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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As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.

Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.

Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes.

In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.

A minimum of three scholarly references are required for this assignment.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

 

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Assignment: Evidence-Based Capstone Project, Part 6: Disseminating Results

The dissemination of EBP results serves multiple important roles. Sharing results makes the case for your decisions. It also adds to the body of knowledge, which creates opportunities for future practitioners. By presenting results, you also become an advocate for EBP, creating a culture within your organization or beyond that informs, educates, and promotes the effective use of EBP.

To Prepare:

• Review the final PowerPoint presentation you submitted in Module 5, and make any necessary changes based on the feedback you have received and on lessons you have learned throughout the course.
• Consider the best method of disseminating the results of your presentation to an audience.

To Complete:

Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project.

• Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
• Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

 

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1)Describe technology advances that are used in health care today. 

 2.) The nursing faculty concludes the presentation by stating that decisions should be made about what technology can best be used in each individual setting and how it should be used.

 3)Describe some points to consider in implementing technology in health care.

4  The nurses debate whether the country feels that health care reform is really necessary.  Discuss reasons why reform is needed and what that reform should address

.5 What were the 10 essential benefits guaranteed by insurance plans in the ACA Health Care Marketplace? 

 6 What are the successes of the ACA?4.  What are the failures of the ACA?

 

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A nurse manager is attending a national convention and is attending a concurrent session on staffing ratios. Minimum staffing ratios are being discussed in the nurse manager’s own state. The nurse manager has a number of questions about staffing ratios that the session is covering. The nurse manager knows that evidence exists that increasing the number of RNs in the staffing mix leads to safer workplaces for nurses and higher quality of care for patients.

1. What are the three general approaches recommended by the American Nurses Association (2017) to maintain sufficient staffing?

2. Summarize the findings that are often cited as the seminal work in support of establishing minimum staffing ratio legislation at the federal or state level

.3. Analyze what proponents and critics say about whether mandatory minimum staffing ratios are needed.

Two registered professional nurses are attending a meeting where the focus is examining teaching methods that enable them to share information with newly diagnosed diabetic patients. One nurse initiates a discussion on the use of social media in teaching patients and the use of social media for all health care providers.

1. Discuss actions the nurse should take before using social media as a teaching tool.

2. What types of social media could benefit health care providers and patients?3. What are the pitfalls to utilizing social media for both patients and health care providers? 

 

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