Evidence-Based Practice: Nurses Overcoming the Barriers
From ancestral times to present, healer’s dedicated their life’s passion to exercise experienced medical techniques to improve a patient’s quality of life. As many techniques are passed from generation-to-generation they continue to evolve as research philosophers discover improved ways to enhance patient care through evidence-based practices (EBP). EBP has emerged through the years as an effective strategy to improve the quality clinical experience, implement best-researched practices, and tailor to patient values and preferences. The impact of EBP has echoed across the united states, as well as many countries, in transforming health care facilities by redesigning effective, safe, and efficient platforms. However, there has been much hardship for nurses to incorporate EBP into their daily nursing process. This paper will discus the common barriers nurses encounter when implementing evidence-based practices into the nursing process, and the effective workshop programs management has placed to overcome those barriers.
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Due to the many barriers health care facilities face from the lack of resources, time, and knowledge, major changes need to be made. By nursing taking the initiative to understand and learn the format and techniques of EBP, over time nurses will become proficient in their daily nursing process. As a BSN prepared nurse equipped with the knowledge and techniques of implementing EBP, this nurse will conduct the most current research practices and encourage others to facilitate the change as well. Nurse are the first a patient sees when they are admitted and the last when they are discharged. It is up to nurses to stay on top of the educational curve to know they are providing the best-practiced care
Evidence-based practice (EBP) entails the use of explicit, reliable, and judicious evidence to make effective decisions about the care of patients. This DNP student will introduce EBP with the IOWA model. The IOWA model applies to this DNP proposal. The IOWA model is an EBP applicable in healthcare setting and implemented to show the applicability of evidence in nursing to give the best outcome. Doody and Doody (2011) noted that the IOWA model focuses on problem-focused triggers and knowledge in undertaking quality improvement study. The steps involved include topic selection, team formation, evidence retrieval, grading evidence, developing an EBP evidence, implementation of EBP, and evaluation of the progress. These steps apply to this DNP proposal, showing best practices, guidelines, procedures, and policies
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
Bachelor of Science in Nursing (BSN) programs strive to prepare 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, benefits 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 careers in which simulation labs or nonspecific clinical settings fail to adequately prepare them. With more hours spent in specialty areas, student nurses will be able to establish higher degrees of mental preparedness and hands-on experience as well as understanding of the difficulties and demands of working as a nurse in a specific field as opposed to shifting between various focuses of nursing.
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
Over the last 10 years evidence-based practice (EBP) has grown substantially and is changing the nursing care delivered to patients along with the nursing work environment. Nurses are more involved in the decision making process, and are making clinical decisions with better patient outcomes (Good, Fink, Krugman, Oman, & Traditi, 2011). With technology growing at such a fast pace, new and more effective medicines, medical devices, and procedures are developed daily. Digestible sensors that monitor your bodily systems and 3D printing of embryonic stem cells, blood vessels, and sheets of cardiac tissue that actually beat like a real heart, are significantly impacting the future of healthcare (Honigman,
Quality of care and patient outcomes rely heavily on practice based on evidence found in systematic reviews of randomized-control trials. While administration often-times implements core measures that involve EBP in their regulations, it is ultimately the nurse’s responsibility to include EBP into their care of patients. Nurses have an obligation to include EBP into their care because “it leads to the highest quality of care and the best patient outcomes” (Melnyk & Overholt, 2015). The nurse leaders really have a responsibility here because it is their responsibility to stress the importance of EBP as well as reviewing research to determine the best possible findings to implement into their unit’s care. Careful monitoring must be performed to assure compliance because “despite the multitude of positive outcomes associated with EBP and the strong desire of clinicians to be the recipient of evidence-based care, an alarming number of healthcare providers do not consistently implement EBP” (Melnyk & Overholt, 2015). Often times, I find seasoned nurses act putout with anything that changes their methods of care. The important thing to remember is that seasoned nurses, while often-times set in their ways, are great nurses and presenting EBP findings and their success during implementation will keep them involved with EBP because they ultimately want to do what’s best
Counselors are very dependent on the research of others. Counselors are among many who are responsible for producing evidence based practice. Counselors have a responsibility to be eager and capable of locating and using evidence based interventions. Research reports are used to help summarize the findings of different types of research in the counseling profession. The results of a research report should summarize the findings of the research. According to Sheperis, Young, and Daniels 2010, “it should be easy for the reader to connect the findings with the stated research questions and to determine whether the finding support or refute your hypothesis” (p.239). The following are two challenges that the counseling profession is faced with when it comes to outcome research: (1) producing sufficient volumes of evidence and (2) being able to find, interpret, and use the evidence from previous research. These challenges place a limit on the variety of interventions that are available to the counseling profession. One intervention that works for one child, might not produce the same results for another child. So it is very important that research provides information that is useful and effective. The lack of studies makes it more challenging to determine whether or not an intervention is an effective solution that will improve a student’s behavior or academics. “Ultimately, regardless of how effective a counselor may be, if the problems are not properly measured and assessed, intervention is disadvantaged and treatment is comprised” (Sheperis, Young, & Daniels, 2010, p. 3). In order to best serve clients we have to complete comprehensive research and use the results to the advantage of the client.
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
The Johns Hopkins Nursing Evidence-Based Practice Model provides nurses with a system to formulate a practice question, appraise both research and non-research evidence, and to develop recommendations for practice (Dearholt & Dang, 2012). This model guides nurses through the evidence-based research process with ease and minimal difficulty using a problem solving approach.
Ubbink, DT, et al. Implementation of evidence-based practice: outside the box, throughout the hospital. Netherlands Journal of Medicine [serial online]. 2011;69(2):87-89
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.
Evidence based practice is the combination of clinical expertise, patients expectations and values, and best research evidence into the process of clinical decision making for the purpose of patient care and welfare. Clinical expertise refers to the experience, skills and education of the clinicians. Patient expresses his or her own personal values, expectations, preferences and individual concerns. And best research evidence is often found through the clinical based research which has been conducted using proper methodology. (Isenburg and Handler, 2016)
One feature of evidence based practice is a problem-solving approach that draws on nurses’ experience to identify a problem or potential diagnosis. After a problem is identified, evidence based practice can be used to come up with interventions and possible risks involved with each intervention. Next, nurses will use the knowledge and theory to do clinical research and decide on the appropriate intervention. Lastly, evidence base practice allows the patients to have a voice in their own care. Each patient brings their own preferences and ideas on how their care should be handled and the expectations that they have (Fain, 2017, pg.
Evidence based practice (EBP) is a key component in delivering cost-effective, high quality health care. [1] However, only around half of the care providers in the United States utilized EBPs. Additionally, nearly a quarter of services delivered to American consumers are unnecessary and potentially harmful. Today, educators are teaching and promoting evidenced based health care to future nursing professionals. The Institute of Medicine (IOM) supports this action as a means to achieve the objective that 90 percent of all medical treatments have a foundation in evidence based practices by the year 2020.
The purpose if this discussion is to define and understand nursing research, appropriate research and clinical questions, and evidence-based practice with support of examples and clinical scenarios. Nursing research refers to the identification, investigation, and critical analysis of matters or questions pertaining to the profession of nursing through a scientific and methodical process (Wood & Haber, 2013). The purpose of research is to gain new knowledge or validate current knowledge, and a research question should indicate an area, have an impact in nursing, reflect previous literature, and can be researched with a quality or quantity approach (Wood & Haber, 2013). An example of a research question for instance is, what is the correlation between assigning patients based on acuity in an acute care hospital and