...A Model for change to evidence-based practice that will guide my potential DNP project is Stetler Model. This model was based on the theoretical and research literature related to evidenced-based practice, research utilization a standardized language, and change theory. The model for change EBP model is a five progressive steps model. The steps are; Preparation phase, validation, comparative evaluation and decision making, Translation and application, and lastly, evaluation. The Stetler model for change will guide me throughout my prospective DNP project in the following ways. In Step one, it entails defining problem purpose and outcome; and searching for evidence from the literature that detailed management of hypertension, for example, is...
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...have learned, evidence-based practice is the gold standard for guiding nursing policies that result in quality care and best patient outcomes. Unfortunately, despite significant evidence supporting the need for practice change, many barriers exist that prevent integrating evidence into practice. According to Schmidt and Brown (2012), using research, nurses have a direct role in contributing to evidence-based practice changes. When a discrepancy is identified between a care standard and nursing practice, resulting in negative patient outcomes, nurses have a responsibility to take actions to change the practice. When investigating a discrepancy, nurses utilize existing evidence and research to shape new policies supported by scientific evidence. Schmidt and Brown explain that Roger’s model of diffusion mirrors the process in which evidence-based practice originates in small institutions and eventually diffuses into standards of care. According to these authors, evidence-based practice is cultivated and supported at five levels: by the individual nurse, the healthcare institution, and at the regional, national, and international levels. By involving participation at all five levels, evidence-based practice changes can be implemented and supported. The change process involved in creating policies supported by evidence is often time consuming and complex. After compiling evidence supporting the practice change, incorporating this evidence into practice and implementing...
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...Overcoming Barriers In Evidence-Based Practice University of Louisiana at Lafayette Overcoming Barriers in Evidence-Based Practice All healthcare organizations will experience some kind of change over time. When it comes to using evidence- based practice within a healthcare system, deciding on what to implement is the easy part. The hard part is implementing the practice and making it stick. There are many barriers for why implementing EBP is not easily attainable by nurses. Some of these barriers include, "lack of time, lack of value placed on research in practice, lack of knowledge about EBP, lack of technical skills to find evidence, lack of resource to access evidence, lack of ability to read research, resistance to change, and lack of organizational support for EBP” (Schmidt & Brown, 2015, p. 10-11). Personal Barriers A barrier that I can personally relate to is the resistance to change barrier. While orienting to a new job in labor and delivery, I was paired with a preceptor who was a far more experienced nurse than I was. She taught me the ins and outs of labor and delivery, as well as, explained to me why things are done the way they are done. Since she started as a labor and delivery nurse, there has been more research and more evidence-based practice strategies that have come out. My preceptor was resistant to these practices. She felt like there was no reason she should change the way she did certain things. Because she was resistant to change, I felt like I was also...
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...EVIDENCE BASED PRACTICE BENCY GNANASIGHAMANI AMERICAN SENTINEL UNIVERSITY Introduction Medical and health care is one of the most dynamic human disciplines, and large amounts of money are spent annually on high-quality and sophisticated research, resulting in an exponential growth in health care literature. Regularly, new and more effective medicines, medical devices, and procedures are invented. One major objective behind all these efforts is to help doctors, nurses, and medical technicians provide the best possible care and treatment to patients. In addition to using traditional and well-established procedures and practices, health care practitioners are adopting innovative interventions that are based on best practices as well as solid research-based evidence. Evidence-based practice is one such technique and is quickly gaining popularity due to its potential to effectively handle clinical issues and provide better patient care (ANA 2003). Implementation of Evidence Based Practice places additional demands on nurses to apply credible evidence to individual client situations through searching related evidence, using clinical judgments, and considering client values and system resources. To effectively apply the Evidence Based Practice process, in addition to the basic skills required to undertake nursing work, a nurse must have the ability to: identify knowledge gaps, formulate relevant questions, conduct an efficient...
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...NRS-433V Week 5 - Evidence-Based Practice Presentation - Healthcare Associated Infections To purchase this tutorial visit here: http://mindsblow.us/question_des/NRS-433VWeek5-Evidence-BasedPracticePresentation-HealthcareAssociatedInfections/2856 contact us at: help@mindblows.us NRS-433V Week 5 - Evidence-Based Practice Presentation - Healthcare Associated Infections NRS-433V Week 5 - Evidence-Based Practice Presentation - Healthcare Associated Infections [12 Slides + Speaker Notes] This is a CLC assignment. Choose a nursing problem from your current practice setting, and identify a possible solution to that problem. Conduct a search of the literature related to this problem. Analyze and critically appraise evidence-based literature to support the solution to the identified problem. A minimum of (5) articles must be identified. This may include guidelines from the National Guideline Clearinghouse, Joanna Briggs Institute, or a review from the Cochrane Database of Systematic Review. Prepare a 10-minute (8-10 slides; no larger than 5 MB) PowerPoint presentation related to the problem, evidence appraisal, and practice implications. Include the following components into the presentation: 1. Present the nursing practice problem with the PICOT question. 2. Discuss your appraisal of the literature that addresses the problem. 3. Present the proposed practice changes from an integration of the findings. While APA format is not required for the body of this assignment, solid...
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...Application of Evidenced-based Practice Regarding pediatric Patients and Otitis Media 1 Running head: Application of Evidenced -based Practice Application of Evidence-based Practice Regarding Pediatric Patients and Otitis Media Western Governors University Running head: Application of Evidence-based Practice 2 The nursing practice heavily relies on the evidence based clinical information to determine current standards of practice within the nursing scope of practice. A multitude of informational journals and peer reviewed articles are readily available to help guide the decisions placed into practice. The nurse is responsible for recognizing the quality of evidence collected to improve the standard of care patients receive. This paper will investigate four articles regarding the appropriate care and treatment of the pediatric population with otitis media. In addition, an appropriate recommendation for antibiotic therapy will be made based on information gathered during the research. To answer the question of whether a wait-and -see approach is recommended, an initial validation of the information collected must be determined. Four articles will be assessed based on the type of research collected as filtered, unfiltered, or general information. The source will be investigated as inappropriate or appropriate. Lastly, the articles will be classified...
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...HPNA Position Statement Evidence-Based Practice Background Increased attention is being directed toward the development of methods that can provide valid and reliable information about what works best in healthcare. The careful scientific evaluation of clinical practice became a prominent focus during the second half of the 20th century.1 More recently, attention has been paid to methods of determining which of multiple proven approaches to a healthcare problem works best for which patients.2 Evidence-based practice encompasses implementing the best-known practices into the clinical setting using a scientific approach. It evolved from evidence-based medicine, which was developed in Canada to teach medical students. “Evidence-based medicine has been defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”3, p. 3 The National Quality Forum’s report A National Framework and Preferred Practices for Palliative and Hospice Care Quality is a consensus report that is a first step toward introducing evidence-based measures into palliative practice on a formal, national level.4 The Agency for Healthcare Research and Quality (AHRQ) supports organizations in their efforts to improve the quality and efficiency of healthcare by facilitating the use of evidence-based research findings in clinical practice.5 The nursing discipline has also embraced evidence-based practice over the past 25 years, initially through...
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...Inquiry into health care Assignment 1 This essay aims to thoroughly examine the importance of evidence-based practice within the health care setting. The use of evidence-based practice as a practical framework to locate, appraise and apply the best research will further discussed throughout this essay. In addition this essay will explore how health care professionals can use the five steps of evidence based practice (EBP) as a practical framework to overcoming barriers to locating, appraising and applying the best research evidence in relation to Occupational Health and Safety (OHS). The use of hand washing in relation to infection control will be the OHS area explored. Evidence based practice is a framework that involves an expert finding experimental evidence concerning the value of or effectiveness of altered treatment options, the significance of this evidence is then established in relation to the patients situation (Liamputtong, 2010).Evidence Based Practice generates the need for clinically vital information regarding clinical and health care issues (Liamputtong, 2010). This clinically vital information is gathered by altering evidence into answerable questions, once this information is gathered the appraised information will be put into clinical practice and evaluated based on performance (Liamputtong, 2010). The importance of the five steps of Evidence Based Practice is consistent and conclusive. Before EBP, clinical knowledge was primarily relied on in areas where...
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...RUNNING HEAD: CHANGE USING EVIDENCE BASED RESEARCH Change Using Evidence Based Research Glenda Doctor Western Governor’s University Procedure, basis for practice, rationale and explanation The procedure for the use of povidone-iodine for surgical cite antisepsis is: skin preparation for surgery includes the use of sterile drapes to drape the patient and square off surgical area with sterile towels to absorb excess solution. The incision site is where the prep begins and proceeds outward from that point. Iodine soap or scrub, wet the skin with sterile water the iodine scrub will be added to the point of lather, the site is to be scrubbed for 5 minutes. Excess solution is to be blotted with sterile towels or sterile gauze. When iodine paint is used the iodine paint will be applied and allowed to dry before first incision. This practice of surgical skin preparation has been a standard for many years. At this facility povidone-iodine is used predominantly however a few surgeons do use chlorhexidine, it has typically been surgeon choice for skin preparation. Studies have shown that Chlorhexidine-alcohol is a superior product to povidone-iodine to reduce skin colonization and reduce surgical site infection, (Darouiche, Wall, Itani, Otterson, Webb, Carrick, & ... Berger, 2010). No specific use for either product was found in the policy and procedures for the hospital on the hospital web site. There were no available protocols involving the products that...
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...Evidence to Action: A Model Analysis Tera J. Gwaldis, RN St. Johns River State College July 8, 2015 Discussion In order to understand evidence-based practice (EBP), it is important to recognize that EBP is detrimental to the quality improvement of patient outcomes while also helping to control the cost of health care. EBP is an approach to problem-solving and clinical decision- making that incorporates the best available evidence from well-designed studies based on clinician experiences and patients’ principles, values and preferences (Melnyk & Fineout-Overholt, 2015). The assessment of the effectiveness of EBP models can help to decide which models would be most practical and applicable to the actual practice setting. The Iowa Model of Evidence-Based Practice stands out as a model that will be carefully deliberated for the reason that it can be used successfully to initiate a practice change at the unit and organizational levels. The Iowa model is used throughout a multitude of clinical and academic settings. This model merges research utilization and quality improvement using processes that are innately clear and logical to nurses and is unique in that it uses the concept of “triggers” meaning that evidence-based practice may possibly be prompted by either facts or data from an outside organization, or by specific clinical problems (Brown, 2014). The Ace model uses an interdisciplinary approach for conveying knowledge for use in healthcare and nursing practice...
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...Evidence Based Practices Abstract Quality nursing and outcomes have a strong correlation with evidence based practices, a model that guides patient provider decision making and health care. Evidence based practices uses contentious and judicious use of current best evidence in decision making about the care of individual patients. Strong nursing and organizational leadership is needed to invest in nurses ability and the resources to facilitate evidence based practices. With business principles applied to quality health care the return on investment can increase revenues, saving costs, increases patient safety, and achieves the highest quality care. Keywords: clinical decision making, patient safety, best health care outcomes Evidence Based Practices in Nursing Evidence based practices occurs in many disciplines but most recently it has occurred in the discipline of nursing. Evidence based practices helps to identify and recognize the best health outcomes for patients and their families obtained through clinical expertise and best scientific evidences. Health care professionals are constantly asking questions in regards to health care practices in regards to how and why practices are being performed the way they are. Health care professionals want to know if the way they are caring for a patient is the best way or is there another method that is more effective. In a dynamic health care setting these questions are being asked to ensure quality care and safety for patients...
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...Explain how evidence-based practice is utilized in your current or previous professional setting facility. As I read the article titled, “Evidence-Based Practice in Nursing”, it sets the tone and tenor to the nursing profession to include “careful review of research findings according to guidelines that nurse scholars have used to measure the merit of study or group of studies” (Mc Ewen & Wills, 2011). The one that stood out and best fit the practice at the Veteran Hospital Administration was well-defined by Miller, Ward, Young (2010) by stating” EBP, “is the process by which nurses make clinical decisions using the best available research evidence, their clinical expertise and the health care preferences of their clients”. The Veteran Hospital...
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...Evidence Based Practice Nursing Implications Evidence Based Practice Nursing Implications Evidence based practice has been changing the direction of care and clinical research with regards safety, patient centered, and cost efficient care delivered to patients. The purpose of this paper will show the importance of Evidence Based Research by defining this form of research and the importance of using the research to improve on nursing practice. It will also show research examples of qualitative and quantitative studies and how it would improve patient outcomes and nursing practice within the Neonatal Intensive Care Unit. Barriers will be discussed that prevent nursing from using and embracing the current research. Finally, the conclusions will summarize the main points of this paper. Importance of Evidence Based Research The importance of evidence based research is, and should, be the driving force on nursing practice to patients. It should go hand in hand with the critical thinking skills that nurses already have and use with regards to care. Evidence Based Research is important because it is an accumulation of information that forms clinical practice. Evidence based research incorporates the patient/family, cost, and safety of care to be delivered. It changes the care from; the way it was always done to the way research proves it should be done, which may still be the way it was always done. The difference is that the now the processes are backed by highly reviewed...
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...Teachers and school leaders: making a difference through evidence-based practice A research paper for ACT Government schools ISBN 978-0-9757487-4-9 © Australian Capital Territory, Canberra 2007 Apart from any use as permitted under the Copyright ACT 1968, no part may be reproduced by any process without written permission from the ACT Department of Education and Training, ACT Government, PO Box 1584, Tuggeranong ACT 2901. Produced for the ACT Department of Education and Training by the Measurement, Monitoring and Reporting Directorate. Telephone: Canberra 6205 9214 Fax: Canberra 6205 8353 ACT Government Homepage address 2 Introduction The purpose of this paper is to provide a research base for the ACT Department of Education and Training’s discussion paper for ACT government school teachers: Teachers and school leaders: making a difference through evidence-based practice. Evidence-based practice is defined as the collection and analysis of relevant data and research and the application of this evidence to teaching and learning and to whole school improvement. The conceptual framework of the School Excellence Initiative underpins the paper. This places student achievement and learning at the centre of any discussion. In the research literature, there are many, often contradictory definitions of data, information and knowledge. This paper will use ‘data’ as a collective (singular) noun and define terms as follows: • data: a collection...
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...in consistent protocols for central venous access devices accrue an approximately 250,000 bloodstream infections in U.S hospitals yearly (Hatler et al., 2009). An estimated 90,000 deaths a year result from these bloodstream infections associated with intravascular catheters (Hatler et al., 2009). The health care system averages $25,000 to $40,000 per incidence (Mathers, 2011). The identification of proper and/or improper practice and application of evidence-based practice protocols is essential to keeping catheter patency and prevention of infections. Definition of Topic Stated by the authors of Evidence-based Practice to Reduce Central Line Infections, “a catheter related blood stream infection is defined as a positive blood culture with clinical or microbiologic evidence that strongly implicates the catheter as the source of infection” (Render et al., 2006, p. 254). What, besides what we already are taught to perform, can be further done to reduce the percentage of blood stream infection in central venous catheters and access devices? Existing practices used for infection control of central line placement include maximal barrier precautions, which consists of strict compliance with hand hygiene, wearing a cap, mask, sterile gown, and...
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