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- QUESTION
Introduction
Have you ever had an idea about a streamlined process or new method for doing things? Unfortunately, such ideas often fail to be implemented because of mild interest, lack of resources, and force of habit. This is also the reality of evidence-based practice. Nurses who immerse themselves in scholarly literature, research, and clinical discourse may have many ideas about how to improve practices in their health care settings. However, this only fulfills the “evidence” component of evidence-based practice (EBP). Applying the evidence and translating it into nursing practice is often the most difficult part of the process.
This week, you consider how you can take evidence and turn it into practice, focusing on how to develop a culture of EBP. Finally, you anticipate barriers that you might encounter in the change process.
Objectives
By the end of this week, you will be able to:
- Evaluate organizational culture and policies for supporting evidence-based practice
- Develop strategies for creating an organizational culture to support evidence-based practice
- Assess the professional responsibility of nurses to promote the use of evidence-based practice
- Evaluate how nurses can prCreating a Culture of Evidence-Based Practice
An abundance of evidence can be found on almost any medical issue or health topic. Often, the availability of information is not the concern, but rather nurses struggle with how to convey the evidence to others and change practices to better reflect the evidence. Deep-rooted organizational cultures and policies can make some resistant to change, even to changes that can vastly improve the quality, effectiveness, and efficiency of health care. However, there are many strategies that nurses can employ to bring about changes to practice.
In this Discussion, you focus on how to create an organizational culture that supports evidence-based practice.
To prepare:
- Review the information in this week’s Learning Resources. Examine the various suggestions for promoting an organizational culture that embraces the use of EBP.
- Reflect on your own organization’s (or one in which you have worked) support of evidence-based practice. Examine how culture and policies impact the adoption of changes to practice based on evidence. What barriers exist?
- Consider the models and suggestions for promoting evidence-based practice featured in this week’s Learning Resources. Identify models and suggestions that would work well in your organization.
- Reflect on the significance of evidence-based practice in health care. What responsibility do nurses have to promote EBP and change practices to better reflect evidence and research findings more evidence-based practices through dissemination
Readings
- Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (Laureate Education, Inc., custom ed.). Philadelphia, PA: Lippincott Williams & Wilkins. ◦ Chapter 28, “Disseminating Evidence: Reporting Research Findings” ( this IS THE COURSE TEXTBOOK. use it for most of references)
In this chapter, the focus is on actually reporting on the research findings and how to determine the best approach for reaching the desired audience. The chapter also includes tips on how to organize the information and describes what is usually included in such reports.
- Aitken, L. M., Hackwood, B, Crouch, S., Clayton, S., West, N., Carney, D., & Jack, L. (2011). Creating an environment to implement and sustain evidence based practice: A developmental process. Australian Critical Care, 24(4), 244–254.
Retrieved from the Walden Library databases.
This article describes a multi-dimensional EBP program designed to generate sustainable improvement in patient care and patient outcome. The text details the program’s strategies for implementation along with achievements and lessons learned.
- Barnsteiner, J. H., Reeder, V. C., Palma, W. H., Preston, A. M., & Walton, M. K. (2010). Promoting evidence-based practice and translational research. Nursing Administration Quarterly, 34(3), 217–225.
Retrieved from the Walden Library databases.
In this text, the authors highlight established systems and structures designed to supply staff with resources to translate research and deliver EBP. Additionally, the article explicates a multitude of initiatives designed to disseminate evidence to the point of care.
- Cullen, L., & Adams, S. L. (2012). Planning for implementation of evidence-based practice. Journal of Nursing Administration, 42(4), 222–230.
Retrieved from the Walden Library databases.
This article provides several models for implementing evidence-based practice within an organization. It introduces four different phases through which an implementation should progress, and provides examples of each.
- Estrada, N. (2009). Exploring perceptions of a learning organization by RNs and relationship to EBP beliefs and implementation in the acute care setting. Worldviews on Evidence-Based Nursing, 6(4), 200–209.
Retrieved from the Walden Library databases.
In this article, the authors detail a survey design study conducted to determine the relationship between a learning organization’s characteristics and the beliefs of registered nurses with respect to EBP. In addition, the study examines the impact of EBP beliefs on registered nurses’ implementation of EBP.
- Fineout-Overholt, E., Williamson, K. M., Kent, B., & Hutchinson, A. M. (2010). Teaching EBP: Strategies for achieving sustainable organizational change toward evidence-based practice. Worldviews on Evidence-Based Nursing, 7(1), 51–53.
Retrieved from the Walden Library databases.
The authors of this text suggest multiple strategies for integrating the EBP paradigm at the organizational level. The text provides rationale for why educators should also consider change at the individual level as an effective conduit for disseminating the EBP paradigm at the organizational level.
- Munten, G. van den Bogaard, J., Cox, K., Garretsen, H., & Bongers, I. (2010). Implementation of evidence-based practice in nursing using action research: A review. Worldviews on Evidence-Based Nursing, 7(3), 135–157.
Retrieved from the Walden Library databases.
This text reviews 21 action research studies to determine what is known about using action research to implement evidence-based practice. The authors explicate the promising features and flaws that were common across the action research studies they used.
- Satterfield, J. M., Spring, B., Brownson, R. C., Mullen, E. J., Newhouse, R. P., Walker, B. B., & Whitlock, E. P. (2009). Toward a transdisciplinary model of evidence-based practice. The Milbank Quarterly, 87(2), 368–390.
Retrieved from the Walden Library databases.
This article presents the primary issues and challenges in EBP across numerous health disciplines. The authors then posit a transdisciplinary EBP model designed to incorporate the strengths and diminish the flaws of each discipline’s EBP model.
- Steurer, L. M.(2010). An evidence-based practice scholars program: One institution's journey toward excellence. Journal of Continuing Education in Nursing, 41(3), 139–143.
Retrieved from the Walden Library databases.
The author of this article details the efforts of an EBP scholars program that was designed to teach an overview of EBP, along with the skills necessary to improve patient outcomes. In addition to the program’s development and implementation, the article highlights lessons learned.
Media
- Laureate Education, Inc. (Executive Producer). (2012k). Translating evidence into practice. Baltimore, MD: Author.
Note: The approximate length of this media piece is 9 minutes.
Dr. Kristen Mauk discusses the outcomes of her DNP project in this video. She explains how nurses in the rehabilitation unit where she conducted her project used the results of her project to improve their practices.
Accessible player --Downloads--Download Video w/CCDownload AudioDownload Transcript
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| Subject | Nursing | Pages | 8 | Style | APA |
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Answer
Introduction
Evidence usually features research findings, basic science knowledge, clinical knowledge, and even expert opinion (Polit & Beck, 2012). Therefore, when all these are put to use in a healthcare facility, the result is what is called evidence based practice. Unfortunately, the act of putting the evidence into practice is what poses a challenge to health care professionals. This paper will explain how a nurse can take evidence and turn it into practice, by focusing on how a culture of evidence based practice can be developed.
Significance of Evidence Based Practice in Healthcare
Evidence based practice is of great significance in healthcare in that it ensures that the quality of services offered to patients are of high quality, thus yielding desirable results (Polit & Beck, 2012). This is because it creates opportunities for nurses to provide care that is more individualized, highly effective, streamlined, and also dynamic. It further helps in maximizing the clinical judgment effects, thus resulting in patient satisfaction (Polit & Beck, 2012).
Responsibility of Nurses in Promoting Evidence Based Practice
Nurses have two main responsibilities when it comes to promoting evidence based practice. First, a nurse has a responsibility of networking to others. A nurse who understands the benefits of using evidence based approach in nursing can act as a mentor to the colleagues who may not have an idea about it (Barnsteiner et. al., 2010). This will ensure that other nurses are also persuaded to use this approach in the facility.
Second, the nurse has a responsibility of promoting accessibility to the evidence materials (Barnsteiner et. al., 2010). She also has a responsibility of ensuring that the available material is updated and of good quality (Polit & Beck, 2012). This is important because accessibility and quality are all important aspects required for efficient clinical decision making.
Responsibility of Nurses in Changing Practices to Better Reflect Evidence and Research Findings
In most organizations, introducing the evidence based approach of doing things is usually challenged by resistance to change (Aitken et. al., 2011). This is because the nurses have already gotten used to their current culture. The nurse, therefore, has a responsibility of encouraging others to adapt to the new method by explaining the advantages of evidence based practice (Barnsteiner et. al., 2010). Another reason why many nurses fail in their attempts to use evidence based practice is because they use the evidence to support the existing practices, instead of using them to develop new and improved practices (Aitken et. al., 2011). It is important to ensure that the obtained evidence is used to come up with a new way of handling decision making so as to avoid “forcing” other methods that may have grown old and inefficient (Polit & Beck, 2012).
Lastly, the nurse has a role of following five elements to ensure evidence has been moved into practice (Cullen & Adams, 2012). First, the nurse must select a specific model for evidence based practice. Second, an identification of the clinical question is required to ensure the right evidence will be collected. Third, the current evidence collected will be critiqued to rule out any that is of poor quality. Fourth, the nurse is required to evaluate the current practice being used, in relation to the clinical question. There is also a need to develop a strategy that will be used in implementing the evidence based practice change (Cullen & Adams, 2012). Lastly, after all the above have been achieved in the said order, the nurse is expected to evaluate the translation as well as the outcomes achieved as a result.
Conclusion
Although evidence based practice is common in healthcare, some professionals still do not fully understand its benefits. This is why they cannot translate evidence into practice effectively because they have not fully given up the old approach of care delivery. For the translation from evidence to practice to be successful, the five elements mentioned must be fully achieved.
References
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Aitken, L. M., Hackwood, B, Crouch, S., Clayton, S., West, N., Carney, D., & Jack, L. (2011). Creating an environment to implement and sustain evidence based practice: A developmental process. Australian Critical Care, 24(4), 244–254. Barnsteiner, J. H., Reeder, V. C., Palma, W. H., Preston, A. M., & Walton, M. K. (2010). Promoting evidence-based practice and translational research. Nursing Administration Quarterly, 34(3), 217–225. Cullen, L., & Adams, S. L. (2012). Planning for implementation of evidence-based practice. Journal of Nursing Administration, 42(4), 222–230. Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (Laureate Education, Inc., custom ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
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