NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them

NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them

Describe the steps of the evidence-based research process and the importance of using them. In the initial stages of an EBP project, where do nurses in your specialty go to locate sources of information that help them to determine whether or not a practice problem is appropriate for an evidence-based practice change proposal. Include two specific sources on information in your discussion.

Re: Topic 7 DQ 1

The first step in the Evidence Based Practice (EBP) process is identifying a clinical problem or question. Sounds easy enough, but this problem or questions must be something that is answerable. The PICOT method is very useful in providing guidance in the development of a research questions (DeNisco & Barker, 2016). The “P” refers to the target population, “I” is the intervention or variable that one is interested in studying, “C” is a comparison of with and without said intervention of variable, “O” is the outcome, and “T” refers to the time it takes to reach an outcome.

The next step in EBP is research. After forming a PICOT, you want to search for all existing and current evidence related to your topic. There are steps related to research as well. You must have inclusion and exclusion criteria; this is often related to age of study. You must select appropriate databases to search, and you must critically analyze the evidence types. Not all evidence is created equally, there is a major difference between evidence from a systemic review or meta-analysis with randomized trials versus observational descriptive or qualitative studies. According to DeNisco and Barker, the AACN has created a new evidence leveling system that essentially grades the evidence (2016, p. 476). Critically analyzing the newfound evidence is important to determine if the research is valid, of quality and applicable to your EBP. There are a number of models, checklist, and grading systems available to help with the critical analysis and organization of evidence (DeNisco & Barker, 2016). There are a number of databases that can be used to research, the GCU nursing library page lists several nursing databases that are great for the initial stages of EBP and research (GCU Library, n.d.). To name a few: CINAHL Complete is a good data based to start because it has quite a few specialties and is very nursing specific. PubMed is another one that has a gigantic database and is free to use. And COCHRAN library is a good one because it has seven different databases that related to providing medical providers with high-quality and independent evidence that can help with decision making in care.

After collecting new evidence, critically appraising it, one must then determine if the new evidence is strong enough to support an intervention or change in practice; or if more evidence is needed and more research must be conducted. If an intervention or implementation is made, they must be measurable, and one must be able to evaluate the effectiveness of said interventions. DeNisco & Barker said “Evaluating practice and changes in practice is essential to the successful implementation of any quality improvement or evidence-based practice initiative. Evaluation is an ongoing process that must start early in a project and be continual” (2016, p. 522). These outcomes can then be compared to national benchmarks; benchmarking is essentially like continuously comparing your outcomes to the industry’s “gold standard” or the best of the best. Benchmarking is a way to make sure that current practices are staying relevant with practices of other organizations or competitors.

References

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.

GCU Library, (n.d.). Nursing & health sciences: Evidence-based practice. https://libguides.gcu.edu/Nursing/ebp

 

RESPOND  HERE (150 WORDS, 2 REFERENCES)

Hello ,

I agree with you that in the process of coming up with an EBP topic of research it is imperative for the nurse to develop a PICOT analysis that will be crucial in identifying the feasibility of the problem of research. The nurse requires adequate information about the topic of research in order to understand the greater scope of area of study and be able to build on the already existing knowledge available on a given a chosen research topic. These checks have to be made before conducting the EBP so that the research work generated has a practical application in promoting quality care among the target population (Li et al., 2019). Some of the pertinent questions considered in the PICOT include; will the target population benefit from the findings of the study? will the finding be applicable to the practice? Will the finding support an existing concept or practice or it will build a new theory? Will the finding support the existing nurse theory or will provide evidence for change of existing nurse theory? These are the key areas that the research problem in EBP should address, if not then the problem has to be re=examined and adjusted in order for it to have a clinical relevance and importance to the nurse practice (Duff et al., 2020).

 

References

Duff, J., Cullen, L., Hanrahan, K., & Steelman, V. (2020). Determinants of an evidence-based practice environment: an interpretive description. Implementation Science Communications, 1(1).

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice. Medicine, 98(39), e17209.

Re: Topic 7 DQ 1

Evidence-based practice (EBP) unites research evidence with clinical expertise and encourages individualized care by including patient preferences (Stevens, 2013). A major paradigm shift in the way nurses began to think about research results, framed the context for improvement, and employed change to transform healthcare was apparent with EBP on the scene. Patient care outcomes substantially improve with the use of EBP and tested interventions.

Two nursing educators and researchers, Melnyk and Fineout-Overholt, suggest seven steps in the EBP process, all proving vital for effective implementation and integration into the clinical setting (Melnyk & Fineout-Overholt, 2011, as cited in DeNisco & Barker, 2016, p.465). In the past, it has taken years to transfer new knowledge into practice, so speed is the primary goal for EBP models (DeNisco & Barker, 2016). Many models exist and common aspects include: identifying a problem and having a spirit of inquiry, asking practice questions, reviewing the latest evidence, critically appraising the evidence, integrating personal expertise and patient preferences in and grading, and finally organizing pieces in a meaningful way.

In the initial stages of locating information, I would start searching in PubMed because it is a free database accessible from any mobile device (DeNisco & Barker, 2016). Begin with a researchable and answerable question is essential. The PICOT question formulation method is widely used for clinical problems. Searching databases such as CINAHL, The Cochrane Library, or MEDLINE would be my next approach. The CINAHL database provides access to over 3,000 nursing and allied health journals yet, a subscription is required for access.

Nurses within leadership have an unprecedented opportunity as mentioned by Stevens (2013), to step forward and transform

healthcare from a systems perspective, focusing on EBP for patient safety, patient engagement, and clinical effectiveness. The “next big ideas” in EBP focus on making systems improvements and transforming healthcare. Moving beyond the individual and shifting the focus on groups, health systems, and the community is one part. Dissemination and implementation of strategies to assure effective and safe patient care are delivered rapidly is the second part. While there are benefits to the evidence gathered and applied, the true benefit goes to the patient.

Resources

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession. Jones & Bartlett Learning.

Stevens K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. Online Journal of Issues in Nursing, 18(2), 4.

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Hello

I agree with you that the nurse leaders and nurse managers have a responsibility of driving change in the nursing practice by promoting the successful implementation of the EBP project findings into the nurse practice. However, for the EBP project to have significant relevance to the nurse practice it is imperative that all the steps required in conducting an EBP are properly adhered to. The problem of research should be a clinical or a nursing area of concern whose solution can be arrived at through carrying out a viable research project that will generate new knowledge and nurse practice or build on the already existing bulk of knowledge (Li et al., 2019). The research objective should be SMART, that is, it should be specific, and target specific area of nursing or population, measurable, achievable, relevant to the area of practice and time bound. I do also agree with you that there are a number of sites that one can use when doing research on the topic or nursing area of research to focus on. The nursing data bases such as CINAHL, EMBASE, ERIC, MEDLINE via PUBMED or via Ovid, Cochrane Library, HAPI and Nursing Reference Centre Plus. These databases contain sufficient nursing research work that one can build on when developing and EBP research question to ensure its relevance and usefulness in the nursing practice (Hopia & Heikkilä, 2019).

References

Hopia, H., & Heikkilä, J. (2019). Nursing research priorities based on CINAHL database: A scoping review. Nursing Open, 7(2).

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice. Medicine, 98(39), e17209.

 

Re: Topic 7 DQ 1

The steps of the evidence-based research process include asking a clinical guided question, searching for appropriate evidence, analyzing the evidence, integrating the evidence into clinical practice, evaluating outcomes, and distributing the outcomes (University of Saint Mary, 2019). The evidence-based research process steps are systematic.

The first step of the process involves asking clinical guided questions. Based on the identified clinical problems found, the researcher forms what is called a PICOT statement (DeNisco & Barker, 2016). PICOT is an acronym where P- means patient or population problem, I- means intervention, C- means comparison, O- means Outcome, and T- means time frame (DeNisco & Barker, 2016). The second step allows researchers to search for evidence to determine whether a practice problem is appropriate for an evidence[1]based practice change proposal by using scholarly library databases, such as Cochrane Library, and PubMed. In the third step, the evidence is analyzed by completing a thorough investigation of the collected evidence before coming to conclusion. The fourth step is based on the conclusion of the investigation where the researcher will decide if the evidence can then be applied to clinical practice (DeNisco & Barker, 2016). The fifth step is when the researcher evaluates the outcome to see if the expected results was achieved or not. In the sixth step which is the final step of the evidence-based research process the evidence is made availability for distribution and use in the healthcare industry (University of Saint Mary, 2019).

It is important to incorporate all the steps of the evidence-based research project to produce an effective result for quality improvement in the healthcare industries by meeting individual patient’s needs (DeNisco & Barker, 2016).

References

DeNisco, S. M., & Barker, A. M. (2016). (3rd ed.). Advanced practice nursing: Essential knowledge for the profession. Burlington, MA: Jones & Bartlett Learning

University of Saint Mary. (2019). 6 steps of the evidence-based practice process. Retrieved from https://online.stmary.edu/msn/resources/evidence-based-practi*ce-for-the-busy-nurse-practitioner.

RESPOND HERE

Hello,

I agree with you that in order to carry out an effective EBP it is imperative to carry out all the six necessary steps so that the entire process is complete and meets the required standards of clinical research process. This is the key to transforming the nursing practices into more efficient, effective and safe for the patients (Stevens, 2020). The EBP in nursing is crucial in developing new ideas or practices or improve on already existing knowledge. As a nursing student, I do believe the EBP is an essential and crucial part in the nursing curriculum that will equip me with adequate skills and knowledge on how best to improve on my nurse practice and experiences. The steps in formulating an evidence-based practice helps the nurse student appreciate and realize the need to incorporate all the steps in their EBP project. Each step is crucial and cannot be by passed. It is well conducted EBP research projects that has helped in the improvement of the quality of nurse care and promoted better patient outcomes (Lehane et al., 2018).

 

References

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.

Stevens, K. (2020). The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas. Nursingworld.org.