Introduction
Since Nightingale’s Notes on Nursing was published in 1859 (Polit & Beck, 2012), nursing research with a focus on evidence-based practice has driven patient care practices and policies within healthcare facilities. At my facility, practice changes are driven through the Practice Council of the Shared Governance Council with support from the Research Council.
Within the Organization
The concept of these councils is to empower the nurses to lead change within the facility. One barrier to the continued success of the council is some ideas within the council become stagnant and do not disseminate. Often times, the bureaucracy involved in implementing a change within the hospital slows the process, increases workload of the change agent which ultimately loses council member buy-in. Thus, disallowing a project to become implemented which is one of the many challenges to maintaining a Shared Governance Council (Moore, Strachan, O'Shea, & Leitch, 2012).
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It is the responsibility of the organization to create a culture of evidence-base practice. Instructing nursing students about EBP can require different teaching and evaluation strategies to practicing nurses (Streurer, 2010). The questions that arise from a practicing nurse may provide more information than a student of nursing. Therefore, Streuer urges organizations to adopt a model for evidence-based practice, such as the Stevens (2004) ACE Star Model of Knowledge Transformation. The phases in this model move from discovery of a clinical practice question to the dissemination of EBP findings (Streurer, 2010). As the figures in the article by Streurer (2010) depict, phases consist of discovery, summary, translation, integration and
A family nurse practitioner could apply theory, information from research, and knowledge learned in class to formulate patient education strategies as well as to create patient education material. The nursing profession advocates for evidence-based practice. This requires the nurse to know, in order to provide proper care. Therefore, it is important to link research to nursing practice because the data collected through research makes it easier to make clinical decisions (Pipe, Wellik, Buchda, Hansen, & Martyn, 2005). An understanding of nursing theory would also prove important in handling nursing dilemmas by offering a systematic guide for handling nursing issues.
I like the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, because it is a powerful problem-solving approach to clinical decision-making, and it has user-friendly tools to guide. According to Zaccagnini & White, “it is designed specifically to meet the needs of the practicing nurse and uses a three-step process called PET: practice question, evidence, and translation” (2015). The goal of this model is to ensure that the latest research findings and best practices are quickly and appropriately incorporated into patient care. Great choice!
As a result, this adjustment in practice should be prioritized. The third phase is to build a team to develop, evaluate, and implement the change in practice. The team should comprise nursing and non-nursing professionals and stakeholders from the organization or unit. This team should be in charge of developing,
Following the practice stage is the evidence phase, this particular phase evidence is conducted and evidence is screened, rated, and summarized. Recommendations are then suggested based on the results of the evidenced obtained. Lastly, the translation phase a plan is
Evidence base practice (EBP) is a proactive methodology to improving patient care. Nurses are now called upon to research, identify and analyze practice problems so that questions can be answered on how to deliver care. Therefore, the translation of research into practice require strategies such as protocol and guideline to disseminate EBP within an organization (Yoder-Wise, 2015). By researching barriers to breastfeeding in the neonatal intensive care (NICU), policy changes are noted to be indicated.
According to Matthias & Kim-Godwin (2016), nurses who pursue a BSN degree encounter increased self-assurance and proficiency, enabling them to take charge of implementing change in practice based on evidence derived from research. As a baccalaureate-prepared nurse, my role in an interprofessional team would be to communicate effectively with team members, share my knowledge and critical thinking skills, and utilize evidence-based practice that meet the needs of each
Shared governance is an innovative model used to provide direction for the professional practice of nursing. This model is used to direct nurses to participate in unit-based decision making that allow nurses to demonstrate accountability and ownership for their practices. The goal of the model is to improve quality patient care contain costs, and retain nursing staff. According to Marquis and Houston (2012), “In shared governance, the organization’s governance is shared among board members, nurses, physicians, and management” (p. 270-271). Shared governance is imperative in the healthcare institutions.
EBP has its own language and concepts, that some health professionals have not had the opportunity to understand. However there are tools available to assist. Databases such as Medline which is available on the internet via the PubMed interface provide tools to enhance knowledge and decision making as information may be reviewed and classified for you. Melnyk et.
1. Define research, nursing research, and evidence-based practice, and describe the purposes of research in implementing an evidence-based practice. Research is investigating and studying of materials and sources to establish facts and reach new conclusions or to report knowledge about something. Research can also mean to validate something that already exists based on some kind of theory.
The term Evidenced-based practice (EBP) is one of the most talked about concepts in healthcare. Nursing scholars, worldwide, have sought to provide healthcare workers with the evidence from research to be transform this into clinical care. To ease this transference of data into practice, scholars have developed EBP models. These models direct the researcher with the process from hypothesis to implementation of the data. The perplexity of EBP is that the data can come from research, clinical experience, patients, or local context and environment (Rycroft-Malone, et al., 2012).
In the strategic planning process, the structure of the clinical integration network is defined, the economies of scale are established, and the shared savings are developed. According to Miller, McWilliams, and Hankwitz (n.d.), an organization that has implemented an information system to measure and report quality and cost-effectiveness to payors, choose those physicians that are on board with the goals of the organization, and that has made not only financial but human investment in the development of the processes for achieving care competence are considered a clinically integrated network. The planning stage includes creating a vision statement that explains the purpose of the clinical integration network, what the goals are, and what the organization will look like in a couple of years (Miller, McWilliams, & Hankwitz, n.d.). Once the structure and governance have been developed, committees can be established which oversee credentialing, budgets, care management, and implementation of data systems, for example (Miller, McWilliams, & Hankwitz, n.d.). Financial management includes the pooling of resources, global capitation, a common form used for population needs-based funding, and system funding which is used for insured health systems (Suter, Oelke, & Adair, 2009).
1. CONCEPT 1-EVIDENCE-BASED PRACTICE IN NURSING This concept was deducted from module 2 with the topic “Concept of Evidence-based practice”. Evidenced-based nursing is a way of making decision and providing nursing care that is based on clinical issues and combine it with the most current, relevant research that is available on that issue. Evidence based nursing utilize the most up to date method of providing care, which have been proven via assessing high quality studies and statistically with significant research findings.
In the clinical setting, the nurses’ expertise can be used to make clinical assessments and recommendations for routine care at a lower cost than a physician visit. This would increase the number of patients seen and increase the quality of the care provided. The advance practice nurse would be able to hone in on preventative measures and increase patient education. The advance practice nurse can also make recommendations about practice changes needed to facilitate better health outcomes through the use of evidence-based practice. Nursing leaders are aware of how important nursing science is to provide needed evidence to transform practice, even though, finding the time and resources to support any research activity is often challenging (Stone, 2017).
Before EBP was imbedded into healthcare, nurses relied in the advice of senior nurses and what they learned through education and trial and error. Floranc enightengal ……. However, it wasn’t until the mid-1800s that evidence-based medicine had its beginnings, but did not come into play until the year of 1972. Through many years different modifications, various groups of nurses have drafted their own versions of evidence-based practice guidelines into play.
I believe you must understand the core of patient/ person to practice evidence-based nursing. I am dealing with many different patients daily with so many different health concerns I start my plan of care by assessment and observation. Utilizing my nursing skills looking for any signs related to possible health issues. This is the beginning of my head to toe assessment. While establishing my assessment I am constantly asking questions to build a nurse patient relationship.