In the AHRQ website, there is an abundance of reliable articles backed up by EBP. I was able to find several articles listed under the research tab relating to medication error prevention, primary care, and chronic care research. A study that used the AHRQ guidelines under their research methods incorporated the SHARE Approach suggested by the AHRQ to improve shared decision-making (SDM) amongst healthcare providers and patients. The SHARE approach follows five SDM steps to guide decisions related to patients’ plan of care (Hargraves, I., Fournier, A., Monton, V., & Bierman, A., 2020). The study concluded that employing the SHARE approach positively impacted communication among patients and physicians.

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A second study used the AHRQ’s Health Literacy Universal Precautions Toolkit to perform a brown bag medication review to increase medication adherence. Patients were required to bring all their medications to their medical appointment and received teaching on each of their medications (Murtha, E., Elder, B., & Faragher, M., 2019). This study showed that using the AHRQ’s toolkit resulted in significant health outcomes and consistent adherence to medication regimens.

Since I was unaware of AHRQ’s existence, my perception of this organization did not change. Nevertheless, I will undoubtedly use AHRQ as a reliable source of information for future research. I also found it beneficial to have free access to hundreds of reports in the AHRQ website. NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice Overall, after reviewing the number of research studies conducted, I am impressed with the number of evidence-based findings produced, which can improve the quality of healthcare provided to patients in the U.S.A.

References

Agency for Healthcare Research and Quality (AHRQ) (2019). AHRQ’s Core Competencies. https://www.ahrq.gov/cpi/corecompetencies/index.html

Hargraves, I., Fournier, A., Monton, V., and Bierman, A. (2020). Generalized shared decision-making approaches and patient problems: Adapting AHRQ’s SHARE Approach for purposeful SDM. Patient education and counseling.https://doi.org/10.1016/j.pec.2020.06.022

Murtha, E., Elder, B., & Faragher, M. (2019). Brown bag medication review: Using AHRQ’s brown bag medication tool. Journal of Nursing Care Quality, 35(1), 58-62.DOI: 10.1097/NCQ.0000000000000399 NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice

Hi Alberto,

Your description of your experience in exploring a healthcare organization website (AHRQ) and learning about how EBP was utilized there was nicely stated. It is difficult to enculturate EBP at an organization. An article by Sanares-Carreon et al. (2015) offers an interesting perspective on how to fast track EBP at the bedside. Do you agree that this novel pathway would encourage enculturation of EBP?

Thanks,

Dr. Sullivan

Sanares-Carrion, D., Comeau, O.,  Heliker, D., Marshall, D., Machner, D., Bell, L., …Sandridge, J. (2015). An educational pathway to fast track evidence-based practice at the bedside. Journal of Nurses ProfessionalDevelopment 31(1), E1-6. doi: 10.1097/NND.0000000000000113

NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice  Agency for Health care Research and Quality (AHRQ) website is one of my favorite health care organization websites. You are right; it has got an incredible amount of evidence-based research data. Failure to adhere to medication is a serious problem that affects the patient and the health care system. Medication non-adherence in patients leads to substantial worsening of the disease, death, and increased health care costs. Research shows medication nonadherence is due to a lack of health literacy. AHRQ’s primary objective was to assess whether the use of this tool helped those practices improve the rate with which patients bring all their medications to office visits for review. A second objective was to investigate the percentage of patients who had drug therapy problems identified during the reviews and whose medication regimens were modified due to reviews performed before and after implementing the tool. Evaluation before and after implementation revealed a 3-fold increase in the percentage of patients who brought all their prescription medications and a 6-fold increase in the number of prescription medications brought to office visits. The percentage of reviews in which drug therapy problems were identified doubled, as did the percentage of medication regimens revised (Weiss et al., 2016) NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice.

References

Conduct Brown Bag Medicine Reviews: Tool #8. AHRQ. (2020, September). https://www.ahrq.gov/health-literacy/improve/precautions/tool8.html.

Weiss, B. D., Brega, A. G., LeBlanc, W. G., Mabachi, N. M., Barnard, J., Albright, K., … West, D. R. (2016). Improving the Effectiveness of Medication Review: Guidance from the Health Literacy Universal Precautions Toolkit. Journal of the American Board of Family Medicine: JABFM. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5091803/#:~:text=The “brown bag medicine review, to their clinician for review. NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice

Alberto, your post was very informative in describing the Agency for Healthcare Research and Quality (AHRG). Evidence-based practice is beneficial in nursing because it can reduce costs and improve the outcomes of patients.  According to Rahmayanti et al., (2020), evidence-based practice is fundamental in nursing in improving patient care. Since, 1998 AHRG became the  parental company with the U.S. Preventive Services Task Force (USPSTF)  (U. S. Preventive Services Task Force, 2020). One of the goals of the USPSTF is the use of the evidence-based practice to prevent diseases and clinical recommendations and services (U. S. Preventive Service Task Force, 2020).

The USPSTF has similar goals as AHRG. Both have a purpose for health systems in providing evidence-practice about delivering safe, high-quality, high-value healthcare and for frontline clinicians to offer strategies to high-quality, safe, high-value healthcare (Agency for Healthcare Research and Quality, 2019). The USPSTF is also bounded to evidence-based practice and tries to secure the quality of recommendations and safety.

References

Agency for Healthcare Research and Quality. (2019). AHRQ’s Core Competencies. Retrieved March 2, 2021 from https://www.ahrq.gov/cpi/corecompetencies/index.html

Rahmayanti, E. I., Kadar, K. S., & Saleh, A. (2020). Readiness, Barriers and Potential Strenght of Nursing in Implementing Evidence-Based Practice. International Journal of Caring Sciences, 13(2), 1203–1211. Retrieved  March 3, 2021 from 44_rahmayanti_original_13_2 (internationaljournalofcaringsciences.org)

Hi Everyone,

Welcome to the first week discussion board. For this week you are to reflect on the definition and goal of EBP. Then find a healthcare organization’s website and explore the site to determine the where and what extent EBP is evident.

It is always a good idea to use subheadings on the discussion board postings, for a couple of reasons. One it helps you to be sure you have addressed all of the expectations and two it keeps you focused. For this week your subheadings could be the following:

• Healthcare Organization Website Review
• EBP Utilization
• Grounding of EBP
• New Perception of Healthcare Organization

I look forward to reading your discussions.

Thanks

Dr. Sullivan

According to Melnyk et. al., (2014), evidence-based practice (EBP) has been widely adopted in the clinical setting because it improves healthcare safety, reliability, quality, and patients outcomes. EBP also reduces the overall cost of care. However, to effectively implement EBP, healthcare organizations and caregivers must cultivate the spirit of inquiry, ask clinical questions, search for quality evidence, assess the evidence, implement that evidence and evaluate the results or outcomes before sharing (Melnyk and Fineout-Overholt, 2018). This procedure is evident in the healthcare organization website reviewed in this discussion post.

Hence, the healthcare organization website I reviewed is known as the Center for Evidence and Practice Improvement (CEPI). CEPI is an organization to conducts and supports research work and synthesize evidence on care delivery and improvement. The organization’s mission is to generate evidence to make healthcare higher quality, safer, equitable, more accessible, and affordable (Center for Evidence and Practice Improvement, 2014).   The organization’s philosophy is centered on generating new knowledge, synthesizing evidence, translating research on what works in healthcare delivery, and encourages practice improvement across the clinical setting.  It is evident that EBP appears in the organization’s mission and core philosophy (Center for Evidence and Practice Improvement, 2014).

So, CEPI’s work is centered on five divisions. One of the categories is the “evidence-based practice center program,” which generates evidence synthesis by undertaking systematic evidence appraisals or reviews using rigorous and robust methodologies (Center for Evidence and Practice Improvement, 2014). The organization also advances evidence evaluation and synthesis approaches to ensure unbiased reviews and scientific rigor (Center for Evidence and Practice Improvement, 2014). The information I have found on the website has made me understand that EBP can only be a practical care delivery approach or model unless implemented appropriately (Crabtree et al., 2016). For example, healthcare organizations should focus on the value of data to produce knowledge from rigorously synthesized research NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice.

References

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving patient care through nursing engagement in evidence-based practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. Retrieved February 28, 2021 from doi:10.1111/win.12126.

Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(1), 5-15.  Retrieved February 28, 2021 from https://doi.org/10.1111/wvn.12021.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Hi Maame,

Thank you for such a nice description of your experience in exploring a healthcare organization website ( Center for Evidence and Practice Improvement ) and learning about how EBP was utilized there was nicely stated. One of your articles in your week 1 resource list, Melnyk et al. (2010) does a nice job of summarizing the seven steps of EBP. We will follow this format in this class, did you find this article helpful in understanding the basic concepts of EBP?

Thanks,

Dr. Sullivan

http://download.lww.com/wolterskluwer_vitalstream_com/PermaLink/NCNJ/A/NCNJ_165_516_2010_08_23_DGSODKGNM_1651_SDC516.pdfMelnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51–53. doi:10.1097/01.NAJ.0000366056.06605.d2.

The article was very helpful in understanding evidence practice.  With thorough reading, I can learn about evidence-based that aids in pinpointing strategies to help my patients in my organization.  With the knowledge gained from this reading, I am confident about how much emphasis I will place on a study, report,  and clinical practice guidelines when making decisions about a patient’s care.

Dr. Sullivan

The article was very helpful in understanding evidence practice.  With thorough reading, I can learn about evidence-based that aids in pinpointing strategies to help my patients in my organization.  With the knowledge gained from this reading, I am confident about how much emphasis I will place on a study, report,  and clinical practice guidelines when making decisions about a patient’s care.

Dear Maame,

I agree with your statement that evidence-based practice improves health care quality and reduces the cost associated with it. Health care decisions backed up with proof will reduce the associated errors, and thus, the quality of health care will upsurge (Li et al., 2019). Your choice of Center for Evidence and Practice Improvement is commendable since it is an organization whose primary purpose is to support evidence-based practice in the area of jurisdiction. The organization’s mission and philosophies connect an evidence-based approach, making them champion research work and improve healthcare quality. The organization produces evidence fusion by undertaking systematic evidence assessments by using strong and vigorous procedures which are essential in supporting evidence-based practice. I have enjoyed reading your work. Keep it up.

References

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice. Medicine, 98(39), e17209. https://doi.org/10.1097/md.0000000000017209

Evidence-based practice is a conscientious way of providing health care through a problem-solving approach to clinical practice that incorporates the best evidence from well-designed studies, patient values and preferences, and clinical expertise in patient care decision-making (Titler, 2008). Health care agencies, government agencies, and national professional organizations support evidence-based practice (EBP). Studies continue to show improved outcomes when the best evidence is used to deliver patient care.

Healthcare Organization website reviews

The healthcare organization that I chose is Advent Health Systems, Florida. The organization’s mission and promise are to help you feel whole through compassionate care and world-class expertise (Advent Health, 2021).

EBP Utilization

Evidence-based practice (EBP) is one such technique and is quickly gaining popularity due to its potential to handle clinical issues and provide better patient care effectively. The care plans are based on hard science, data, and the latest research at advent health. Advent health uses EBP in various day-to-day operations. They provide excellence in patient care through improvement projects and research data to compare the patient outcomes with other hospitals. EBP enables nurses to evaluate the research to understand the risks or effectiveness of a diagnostic test or treatments.

Grounding Of EBP

Advent health website says clinical trials are the mainstay of evidence-based care. The Advent Health team conducts hundreds of clinical trials each year; currently, more than 550 clinical trials underway at Advent Health, which gives access to exclusive recent treatment options to improve whole-person treatment. I work at CVICU always gets passionate about clinical trials based on cardiovascular research. It is essential that nurses follow evidence-based practice; recently, there was a clinical trial, oxygen requirement of COPD patients after cardiac surgery in my ICU. Many clinicians are concerned about worsening hypercarbia and respiratory failure when oxygen is administered to this group of patients. EBP shows that patients should receive the necessary amount of oxygen to maintain an oxygen saturation just above 90% (B. Ibanez et al., 1970).

Another evidence-based practice for patient safety is recommending a strict transfusion protocol for cardiac surgery patients with hemoglobin levels below 7 g/dL. Blood transfusions are reasonable and lifesaving if the patient exhibits hemodynamic instability. The study shows that blood transfusion in cardiac surgical patients can lead to increased short-and long-term mortality, organ injury, stroke, myocardial infarction, sepsis, surgical site infections, and increased use of health care resources with prolonged intensive care hospital stays (Patel & Murphy, 2017).

Perception of Healthcare Organization

By reviewing this website, goals and evidence-based practice have positively changed my perception of this organization. I like the CREATION life principles of this organization Choice, Rest, Environment, Activity, Trust, Interpersonal Relationships, Outlook, and Nutrition — designed to improve health and happiness by living a balanced life. Also, they are committed to providing the best and quality care for their patients based on evidence-based practice (Advent Health, 2021).

Conclusion

Clinicians can achieve tremendous outcomes in patients care through EBP. Still, they often fail to share their experiences with colleagues and their own or other health care organizations, which can lead to needless duplication of effort and perpetuates clinical approaches that are not evidence-based.

References

A Leader in Whole-Person Health Care. AdventHealth. (2021). https://www.adventhealth.com/.

B. Ibanez, S. J., PT. O’Gara, F. G. K., WJ. Powers, A. A. R., A. Kobayashi, A. C., CM. Morkane, H. M. K., Meyhoff, C. S., … RAC. Siemieniuk, D. K. C. (1970, January 1). Oxygen administration for postoperative surgical patients: a narrative review. Journal of Intensive Care. https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-020-00498-5.

Patel, N. N., & Murphy, G. J. (2017, June 21). Evidence-Based Red Blood Cell Transfusion Practices in Cardiac Surgery. Transfusion Medicine Reviews. https://www.sciencedirect.com/science/article/abs/pii/S0887796317300470.

Titler, M. G. (2008, April). The Evidence for Evidence-Based Practice Implementation. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. https://www.ncbi.nlm.nih.gov/books/NBK2659/.

Hi Sherin,

You did a nice job describing your experience in exploring a healthcare organization website ( Advent Health Systems, Florida.) and learning about how EBP was utilized there was nicely stated. One of your articles in your week 1 resource list by Boller (2017) discuss the quadruple aim sweet spot. What do the authors mean by this this title?

Thanks,

Dr. Sullivan

Boller, J. (2017). Nurse educators: Leading health care to the quadruple aim sweet spot. Journal of Nursing Education, 56(12), 707–708. doi:10.3928/01484834-20171120-01

Hi Erin,

You have presented a nice description of your experience in exploring a healthcare organization website (WHO) and learning about how EBP was utilized there was nicely stated. One of your articles in your week 1 resource list, Melnyk et al. (2014) discuss  a “set of clear EBP competencies for both practicing registered nurses and APNs in clinical settings that can be used by healthcare institutions in their quest to achieve high performing systems that consistently implement and sustain EBP.”(p. 5) Do you think having these competencies is a good idea?

Thanks,

Dr. Sullivan

Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(1), 5–15. doi:10.1111/wvn.12021. https://sigmapubs.onlinelibrary.wiley.com/doi/full/10.1111/wvn.12021

Shannon McBrayer Response to Erin Ward

          Erin, the World Health Organization (WHO) has great potential to impact global health as the organization committed to overall global health matters. I perused the website to see just how much mention of evidence-based practice I could find. The first place I like to look is the section that talks about an organization. In About Us, I found the section on the WHOs values and DNA which describes professionals that are “guided by the best available science, evidence and technical expertise” (WHO, n.d., About Us tab). Part of what the WHO does is provide information in the form of nearly 200 fact sheets on health topics such as Autism, abortion, Hepatitis, Chikungunya, Poliomyelitis, mercury health, HIV/AIDS, and many more global health concerns (WHO, n.d., Fact sheets tab). Many of these fact sheets have WHO recommendations regarding the health issue and some specifically state they are evidence-based recommendations. 

          I did find a section on WHO Academy to begin online in May this year, that was spoke to the challenge of getting the latest evidence and information disseminated to healthcare providers who can use it, noting it can take 10 years to implement new practices (WHO, n.d., About WHO tab). Melnyk & Fineout-Overholt (2018) note this problem stating that translating new evidence into practice can take many years or decades because clinicians lack the evidence-based practice skills to apply and use in their practices. The fact that the WHO has recognized this problem and is taking measures to address it is a true indicator of their commitment to a global movement toward evidence-based practice. 

References

Melnyk, B., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice ( 4th ed.). Wolters Kluwer.

World Health Organization. (n.d.). Retrieved March 6, 2021. https://www.who.int

Evidence-Based Nursing

The evidence-based practice incorporates the greatest research proof with clinical knowledge and patient standards (Li et al., 2019). It implies that when health specialists make a treatment pronouncement with their client, they ground it on their medical knowledge, the client’s inclinations, and the best existing proof. EBP is significant due to its purpose to offer the most effective nursing care that is accessible, intending to enhance patient results. Patients presume to obtain the most nominal care grounded on the paramount accessible evidence (Lehane et al., 2018, p. 107).  The healthcare organization that I select to evaluate for evidence-based practice information is the American Academy of Medical-Surgical Nurses.

I noticed that evidence-based practice data is contained on the American Academy of Medical-Surgical Nurses’ website. American Academy of Medical-Surgical Nurses has a practice tab on the website and professional publications for a broad range of health-related matters that are made by applying evidence-based practice research information easily accessible (Academy of Medical-Surgical Nurses, 2021). The website also has data gathering tools that the American Academy of Medical-Surgical Nurses uses to gather and scrutinize data on modern subjects that influence the association (Gigli et al., 2020). American Academy of Medical-Surgical Nurses seems to be grounded in evidence-based practice by applying the technique to back up the information related to the health matters that are accessible on the website and publications.

American Academy of Medical-Surgical Nurses’ duties are focused on the various section. One of the section is the “practice,” which holds evidence fusion by making methodical evidence evaluations or assessments by applying difficult and vigorous practices. American Medical-Surgical Nursing uses too much research to base their investigations and back up their publication, which is very rich in knowledge (Academy of Medical-Surgical Nurses, 2021). Observing the American Academy of Medical-Surgical Nurses’ work and publication, I gain enough confidence as the work is dully validated.

References

Academy of Medical-Surgical Nurses. (2021). Practice | Academy of Medical-Surgical Nurses (AMSN). Www.Amsn.Org. https://amsn.org/practice

Gigli, K. H., Davis, B. S., Ervin, J., & Kahn, J. M. (2020). Factors Associated With Nurses’ Knowledge of and Perceived Value in Evidence-Based Practices. American Journal of Critical Care, 29(1), e1–e8. https://doi.org/10.4037/ajcc2020866

Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., O’Connor, M., Corrigan, M., Burke, F., Hayes, M., Lynch, H., Sahm, L., Heffernan, E., O’Keeffe, E., Blake, C., Horgan, F., & Hegarty, J. (2018). Evidence-based practice education for healthcare professions: an expert view. BMJ Evidence-Based Medicine, 24(3), 103–108. https://doi.org/10.1136/bmjebm-2018-111019

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice. Medicine, 98(39), e17209. https://doi.org/10.1097/md.0000000000017209

Hi Margareth,

You have offered a great description of your experience in exploring a healthcare organization website ( American Academy of Medical-Surgical Nurses) and learning about how EBP was utilized there was nicely stated. Kaplan et al. (2014) discuss the problem of how EBP is not widely adopted. Their study conducted a survey after an interviention of increase EBP confidence. Do you think their intervention has merit?

Thanks,

Dr. Sullivan

Kaplan, L., Zeller, E., Damitio, D., Culbert, S. & Bayley, B. (2014). Improving the culture of evidence-based practice at a Magnet hospital.  Journal for nurses in professional development 30(6), 274-280. https://www.nursingcenter.com/cearticle?an=01709760-201411000-00002&Journal_ID=54029&Issue_ID=2651313

Margareth,

Thanks for the information you shared regarding the American Academy of Med-Surg’s (AMSN) website.  When I visited

their website, one of the first things that I noticed was the Professional Development area. As nurses, we must be informed in the

evidence in order to base our practice it.  It is clear to me through all the resources offered by the AMSN (2021) like CEs, access

to medical journals, webinars and more, that they place education and growth as a top priority.  I agree that this organization is

grounded in evidence-based practice and encourages nurses towards achieving the quadruple aim. With continuing education

and professional education, we as nurses can improve population health, enhance the patient experience, decrease healthcare

costs and improve our own work-life (Laureate Education, 2018).

References 

Academy of Medical-Surgical Nurses. (2021). Professional Development | Academy of Medical-Surgical Nurses (AMSN).

https://www.amsn.org/index.php/career-development/professional-development

Laureate Education (Producer). (2018). Evidence-based Practice and the Quadruple Aim [Video file]. Baltimore, MD: Author.

Week 1 Response Post to Margareth

Margareth,

I never knew about the Academy of Medical-Surgical Nurses. It’s good to see their web page. I found the information to be grounded in EBP research as well. I am not a member of the organization but If you are a member, they have access to research articles using the database CINAHL and MEDLINE Access (Academy of Medical-Surgical Nurses, 2021). That is the database I enjoy searching on the Walden library as well. This database is full of rich EBP research and nursing practice. I enjoyed reading over the article by Crabtree et al. (2016), as they discuss how to process of EBP works by identifying the issue and then finding a solution so that the patient has the best experience possible. I agree with you, the work in this website is credible and validated.

Resources

Academy of Medical-Surgical Nurses. (2021). Practice. Academy of Medical-Surgical Nurses (AMSN). https://amsn.org/practice

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving patient care through nursing engagement in evidence-based practice. Worldviews on Evidence-Based Nursing, 13(2), 172-175. doi:10.1111/wvn.12126

Main Posting

American Association of Critical-Care Nurses

American Association of Critical-Care Nurses website review

The American Association of Critical-Care Nurses (AACN) is a not-for-profit health care organization established in 1969. The directors are critical and acute care nurses who provide professional and personal support to the patients and communities (“About American Association of critical-care nurses – AACN,” n.d.). AACN has evolved over the years. In the 1970s, they changed the organization’s name from the American Association of Cardiovascular Nurses (AACN) to the American Association of Critical-Care Nurses. The change was an effort to acknowledge a broader diversity in critical illnesses. As they continued their growth, they obtained credentialing approvals for certification and certification renewals for critical care registered nurses (CCRN) in the United States (“Complete history of American Association of critical-care nurses – AACN,” n.d.).

In the 1980s, they started the Critical Care Nurse Clinical Practice Journal to provide current, evidence-based information on acutely and critically ill patients’ bedside care. Subsequently, they initiated the Clinical nurse specialist (CNS) specialty certification for CNS educated at the master’s level to improve care delivery for all age groups (“Complete history of American Association of critical-care nurses – AACN,” n.d.). In the twenty-first century, the AACN released the Standards of Professional Performance for the Critical Care Clinical Nurse Specialists. Essentials of Critical Care Orientation (ECCO), Progressive Care Certified Nurse (PCCN) specialty certification, and Basic ECG Interpretation are learning resources implemented in that era (“Complete history of American Association of critical-care nurses – AACN,” n.d.).

EBP utilization

The American Association of Critical-Care Nurses has proven to employ evidence-based practice (EBP) in its operations. Primarily through the educational programs provided. The information is visible on the website, as most of their programs, webinars, and journals are accessible online. The standard of conduct, mission statement, privacy, and policy statements are other locations on their website promoting EBP. They also dedicate a section with a list of evidence-based practices under the Clinical resources menu on their website (“AACN levels of evidence,” n.d.).

The AACN firmly promotes EBP.

The AACN promotes EBP and guides nursing care in a safe work environment. I believe they firmly practice under EBP because they are an accredited nurse organization. Moreover, they posted the levels of evidence on their website outlining their methodologies for ascertaining research base resources (“AACN levels of evidence,” n.d.).

My perceptions of the AACN

I have been a member of the AACC since 2017. from time to time, I purchase courses that are relevant to my career development. Therefore, I knew that that the organization is credible and displays examples of professional ethics. My perception of this organization has been positive for over three years. They are a model and a guide to the nursing profession and healthcare industry. Over the years, acute and critical care professional nurses look towards AACN for expert knowledge, recommendations, and motivation to deliver quality care (“About American Association of critical-care nurses – AACN,” n.d.).

References

AACN levels of evidence. (n.d.). https://www.aacn.org/clinical-resources/practice-alerts/aacn-levels-of-evidence

About American Association of critical-care nurses – AACN. (n.d.). https://www.aacn.org/about-aacn

Complete history of American Association of critical-care nurses – AACN. (n.d.). https://www.aacn.org/about-aacn/complete-history-aacn

Discussion Week 1

Definition and Goal of Evidence-Based Practice

Evidence-based practice is a paradigm and lifelong problem-solving approach to clinical decision making that involves the conscientious use of the best available evidence with one’s own clinical expertise and patient’s values and preferences to improve outcomes for individuals, groups, communities, and systems (Melnyk, B. M., & Fineout-Overholt, E., 2018). The goals of evidence-based practice are to enhance healthcare quality, improve patient outcomes, reduce costs, and empower clinicians. These goals are known as the quadruple aim in healthcare (Melnyk, B. M., & Fineout-Overholt, E., 2018).

Healthcare Organization Website Review

The professional healthcare website I chose to review was the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). The AWHONN is devoted to making a difference in the lives of women and newborns. They are committed to the health of women and newborns. Evidence-based practice is demonstrated in the mission statement “Empower and support nurses caring for women, newborns, and their families through research, education, and advocacy (AWHONN, 2020).” The goals of this organization are to promote diversity and inclusion in our organization and profession, advocate for critical issues that impact nursing care to women and newborns while developing collaborations with other communities and organizations, maximize the member experiences, advance AWHONN as the trusted leader in research, education, and evidence-based practice, and invest in people, technology, and facilities to advance the mission of the organization (AWHONN, 2020). These goals demonstrate evidence-based practice.

EBP Utilization

This organization uses EBP in every aspect of its work. They are constantly collaborating with researchers and professionals in women’s care and newborn care to provide the best evidence-based practices and recommendations for care. An example of this would be the “Go the Full 40” campaign (AWHONN, 2020). Many women think of their pregnancy as only 9 months, however, a full pregnancy is completed at the end of the 40th week or the 10^th month. Many providers feel like this is the appropriate amount of time for mother and child. The AWHONN website includes a tool that can be shared with expecting mothers. The goals of the initiative are met when all women who are expecting are informed and supported in their pregnancy.  The program ensures all women receive care that facilitates the physiologic processes of labor and birth. Another example would be the publication of the Healthy Mom, Healthy Baby magazine (AWHONN, 2020). This gives expecting mothers and new mothers information that they may not be able to obtain from other sources. These goals and initiatives are dedicated to sharing information learned from research and are used to collaborate with other initiatives.

Grounding of EBP

This organization is grounded in EBP. Many professionals associated with AWHONN are well respected in the women and newborn care community and are healthcare experts in the field. The information and research associated with AWHONN are considered as one of the best information websites available. The information is held in such high regard that policies and procedures in healthcare facilities are based on the research and recommendations that the organization releases.

New Perception of Healthcare Organization

I had always held the AWHONN to high standards. After reading more on the website, it became clear to me that this was an exceptional website for information and education. This website is an evidence-based practice. For example, the learning material to the magazine subscription. I cannot begin to name everything included but look for yourself. It is an eye-opener. As nurses and providers in healthcare, we must stay informed of what is happening in our areas of practice, and we must stay informed of what is happening within the organizations in which we are members (Laureate Education, 2018). This website covers it all.

References

AWHONN (2020). Association of Women’s Health, Obstetric and Neonatal Nurses.https://www.awhonn.org

Laureate Education (Producer). (2018). Introduction to Evidence-Based Practice and Research[Video file]. Baltimore, MD: Author.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing &healthcare: A guide to best practice (4th ed.).                          Philadelphia, PA: Wolters Kluwer.

Healthcare Organization Website Review & Evidence-Based Practice Utilization

Evidence-based practice helps the quality of healthcare, reduces costs, empowers clinicians, and improves patient outcomes (Melnyk & Fineout-Overholt, 2018).  The Healthcare Organization that I have reviewed is the Florida Health Department in Polk County.  The evidenced-based practice (EBP) is shown on the initial About Us tab on the home screen.  Within this screen, it tells you their mission, vision, values, and has a link that takes you to their strategic plan and goals for the year 2019-2022 (Florida Health Department of Polk County, 2019).  Their mission is “to protect, promote, and improve the health of all people in Florida through integrated state, county, and community efforts” (Florida Health Department of Polk County, 2019).  Their Vision statement is “to be the healthiest state in the nation” (Florida Health Department of Polk County, 2019).  They use the ICARE acronym which stands for innovation, collaboration, accountability, responsiveness, and excellence” (Florida Health Department of Polk County, 2019).

Grounding of Evidence-Based Practice

            The Florida Health Department in Polk County is grounded when it comes to evidenced-based practice.  They use Mobilizing for Action through Planning and Partnership (MAPP) using four different assessment themes to support and form their EBP; these themes are the forces of change, community theme and strengths, local public health system assessment, and community health status (Florida Health Department of Polk County, 2012).  MAPP was created by the National Association of County and City Health Officials (NACCHO) in support of the Centers for Disease Control and Prevention (CDC) and performed every three to five years (Florida Health Department of Polk County, 2012).

New Perception of Healthcare Organization

            This website gives more information and links than I had expected.  All of this information would be extremely helpful to educate patients and the community to utilize this EBP to improve health within themselves, the community, and much more.  I know as a Nurse I am supposed to be very resourceful but I can honestly say I continue to be amazed on the new information and resources I have obtained in less than a week of starting this class.  One example of being amazed is I did not know that Polk County has a strategic plan that they layout with goals every four years, they find out the needs of the community and what they need to work on have it displayed in lay terms for the public to read; this is a WOW, did not know this (Florida Health Department of Polk County, 2019).

References

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4^th ed.). Philadelphia, PA:  Wolters Kluwer.

Florida Health Department of Polk County.  (2019).  About Us.  Retrieved from http://polk.floridahealth.gov/about-us/index.html

Florida Health Department of Polk County. (2012).  Mobilizing for Action through Planning & Partnerships.  Retrieved from http://www.floridahealth.gov/provider-and-partner-resources/community-partnerships/floridamapp/state-and-community-reports/polk-county/_documents/polk-cha.pdf

Florida Health Department of Polk County.  (2019)  Strategic Plan 2019-2022.  Retrieved from http://polk.floridahealth.gov/about-us/_documents/Polk_StrategicPlan.pdf

Thank you, Kelly.  I find it interesting that Florida and Virginia’s Department of Health’s vision is the same.  After researching most states’ visions are the same.

Grounding of EBP

EBP is defined as the conscientious use of current best evidence concluded from a systematic search for and critical appraisal of the most relevant and best research (Melnyk & Fineout- Overholt 2018). Supporting evidence can be implemented in clinical practice through rigorous research (external), or through quality improvement projects or outcome management (internal). In my opinion, healthcare institutions should adhere to EBP clinical practice guidelines when caring for all patients across the lifespan.

In the year 2000, the Institute of Medicine released a report that 100.000 patients die a year due to medication errors (Boller 2017). In an effort to provide safer and more effective care a subsequent report was released by IOM that focused on five core competencies: patient centered care, interprofessional collaboration, EBP, quality improvement and informatics (Boller 2017). Incorporating EBP has reinvented how we care for patients, and like any new concept has created barriers. Nurses, physicians, and healthcare professionals contribute barriers to EBP due to lack of knowledge or skill, cultures steeped in tradition, lack of belief, and overwhelming patient loads to name a few (Melnyk & Fineout- Overholt 2018). To overcome barriers, it is essential for healthcare organizations to establish and incorporate an organizational culture and system- wide readiness to implement EBP (Melnyk & Fineout- Overholt 2018.

EBP Utilization

EBP is the fundamental goal standard of nursing. Adopting and implementing EBP is essential to ensure optimal patient outcomes and quality of care (Kim, et al 2016). According to an article release on Worldviews of Evidence- Based Nursing, higher levels of education and advanced practice nurses had stronger EBP beliefs and greater EBP implementation (Kim, et al 2016). As we prepare to advance our careers in nursing leadership it is most important as healthcare professionals that we develop a way to incorporate current EBP similarly to the commitment of lifelong learning to promote high quality care and improve patient outcomes.

Healthcare Organization Website Review and Perception

The Joint Commission (TJC) is a non-profit organization that accredits and certifies more than 21,000 health care organizations in the Unites States. TJC provides a standard to healthcare organizations to achieve high-quality cost-effective care and reduce harm to patients. I believe the work and contributions of TJC is supported by EBP through Targeted Solutions Tools (TSTs), workshops, and online programs led by experts to highlight performance barriers to improve the safety of patients.  National patient safety goals are recognized by stakeholders and experts and assessed yearly for quality and safety improvement to be sure that care is updated and relevant to current health care issues. TJC also releases reports that are accessible on the website to remain current with expectations that are accompanied with rationale and references. My perception of TJC has not changed I consider their contributions the gold standard for healthcare organizations and nursing to improve patient care and outcomes.

References

Boller, J. (2017). Nurse educators: Leading health care to the quadruple aim sweet spot. Journal of Nursing Education, 56(12), 707–708. doi:10.3928/01484834-20171120-01

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. doi:10.1111/wvn.12171

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Hi Sheena,

You have offered a nice description of your experience in exploring a healthcare organization website ( Joint Commission) and learning about how EBP was utilized there was nicely stated. One of your articles in your week 1 resource list, Sikka et al. (2015) discus the triple aim. Did you see any mention of the triple aim in the organization’s website?

Thanks,

Dr. Sullivan

Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in work. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160. https://qualitysafety.bmj.com/content/qhc/24/10/608.full.pdf

As mentioned by Sikka et al (2015) Triple Aim focuses on redesigning healthcare systems in an approach to delivery high value care in the United States. Triple Aim initiatives include improving individual experiences of care, improving health population, and reducing costs (Sika, et al 2015). The Joint Commission addresses Triple Aim as their mission to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. Reduction in healthcare costs is not mentioned in any of the mission and vision statements. However, improving   care to adhere to evidence base practice guidelines will decrease hospital length of stay, risk of nosocomial infections, and decrease risk of falls overall reducing healthcare costs.

Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in work. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160

For Consumers. (n.d.). Joint Commission Resources. https:// www.jointcommission.org/resources/for-consumers/

Week 1 Discussion

The selected organization is the American Nurses Association (ANA). ANA is an organization that was established to lead as well as shape the future of nursing and healthcare in America. The organization provides nurses with ethics that inform their practice. The assessment of the information contained in the website of ANA shows it to support evidence-based practice. Evidence-based practice is seen in its certifications, articles, books, and courses. The certification that ANA offers supports evidence-based practice in nursing (ANA, n.d.-c). For example, the certification in general nursing seeks to ensure that the nurses have adept knowledge and skills in applying best evidence into the decisions made in caring diverse populations. The courses that ANA offers also supports evidence-based practice. For example, courses such as osteoarthritis management, epilepsy care, and nasogastric tube management that the organization offers advocates the use of evidence-based data. Lastly, the organization publishes articles that relate to evidence-based practice (ANA, n.d.-a). An example can be seen in its article that focuses on the use of cardiac resynchronization therapy to reduce readmissions among patients with heart failure.

The assessment of the website of the organization shows that its work is grounded on evidence-based practice. The organization utilizes evidence-based practice interventions to accredit its nurses. The organization also advocates the use of evidence-based practices in nursing practice. The ANA provides opportunities for continued professional development for nurses that are evidence-based (ANA, n.d.-b). Based on the above, it can be argued that the work of ANA is grounded on EBP. The information that I discovered from the organization’s website has changed my perception of the health organization. The information has made me understand the critical role that ANA plays in ensuring professionalism in nursing. The information has also made me understand the organization’s role in advocating for evidence-based practice.

References

ANA. (n.d.-a). American Nurses Association. ANA. Retrieved February 26, 2021, from https://www.nursingworld.org/ana/

ANA. (n.d.-b). ANA Continuing Education. ANA. Retrieved February 26, 2021, from https://www.nursingworld.org/education-events/ana-continuing-education/

ANA. (n.d.-c). Nursing certifications: Our Certifications | ANCC. ANA. Retrieved February 26, 2021, from https://www.nursingworld.org/our-certifications/

Hi Basirat,

Thank you for such a nice description of your experience in exploring a healthcare organization website ( American Nurses Association) and learning about how EBP was utilized there was nicely stated. One of your articles in your week 1 resource list, Melnyk et al. (2010) does a nice job of summarizing the seven steps of EBP. We will follow this format in this class, do you agree that EBP culture should be the first step?

Thanks,

Dr. Sullivan

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51–53. doi:10.1097/01.NAJ.0000366056.06605.d2. http://download.lww.com/wolterskluwer_vitalstream_com/PermaLink/NCNJ/A/NCNJ_165_516_2010_08_23_DGSODKGNM_1651_SDC516.pdf

Basirat, thanks for sharing important information about the American Nursing Association (ANA).  Besides utilizing EBP in their philosophy and scope of practice guidelines, the ANA is perhaps the largest collective voice for the nursing profession.  The ANA incorporates evidence-based information from Agency for Healthcare Research and Quality (AHRQ) into a toolkit that ANA members are able to access and utilize in both practicum and academic research (Agency for Healthcare Research and Quality: a Profile, 2014).  The other important component is that the ANA is known to encourage safe and ethical work environments, health and wellness for nursing staff, and advocate for issues that affect nurses and the nursing profession both at the local and national level (ANA, n.d.).  This is a great platform for nursing voices to be heard in hopes of bringing about change in a positive way to our sacred profession. While I was browsing through the website, I realized that the ANA had 3 companies under its umbrella to include the all-important American Nurses Credentialing Center (ANCC).  I had no idea that this agency was part of ANA.  Thanks for sharing everyone!

References

Agency for Healthcare Research and Quality: a Profile. (2014, March). Retrieved on March 5, 2021, from https://www.ahrq.gov/cpi/about/profile/index.html

ANA (n.d.) American Nurses Association. ANA. Retrieved March 5, 2021, from https://www.nursingworld.org/ana

       Evidence base practice is useful in the clinical decision making process and is described as looking for patterns

and problem solving approaches with the best available evidence. Couple these clinical decisions with your own

clinical knowledge plus the patients ideas and values results in better outcomes for patients and communities. Goals

for evidence-based practice can be described as the quadruple aim in health care. These goals include elevating

health care quality, enhancing patient outcomes, cost reduction and effectiveness of services, and give clinicians a

clearer picture of what to treat and how dependent on patient preference and best outcomes (Melnyk & Overholt,

2019). Barriers to evidence-base practice include resistance to change, previous practice habits, limited education

on evidence-base practice , and limited support from administrative personnel (University of Texas, 2017). Boiler,

2017, describes the ability of nurses to bring health care disciplines together to promote patient safety, quality,

population health which is affordable. Development of efforts to make a more cohesive health care system could and

should be developed when patients are the center of care.

Health Care Organization Review 

The Patient-Centered Outcomes Research Institute (PCORI), is a non-profit institute created in 2010 through the

Affordable Care Act.  The PCORI was created to improve relevance and quality of evidence for all stakeholders,

patients, clinicians, employers, insurance and policy makers to make informed decisions (PCORI, 2021).

EBP Utilization 

The PCORI funds research on patient outcomes rather than comparison of patients. The outcomes of health

decisions consider what is important to the patient and providers to promote use of evidence-base practice. PCORI

funds studies to compare health care options to attempt to see which intervention is most effective. Increasing

quantity and quality , useful information for making the best health decisions. The PCORI wants to increase the use

of patient centered outcomes and influence other research to become patient centered. The vision for PCORI is

providing patients and the general public with information to make informed decisions about health outcomes. The

mission for PCORI is the provision of high quality, evidence base practice information which includes patients,

caregivers , and health care providers . The philosophy of PCORI is the incorporation of all stakeholders involved

within the health care system which will lead to improved clinical decision making and improved outcomes.  A

strategic plan is in place which includes the engagement of all stakeholders in the the research process. development

and promotion of patient-focused research, funding of patient-centered research, disseminate findings and support

implementation, and development of an infrastructure for conducting research. Core values include usefulness,

transparency, patient centered, inclusiveness, and evidence-base outcomes (PCORI, 2021).

This is a new institute to me. The goals and mission of this institute sound patient and goal centered. The research

performed is based on patient outcomes with the hope for others to look for EBP during research to include

patients and not just be research subjects.

References 

Boiler, J. (2017). Nurse educators: Leading health care to the quadruple aim sweet spot. Journal of Nursing Education. 

       56 (12), 707-708. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.3928/01484834-20171120-01

Melnyk, B. & Fineout-Overholt, E. (2018). Evidence-based practice in nursing and healthcare: A guide to best practice.

       (4th ed.). Philadelphia, PA : Wolters Kluwer

The Patient-Centered Outcomes Research Institute, PCORI . (2021)https:// www.pcori.org

University of Texas, (2017). Evidence-Based Practice (EBP) : The Problem-Solving Approach, 2017.

http://academicpartnerships.uta.edu/articles

Teresa,

Thank you for highlighting the goals of the Patient- Centered Outcomes Research Institute (PCORI).  PCORI’s mission to help people make better-informed healthcare decisions by producing and promoting evidence-based research guided by patients and other stakeholders would have a significant impact on how our patients view healthcare and the recovery process. As reported by Melnyk and Fineout- Overholt (2018) EBP leads to the highest quality of care and best patient outcome, without current EBP care becomes outdated which can be detrimental to the patent. Healthcare organizations, such as PCORI, familiarizes the nurse to incorporate EBP when caring for all patients thus educating the community on healthcare options that are beneficial to the patient.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Evaluation and Analysis. (n.d.) Patient- Centered Outcomes Research Institute. https:// www.pcori.org/about-us/our-programs/evaluation-and-analysis

Peer Response 2

Teresa,

I agree that evidence-based practice (EBP) is an essential clinical decision-making approach because it uses research evidence to solve patients’ medical problems. It involves integrating collected research findings in clinical practices to improve patient’s outcomes by providing them with individualized patient care. Wu et al. (2018) states that EBP enhances medical procedures by enabling nurses and caregivers to stay updated on current and advanced medical practices that facilitate efficient patient care.

Furthermore, through EBP, health care workers could use documented and previously successful interventions that relate to a patient’s medical condition, thus increasing the chances for the patient’s recovery. Ideally, it enables nurses to determine the most effective and safest ways to address a patient’s medical condition.

EBP is useful in research, as depicted in its utilization by the Patient-Centered Outcomes Research Institute (PCORI). According to Fleurence et al. (2015), this organization facilitates research on patient-centered outcomes, which works in conjunction with evidence-based practice. A patient-centered outcome approach aims to study the patients’ experience by actively involving them to determine a medical intervention’s effectiveness. As such, the patient’s examination is the evidence of the research, which would be useful in providing a customized medication for various patients.

With the mentioned barriers posing a considerable drawback to the full realization of evidence-based practice in all healthcare systems, PCORI is based on a detailed study to address those delimiting concerns. The organization can use its documented patient’s examination outcome to prove to those who have reservations on the practicability of EBP that it is a viable process (Kim et al., 2016). Therefore, it would convince the skeptical individuals that the approach would make their work more comfortable and efficient, thus helping resolve the barriers to implementing the evidence-based practice approach.

References

Fleurence, R., Whicher, D., Dunham, K., Gerson, J., Newhouse, R., & Luce, B. (2015). The patient-centered outcomes research institute’s role in advancing methods for patient-centered outcomes research. Medical Care, 53(1), 2-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4336314/

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail?vid=2&sid=560b8646-a181-49b0-937e-4026d53e80a0%40sdc-v-sessmgr03&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=000388307700002&db=edswsc

Wu, Y., Brettle, A., Zhou, C., Ou, J., Wang, Y., & Wang, S. (2018). Do educational interventions aimed at nurses to support the implementation of evidence-based practice improve patient outcomes? A systematic review. Nurse Education Today, 70, 109-114. https://www-sciencedirect-com.ezp.waldenulibrary.org/science/article/pii/S0260691718304738?via%3Dihub

Hi Jenny,

It was interesting reading about your experience in exploring a healthcare organization website (Georgia Department of Human Services) and learning about how EBP was utilized there. Many organizations will state that EBP is part of their mission statement. Did you feel that the organization you referenced had a culture of EBP?

Thanks,

Dr. Sullivan

Main Discussion Post #1

When you think of a healthcare organization that promotes patient safety and quality evidence-based care, what is the first organization that comes to mind? For me, many healthcare organizations like the Joint Commission (TJC), Agency for Healthcare Research and Quality (AHRQ), and Centers for Medicare and Medicaid Services (CMS) come to mind. These organizations are central to utilizing evidence-based practice (EBP) to achieve a high-quality patient outcome. This discussion thread will review the Joint Commission’s impact on quality evidence-based practice (EBP) care and my perception of the benefit of using TJC.

Healthcare Organization Website Review

This discussion thread’s chosen organization website review is TJC, an organization that accredits hospitals for their high-quality and safe care. TJC has a long-standing claim of helping hospitals like my workplace transform into high-reliability organizations where zero harm is the norm (TJC, n.d.). BY achieving TJC’s accreditation, hospitals can further improve outcomes for their patients through certification programs. TJC provides standardized core performance measure sets for hospital operations for improving healthcare quality.

Through TJC’s accreditation process, my workplace learns state-of-the-art performance-improvement strategies in delivering safe and efficient care. TJC also provides invaluable education through online education services and interactive web-based tools that TJC provides us. My workplace also provides an entire online education section on the hospital’s intranet dedicated to TJC’s standard measures.

Utilization and Grounding of EBP

My workplace is a good ambassador for the use of EBP. Like many experts like Melnyk et al. (2019, p. 328), the nursing leaders at my workplace identified quality values of applying EBP to improve patient outcomes. The nursing managers ensure that EBP measures are aligned to our care to enhance an effective, safe, and efficient care delivery. At my workplace, the nursing managers cultivate a culture where nurses can safely implement EBP measures. The hospital makes sure that resources like safety databases and enough computers and space are available for nurses to review the care they provide. Our nursing leader empowers us by allowing the nurses to review, question, and apply EBP measures within their scope.

New Perception of Healthcare Organization

My perception of TJC remained the same from day one when the organization was known as the Joint Commission and Accreditation of Healthcare Organization (JCAHO). Their mission continues to improve health care and ensuring that hospitals excel in providing safe and effective care of the highest quality. Even with the name change, the mission remains the same! TJC has long-standing quality measures that hold hospitals like my workplace accountable for health-related outcomes. They do so by offering an unbiased assessment of the hospital’s patient care and safety.

References

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving patient care through nursing engagement in evidence-based practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. doi:10.1111/wvn.12126

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51–53. doi:10.1097/01.NAJ.0000366056.06605.d2

The Joint Commission. (n.d.). Who we are. Retrieved from https://www.centerfortransforminghealthcare.org/?_ga=2.74874452.719431498.1614739573-1477116417.1613390888

H David,

Thank you for such a nice description of your experience in exploring a healthcare organization website (AHRQ)  and learning about how EBP was utilized there was nicely stated. One of your articles in your week 1 resource list, Melnyk et al. (2010) does a nice job of summarizing the seven steps of EBP. We will follow this format in this class, do you agree that EBP culture should be the first step?

Thanks,

Dr. Sullivan

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51–53. doi:10.1097/01.NAJ.0000366056.06605.d2. http://download.lww.com/wolterskluwer_vitalstream_com/PermaLink/NCNJ/A/NCNJ_165_516_2010_08_23_DGSODKGNM_1651_SDC516.pdf

David, thank you for your post. Evidence-based practice(EBP) involves using the application of numerous sources of knowledge, such as using clinical expertise and research (Horntvedt et. al., 2018). As nurses, our primary goal is to demonstrate and educate our staff and new patients on how EBP is essential for patient outcomes. Some nurses perform a particular task because it has been done that way for so long. When we voice out to patients and family that practices done on EBP can result in excellent patient care outcomes. Healthcare providers share a common goal throughout the world: providing safe and high-quality care to our patients. The Joint Commission’s goal is to boost the public’s healthcare by joining forces with other team members (The Joint Commission, 2021).

References

The Joint Commission. (2021). Evolving with care. Retrieved March 4, 2021 from https://www.jointcommission.org/about-us/evolving-with-care/

Horntvedt, ME, T., Nordsteien, A., Ferman, T., & Severinsson, E. (2018). Strategies for teaching evidence-based practice in nursing education: a thematic literature review. BMC Medical Education, 18, 172. Retrieved March 4, 2021 from https://doi.org/10.1186/s12909-018-1278-z

Introduction

In healthcare, we strive to provide top-tier service to our patients. Using evidence-based practice is the standard practice within healthcare in order to protect and promote our patients’ health. Evidence-based practice is used as we, as healthcare professionals, make leaping medical advances through research and studies. By keeping up with the most recent evidence-based practice, we are able to give our patients the best possible care NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice.

Healthcare Organization Review

The website I chose to review is the Centers for Disease Control (CDC). The CDC website provides us with the most up-to-date information regarding various diseases such as the most recent Coronavirus. The CDC is known as the nation’s health protection agency – keeping the country in the loop regarding emerging diseases and outbreaks. According to the website, “[the] CDC saves lives and protects people from health threats” (CDC, 2021).

EBP Utilization

NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice The CDC website is a reputable source for current news and updated information regarding various diseases. It states that this organization “is the nation’s leading science-based, date-driven, service organization,” which is exactly what evidence-based practice is. The CDC has many prevention programs guided by evidence-based practice such as the Advisory Committee on Immunization Practices (ACIP), which is run by medical and public health experts that together develop recommendations on how to use vaccines and control diseases in the United States. They have most recently updated the recommended vaccines for both children and adults as of October 2020 (CDC, 2021).

Conclusion

When looking for reputable resources regarding healthcare, the CDC website is always a safe bet. The goal of the CDC is to promote health and prevent outbreaks in the United States. Therefore, the use of evidence-based practice is a must; to stay current in research and inform the surrounding population of potential health threats. Finding that this website uses EBP did not change my view, as I know that they are the standard for updated information for the US.

Centers for Disease Control and Prevention (2021, January). CDC Organization. https://www.cdc.gov/about/organization/cio.htm

Centers for Disease Control and Prevention (2021, March). Advisory Committee on Immunization Practices (ACIP). https://www.cdc.gov/vaccines/acip/index.html

Hi Taylor,

You did a nice job describing your experience in exploring a healthcare organization website (CDC) and learning about how EBP was utilized there was nicely stated. One of your articles in your week 1 resource list by Kim et al. (2016) discuss how a fellowship program improved job satisfaction, EBP implementation, and group cohesion. Can you explain how the program improved EBP implementation? NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice

Thanks,

Dr. Sullivan

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. doi:10.1111/wvn.12171

         Taylor Sikes, the website you selected for your analysis, has become extremely relevant in recent times. The Center for Disease Control (CDC) is an evidence-based organization that has been at the forefront of the battle against COVID-19. The CDC’s mission is centered around population health and promoting public safety in our nation and abroad. NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice To save people from significant health threats, the CDC continuously conducts evidence-based scientific research concerning potential health threats and provides resources to guide the appropriate response when these arise (Centers for Disease Control and Prevention, 2020). One of the necessary components of gaining public trust is consistently producing reliable guidelines generated from evidence-based practice.

According to Melnyk et al. (2014), evidence-based practice research strives to provide highly reliable data, enhance healthcare quality, and improve the standards of care. Interestingly enough, the CDC also provides resources to us on topics other than the usual COVID19 recommendations. According to the Journal of Environmental Health (2020), these topics range from “preventing environmental causes of foodborne illnesses and outbreaks” to “addressing threats to health from recreational water and drinking water.” As you mentioned, the CDC is always a “safe bet” when you need reliable information associated with health.

References

Centers for Disease Control and Prevention. (2020, March). Data and Research. U.S. Department of Health and Human Services. https://www.cdc.gov/publichealthgateway/data-research/index.html

Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(1), 5–15. doi:10.1111/wvn.12021

Use Resources From the Centers for Disease Control and Prevention to Strengthen Environmental Health Programs. (2020). Journal of Environmental Health, 83(5), 24–26.

Main Post

Healthcare professionals adopt evidence-based practice (EBP) to achieve quality and safe care (Horntvedt et al., 2018). EBP approach helps health organizations search for information that can enhance patient satisfaction and safety and empower nurses and clinicians to improve health outcomes. Nurses and doctors use this evidence-based information to make clinical decisions to improve patient outcomes (Melnyk & Fineout-Overholt, 2018). In this discussion, I have focused on the National Institutes of Health’s (NIH) website to explore if it uses EBP data NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice.

NIH is a federal agency in the United States focusing on biomedical research, supporting, and saving patients’ lives (National Institute of Health, 2017). The healthcare organization’s website utilizes clinical trials to answer scientific questions regarding diagnosis, prevention, and treatment of different diseases. Much of the NIH’s website information is evidence-based, as they are found on the research and training section on the website. Also, NIH has twenty-seven centers and institutions, which coordinate and conduct biomedical clinical trials on its behalf.

National Institutes of Health uses clinical trials to study illnesses, evaluate interventions, and medical interaction on health outcomes. As NIH uses clinical trials, different stakeholders, such as the government, policymakers, and researchers, must revisit procedures and policies to protect patients for effective healthcare outcomes (Vardeny et al., 2019). Therefore, the healthcare organization’s data is grounded in EBP based on its evidence on clinical trials’ information.

The healthcare organization’s website summarizes research evidence and links to actual research articles. The summary provides healthcare providers with effective information when they need to make clinical choices without reading entire articles (Boller, 2017). For example, I retrieved an article with information about schizophrenia. By clicking the link on the article, I was directed to a summary of the article with information on schizophrenia, such as its causes and how it can be prevented.

Currently, I am a Registered Nurse (RN) at an all-male prison, a mental health camp. As an RN working at a mental health camp, I extensively used NIH’s website to learn about mental illnesses. I have also used the information to educate my patients. Therefore, the healthcare organization’s website provides useful information, which healthcare professionals can use to guide their patients and family members on different treatment options.

Overall, the information I discovered from NIH’s website has changed my perception of the healthcare organization, especially on how healthcare practitioners use current evidence-based data and healthcare technology to advance patient outcomes.NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice For example, when a patient with a mental health problem presents with vague signs and symptoms, a healthcare practitioner can utilize advanced diagnostic tools to search for the causes of the disease and offer effective treatment using EBP. Furthermore, the information on NIH’s website is free; patients and their family members can obtain evidence-based articles and current clinical trials, such as those for COVID-19, to stay updated with current healthcare evidence. With this information available, patients with chronic illnesses can find and discuss their medical history with their healthcare providers to receive better treatment options.

In summary, the National Institutes of Health’s website showed that NIH work is grounded on evidence-based practice. This institution uses clinical trials to conduct several biomedical researches for improving patient outcomes and saving lives. Therefore, I recommend that healthcare professionals use NIH’s website to enhance health outcomes by using EBP NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice.

References

Boller, J. (2017). Nurse educators: Leading health care to the quadruple aim sweet spot. Journal of Nursing Education, 56(12), 707–708. https://www-proquest-com.ezp.waldenulibrary.org/docview/1972281107?accountid=14872

Horntvedt, M. E. T., Nordsteien, A., Fermann, T., & Severinsson, E. (2018). Strategies for teaching evidence-based practice in nursing education: a thematic literature review. BMC Medical Education, 18(1), 1-11. https://link.springer.com/article/10.1186/s12909-018-1278-z

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice.

National Institute of Health (2017). Mission and goals. National Institute of health, turning discovery into health. https://www.nih.gov/about-nih/what-we-do/mission-goals

Vardeny, O., Hernandez, A. F., Cohen, L. W., Franklin, A., Baqai, M., Palmer, S., Bierer, B. E., & Cobb, N. (2019). Transitioning to the National Institutes of Health single institutional review board model: Piloting the use of the Streamlined, Multi-site, Accelerated Resources for Trials IRB Reliance. Clinical Trials, 16(3), 290–296. https://doi-org.ezp.waldenulibrary.org/10.1177/1740774519832911

Shannon,

NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice Thank you for providing insight on the ENA framework used to care for patients in the Emergency Room. Its apparent that the ENA has focused on redesigning care in the ED that focuses on Triple Aim initiatives’ which include improving individual experiences of care, improving health population, and reducing costs (Sikka, et al 2015). As a critical care nurse, I am aware of the hard work and heroic efforts portrayed by the ED team to diagnose and stabilize the patients in so little time. It is essential to utilize those initial moments for patients seeking care to ensure the first couple hours of care are being used effectively, such as TBI’s, sepsis and STEMI’s. I am elated that there is an entire organization geared toward providing current researched based solutions to improve the clinical outcome of our patients. EBP leads to the highest quality of care and best patient outcome, without current EBP care becomes outdated which can be detrimental to the patent (Melnyk & Fineout- Overholt 2018).

Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in work. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice.

Excellent post Shannon. The healthcare organization you reviewed, Emergency Nurses Association (ENA), has so many interesting things going on. A simple search for EBP on the website reveals links to many projects completed by nurses; impact of POC influenza testing to how to be a first responder for a colleague to name a few. I agree with you, there is an underlying commitment to EBP across the ENA website and embedded throughout much of their research. There is even a message of the importance of EBP in the ENA mission, “Emergency care evolves through lifelong learning and a culture of inquiry for the discovery and integration of evidence-based research into emergency nursing practice” (ENA, n.d.). I cannot envision any other area of nursing where EBP would need to be utilized more than the emergency department. Understanding the EBP reduces costs, improves patient outcomes, and helps shape the quality of healthcare is seen repeatedly in the ED (Melnyk & Fineout-Overholt, 2018).

References

Emergency Nurses Association. (n.d.). About emergency nurses association: About ENA.

https://www.ena.org/about

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing &

healthcare: A guide to best practice (4^th ed.). Philadelphia, PA: Wolters Kluwer.

Hello Shannon

I really liked that you choose the Emergency Nurses Association (ENA) as your choice of healthcare organization website to review. As a member of the ENA, I can relate to quantity and quality of evidenced-based information located there. “Research studies show that evidence-based practice (EBP) leads to higher quality care, improved patient outcomes, reduced costs, and greater nurse satisfaction than traditional approaches to care.”  (Grimshaw, et al, 2006).  The ENA does a great job of promoting positive change. Then by integrating the best evidence found from their website and from credible literature, nurses can take this information and utilize their expertise, patient preferences, and values and put it into action. (Melynk & Fineout-Overholt, 2018) NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice.

References:

Grimshaw J, Eccles M, Thomas R, MacLennan G, Ramsay C, Fraser C, Vale L. (2006). Toward evidence-based quality improvement. Evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966-1998. J Gen Intern Med. 2006 Feb;21 Suppl 2(Suppl 2):S14-20. doi: 10.1111/j.1525-1497.2006.00357.x. PMID: 16637955; PMCID: PMC2557130.

Melnyk, B., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice ( 4th ed.). Wolters Kluwer.

Week 1 – Main Discussion

In my company, it has become a norm for us to look for ways to enhance our customer service in terms of their satisfaction. The most important commitment is to become a High-Reliability Organization (HRO). Our hospital goal is to continue to advance and become the safest most reliable health care system in California. Its about doing right, every time with the goal of having zero defects and zero harm NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice. The adoption of a high-reliability mindset in the workplace involves teaching all individuals to critically think about their work and perform reliable behaviors that ensure all our processes are working as intended, consistently over time.

The EBP project we are currently working is the prevention and impact of hourly rounding on falls preventions, and reduction of pressure ulcers among the patients. One of the things I have discovered in my recent experiences with both academic and clinical education and an EBP project is that there are numerous and effective ways of learning, presenting, and communicating. Each method however, has on critical thing in common, it must be a two-way path and none are effective unless there is clear communicative understanding on the part of the recipient, patient, family members and colleagues.

In the hospital environment, falls are the common occurrence that may cause fatal injuries to older adults and older. Most hospitalized older patients are facing the risks of falls that can lead to unexpected injuries. Consequently, falls can lead to negative effects that include increase in hospital costs and longer hospital stay (Poit & Beck, 2017). In order to overcome the increasing rates of falls within the hospital settings, our organization devised strategies to prevent or decreased hospital acquired injuries. While these health practices are devised to enhance safety among patients and health practices to prevent falls.

An hourly rounding has been identified as an effective proactive health practice that can reduce falls, pressure ulcers, and improve patient’s satisfaction. Hourly rounding is defined as a proactive and systematic health intervention that healthcare organizations design to meet the need of in-patients in order to promote patient safety and satisfactions (Allatzas, 2018).  Pressure ulcer occurs among people who have nerve damage, such as paralysis or limited mobility.  A patient can suffer a pressure ulcer due to poor circulation in bony areas of the body due to prolonged compression of the site.  An effective hourly rounding is particularly effective for the management of pressure ulcer since the disease is one of the top causes of untimely death in the United States (Mitchell, 2017).  Repositioning is an appropriate strategy to manage a pressure ulcer and redistributes the body to enhance an effective blood circulation. Since patient satisfaction is very critical for health organizations, hourly rounding has been identified as an effective health strategy to improve patient’s satisfactions.

Conclusion

Patient’s satisfaction is very important part of a healthcare environment, most especially in my organization that the main focus is patient centered care. Typically, hourly rounding practice has been able to reduce patient’s falls, and the outcomes are the increase in patient’s safety and satisfactions.

References

Allatzas, R. (2018). The Effects of Hourly Rounding on Patient Safety and Satisfaction. ScholarWorks. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ir00976a&AN=wldu.dissertations.6579&site=eds-live&scope=site

Mitchell, R, (2017). Hourly Rounding: A Fall Prevention Strategy in Long-Term Care. ScholarWorks. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ir00976a&AN=wldu.dissertations.4811&site=eds-live&scope=site

Poit, D. F., & Beck, C. T., (2017). Nursing Research: Generating and assessing evidence for nursing practice (10^th ed.). Philadelphia, PA: Wolters Kluwer. Chapter 1, 2, & 3.

Evidenced Based Practice- Week 1 Initial Post

Healthcare Organization Website Review

In 2010, the Affordable Care act was signed, and medical standards of care were improved as a result of the increased focus on evidenced based practice (Laureate Educational Video, 2018). Evidenced based practice has been defined in many ways and differs slightly by organization but it involves gathering information and reviewing research to identify the best treatment options and outcomes (Dictionary, n.d.).

What is known as the quadruple aim; evidenced based-practice has had a positive impact on health care because of its correlation to lowered healthcare cost, improved quality of care, better patient outcomes and improved clinical environment for healthcare workers (Melnyk & Fineout-Overholt, 2018) NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice.

Network of the National Library of Medicine EBP Utilization

            In doing my own research on national health organizations I was very please to discover the U.S. Network of the National Library of medicine (NNLM). NNLM is a national organization that is under the umbrella of the National Institute of Health. The focus of the NNLM is to improve access to health information through research and educational funding (NNLM n.d.).

The organization supports six health initiatives which include HIV/Aids information and substance use disorders, to name a few. When exploring site content, consumers can find links to health literacy or use one of the eight health libraries which make up the regional library data base. I live in Florida and the Southeastern Atlantic region would be used by Physicians in my area. A deeper dive into my region took me to a page entitled, “From Problem to Prevention: Evidence-Based Public Health.” This linked to a 1-hour class that teaches participants about Evidenced Based Public Health.

Statements about evidenced based practice can be found on the main page of the website and is a part of the organizational goals. As described in our current textbook, evidenced based practice empowers clinicians (Melnyk & Fineout-Overholt, 2018). The NNLM reiterates this as saying they improve health information, expand knowledge, support outreach, and increase the use of research and data (NNLM, n.d.).

Grounding of EBP

The acknowledgement that evidenced based practice is important to bettering healthcare is at the core of the NNLM. One of the services provided through the NNLM ensures that physicians understand and maintain continuing education about research design. The NNLP offers providers access to 12 learning modules which review the benefits of evidence-based practice, how to formulate a research question, and how to find, evaluate and apply evidenced based research in the clinical environment (NNLM, n.d.).

New Perception of Healthcare Organization

Prior to doing the research for this discussion I was unfamiliar with the NNLM so I did not have a preconceived opinion about them. What I have learned is that the programs and services provided by the NNLM are important to the continued belief that evidenced based practice is most comprehensive and leads to the best patient outcomes (Melnyk & Fineout-Overholt, 2018).

It is essential that medical providers continue to learn and grow and the NNLM provides knowledge to help physicians stay up to date and conduct proper data collection and reporting. EVP for medical research is important because it is the foundation upon which healthcare providers build treatment plans. As a consumer, one cannot assume that all physicians are equal in their effort for continued growth and development through research. Patients have a responsibility to learn how to self-advocate. Selecting a physician offers opportunity to ask questions and ensure that the physicians background and knowledge will coincide with one’s personal health goals and ideals.

References

Dictionary by Farlex (n.d.). Evidenced-Based Practice definition. Retrieved March. 1, 2021 from

Evidence-based practice | definition of evidence-based practice by Medical dictionary (thefreedictionary.com)

Laureate Education (Producer). (2018). Evidence-based Practice and the Quadruple Aim [Video file].

Baltimore, MD: Author.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. Chapter 1, “Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry” (pp. 7–32)

National Library of Medicine (n.d.). Retrieved March. 1, 2021 from

National Library of Medicine – National Institutes of Health (nih.gov)

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. Chapter 1, “Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry” (pp. 7–32)

Hi Stephanie,

You did a nice job describing your experience in exploring a healthcare organization website, NNLM,  and learning about how EBP was utilized there was nicely stated. One of your articles in your week 1 resource list by Kim et al. (2016) discuss how a fellowship program improved job satisfaction, EBP implementation, and group cohesion. Can you explain how the program improved EBP implementation? NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice

Thanks,

Dr. Sullivan

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. doi:10.1111/wvn.12171

         Hi Dr.Sullivan,

I think the main reason that EVP implementation improved was because of the organizational culture change that occured. As the article pointed out, there is a big difference in educating staff about EBP and involving them in a way that they become the leader/teacher/mentor. Having the nurses create the EBP projects caused that change because now they are more invested. They in a sense become the spokesperson on the unit for a particular topic and take on the role of the educator. The less educated, less experienced nurses would not likely push back in an environment where best practice is the expectation. Overtime this ideal would spread within the organization.

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When I was in nursing school in Illinois, I applied to a paid externship program at Mary Washington Hospital in Fredericksburg Virginia. I spent the summer before my last semester of school in the program and it was great. I rotated through interventional radiology, PCU, Cath lab and endoscopy. This article reminded me of my experience there. They are a Magnet facility and I remember that they had posters posted up all over PCU that were created by nurses. Topics such as wound care and about various cardiac topics lined the walls of the unit. I remember my preceptor saying that the patient’s family members liked to read them. Perhaps they were putting this into practice?

In conclusion, the article stated that more educated nurses with higher levels of experience had stronger EBP beliefs. I was wondering if that is why magnet facilities require a high percentage of their nurses to be BSN prepared?

Thanks for the feedback.

Stephanie Hollowich

References

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice             implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on                  Evidence-Based Nursing, 13(5), 340–348. doi:10.1111/wvn.12171

Hello Shannon,

Thanks for all you do as a dialysis nurse. I work as a float/travel nurse and I have cared for dialysis/renal patients. I have witnessed the meticulous and rigorous process of ensuring that these patients get the right care at the right time especially those with end stage renal disease. The use of evidenced practice on these patients can never be overemphasized due to them having invasive lines such as ports, fistula, and PICCs.

Evidenced-based practice is the integration of clinical expertise/expert opinion known as knowledge, judgement, and critical reasoning acquired through training and professional experiences, evidence (external and internal), together with client/patient/caregiver perspectives (Asha, n.d). This definition of EBP truly resonates with what I see and do every day at the hospital where I work. I currently work at Piedmont hospital where a whole unit in the hospital is dedicated to Da Vita Kidney Care and all patients on dialysis are sent there. Before any patient is sent to them, the dialysis nurse would call first to get a full report about the patient from the primary nurse. So much evidenced based practice goes into their care which given me the so many learning opportunities. When EBP is delivered in a context of caring and a culture as well as an ecosystem or environment that supports it, the best clinical decisions are made that yield positive patient outcomes (Meluyk et al., 2014) NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice.

References

American Speech-Language-Hearing Association (n.d.). Evidence-based practice (ebp). Retrieved March 05, 2021, from https://www.asha.org/research/ebp/

Melnyk, Ford, Long, Overholt (2014, February). The Establishment of Evidence‐Based Practice Competencies for Practicing Registered Nurses and Advanced Practice Nurses in Real‐World Clinical Settings: Proficiencies to Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs. Retrieved March 05, 2021, from https://sigmapubs-onlinelibrary-wiley-com.ezp.waldenulibrary.org/doi/full/10.1111/wvn.12021

Shannon,

Thank you for sharing your research on the DaVita website. I think your suggestion of using the money saved to help compensate the employees is a great way to boost morale and escape the too familiar burn out. At my job we are going through a pretty awful shortage of staff, not just with nurses but throughout the interdisciplinary teams which makes it very hard to avoid burnout. I, along with other nurses, have suggested getting paid the addition of an hourly nurse rate to compensate for the staffing but to no avail. The DaVita website is very well laid out with services, providers, and of course the mission and values. It’s incredible that they have additional businesses for the consumers (DaVita, n.d.). The definition of EBP was broadened in 2000 to include critical appraisal, external evidence, internal evidence, outcomes management, or evidenced-based quality improvement projects, and patient and family preferences and values (Melnyk, et al., 2018). When looking at the website for DaVita it appears that they do a very good job in tackling most, if not all, of the listed qualities of EBP.

Mazurek Melnyk, B., & Fineout-Overholt, E. (2018). Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry. In Evidence-Based Practice in Nursing and Healthcare (4th ed., p. 8). Philadelphia : Wolters Kluwer Health.

About. (n.d.). DaVita. Retrieved March 6, 2021, from https://davita.com/about

Main Post

Evidenced-based practice has been a welcome development in the last decades or more. Evidence-based practice has reduced and prevent medical errors in healthcare and improved patients’ outcome. According to Boller, with 10 years Quality and Safety education for nurses (QSEN) project, and 9 years after triple aim was lunched, improvements in some health outcomes have been reported in the United States as infant mortality rate has reduced by 15% compared with 2005 (Boller, 2017) NURS 5052/NURS 6052/NURS 6052N/NRSE 6052C/NURS 6052C/NURS 5052C/NURS 6052A/NRSE 6052A: Essentials of Evidence-Based Practice. Evidenced-based practice has contributed to the practice of nursing with patient centered care.

Evidenced-based practice is the integration of clinical expertise/expert opinion known as knowledge, judgement, and critical reasoning acquired through training and professional experiences, evidence (external and internal), together with client/patient/caregiver perspectives (Asha, n.d). This definition of EBP truly resonates with what I see and do every day at the hospital where I work.

My hospital policies and procedures are aligned with that of the Joint Commission (JC). The JC body for EBP in nursing carries out yearly visits to my hospital to ensure that patient care is not compromised but carried out based on research and findings. When I visited the Joint commission website, I was amazed to see the amount of research being carried out in order to prevent errors and deaths and to hold hospitals to high standards. For example, I work at piedmont hospital in Atlanta as a surgical nurse and the use of Chlorhexidine to prep patients before surgery has great significant outcome in preventing infections. Piedmont’s mission statement entails a healthcare marked by compassion and sustainable excellence in a progressive environment, guided by physicians, delivered by exceptional professional and inspired by the communities they serve. This 643 beds hospital has been certified by the American heart association and named top acute-care community hospital in metro Atlanta https://www.piedmont.org/locations/piedmont-atlanta/pah-home . Piedmont hospital is also accredited and certified by the Joint Commission.

When EBP is delivered in a context of caring and a culture as well as an ecosystem or environment that supports it, the best clinical decisions are made that yield positive patient outcomes (Mazurek et al., 2014). In order for hospitals not to lose their accreditation and certification, they must maintain standards of practice by the Joint Commission.

References

American Speech-Language-Hearing Association (n.d.). Evidence-based practice (ebp). Retrieved March 05, 2021, from https://www.asha.org/research/ebp/

Boller J.(2017). Nurse Educators: Leading Health Care to the Quadruple Aim Sweet Spot. J Nurs Educ. 56(12) 707-708. doi: 10.3928/01484834-20171120-01

Melnyk, Ford, Long, Overholt (2014, February). The Establishment of Evidence‐Based Practice Competencies for Practicing Registered Nurses and Advanced Practice Nurses in Real‐World Clinical Settings: Proficiencies to Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs. Retrieved March 05, 2021, from https://sigmapubs-onlinelibrary-wiley-com.ezp.waldenulibrary.org/doi/full/10.1111/wvn.12021

Piedmont Healthcare Atlanta, https://www.piedmont.org/locations/piedmont-atlanta/pah-home