Creating a Culture of Evidence-Based Practice

An abundance of evidence can be found on almost any medical issue or health topic. Often, the availability of information is not the concern, but rather nurses struggle with how to convey the evidence to others and change practices to better reflect the evidence. Deep-rooted organizational cultures and policies can make some resistant to change, even to changes that can vastly improve the quality, effectiveness, and efficiency of health care. However, there are many strategies that nurses can employ to bring about changes to practice.

In this Discussion, you focus on how to create an organizational culture that supports evidence-based practice.

To prepare:

· Review the information in this week’s Learning Resources. Examine the various suggestions for promoting an organizational culture that embraces the use of EBP.

· Reflect on your own organization’s (or one in which you have worked) support of evidence-based practice. Examine how culture and policies impact the adoption of changes to practice based on evidence. What barriers exist?

· Consider the models and suggestions for promoting evidence-based practice featured in this week’s Learning Resources. Identify models and suggestions that would work well in your organization.

· Reflect on the significance of evidence-based practice in health care. What responsibility do nurses have to promote EBP and change practices to better reflect evidence and research findings?

· Reflect on how nurses can disseminate findings from evidence-based practice research.

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter      30, “Disseminating Evidence: Reporting Research Findings”

       In this chapter, the focus is on actually reporting on the research      findings and how to determine the best approach for reaching the desired      audience. The chapter also includes tips on how to organize the      information and describes what is usually included in such reports.

Aitken, L. M., Hackwood, B, Crouch, S., Clayton, S., West, N., Carney, D., & Jack, L. (2011). Creating an environment to implement and sustain evidence based practice: A developmental process. Australian Critical Care, 24(4), 244–254. 

This article describes a multi-dimensional EBP program designed to generate sustainable improvement in patient care and patient outcome. The text details the program’s strategies for implementation along with achievements and lessons learned.

Barnsteiner, J. H., Reeder, V. C., Palma, W. H., Preston, A. M., & Walton, M. K. (2010). Promoting evidence-based practice and translational research. Nursing Administration Quarterly, 34(3), 217–225. 

In this text, the authors highlight established systems and structures designed to supply staff with resources to translate research and deliver EBP. Additionally, the article explicates a multitude of initiatives designed to disseminate evidence to the point of care.

Cullen, L., & Adams, S. L. (2012). Planning for implementation of evidence-based practice. Journal of Nursing Administration, 42(4), 222–230.

This article provides several models for implementing evidence-based practice within an organization. It introduces four different phases through which an implementation should progress, and provides examples of each.

Estrada, N. (2009). Exploring perceptions of a learning organization by RNs and relationship to EBP beliefs and implementation in the acute care setting. Worldviews on Evidence-Based Nursing, 6(4), 200–209. 

In this article, the authors detail a survey design study conducted to determine the relationship between a learning organization’s characteristics and the beliefs of registered nurses with respect to EBP. In addition, the study examines the impact of EBP beliefs on registered nurses’ implementation of EBP.

Fineout-Overholt, E., Williamson, K. M., Kent, B., & Hutchinson, A. M. (2010). Teaching EBP: Strategies for achieving sustainable organizational change toward evidence-based practice. Worldviews on Evidence-Based Nursing, 7(1), 51–53. 

The authors of this text suggest multiple strategies for integrating the EBP paradigm at the organizational level. The text provides rationale for why educators should also consider change at the individual level as an effective conduit for disseminating the EBP paradigm at the organizational level.

Munten, G. van den Bogaard, J., Cox, K., Garretsen, H., & Bongers, I. (2010). Implementation of evidence-based practice in nursing using action research: A review. Worldviews on Evidence-Based Nursing, 7(3), 135–157. 

This text reviews 21 action research studies to determine what is known about using action research to implement evidence-based practice. The authors explicate the promising features and flaws that were common across the action research studies they used.

Satterfield, J. M., Spring, B., Brownson, R. C., Mullen, E. J., Newhouse, R. P., Walker, B. B., & Whitlock, E. P. (2009). Toward a transdisciplinary model of evidence-based practice. The Milbank Quarterly, 87(2), 368–390. 

This article presents the primary issues and challenges in EBP across numerous health disciplines. The authors then posit a transdisciplinary EBP model designed to incorporate the strengths and diminish the flaws of each discipline’s EBP model.

Steurer, L. M.(2010). An evidence-based practice scholars program: One institution’s journey toward excellence. Journal of Continuing Education in Nursing, 41(3), 139–143. 

The author of this article details the efforts of an EBP scholars program that was designed to teach an overview of EBP, along with the skills necessary to improve patient outcomes. In addition to the program’s development and implementation, the article highlights lessons learned. 

Media

Laureate Education (Producer). (2012k). Translating evidence into practice. Baltimore, MD: Author. 

Dr. Kristen Mauk discusses the outcomes of her DNP project in this video. She explains how nurses in the rehabilitation unit where she conducted her project used the results of her project to improve their practices.

Laureate Education (Producer). (2012c). Disseminating findings. Baltimore, MD: Author.

In this video, Dr. Kristen Mauk offers advice for nursing students and practitioners in disseminating the findings of their research and evidence-based practice projects. She identifies many options for dissemination that are available to nurses.

 

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  Discussions 

1.Quantitative Research Designs

In order to find the best information on a topic, not only should you develop a question and search for resources, but you should also know how to analyze the value of the resources that you identify. There are different ways to evaluate resources, such as using the hierarchy of evidence, which you explored in Week 4 of this course. Another way to evaluate resources is to consider the appropriateness of the research design. Understanding how research designs contribute to the quality of a study is essential for being able to analyze resources when conducting a literature review or locating evidence for practice.

In this Discussion, you consider the different research designs and evaluate how these designs have been used to research a specific topic. You also consider strategies for selecting an appropriate research design.

To prepare:

· Review the information in the course text on quantitative research designs. Focus on the information on, “Guidelines for Critiquing Research Designs in Quantitative Studies”.

· Select a topic from the list below and search the Walden Library to find two different quantitative research studies addressing that issue:

o Caregiver stress

o Anxiety in children

o Sleep apnea

o Depression in college freshmen

o Rural health care issues

o Post-traumatic stress syndrome

o Traumatic brain injury in veterans

o Health effects of environmental contaminants

o Bipolar disorder

o End-of-life ethical issues

o Alternative medicine

· For each of the sources that you select, identify the type of quantitative research design used, and evaluate whether it is the most appropriate approach to the research.

· Consider the ramifications of choosing an inappropriate design for a research study.

RESOURCES

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 8, “Planning a Nursing Study”

This chapter focuses on the necessary steps for planning a research study. It describes different research designs and their key features and discusses how to plan for data collection.

Chapter 9, “Quantitative Research Design”

This chapter explores quantitative research in greater depth including the importance of experimental design and the role of randomization in conducting research. The chapter also describes quasi-experimental design and observational research.

Media

Laureate Education (Producer). (2012m). Quantitative research for evidence-based practice. Baltimore, MD: Author.

In this video, Dr. Kristen Mauk explains specific quantitative research designs, methods, and considerations related to her Doctorate of Nursing Practice (DNP) project. She discusses how she developed her research design and how she used sound quantitative research methods throughout her project.

2.Validity in Quantitative Research Designs

Validity in research refers to the extent researchers can be confident that the cause and effect they identify in their research are in fact causal relationships. If there is low validity in a study, it usually means that the research design is flawed and the results will be of little or no value. Four different aspects of validity should be considered when reviewing a research design: statistical conclusion validity, internal validity, construct validity, and external validity. In this Discussion, you consider the importance of each of these aspects in judging the validity of quantitative research.

To prepare:

· Review the information in Chapter 10 of the course text on rigor and validity.

· Read the method section of one of the following quasi-experimental studies. Identify at least one potential concern that could be raised about the study’s internal validity.

o Metheny, N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59(1), 18–25.

o Padula, C. A., Hughes, C., & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4), 325–331.

o Yuan, S., Chou, M., Hwu, L., Chang, Y., Hsu, W., & Kuo, H. (2009). An intervention program to promote health-related physical fitness in nurses. Journal of Clinical Nursing, 18(10), 1,404–1,411.

· Consider strategies that could be used to strengthen the study’s internal validity and how this would impact the three other types of validity.

· Think about the consequences of an advanced practice nurse neglecting to consider the validity of a research study when reviewing the research for potential use in developing an evidence-based practice.

RESOURCES

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 10, “Rigor and      Validity in Quantitative Research”

This chapter introduces the concept of validity in research and describes the different types of validity that must be addressed. Key threats to validity are also explored.

 
 

• Chapter 11, “Specific Types      of Quantitative Research”

This chapter focuses on the specific types of quantitative research that can be selected. The focus is on the purpose of the research rather than the research design. These include such approaches as clinical trials, evaluation research, health services and outcomes research, needs assessments, or replication studies.

Cantrell, M. A. (2011). Demystifying the research process: Understanding a descriptive comparative research design. Pediatric Nursing, 37(4), 188–189.

The author of this article discusses the primary aspects of a prominent quantitative research design. The article examines the advantages and disadvantages of the design.

Schultz, L. E., Rivers, K. O., & Ratusnik, D. L. (2008). The role of external validity in evidence-based practice for rehabilitation. Rehabilitation Psychology, 53(3), 294–302.

This article details the results of a study that sought to balance concern for rigor with concern for relevance. The authors of the article derive and determine a rating format for relevance and apply it to cognitive rehabilitation.

Note: For the Discussion this week, you will need to read the method section of one of the following quasi-experimental studies. Refer to the details provided in the Week 6 Discussion area.

Metheny, N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59(1), 18–25.

Padula, C. A., Hughes, C., & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4), 325–331.

Yuan, S.-C., Chou, M.-C., Hwu, L.-J., Chang, Y.-O., Hsu, W.-H., & Kuo, H.-W. (2009). An intervention program to promote health-related physical fitness in nurses. Journal of Clinical Nursing, 18(10), 1,404–1,411.

Walden University. (n.d.a.). Paper templates. Retrieved July 23, 2012, from http://writingcenter.waldenu.edu/57.htm

This resource provides you access to the School of Nursing Sample Paper, which will serve as a template for formatting your papers.

Document: Critique Template for a Qualitative Study (Word document)

Note: You will use this document to complete this week’s Assignment.

Document: Critique Template for a Quantitative Study (Word document)

Note: You will use this document to complete this week’s Assignment.

Document: Critique Template for a Mixed-Methods Study (Word document)

Note: You will use this document to complete this week’s Assignment.

  

3. Qualitative Research Designs

For the past 2 weeks, you have focused on the features and considerations of quantitative research designs. However, quantitative designs are not appropriate for all research questions. Perhaps you are concerned with how patients react when confronted with negative test results, or you wish to study how views on a certain health topic change over time. In each of these cases, the emphasis is more on understanding the thinking and experiences of an individual or group than on numerical measurements. For these types of questions, a qualitative or mixed methods research design is the most appropriate.

For this Discussion, you focus on the different types of qualitative research designs, when they are used, and why they are important.

To prepare:

· Reflect on the comments made by Dr. Mauk in this week’s media presentation on the value of qualitative research in nursing.

· Locate the journal Qualitative Health Research in the Sage Premier database in the Walden Library.

· From this journal, select an article of interest to you that was published within the last 3 years.

· Review the information on different qualitative research designs in Chapter 21 of your course text.

· Determine what qualitative research design was used in your selected article and evaluate whether it was the best choice.

· Consider ethical issues involved in the study and how the researchers addressed them.

· Think about how using a quantitative design would have affected the type of data gathered.

RESOURCES

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 21, “Qualitative Research Design and      Approaches”
       This chapter introduces qualitative research designs. It provides an      overview of the different types of qualitative research and then describes      each one in greater detail, outlining how and when they should be used.

Houghton, C. E., Casey, D., Shaw, D., & Murphy, K. (2010). Ethical challenges in qualitative research: Examples from practice. Nurse Researcher, 18(1), 15–25. 

This article explores ethical challenges associated with qualitative research. Specifically, the authors examine the challenges of informed consent procedures, the researcher-participant relationship, risk-benefit ratio, confidentiality, and the dual role of the nurse-researcher.

Pringle, J., Hendry, C., & McLafferty, E. (2011). Phenomenological approaches: Challenges and choices. Nurse Researcher, 18(2), 7–18. 

This article examines the dilemmas faced by a researcher looking for appropriate methods and approaches for investigating the experiences of stroke survivors. In addition, this article reviews the challenges of using phenomenology as a research method.

Ryan-Nicholls, K. D., & Will, C. I. (2009). Rigour in qualitative research: Mechanisms for control. Nurse Researcher, 16(3), 70–85. 

The authors of this article provide recommendations for improving the control mechanisms of methodological rigor in qualitative research methods. The text establishes the basis of criticism on the rigor of qualitative work, ways of demonstrating methodological rigor, and the definition of rigor.

Smith, J., Bekker, H., & Cheater, F. (2011). Theoretical versus pragmatic design in qualitative research. Nurse Researcher, 18(2), 39–51. 

This article assesses the benefits of using a generic qualitative approach to design studies for understanding user and caregiver perspectives. The authors assess these benefits in the context of a qualitative study that focused on parents’ experience of living with children with hydrocephalus.

Walker, W. (2011). Hermeneutic inquiry: Insights into the process of interviewing. Nurse Researcher, 18(2), 19–27. 

This article examines the process of interviewing from a research perspective. The authors supply personal and theoretical insights into using the research interview, along with a guide to the practicalities of interviewing.

Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association, 15(3), 202–207.

This article highlights the importance of qualitative evidence to mental health clinicians. The author stresses that critically appraising evidence is crucial to the EBP process and provides guidelines for appraisal.

Wuest, J. (2011). Are we there yet? Positioning qualitative research differently. Qualitative Health Research, 21(7), 875–883. 

This article focuses on the shifting role of qualitative research in the past two decades. The author discusses the merits and detriments of concrete distinctions, the hurdles of flexibility and convergence, and the need to develop a complete research toolbox for improving health.

Media

Laureate Education (Producer). (2012l). Qualitative and mixed methods research designs. Baltimore, MD: Author. 

This video features Dr. Kristen Mauk’s overview of how she applied qualitative research designs and methods to her doctoral dissertation work. Dr. Mauk explains the advantages of qualitative research as well as strategies for increasing credibility when conducting qualitative or mixed methods research.

4. Planning for Data Collection

Data collection is an important part of both quantitative and qualitative research. Although the actual approach to gathering information may vary, for either research design, researchers need to plan in advance how the data will be gathered, reported, and stored, and they need to ensure that their methods are both reliable and valid. As nurses’ review research when considering a new evidence-based practice, it is important to be familiar with sound collection practices in order to ascertain the credibility of the data presented.

Consider the following scenario:

Nurses and other health care professionals are often interested in assessing patient satisfaction with health care services. Imagine that you are a nurse working in a suburban primary care setting that serves 10,000 patients annually. Your organization is very interested in understanding the patient’s point of view to help determine areas of care that can be improved. With this focus in mind, consider how you would create a survey to assess patient satisfaction with the services your organization provides. You may wish to consider variables such as the ease of accessing care, patient wait time, friendliness of the staff, or the likelihood that a patient would recommend your organization to others.

For this Discussion, you generate questions and an overall plan for data collection that would be appropriate for a patient satisfaction survey in relation to the above scenario.

To prepare:

· Consider the guidelines for generating questions presented in this week’s Learning Resources.

· Review the scenario and formulate at least five questions that you could use to evaluate patient satisfaction.

· Reflect on the different methods or instruments that can be used for gathering data described in Chapter 13 and Chapter 23 of the course text.

· Which methods or instruments would work well for the scenario? Determine an appropriate sample size for the scenario.

RESOURCES

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 12, “Sampling in      Quantitative Research”

This chapter introduces key concepts concerning sampling in quantitative research. This includes such concepts as a description of populations, different types of sampling and their uses, and how to determine a manageable, yet sufficient number to be included in a sample. The chapter also includes suggestions for implementing a sampling plan.

 
 

• Chapter 13, “Data Collection      in Quantitative Research”

Once a sampling design is complete, the next step is to collect the data, and this is the focus of Chapter 13. The chapter describes how to develop a data collection plan, and provides information about the different types of instruments that can be used, such as structured observation and biophysiologic measures.

 
 

• Chapter 22, “Sampling in      Qualitative Research”

The focus of this chapter is on the sampling process in qualitative research. The chapter describes the different types of sampling and when they are commonly used. Sampling techniques in the three main qualitative traditions (ethnography, phenomenological studies and grounded theory studies) are highlighted.

 
 

• Chapter 23, “Data Collection      in Qualitative Research”

This chapter examines the process of data collection in qualitative research as well as key issues surrounding data collection. This includes such methods as self-reporting, surveys, interviews, and personal journal keeping. The chapter also highlights important considerations when utilizing unstructured observations to gather data and how to record field notes.

Keough, V. A., & Tanabe, P. (2011). Survey research: An effective design for conducting nursing research. Journal of Nursing Regulation, 1(4), 37–44. Copyright 2011 by Elsevier Science & Technology Journals. Used with permission of Elsevier Science & Technology Journals via the Copyright Clearance Center. 

This text emphasizes the advantages of survey research. The authors describe the nuances of survey research projects, including their design, methods, analysis, and limitations.

Walden University. (n.d.a.). Paper templates. Retrieved July 23, 2012, from http://writingcenter.waldenu.edu/57.htm

This resource provides you access to the School of Nursing Sample Paper, which will serve as a template for formatting your papers.

Media

Laureate Education (Producer). (2012b). Data collection. Baltimore, MD: Author. 

Note: The approximate length of this media piece is 4 minutes.

Dr. Kristen Mauk discusses how she collected data for her DNP project in this video. She describes the details of her pre- and post-tests used to track nurses’ knowledge in a rehabilitation unit.

Optional Resources

Krainovich-Miller, B., Haber, J., Yost, J., & Jacobs, S. (2009). Evidence-based practice challenge: teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students. Journal of Nursing Education, 48(4), 186–195.

This text emphasizes the advantages of survey research. The authors describe the nuances of survey research projects, including their design, methods, analysis, and limitations.

Horsley, T., Hyde, C., Santesso, N., Parkes, J., Milne, R., & Stewart, R. (2011). Teaching critical appraisal skills in healthcare settings. Cochrane Database of Systematic Reviews (Online), 11, Art. No.: CD001270.

Melnyk, B., Fineout-Overholt, E., & Mays, M. (2009). The evidence-based practice beliefs and implementation scales: Psychometric properties of two new instruments. Worldviews on Evidence-Based Nursing, 6(1), 49.

Fawcett, J., & Garity, J. (2009). Evaluating research for evidence-based nursing. Philadelphia, PA: F.A. David Company.

• Chapter 9, “Evaluation of Research Instruments      and Experimental Conditions”

  

5.Weighing the Evidence

When conducting original research, the final step researchers must complete is weighing the evidence and interpreting the meanings of their data, statistics, and analyses. This is the culmination of the research process in which all of the research methods and designs can be synthesized into a meaningful conclusion. In this stage, researchers should formulate explanations for what their data indicates, determine whether the data answers their initial research question, identify areas of uncertainty, and consider directions for further research.

In this Discussion, you focus on one of the research articles that you identified for Part 2 of the Course Project (Literature Review). You then explore the process of how the researchers generated conclusions based on their data, consider other possible interpretations of their data, and formulate ideas for further research.

To prepare:

· Review this week’s Learning Resources, focusing on how researchers find meaning in their data and generate sound conclusions. Pay particular attention to Table 2 in the article, “Study Design in Medical Research.”

· Revisit the 5 articles that you identified in Part 2 of the Course Project. Select one to consider for the purpose of this Discussion.

· Read sections of the chosen article where the data is presented, analyzed, and interpreted for meaning. What reasoning process did the researchers use to formulate their conclusions? What explanation did they give to support their conclusions? Were there any weaknesses in their analysis or conclusions?

· Consider possible alternate conclusions that the researchers could have drawn based on their data.

· Examine the findings that the article presents and consider how well they addressed the researcher’s initial question(s). What additional research could be done to build on these findings and gain a fuller understanding of the question?

RESOURCES

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Review Chapter 2, Fig. 2.1

Chapter 29, “Systematic Reviews of Research Evidence: Meta-analysis, Metasynthesis, and Mixed Studies Review”

This chapter focuses on the different types of systematic reviews. The chapter discusses the advantages of this type of analysis and the steps for conducting a meta-analysis or metasynthesis.

Dingle, P. (2011). Statin statistics: Lies and deception. Positive Health, 180, 1.

In this article, the author outlines how misleading statistics are used to make false claims about the positive use of statin drugs in order to retain a market share of sales for pharmaceutical firms.

Katapodi, M. C., & Northouse, L. L. (2011). Comparative effectiveness research: Using systematic reviews and meta-analyses to synthesize empirical evidence. Research & Theory for Nursing Practice, 25(3), 191–209.

The authors of this article assert that more comparative effectiveness research (CER) is necessary to accommodate the elevated demand for evidence-based health care practices. The article supplies a summary of methodological issues relevant to systematic reviews and meta-analyses used in the process of CER.

Stichler, J. F. (2010). Evaluating the evidence in evidence-based design. Journal of Nursing Administration, 40(9), 348–351.

The quality of evidence used in EBP can vary considerably. This article highlights the necessity of critically appraising facility design research articles and using a hierarchical model to rate the strength of evidence.

Bernd, R., du Prel, J.-B., & Blettner, M. (2009). Study design in medical research: Part 2 of a series on the evaluation of scientific publications. Deutsches Aerzteblatt International, 106(11), 184–189. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695375/pdf/Dtsch_Arztebl_Int-106-0184.pdf

This article provides guidance in evaluating the study design of scientific publications for reliability and credibility. The authors suggest that the most important elements to consider are the question to be answered, the study population, the unit of analysis, the type of study, the measuring technique, and the calculation of sample size.

Walden University. (n.d.a). Paper templates. Retrieved July 23, 2012, from http://writingcenter.waldenu.edu/57.htm

This website provides you access to the School of Nursing Sample Paper, which will serve as a template for formatting your papers.

Media

Laureate Education (Producer). (2012g). Hierarchy of evidence pyramid. Baltimore, MD: Author.

This multimedia piece explains the hierarchy of evidence pyramid. The piece offers definitions and key information for each level of the pyramid.

Laureate Education (Producer). (2012n). Weighing the evidence. Baltimore, MD: Author. 

In this video, Dr. Kristen Mauk provides insight about how she analyzed her data and interpreted meanings of what the data showed. She describes how she drew conclusions based on the results and how she explained unexpected findings that were contrary to her initial hypotheses.

   

 

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Select one of the AACN BSN Essentials and elaborate on its meaning and importance in your own future professional nursing practice.  I chose Essential VIII.

Essential VIII: PROFESSIONALISM AND PROFESSIONAL VALUES

In your post (intended to provide a clear and thorough answer), be sure to

identify the AACN BSN Essential that you have selected by name and number. 

explain why you selected this Essential. 

explain how this Essential will be used to improve quality in your future professional nursing career.

 

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Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.

More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.

To Prepare:

• Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources. (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)
• Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
• Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.

To Complete:

Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.

Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:

Patient experience

population health

cost

work life of health care provider

 

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Is there a difference between “common practice” and “best practice”?

When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.

Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.

Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?

In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
• Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
• Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: An Introduction to Clinical Inquiry

Create a 4- to 5-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you used keywords to search on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four peer-reviewed articles you selected.

Part 2: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

• The full citation of each peer-reviewed article in APA format.
• A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
• A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
• A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
• A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

 

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