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Evidence based practice in a clinical setting
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A hospital that obtains magnet status displays “knowledge and expertise for the delivery of nursing care globally” (ANCC, 2008). Magnet status means displaying professionalism in models of care with nursing leadership, organizational structure and evidence based practice. The American Nurses Credentialing Center (ANCC) provides a model to help aid visually with understanding the components a hospital must achieve to be considered magnet. This 5 component model was designed “to provide a framework for nursing practice and research in the future, as well as serving as a road map for organizations seeking to achieve Magnet recognition” (ANCC, 2008).
The first step in the model addresses transformational leadership. This type of leadership not
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This addresses the environment in which nurses practices and strives for “an innovative environment where strong professional practice flourishes and where the mission, vision, and values come to life to achieve the outcomes believed to be important for the organization” (ANCC, 2008). This type of environment is accomplished by nurses working together towards a strategic plan outlined with facility policies and knowledge-based nursing and skills to achieve desired outcomes and accomplish organizational goals. I believe my facility does a great job with structural empowerment. Our nurse manager makes sure we know what our goals are as a unit. We review hospital satisfaction scores and infection rates to determine what practices need to be addressed for achieving organization and desired outcomes. We work to provide cost-effective care that exceeds national standards for excellence while working to strengthen bonds between staff members and making sure that at our facility “caring comes first” …show more content…
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
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
Magnet hospitals are named for their potential to attract and retain qualified nurses. Magnet hospitals are facilities that have been certified by the American Nurses Credentialing Center for promoting positive patient outcomes through best practices in nursing (Upenieks, 2003). The Magnet environment fosters autonomy and professional nursing practice. Research shows that Magnet hospitals have better work environments, a more highly educated nursing workforce, superior nurse-to-patient staffing ratios, and higher nurse satisfaction than non-Magnet hospitals (Aiken, Kelly, & McHugh, 2011). Implementation of that environment requires the ability to create trust, accountability, and open communication in changing times. The American Nurse Credentialing Center (ANCC) organized 14 Forces of Magnetism into 5 Model Components to measure outcomes for the Magnet Recognition program. The first of the five components, Transformational Leadership, encompasses two of the 14 Forces of Magnetism: Quality of Nursing Leadership and Management Style (American Nurses Credentialing Center). The leadership approach best suited for the pursuance of Magnet recognition would be a transformational leadership approach. Nurse executives in a Magnet institution require the ability to foresee the future needs of healthcare, and must devise plans of action to meet those needs. They must communicate, monitor, engage, and inspire others toward the common goal. Management, likewise, has to communicate ideas and monitor progress, but must also be prepared to organize the undertaking and implementation of future pathways.
The history of Magnet Status began in 1992. The American Nurse Credentialing Center first developed of the idea of Magnet Status after extensive research studies were perform during the nursing shortage of the 1980’s. The goal was to find out why some hospitals were able to retain and even recruit nurses during the shortage. It was found that of the 165 hospitals that participated, 41 shared seven core attributes. (Chaffee, Leavitt, & Mason, 2007) These seven attributes were the beginning of what have become the fourteen forces of Magnetism. The attributes or forces are based on nursing standards of care. That is the ability of the hospitals, working with the nursing staff to provide the excellent nursing care. That is care for the patient as well as the nursing staff and the hospital as a whole. The programs first awarded Magnet status in 1994. Since then several hundred have reached Magnet Status with several hundred more in the application process. In 2001 the first international hospital was awarded Magnet status. As with the medical field and even nursing all things must change, this includes the Magnet Program. In 1996 the standards and requirements along with the name evolved and changed. The program became known as the Magnet Recognition program for excellence in Nursing Service with requirements moving from internal review to pu...
For hospitals to reach their peak in the healthcare world they must work to achieve a prestigious credential by the American Nurse's Credentialing Center ( Truth about nursing). In order to receive such a credential, hospitals must fulfill a set of criteria that will take a lot of work and reform within the hospital itself. To receive magnet status hospitals have to express the fourteen forces of magnetism along with the strict list of requirements (Flores, 2007). Magnet status along with everything has its benefits along with its problems. This credential has been researched in depth, and some research feels that certain thing should be changed in order for magnet hospitals to be the best they can possible be. Lastly, there is no doubt that magnet status is of great value because of how it transforms hospitals from great to greater.
The magnet recognition program began in the early 1980s as a stride towards promoting nurse retention in the United States. Administrators, directors, staff nurses, and hospital administration gathered together to discuss the essentials of hospital designation. The original research, gathered in 1983, was targeted to identify successful nurse retention. In 1993, the ANCC approved the standards set forth in previous research to become standardized utilizing the forces of magnetism. The 14 characteristics described by the ANCC as “forces of magnetism” define the structure of excellence within the healthcare environment. McClure & Hinshaw (2002), describe the following 14 characteristics that attract and retain nurses to magnet hospitals: “Quality nursing leadership, organizational structure, management style, personal policies and programs, professional models of care, quality of care, quality improvement, consultation and resources, autonomy, community and health organization, nurses as teachers, image of nursing, interdisciplinary relationships, and professional development”.
The Robert Wood Johnson Foundation has been in operation for more than 40 years and has been instrumental in working to improve the status of health and the health care for all individuals within the United States of America. They hold a vision “as a nation, to strive together to create a culture of health enabling all in our diverse society to lead healthy lives, now and for generations to come” ("Robert Wood Johnson Foundation," 2014). The Foundations nursing programs has early initiatives that would improve the profession with the advancement of nurse practitioners, programs improving nursing academics, improved hospital nursing. Currently the foundation is developing leadership skills in advanced level nurses and transforming working conditions of nurses within the hospital setting. In support of nursing and in light of the nation’s severe nursing short...
152). EBP has inspired nurses to acknowledge the significance of theory and research and utilize it to their area of practice. Through strong educational foundation and advanced practice, APN is able to comprehend the relationship between research, theory and EBP and utilize it in providing quality care to patients. Best research evidence is indispensable, as nurses nowadays use pragmatic evidence in practice and not just previous experiences or beliefs (Chinn, & Kramer, 2011). Evidence based practice has been proven to upgrade patient outcomes, reduce health care expenses, and cause increased patient and provider satisfaction. By using evidence-based care and theories, patients are given proper assessment and treatment without wasting valuable money and supplies on testing and procedures that are not
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.
Provision seven refers to nurse advancement of the profession through contributions of practice, education, administration, and knowledge development. Nurses serve by participation in the profession as mentors, on board of professional committees, and active leadership roles within their organization. While nurse educators promote the advancement of nursing through fostering professionalism and civic values; nurse managers and administrators are responsible for providing and environment which promotes ethical integrity and professionalism (ANA,
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
There are many organizations pursing the accreditation by the American Nurses Credentialing Center (ANCC) Magnet Recognition Program (Pinkerton, 2008). It is a great achievement when an organization receives Magnet recognition. However, “several factors must be considered by those organizations making the decision, and these factors can be grouped and reviewed using the recently released empirical model for the Magnet Recognition Program” (Pinkerton, 2008, p. 323).
Acknowledgement and appreciation are key to nursing retention. Hospitals who are Magnet certified enable nurses to be a key component of healthcare, which increases patient satisfaction and lowers mortality rates. Therefore, it isn’t a matter of only nurse retention rates, but also an increase of patient care, and a decrease in burnout within the profession (Laureate Education, 2009). Ideally, the Magnet status components of care will spread throughout the profession. This will lead to an increase in comradery and accountability of nurses everywhere (Tinham, 2013).
Health care organizations and the way patient care is delivered is rapidly changing. The ability to manage, promote, and facilitate change is one of the most important skills that nursing leaders need to be successful. Influencing change requires effective communication skills, and the ability to help others see the vision (Curtis, De Vries, & Sheerin, 2011). Nursing leadership can no longer take a top down approach when leading change. During periods of organizational change there is great uncertainty. Nurse leaders are responsible for influencing change by creating an atmosphere where information is shared, there is a reshaping of ideas, and a vision is created (Samela, Eriksson, & Fagerstrom, 2011). Effective communication is an essential
Support of a decentralized organizational philosophy can transform organizations, staff, and patients because it affects the culture, improves staff outlook, promotes personal involvement and encourages staff to reach higher levels of quality care. In my organization, nursing leaders should strive to involve all patient care units and staff in shared governance, educate unit leadership council chairs, and build on the positive aspects by empowering, motivating and developing staff members. These actions will increase creativity, responsibility, intellectual stimulation, and well-being.
...ntinually evolve, a certain degree of freedom must be felt by its members, bureaucracy represents and organization from which chaos has completely been eliminated. Nurse Executives, therefore, will need to encourage staff to challenge existing practice. Given the current environment, creative conflict will need to be supported in order for our continued growth.” (McGuire, 1999, p. 9) I believe that Capital Health is on a path for success. They have modernized there organization chart causing a more decentralized environment. This new atmosphere fosters empowerment of its nursing staff. This sense of ownership over their practice provides growth not only for individual nurse, but the entire profession. This positive proactive change of the organizational structure will allow the hospital to experience continued growth and development that is propelled from within.