NR 439 Week 8 Discussion: The Evidence-Nursing Practice Connection
NR 439 Week 8 Discussion: The Evidence-Nursing Practice Connection
One barrier I believe that prohibits nurses from engaging in Evidence-bases practice (EBP) is uncertainty due to lack of knowledge/educational support (Ginex, 2018). To solve this problem, we need to ensure the nurses have access to resources, and time to investigate them. We need to encourage the nurses share what they have learned with other staff members (Houser, 2018). The staff meeting is a good place to building the culture of inquiry and research; we can ask questions, generate evidence-based discussion; we can review new evidence-based policies and procedures relative to patients; we can measure the effectiveness of the evidence-based on care given; we should encourage any suggestions of how change can be implemented on the unit. The problems in daily nursing practice can be translated into questions, and answered with research evidence (Houser, 2018).
I have very little knowledge related to research until I take this course. The research knowledge and skills that I learn from this course give me confident to conduct quality improvement projects on my unit; and the PICOT questions format is the most useful tool for me to get start. I have learned how to look for and read strong research evidence to answer my clinical questions; and develop the strategic plan to facilitate the scientific evidence into our nursing practice. Nurses are responsible for promoting research, transferring research evidence to bedside to improve the health of individuals and groups in our society (Houser, 2018).
Ginex, P. (2018). Overcome barriers to applying an evidence-based process for practice change. May 30, 2018 by Pamela K. Ginex, EdD, RN, OCN®Links to an external site. https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-changeLinks to an external site.
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Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones & Bartlett.
I found that many nurses don’t engage in EBP due to a lack of knowledge to find credible sources. As a newer nurse, I didn’t know much about EBP and the impact it has on nursing practice. I feel better reading many posts where they had little knowledge about EBP as well. I think it is a great idea to have a discussion during a staff meeting and come up with evidence-based ideas to practice, then evaluate the effectiveness of care at the next meeting. Getting input from the bedside nurse is the best way to gain knowledge as to what can be improved upon. You did an excellent job on your post. Thank you for sharing.
Question 1.
Think about nursing practice and describe one barrier that you feel prohibits nurses from engaging in EBP, share one strategy you could use to facilitate the use of evidence to help improve nursing care for patients.
I think that one of the barriers may be support of management, available resources and manpower. Smaller facilities there may be resistance from the staff, unwilling to adapt to change. Not seeing the benefit or need to change their practice. I would engage my peers and brainstorm what intervention that we could do as a team that would improve patient care and outcome which would improve our nursing practice. It could go back to nurse hourly rounding. Each nurse interacting with the patients that are assigned to them for that 12 hour shift, the patient care board is marked off on an hourly basis, to assist with any needs, toileting, pain management comfort care etc. Each charge nurse would keep the data via the assignment sheets which has the patients and their nurses. At the end of a 6 week period, the data from a short discharge survey which is developed by the team members on the patient’s perception of their care could be reviewed and the results presented to management. This is something we could do as nurses that wouldn’t be costly it would increase patient satisfaction, decrease call light usage and improve nursing practice. EBP is the use of the best scientific evidence, integrated with clinical experience and incorporating patient values and preferences in the practice of professional nursing care. Houser (2018).
Question 2.
Reflect back over your time in the course and describe how your thinking has changed about nursing research and evidence based practice; describe one new learning during this course that you believe was the most helpful.
This course showed and encouraged me that nurses are an important part of the care team. We are the ones that execute the interventions, we’re that know what interventions that are the most effective. We can make a large impact on outcomes. Previously I called it brainstorming, I know now it was EBP we were practicing on a more casual level. This course has showed me the proper steps to set up and execute successful EBP research. Starting with an idea or question and the necessary data it takes to validate a proposed intervention. Will the intervention have positive patient care outcomes? Improving nursing practice. I feel that nursing is the driving force of patient and the outcomes and through EBP we have the power to improve and restore patient care outcomes.
Reference.
Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th edition). Jones & Bartlett
One barrier that I feel prohibits the nurses from engaging in EBP is the notion of change. Humans, in general, do not like change. We like consistency…and when someone proposes a change, people want to know why. Trying to defend the “why” is where EBP (and nurses) run into barriers. Houser (2018) talks about the Systemic Review as one strategy to help facilitate the use of evidence to improve nursing care. The systematic review is, “a highly structured and controlled search of the available literature that minimizes the potential for bias and produces a practice recommendation as an outcome,” (p. 460). Houser highlights a number of systematic review databases, such as the BET, CCTR, DARE, HTA, NHS EED, and TRIP, that can be used to support any evidence-based research. These databases provide an unbiased, exhaustive review in conjunction with a methodological evaluation of the study at hand (Houser, 2018).
Upon reflection of my time in this course, I can say that my thinking about EBP and nursing research has changed in a way that is more appreciative for those that conduct these studies. Especially in these times, when everyone wants everything done at lightning speed, the amount of time and effort put into these studies can be arduous, time consuming, and (dare I say) not fun at all! The amount of discipline it takes to follow through with an EBP and nursing research project is certainly to be admired. These individuals help provide the insight as to why nurses and other healthcare disciplines do things the way we do them (Godshall, 2010).
The one new learning tool that I believed was most helpful to me was the week 3 PPE Worksheet. The PPE worksheet helped me organize myself and my thoughts about potential research topics. It provided the foundation for which the research platform can be built upon. I am currently doing an EBP project at my work and the PICOT worksheet helped me present my idea to my mentors.
It has been a pleasure being in this class with all of you! Thank you for all of your insight and best of luck in all your future endeavors!
References:
Godshall, M. (2010). Fast Facts for Evidence-Based Practice: Implementing EBP in a Nutshell. New York:
Springer Publishing Company. https://eds-a-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/detail/detail?vid=3&sid=d7dcba5c-84cb-49c6-abe9-2c17fcf355f4%40sessionmgr4008&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=307460&db=nlebkLinks to an external site.
Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones & Bartlett.
I had not thought about your perspective on this discussion and it really opened my mind to that concept. Going into this profession I had expected there to be constant change, and always heard that nursing is a never ending learning career, and that expectation is real, but I also think that the change is fascinating and were here to witness it and see it through and that’s remarkable! Although the change is uncomfortable, it makes us grow and become better, and who doesn’t want to become better? If it helps the patients too, then I’m all for it no matter how much I don’t like change. However, the changing of the visitor policies in my hospital almost everyday were very annoying!
I enjoyed this class as well and wish you the best of luck!
