Overview of Evidence-Based Practice Many people have ways of doing things that they follow for no other reason than “this is how it has always been done.” Have you ever encountered this in your experiences as a nurse? Do you follow certain processes because they have been shown to contribute to better health outcomes? Or, is the reasoning behind many of your practices simply based on how you were trained or how you have observed others in your practice setting? Consider, for example, the taking of post-operative vital signs in the general surgical setting. According to Zeitz and McCutcheon (2003), specific regimens of collecting vitals at certain set intervals are based on tradition only, with no evidence that they are relevant or even useful. But diligent nurses worldwide still faithfully monitor these vital signs at specific time-intervals within in the post-operative setting. This week, you examine the role that evidence-based practice (EBP) plays in nursing. You consider how EBP is demonstrated within clinical settings and healthcare organizations, and why it is important to base health care practices on evidence. You will formulate background questions and a PICOT question. Finally, you explore barriers that may prevent EBP from being used more consistently. Reference: Zeitz, K., & McCutcheon, H. (2003). Evidence-based practice: To be or not to be, this is the question! International Journal of Nursing Practice, 9(5), 272–279. Learning Objectives Students will: Evaluate the use of evidence-based practice in clinical settingsFormulate strategies for overcoming barriers to evidence-based practiceFormulate background questions and a PICOT questionLearning Resources Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. 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 1, “Introduction to Nursing Research in an Evidence-Based Practice Environment” This chapter provides an introduction to nursing research, its history, and the evolution of evidence-based practice. It includes an overview of credible sources of evidences and a description of the different paradigms used in nursing research. Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice” The focus of this chapter includes an overview of the key aspects of evidence-based practice, a review of how to identify credible research and appraise its value, and, finally, a discussion on how to take the identified evidence and convert it into a practice. Chapter 3, “Key Concepts and Steps in Qualitative and Quantitative Research”In this chapter, quantitative and qualitative research models are compared and the major steps in each approach are described. Information is also presented on the different sections of a research journal article and how you can identify the research model that was utilized. Adams, J. S. (2010). Utilizing evidence-based research and practice to support the infusion alliance. Journal of Infusion Nursing, 33(5), 273–277. Retrieved from the Walden Library databases. This article examines how evidence-based research and practice supports infusion alliances. The text also specifies the increasing challenges that infusion nurses face. Mallory, G. A. (2010). Professional nursing societies and evidence-based practice: Strategies to cross the quality chasm. Nursing Outlook, 58(6), 279–286. Retrieved from the Walden Library databases. This article describes strategies for reducing the gap between research knowledge and practice. The article also details how nursing societies could use these strategies to improve the quality of care. Newhouse, R. P., & Spring, B. (2010). Interdisciplinary evidence-based practice: Moving from silos to synergy. Nursing Outlook, 58(6), 309–317. Retrieved from the Walden Library databases. In this article, the authors examine the state of interdisciplinary evidence-based practice (EBP). The authors detail efforts to promote interdisciplinary EBP, academic and clinical training regarding interdisciplinary EBP, and strategies that may facilitate EBP translation across disciplines. Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y-L., Chang, Y-K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: Nurses' perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229–236. Retrieved from the Walden Library databases. This article reviews a study that sought to determine nurses’ awareness of, knowledge of, and attitude toward EBP. The article also describes factors likely to promote barriers to EBP adoption. Shivnan, J. C. (2011). How do you support your staff? Promote EBP. Nursing Management, 42(2), 12–14. Retrieved from the Walden Library databases. This article explores the role of the nurse manager in supporting evidence-based practice. The article also explains barriers and strategies to promote EBP for a nurse manager. Walden Student Center for Success. (2012). Clinical Question Anatomy. Retrieved July 9, 2014, from http://academicguides.waldenu.edu/content.php?pid=183871&sid=2950360 Media Laureate Education (Producer). (2012). Timeline of nursing research. Baltimore, MD: Author. This multimedia piece features a timeline of major events in nursing research. The timeline highlights how historical events and seminal research have contributed to nursing practice. Discussion: Nursing Research and Evidence-Based Practice In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care. Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP). To prepare: Consider a recent clinical experience in which you were providing care for a patient. Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?What questions have you thought about in a particular area of care such as a procedure or policy?Review Chapter 2, pages 31–34 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier. Write an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.

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