NU 310 Critiquing Evidence Based Assignment

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

Models are the conceptual framework that helps people to understand specific concepts. In examining the three types of models, each presents a unique concept of understanding evidence-based practice.  The John Hopkins model integrates cultural values into evidence-based practice. Furthermore, the main strength of this model is it provides a simple framework for nurses at the bedside and incorporates internal and external factors that may affect research. On the other hand,

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

BSN is expected to also use research studies for a basis for their decision making. ADN analyzes assessment data, where BSN synthesizes comprehensive assessment data to solve problems. ADN’s evaluate and report outcomes and plan interventions from evidence based practice, where BSN nurses compare these interventions and outcomes to benchmarks in research and evidence-based practice and plans follow-up nursing care. They both create teaching plans to promote healthy outcomes, although BSN’s go on to assess population risk (BON,

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.

Slutsky, J. (2005). Using evidence-based guidelines: Tools for improving practice. In B. F.-O. Melnyk, Evidence-based practice in nursing & healthcare. A guide to best practice (pp. 221-236). Philadelphia, PA: Lippincott, Williams & Wilkins.

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).

Measures used to evaluate the outcome of the evidence-based practice (EBP) change will be reviewing quarterly dashboard data. To ensure inter-rater reliability, the infection control nurse, and only the infection control nurse, will monitor ongoing efforts of data collection of CAUTI, and be an integral part of the feedback loop responsible of giving on-sight feedback to clinicians and team members. Also, the infection control nurse along with other team members will revisit the literature to see if any new knowledge focused triggers will be considered. The quarterly dashboard will inform of outcome indicators which may, or may not, affect the process indicators. Process and outcome indicators will be used for improvement purposes within the unit. The quarterly dashboard report also allows questions to be asked by team members and stakeholders, which stimulates more discussion and advanced thought toward quality improvement of the EBP change. The dashboard will assist in

Bachelor of Science in Nursing (BSN) programs strive to ready student nurses for the National Council Licensure Examination (NCLEX) that tests not only pure knowledge, but the reasoning and application of that knowledge. These programs provide student nurses with the necessary knowledge base and ability to apply knowledge in practice; especially since the introduction of Evidence-Based Practice (EBP) has been integrated into didactics. EBP, along with hours of clinical placement, benefit student nurses by arming them with the clinical judgment skills called for in the workplace. However, if student nurses accrue more focused clinical hours in their areas of specialty, they will be better prepared for the situations they will face in their

Evidenced-based practice (EBP) originated in Canada from a new form of medical school which was launched during the 1970s at an institution called McMaster University (Hoffmann, Bennett, & Del Mar, 2010). This new medical program was uncommon in a variety of its methods. The primary variation was the abbreviated three year medical program which is very brief in comparison to other medical school framework (Hoffmann, Bennett, & Del Mar, 2010). Instructors conceded that the ideal concept of teaching medical students everything they would possibly need to know in regards to practicing medicine with in this program was an unattainable undertaking (Hoffmann, Bennett, & Del Mar, 2010). In response to this epiphany, instructors at this institution transformed their educational approach and focused on instruction that would provide students with the skills and tools they would need to effectively locate health information while practicing as healthcare professionals (Hoffmann, Bennett, & Del Mar, 2010). This scientific approach to healthcare is now known as evidence-based practice (Hoffmann, Bennett, & Del Mar, 2010). In the past, healthcare practitioners made decisions for patients based on personal and professional experience, hearsay, and lack of scientific evidence (White, 2004). An evidence-based practice links the

Susan B. Stillwell is clinical associate professor and program coordinator of the Nurse Educator Evidence-Based Practice Mentorship Program at Arizona State University in Phoenix, where Ellen Fineout-Overholt is clinical professor and director of the Center for the Advancement of Evidence-Based Practice, Bernadette Mazurek Melnyk is dean and distinguished foundation professor of nursing, and Kathleen M. Williamson is associate director of the

NPs must know, embrace, and practice the scientific merit of research. This is the bases for having an evidence based practice to provide optimal health services for community members. According to Facchiano and Snyder (2013), it takes critical evaluations of studies to determine the credibility of studies to establish a sound evidenced-based practice. The application of the knowledge of evidence is vital to advancing the profession of nursing. As NPs, the scientific foundation must be an intricate part of providing daily care.

The Doctor of Nursing Practice (DNP) graduates function in the role of transferring the knowledge to practice. This article reports on the development of a DNP-level EBP course to help students evaluate and apply research findings to clinical practice. (Moore, E. R., & Watters, R., 2013). The DNP

Houser, J. (2012). Nursing research: reading, using, and creating evidence. (2nd ed.). Boston: Jones & Bartlett.

Throughout the past ten weeks, I have grown in my understanding of nursing research on all levels. I feel that the most essential knowledge I have gained is the ability to critically review a research article. Because of this class, I have a better grasp on the necessary components to include, as well as how to determine rigor and validity in research. This is a valuable skill which I will utilize throughout my career as a nurse practitioner. I anticipate applying this knowledge as I review articles to determine which intervention is best to incorporate into management plans for my patients. As an example, if I am