Evidence Based Practice Reflection Paper

Evidence-Base practice (EBP) is defined as: “based on problem identified from the practitioner’s area of practice; a combining of best evidence and professional expertise and an integration of this into current practice; about ensuring patients receive quality care, being part of quality improvement processes; about collaboration and requiring a team approach” (French, 1999). Scott and Mcsherry (2008) supported the French’s assertion, proposing the key elements of EBP are that it is a theory-driven process, which involves the use, evaluation and application of research; identification of best evidence; evaluation of care; problem solving; decision-making; clinical expertise; and requires patient involvement. Evidence-based practice is made of evidence, clinical expertise, patient preference, the context of care (Barker, 2013). In brief, evidence-based practice is the parameter in the nursing practice that it requires that the nurses gather and use clinical evidence to make decision for the patients so that in the nursing process they can deliver the quality of care for the patients (Ellis, 2013). In the other words, in the nursing practice all the nursing procedures performed by the clinical evidence supported.

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

I believe the most important aspect to successful implement evidence-based practice is a common understanding and stress of the importance of EBP among health care professionals. Everyone need to be on the same page and understand that practice methods that are not backed by evidence are no longer acceptable. I believe the facility needs to have a mandatory meeting with all the health care professionals and discuss how EBP will be implemented into their facility. I also believe that there should be repercussions if EBP is not put into place.

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

A model is a representation of concepts which are used to help people know, understand or simulate a subject matter. Moreover, a model is used to create the various hypothesis which can be tested in the laboratory or utilized for explaining a case study. The goal of this assignment is to explore three models of evidence-based practice (EBP) that interest the authors and give a summary. Although several models used in research, this paper will highlight three specific models and provide a summary, strengths, weaknesses and a model that can be implemented in a particular practice.

Evidence based practice is the basis for needed change in practice and function. It is a sound method for scientific, fact-based change. Changes which have no evidence to support them are fragile, unscientific, and subjective. These changes don’t effect real change over time, as they aren’t able to be proven to a more general population.

In order to develop nursing knowledge and establish evidence-based practice (EBP) in nursing, there needs to be a "concept model, one or more theories and one or more empirical indicators" (Fawcett & DeSanto-Madeya, 2013, p. 26). The theoretical framework can be advantageous in guiding and supporting the design and execution of an EBP change. Using a conceptual model (C) theory (T) and empirical research (E) provides the foundation for an intervention to an identified clinical problem. Known as C-T-E structure, the application of this system in nursing practice involves an elevated level of critical reasoning, which assists in knowing what data is important and how it relates to practice change (Chinn & Kramer, 2011; Fawcett & DeSanto-Madeya, 2013; Mazurek Melnyk & Fineout-Overholt, 2015). The doctoral level of nursing necessitates the need to combine the understanding and knowledge gained from using the C-T-E structure, and then integrate the concepts and theories into daily practice.

Bradley, S., & Mott, S. (September 2012). Handover: Faster and safer? Australian Journal of Advanced Nursing, 30(1), 23-32.

The aim of this paper is to formulate a PICOT question and describe how important this research question is to nursing practice. It will include a summary of five research articles related to my PICOT question and identify a nursing practice that is supported by current research. The paper will also explain how a nursing practice that is supported by evidence-based practice can contribute to better outcomes. Lastly, I will share a strategy to share evidence-based practice throughout my organization and explain the importance of the practice.

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).

Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored in the implementation of Evidence Based Practice.

This piece of work will be exploring the different forms of research and their significance in the evidence-based practice.

Evidence-based practice will be extremely helpful among the hospital setting because it will allow for me to learn from reliable resources. Using evidence-based practice thus far has helped for me to learn about different cultures and become more prepared when meeting with patients. I will continue to work within the hospital setting and need to be sensitive of how different cultures feel about the medical system as well as treatment options. At times, I have found myself wondering why my patient does not want to go a certain treatment route and many times I can use evidence-based practice to get a better understanding. Many times evidence-based practice has allowed for me to share articles with coworkers and have dependable evidence to fall back on when advocating for my patient within team meetings.

During the program that I am in now I’ve learned that for evidence based practices that you must have the access to evidences based- practices, be careful with fidelity, and to check the progress of the students. Today many teachers search websites such as google to create their lesson plans. They do this because many teachers do not have time to sit down and look for the proper research that is needed. These lesson plans that they are finding may not be considered an evidence based instruction method. There are many websites that have been made for teachers which have the proper evidence based programs that are needed for teachers. Next we have to be careful with “fidelity”, which refers to accuracy or exactness to details. Teachers want to be sure that their evidence based methods have strong outcomes from the students. It is important for teachers to not change or leave out any of the steps in the evidence