assessments and own personal preferences. This use of research has proven effective at providing better outcomes and lower healthcare costs, yet there are several barriers, such as time, education, and support, which prevent nurses from consistently using evidence-based practice (AJN, 2012). The top three barriers to the use of evidence-based practice are lack of time, education, and support in implementing new practices and using them consistently.

Another barrier is that organization does not provide the encouragement and acknowledgment to nurses who implement Evidence Based Practice (Cathy L. O’Nan, 2012). Major factors which prevent nurses from the implementation of Evidence Based Practices (EBP) are a lack of time to read articles, poor coordination with other members of health team and unavailability of nursing research articles. It was also concluded that nurses perceived the lack of managerial and organizational support to implement EBP (Ay, F., 2014).

Evidence-Based Practice Proposal Final Paper Usha Kizhakkedan Grand Canyon Final Paper of Evidence Based Proposal NUR-699 Dr. Debbie Long June 1, 2016 Table of Contents Part 1: Organizational Culture and Readiness Assessment 4 • Introduction to Evidence-Based Practice 4 • Barriers to Evidence-Based Practice 4 • Facilitators of Evidence-Based Practice 5 • Integration of Clinical Enquiry 5 • The Survey 6 Part 2: Problem Description 7 • Description 7 • Identification of change agents in the Health care system 8 • PICOT question 8 • Purpose and Objectives 9 • Rationale 10 • Literature support 10 • Research Method 10 Part 3: Literature Support 11 • Research Questions 11 • Search Method 12 • Organization of Literature 12 • Framework 12 • Nursing Rounds- Patient and Family Satisfaction: 13 • Communication: 15 • Management of Pain, Use of Call Lights and Cases of Patient falls 15 • Data Collection 16 Part 4: Solution Description 16 • Objectives 17 • Change Methodology 17 • Implementation Plan 18 • Evaluation 19 Part 5: Change Model 19 • Change Model 20 • Implementing Change 21 • Rationale 22 Part 6: Implementation Plan 22 • Staff Education 23 • Client feedback 23 • Timeframe 23 • Hiring Process 24 • Implementation 24 • Data collection and Evaluation 24 • Progression 24 • Resource Management 24 • Budget Plan 25 • Outcomes and its impact 25 • Summary 26 Part 7: Evaluation of Process 26 • Objectives 26 • Methodology 27 • Procedure 27 • Collection and Analysis of data

Itroduction: Evidence-based practice is an approach to medicine that uses scientific evidence to determine the best practice (Beyea & Slattery, 2006). As nurses perform their daily tasks they must continually ask themselves, “What is the evidence for this intervention?”. Nurses are well positioned to question current nursing practices and use evidence to make care more effective. In order to improve patients’ outcomes it is the responsibility of the nurse to transition evidence-based practice into the norm, through application of daily practice (Flynn Makic, Rauen, Watson & Will Poteet, 2014). Continual evaluation of current practice must be performed to ensure the use of evidence-based practice opposed to practice based upon tradition. The implementation of evidence-based practice standardizes healthcare practices and diminishes groundless variations within care. These variations lead to the production of uncertain health outcomes (Stevens, 2013).

Pressure ulcers occur over bony prominences when skin is compressed for long periods of time, affecting the blood supply to certain areas, leading to ischaemia development (Waugh and Grant, 2001). Compression of skin is caused by pressure, shearing and friction, but can also occur due to pressure exerted by medical equipment (Randle, Coffey and Bradbury, 2009). NICE (2014) states that the prevalence of pressure ulcers in different healthcare settings in December 2013 was 4.7%, taken from data available for 186,000 patients. The cost of treating ulcers can vary depending on severity from £43 up to £374 (NICE, 2014). Evidence based practice skills are essential in nursing as it allows the best available evidence to be used to improve practice and patient care, while improving decision-making (Holland and Rees, 2010). I will be critiquing two research papers; qualitative and quantitative, using a framework set out by Holland and Rees (2010), and will explore the impact on practice. Using a framework provides a standardised method of assessing quality and reduces subjectivity.

To start my plan for implementation, I will first talk to my director of nursing, manager, and nurse educator for approval. I plan to implement increase evidence based practice use in my department (cardiac unit). I will obtain information from our quality assurance nurse to evaluate how our core measures like AMI, chf, and stroke bundle is being consistently followed by the nurses in my department. I plan to empower staff nurses to use EBP. I will schedule workshops for nurses interested in learning more about research and EBP, increase access to library resources and EBP information, interactive EBP skills and rounds, development of EBP mentors and champions. The change should be an ongoing support from the leaders and organization to

The incorporation of evidenced-based practice (EBP) into nursing practice is supported by research to positively improve the quality of care and improve patient outcomes. EBP is important to the nursing profession because it also leads to increased job satisfaction, teamwork, and levels of engagement in clinicians (Melnyk, et al., 2017). Miniature research projects such as quality improvement projects, surveys, and clinical research studies are frameworks used to get feedback and data from patients during their time spent in health care systems. EBP is not the standard of care in many health care systems (Melnyk, et al., 2017). This due to many factors, including lack of EBP mentors, nursing programs that do not incorporate EBP into the curriculum,

The Iowa Model (IM) of evidenced based practice (EBP) is the conceptual framework used for this proposed project. This model will frame my project by driving quality patient outcomes, promoting new research and innovations to implement in nursing practice, and sharing new knowledge with peers across the globe through research utilization.

Evidence Based Practice is beyond the Advanced Nurse Practitioners and the patients, it is more and part of an organizational culture. Advanced Nurse Practitioners have to understand how literature findings can be reviewed in order to determine if they are relevant and clinically significant to the population they serve as your focus on lesbian, gay, bisexual, and transgender (LGBT) community. It is a good idea to use the evidence-based policy to implement and provide education and training. In addition to education and training, the clinical environments need to be change which can change some behaviors towards this

The process of using Evidence Based Practice in a patients care plan consists of five key stages. Asses the patient and formulate the problems from this you will then need to access the relevant clinical articles. Using this information you should then be able to assess which is the best method of treatment discarding any misleading or ambiguous articles. You then need to incorporate this knowledge into the patients care plan. Finally you need to evaluate and assess the patient during treatment to ensure effectiveness.

Using evidenced based practice in nursing care has been found to improve nursing care and patient outcomes for that matter. Though nurses are gradually embracing the use of evidenced based practice, we still have more to do to achieve EBP across the board. Studies have shown increase in responsiveness and attitude to EBP but are still faced by significant barriers in employing it. Therefore what we think and believe is not what is practiced (Stevens, 2013).

In nursing, we grow every day; learning to be a strong professional takes many skills. Some people are born with, and some acquired through practice and research. It is important in being a good democratic leader to establish rules effectively with peers and subordinates. Leadership involves action, creativity, motivation, and visioning. It is viewing the possibilities and motivating others to make things happen (Kearney-Nunnery, 2016). Evidence based practice is a must to have a successful and a safe practice in your work environment, whether it is a hospital or nursing home. Leadership and evidence based practice are two parts of the coin that are very important in being a nurse leader. Leadership is a critical part of the organization to apply evidence based practice. This paper identifies and defines these important nursing traits and discusses the traits that are significant to being proficient in these skills.

Evidence-based practice (EBP) in nursing means making decisions about patient care on the basis of best, current, standardized practice and guidelines. According to an article, written by Dr. Kathleen Stevens, the development of evidence-based practice (EBP) is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care (Stevens, 2013). The author also mentioned in her article that the intended effect of EBP is to standardize healthcare practices to science and best evidence and to reduce illogical variation in care,