Discussion 1: Nursing Research and Evidence-Based Practice
In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care. Nurs 6052 Week 1 Discussion: Nursing Research and EBP.
Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).
To prepare for Nurs 6052 Week 1 Discussion: Nursing Research and EBP:
Consider a recent clinical experience in which you were providing care for a patient.
Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?
What questions have you thought about in a particular area of care such as a procedure or policy?
Review Chapter 2, pages 31–34 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question. Nurs 6052 Week 1 Discussion: Nursing Research and EBP.
Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.
Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.
Post an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.
Respond to at least two of your colleagues on two different days using one or more of the following approaches:
Ask a probing question, substantiated with additional background information, and evidence.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Validate an idea with your own experience and additional sources.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional strategies for addressing barriers to EBP based on readings and evidence. Nurs 6052 Week 1 Discussion: Nursing Research and EBP.
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE ESSAY. Philadelphia, PA: Wolters Kluwer.
Chapter 1, “Introduction to Nursing Research in an Evidence-Based Practice Environment”
This chapter provides an introduction to nursing research, its history, and the evolution of evidence-based practice. It includes an overview of credible sources of evidences and a description of the different paradigms used in nursing research.
Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice”
The focus of this chapter includes an overview of the key aspects of evidence-based practice, a review of how to identify credible research and appraise its value, and, finally, a discussion on how to take the identified evidence and convert it into a practice.
Chapter 3, “Key Concepts and Steps in Qualitative and Quantitative Research”
In this chapter, quantitative and qualitative research models are compared and the major steps in each approach are described. NURS 5052/NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE ESSAY. Information is also presented on the different sections of a research journal article and how you can identify the research model that was utilized. Nurs 6052 Week 1 Discussion: Nursing Research and EBP.
Adams, J. S. (2010). Utilizing evidence-based research and practice to support the infusion alliance. Journal of Infusion Nursing, 33(5), 273–277.
WEEK 1, Evidence-Based Practice[EBP] Introduction
Week 1: Introduction to Evidence-based Practice
This week’s graded topics relate to the following Course Outcomes (COs).
- CO 3: Identify ethical issues common to research involving human subjects. (PO 6)
CO 5: Recognize the role of research findings in evidence-based practice. (POs 7 & 8)
We begin our journey into discovering the new world of research and evidence-based practice (EBP) by exploring our past. After completing the required readings and lesson, answer the following:
- Explain how research has evolved since the Florence Nightingale era.
- Discuss how research and EBP are different; include how you believe research supports EBP for nursing. Nurs 6052 Week 1 Discussion: Nursing Research and EBP.
Describe one past/historical unethical breach of research conduct; then, share how you would ensure care of a study participant using one ethical or legal research consideration (guideline/principle).
The goals of the tutorial are to clearly outline the theory of EBP and to explain how that theory can be put to practice in the day-to-day work of caring for patients. The tutorial includes an introduction and modules that follow the “5A’s Cycle” of EBP that include assessing the patient and prioritizing questions about his/her care, asking a focused clinical question, acquiring the evidence to answer the question, appraising the research, applying the research findings to patient care, and finally auditing your performance.. The cycle begins again with an assessment of the patient and the patient’s care.1
The tutorial focuses largely on efficient literature searching and therefore on asking questions and acquiring the best evidence. In particular, it suggests specific strategies for finding evidence from primary studies, systematic reviews and meta-analyses using EBP tools. Appraisal is also touched upon, with suggestions for scanning search results to identify articles more likely to yield robust, applicable evidence. Nurs 6052 Week 1 Discussion: Nursing Research and EBP
At the end of the tutorial, you should be able to:
- Formulate a clinical question using the PICO framework;
- Identify five common categories of clinical questions;
- Identify which research methodologies provide the best evidence for your question type;
- Distinguish between systematic reviews, meta-analyses and narrative or clinical topic reviews;
- Search Medline/PubMed effectively for studies likely to provide the current best evidence by
- Identifying appropriate search terms, including Medical Subject Headings (MeSH) terms; and
- Employ evidence filters such as PubMed’s Clinical Queries;
- Identify articles from your PubMed search results that are most likely to provide current, valid, reliable and relevant evidence to answer your question.
This tutorial assumes you already have some familiarity with basic and advanced PubMed search techniques, as well as with MeSH searching.
There are many excellent on-line and print guides that address the critical appraisal of a research report and the application of evidence to an individual patient’s care. You will find links to selected resources that provide especially rich content in these areas in the Appraise and Apply modules of this tutorial. Nurs 6052 week 1 Discussion
It is best to work systematically through the various modules, starting with Introduction: About Evidence-Based Practice, and then the five modules.
Reference Shelf of EBP eBooks and Books
The Library has a vast range of books and ebooks about EBP that can be found via Library Search (the Library Catalogue). The Reference Shelf in this guide lists a range of the EBP eBooks and Books by category and discipline area.NURS 6052 Discussion Essay Assignments
What is Evidence-Based Practice
What is Evidence-Based Practice?
The classic definition of Evidence-Based Practice (EBP) is from Dr David Sackett. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research”.2
EBP has developed over time to now integrate the best research evidence, clinical expertise, the patient’s individual values and circumstances, and the characteristics of the practice in which the health professional works. Nurs 6052 Week 1 Discussion: Nursing Research and EBP. 3
So, EBP is not only about applying the best research evidence to your decision-making, but also using the experience, skills and training that you have as a health professional and taking into account the patient’s situation and values (e.g. social support, financial situation), as well as the practice context (e.g. limited funding) in which you are working. The process of integrating all of this information is known as clinical reasoning. When you consider all of these four elements in a way that allows you to make decisions about the care of a patient, you are engaging in EBP.4
Why is Evidence-Based Practice Important?
EBP is important because it aims to provide the most effective care that is available, with the aim of improving patient outcomes. Patients expect to receive the most effective care based on the best available evidence. EBP promotes an attitude of inquiry in health professionals and starts us thinking about: Why am I doing this in this way? Is there evidence that can guide me to do this in a more effective way? As health professionals, part of providing a professional service is ensuring that our practice is informed by the best available evidence. EBP also plays a role in ensuring that finite health resources are used wisely and that relevant evidence is considered when decisions are made about funding health services.Nurs 6052 Week 1 Discussion: Nursing Research and EBP. 4
What happened before Evidence-Based Practice?
Before EBP health professionals relied on the advice of more experienced colleagues, often taken at face value, their intuition, and on what they were taught as students. Experience is subject to flaws of bias and what we learn as students can quickly become outdated. Relying on older, more knowledgeable colleagues as a sole information source can provide dated, biased and incorrect information. This is not to say that clinical experience is not important – it is in fact part of the definition of EBP. However, rather than relying on clinical experience alone for decision making, health professionals need to use clinical experience together with other types of evidence-based information.5
Is not all Published Research of Good Quality?
Not all research is of sufficient quality to inform clinical decision making. Therefore you need to critically appraise evidence before using it to inform your clinical decision making. The three major aspects of evidence that you need to critically appraise are:
- Validity – can you trust it?
- Impact – are the results clinically important?
- Applicability – can you apply it to your patient? Nurs 6052 Week 1 Discussion: Nursing Research and EBP.