NR 439 Discussion The Evidence-Nursing Practice Connection
NR 439 Discussion The Evidence-Nursing Practice Connection
NR 439 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.
Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones & Bartlett.
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).
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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.
Much appreciation for your insightful and engaging post on nursing practice connection. Change as a factor you identified as one of the barriers to nurses’ engagement in evidence-based practice is a perfect point. Indeed, the fear of the unknown about what change can bring does not only affect health care issues such as evidence-based practice but also in other sectors. Therefore, successful engagement in EBP requires the mitigation of such barriers. One of the things that I feel is acting as a barrier to nurse’s engagement in evidence-based practice is heavy workloads resulting in nurses not having enough time to read from the literature (Mathieson et al., 2019). Thorough literature reading and synthesis can lead to better engagement in EBP. As you have pointed out, database search for evidence requires time and commitment as an individual has to search through several databases to obtain relevant material.
I also agree with you that involvement in nursing research completely changes how an individual views research and evidence-based practice. The student comes to appreciate the amounts of hours spent by the researchers in coming up with the published evidence and the high levels of analysis and interpretations involved. The resources available during the nursing practice process were so helpful. While the week 3 PPE worksheet was vital in helping an individual in the organization of research thoughts, the processes we were taken through for coming up with the PICOT question to guide, the evidence-based practice project was spot on. Some of the directions, such as igniting the spirit of inquiry and asking the right questions, were all useful landmarks in the research process and PICOT question formulation. Thanks a lot for sharing this class with us, and I wish you well, too, as you continue with your EBP project.
References
Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary health care research & development, 20. Doi: 10.1017/S1463423618000488Links to an external site.
One barrier that I feel prohibits nurses from engaging in EBP is lack of technological fluency. I find many older nurses have difficulties when trying to utilize electronic resources. For younger nurses who have more experience with technology, there is less of a learning curve, but many older nurses find the challenge to be too great. As a younger nurse, I often find myself having to guide older nurses through e-learns and computer based competencies and help them locate information that is available online. One strategy that could be used, and one that is already often available, is the utilization of courses designed to help individuals better navigate electronic resources. The ones offered at the hospital I work at are mostly based on the Office 365 system (things like working in Powerpoint and Word). I think a better focus would be on navigating the library and other web-based resources. Accessing these tools can seem intimidating to anyone and if there was more instruction available, I think they would be used more often. In one study, “Although half of the nurses indicated being accustomed to information retrieval in electronic resources, just as many indicated feeling insecure and having a lack of time for information retrieval.” (Lee, 2019, p. 208). In order for nurses to move towards EBP, they need to be given the proper time and resources.
My thinking about nursing research and evidence-based practice has not changed too drastically since the start of this course. I have always been a firm believer in research and knowing your sources but now I believe that I am better able to incorporate it into my practice. What I have found to be most helpful is what I have learned about sharing EBP and information with my peers and how important it is to do so. I’ve learned more that you don’t have to be in a position of leadership to bring something valuable to the table. I will continue to use this throughout my practice to inform my peers of new and interesting information that can better improve our practice. Lee, A., Alving, B. E., Horup, Mette B., & Thrysoee, L., (2019). Information retrieval as a part of evidence-based practice: Retrieval skills, behavior and needs among nurses at a large university hospital. Nordic Journal of Nursing Research. (39) 4, p. 201-208. https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edo&AN=140086122&site=eds-live&scope=siteLinks to an external site.