NR 439 Discussion Where Do You Go From Here?

Over the past 8 weeks, we have been looking at how to improve our clinical practice with decisions based upon evidence. Resistance to change is often a common barrier to implementing EBP practice. Do you see yourself as a facilitator or barrier to implementing EBP? Has this course changed how you view EBP? Often I see early adopters to technology or practice changes as cheerleaders to implementing EBP. Early adopter often creates positive energy to motivate the middle adopter (Kaminski, 2011). This brings along the late adopter because they don’t want to be left behind.

This week we will focus on course outcome 5, recognizing the role of research findings in EBP.

Please share if your feelings or beliefs in nursing research and EBP have changed as a result of this course and if so, please share how they have changed. I am looking forward to seeing how you have grown into your baccalaureate role 🙂 Remember, you use research every day, in all aspects of your life. You use research to buy a car, buy a phone or pick a service provider for your phone. That is all research….you are comparing findings and picking the best option. It is the same for nursing research. So…what have you learned and how will you apply to change patient outcomes. Dr Joy

Kaminski, J. (Winter, 2011). Theory applied to informatics – Lewin’s Change Theory.CJNI: Canadian Journal of Nursing Informatics, 6 (1), Editorial. http://cjni.net/journal/?p=1210

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The past 7 weeks have been very busy. Combining family, work and studies have not been easy. I can proudly state that I have learned a lot in this class. The discussion topics, assignments were great. The feedbacks from Dr. Joyce and contributions from my peers have been wonderful. I think my feelings and believes in nursing research and evidence-based practice have changed after this course. I knew about evidenced-based practice but had no in-depth knowledge about its application in my practice. I have gained a better understanding of how to conduct research, and how to evaluate an article. Through this class, I have learned the first step in evidence-based practice which is to ask a clinical question. I have learned that in researching interventions, the PICO allows me to ask questions that are intervention focused. Through this course, I have learned that even when the best available evidence is being used in patient care, application and outcomes will differ based on patient’s value and preference. As a BSN prepared nurse, I am now able to rely on research evidence when providing patient care.

Through this course, I am now able to read an article beyond the abstract and critique the article. I can read an article and determine if the researcher’s point of view can be applied to nursing practice or not. My critical thinking skills have also improved due to this course. I can sit with other healthcare providers and brainstorm a topic using evidence-based practice. Through this course, I am able to distinguish between qualitative and quantitative nursing research. I am now aware of the fact that a qualitative nursing research is the study of phenomena that are difficult to quantify such as a patient’s illness, while a quantitative research involves quantifying data and generalizing results from a sample to the population of interest. I have also learned that no research study can totally exclude bias. This course has taught me many things when it comes to research and evidenced based practice, and I look forward to implementing what I have learned in this class in my nursing practice. The class has really improved my critical thinking skills and has taught me the importance of evidenced-based practice in providing safe and quality patient care. This course has taught me how to read research reports and select research-based evidence that can be applied in my clinical practice

Through this course, I have learned that barriers could be encountered when implementing evidence-based practice at my workplace. I have learned ways to recognize the barriers and how to manage and overcome them. As a BSN prepared nurse, I can create a climate to support change by being proactive in education and actively involved in research committees in my facility. Thank you, Dr. Joyce, for impacting us with the knowledge, it is our duty to implement what we have learned. This is my last class, and I can proudly state that I am a BSN prepared nurse, and I look forward to furthering my education. Best of luck to everyone.

References

CCN. (2017). NR-439 RN Evidence-Based Practice. Week 8 Lesson. Downers Grove, IL. Online Publication. DeVry Education

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.).Sudbury, MA: Jones & Bartlett.

I have expanded my knowledge of providing quality care for my patients by taking this class. Working as a nurse, I often question a nursing practice that could be improved. Even though an organization’s policies and procedures are designed to provide quality care and good patient outcome, sometimes there is still room for improvement. EBP can provide valuable information that can result in quality care and good patient outcome.

Understanding the importance of EPB, knowing the research process and benefits of EBP can be a valuable asset to my organization. The facility I work is a small outpatient facility owned by a large dialysis company. The policies and procedures we follow are guidelines to give excellent nursing care to patients, however, there is always a need to improve in certain areas of nursing as we care for our patients.

I have learned from this course that I can enhance quality care for my patients by using EBP in my clinic. The initial step would be to introduce EBP to my clinic and encourage my manager to organize a committee of nurses to promote EBP. The process will be identifying a problem, key words, and PICOT, based on the change needed to improve patients’ outcome.The sources we search have to be credible and not bias. We have to examine barriers that could affect the outcome. Also, we have to assure that the research process provides a result that is reliable and valid.

EBP is a good practice for nurses. Taking this course has given me a new outlook on actively implementing measures to contribute to quality patient care and good outcome of patients.

Thanks for the valuable information. I joined ANA about 2 years ago, but I’m not currently active. I will definitely inquire about membership with Chamberlain Alumni and get actively involved with ANA. I have gained vast knowledge about nursing from this course. EBP is a means of educating and benefiting nurses and patients in nursing care.

Being a member of a professional nursing organization, provides benefits of education, personal and professional development, nursing perspective, networking, and certification, as stated by Olin (2012). Collaboration with other nurses can also enhance nursing education.

Thanks, Dr. Joy for your guidance in this course. I appreciate you.

Olin, Jennifer ( 2012 ). Five Reasons to Join A Nursing Specialty Association. Retrieve from http://www.rncentral.com/blog/2012/five-reasons-to-join-a-nursing-specialty-association/

The phrase “evidence-based practice” has been bandied about in my nursing world for many years. It has been made obvious that many of the policies and procedures that are entrenched or are implemented in nursing modalities are as a result of proven successes in performing nursing functions that benefit patients. In the 1990s it became clear in the nursing world that although as knowledge workers we were actually producing new knowledge, we must also transform our knowledge into clinically useful forms that are measured in terms of its meaningful impact across the nursing/ healthcare continuum (Stevens, 2013).

This course in evidence-based practice has enlightened me on the thought processes that trigger research in the quest to improve delivery of nursing care, such as how effective are our interventions, what feelings about care exist from each side, the giver and the receiver of healthcare interventions? How can we affect change to improve lives (Houser, 2018)? We learn that research uses the descriptions generated by its subjects, in narrative form, as well as in analyzing the qualitative and quantitative values of interventions or lack of. This helps to determine how effective is present care and how we can improve what we do, which then triggers more research. Comparing and contrasting research on various topics enlightens us as to what works best and in which situations and demographics can we expect positive results. It helps us to formulate the process of change that is applicable to our nursing environment, and so can be time-saving.

This course has already enlightened me as to why we practice interventions the way we do. When new policies and procedures are implemented by my facility, I can more relate to the processes that led to the change. This course stimulates an inquiring mind as to what can we do better, and how? It addresses the ways in which one can initiate the process of how can we improve the lives of our patients by changing our approach to a particular care issue. It highlights the fact that in evidence-based practice nurses have a powerful demonstratively active voice in improving the lives of others, as we come from a perspective of thought unique to nursing, a profession that has always been intimately connected with the lives and feelings of those in our care. As a BSN prepared nurse, this course has provided me with the tools to be an integral part of the change process. I can use my newly acquired skills in nursing inquiry and in assisting in searching for and examining evidence that support new interventions in my workplace. I have learned how to propose change based on research evidence, and how to participate in the process to initiate change, or to reject a particular intervention that presents with barriers to effective change (Chamberlain, 2017). It increases my value as part of the nursing and even the entire medical care team as a change agent.

References

Chamberlain College of Nursing. (2017). NR439 RN Evidence-Based Practice. Week 8 Lesson. Downers Grove, IL. Online Publication. DeVry Education

Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones & Bartlett.

Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html

I can’t believe this is our last week and I will be starting my last class next week. Thank you all for a great 8 weeks.

My thinking has changed quite a bit about nursing research and evidence-based practice. I was one of those people who would just read the abstract then skip to the conclusion. I didn’t understand the way the studies were tested and trialled. I now actually look at how the study was tested and try to understand what is really being tested.

I would say I am more of a facilitator when it comes to implementing EBP. That is if I agree with the evidence. Sometimes, the barrier is not related to the specific change that has been proposed but rather to change itself. Change within any organization can be a difficult process (CCN Week 8 Lesson, 2017). I try to accept change with an open mind and embrace it. The more I resist, the harder it will be for me to learn the change when it is up and running.

According to Sherman (2011), “The workforce is comprised of four generations with different values, attitudes and beliefs – and some tried and true approaches in human resource management are no longer working well.” Sometimes I lose site of the age differences that we work with. Some people were born into the technology era and some nurses barely had a colored television. When we think of change, we have to keep in mind of the audience we are trying to educate and the possibility of the learning gaps that are come from each generation.

References

CCN Week 8 Lesson (2017). Implementing EBP—Where Do You Go From Here? Online Lesson Sherman, R. (2011). Why is change so hard? Retrieved from http://www.emergingrnleader.com/why-is-change-so-hardLinks to an external site.

NR 439 Discussion Where Do You Go From Here?