New And Innovative Evidence Based Nursing Practices

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 is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

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

Evidenced Based Practice (EBP) is essential to enable all nurses to provide the most current up to date practises for their patients. This process involves research, systematic review of current practises, critical thinking skills, evaluation and application to the clinical setting. In addition to this, the nurse must take into account the patients’ preferences. For nurses to have professional autonomy they must be able to justify their actions and demonstrate an understanding of why they perform the tasks they do. This defines them as unique professionals judged by their knowledge and not simply by their hands on skills.

Magnet asks healthcare organizations to define their philosophy because it is the leading resource for establishing effective and efficient nursing practices. (Magnet Monday, n.d.). This magnet is a landmark behind the success of certain hospitals with low turnover rates, better quality of care, decreased length of stay, and improved outcomes. (Magnet Monday, n.d.). American Nurses Credentialing Center for Magnet status is a prestigious award that not all hospitals attain. Those who are Magnet status have higher nurse retention and satisfaction, improved quality of care, less nurse burnout, and lower mortality rates

Although provider barriers exist, your ability to reflect upon the patient problem “and extract the important components to form the clinical question” will likely form the basis for a review of research on the best evidence to address this concern (Fineout-Overholt & Johnston, 2005, p. 157). According to Dr. White (Laureate, 2011), the Johns Hopkins Nursing Evidence-based Practice (JHNEBP) model is a highly adaptable framework. In her discussion about barriers, Dr. White states “… when you think about how a practice question gets designed, if you're doing it only from the nursing perspective, you may not think about what the other professionals are interested in and knowing about”(Laureate, 2011, Transcript of recorded interview). Therefore,

Conrad, A., Grotejohann, B., Schmoor, C., Cosic, D., & Dettenkofer, M. (2015). Safety and tolerability of virucidal hand rubs: a randomized, double-blind, cross-over trial with healthy volunteers. Antimicrobial Resistance & Infection Control, 4(1), 1. doi:10.1186/s13756-015-0079-y

The articles address the issue of Magnet status and staffing and how they impact the issue of patient safety, satisfaction, and outcomes. They support the question that adequate nurse staffing affects the results of the patient as well as the ability of the hospital to retain nurses the maintain the staffing levels.

This paper will discuss the PICO question of does applying a CHG tegaderm versus a regular tegaderm dressing decrease the rate of infection in patients with invasive lines? There are a high number of invasive line infections and it is important to know if a product can decrease a patient’s rate of infection. This paper will analyze the information found and explore how evidence based practice is useful to nurses.

Magnet recognition is a performance recognition that was started by the American Nurses Credentialing Center (Drenkard, 2010). The recognition is awarded to facilities who have applied and met the requirements (Magnet Recognition and Pathway to Excellence, 2018). The goals of the Magnet recognition are to improve positive patient outcomes while also providing an environment which promotes growth and safety for the nurses (Magnet Recognition and Pathway to Excellence, 2018). The opportunities for nurses that are provided by the Magnet recognition are continued education, promotion of growth by certifications and licenses, recognition of individual nurses, and staff satisfaction (Magnet Recognition and Pathway to Excellence,

Findings of evidenced based practice have to be disseminated to ensure that innovations for practice are replicated or applied in other settings by stakeholders in the health fraternity and healthcare professionals (Forsyth, Wright, Scherb & Gaspar, 2010). One of the objectives of dissemination should be to improve the practice. Dissemination of evidenced based practice findings in nursing is very critical in knowledge synthesis, translation, and translation. It is imperative in strengthening healthcare, informing policy, and improving practice decisions based on clinical evidence (Rycroft-Malone & Bucknall, 2010). This is realized by transforming clinical changes into practice. It actually involves two stage processes namely: translation of evidence into practice and integration of research recommendations into actual practice. Effective dissemination of evidence based practice findings enable staff to share information about developments in healthcare practice and implement innovation (Freemantle & Watt, 1994).

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.

The Johns Hopkins Nursing Evidence-Based Practice model (JHNEBP) is an evidence-based practice model (EBP) created by the health professionals of Johns Hopkins Hospital, and the nursing school at Johns Hopkins University (Schaffer, Sandau, & Diedrick, 2013). It was designed as a strategy to promote EBP and EBP projects that introduced and fostered EBP skills in nurses at all levels (Shivnan, 2011). The model serves as a tool to assist nurses with at the bedside care decisions (Schaffer et al., 2013). Reported in 2011, 80 hospitals and nursing schools have used this model (Shivnan, 2011). JHNEBP consists of three main phases: Practice, Evidence and Translation (Schaffer et al., 2013).

There are five levels of strength of the evidence on the Johns Hopkins tool, and I gave the article “Sleep in the Hospitalized Patient: Nurse and Patient Perceptions” a ranking of level III. I used the Johns Hopkins nursing evidence based practice research evidence appraisal scale tool to decide on my ranking level which breaks it down step by step to find the strength of the research. The description of level III is “nonexperimental study, qualitative study, or meta synthesis” (cite JHNEBP). Non-experimental studies consist of no manipulation of variables and randomization is not controlled, qualitative studies are made up of interviews or focus groups and have small sample sizes, and

Evidence based practices are important to explore for various diseases so that their efficacy level can be determined and medical staff can be trained accordingly. Particularly speaking in the context of chronic diseases, evidence based practices are to be evaluated with the joint efforts of multiple healthcare institutions so that it can bring benefits to the overall healthcare industry.