Discussion: Where in the World Is Evidence-Based Practice?

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Discussion: Where Is Evidence-Based Practice

March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.

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When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.

In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.

To Prepare:

· Review the Resources and reflect on the definition and goal of EBP.

· Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).

· Explore the website to determine where and to what extent EBP is evident.

By Day 3 of Week 1

Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP

Discussion Where Is Evidence-Based Practice

and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples.

RE: Discussion – Week 1

COLLAPSE

Hello Professor and class,

The quality and outcome of health care system depends on best practices. The term evidence plays a major role in designing these best practices. Evidence is a collection of facts that are believed to be true. It is generated through research with the intention of using it in other settings. (Melnyk & Fineout, 2018). Data of empirical evidences paves the way for making policies in health care settings. Evidence based practices (EBP) improves the knowledge and skills of health care professionals since experience is the best teacher. This leads to work as well as client satisfaction by preventing medical errors.

As per Melnyk & Fineout (2018) Evidence based practice process involves rigorous critical appraisal including synthesis and recommendations for practice. It has body of evidence comprised of multiple studies. It also combines with the expertise of the clinician, patient/family preferences and values to make best decision about patient care. The quadruple aims of EBP are improved population health, enhanced patient experience, lower health care cost and Improved work life of health care providers. (Laureate Education, 2018). The rituals, beliefs, and practices followed inhibits implementation of evidence-based practices. But this can be controlled by empirical evidences of EBP supported by well-designed studies.

Patient-Centered Outcomes Research Institute (pcori) is an independent nonprofit, non-government organization in Washington, DC, was authorized by congress in 2010. The aim of this organization is to improve the quality and relevance of evidence available to help patients, caregivers, clinicians, employers, insurers, and policy makers. This will help to make better informed health decisions (pcori, n.d). Making decisions in a critical situation is very crucial. A support or information based on evidence will be unforgettable during that period. It can make demonstrated reliable outcomes and will be asset to EBP.

The vision and mission of pcori is evidence based. It is stated in mission that pcori helps people make informed healthcare decisions. It helps to improve health care delivery and outcomes by producing and promoting high- integrity, evidence-based information that comes from research. These researches are guided by patients, caregivers and the healthcare community (pcori, n.d.).

Pcori (n.d) states that their Clinical Effectiveness and Decision Science (CEDS) program produce valid, trustworthy and useful new evidence comparing the effectiveness of different clinical options. This will help the users to make best decisions. They must be able to access and use reliable information about the option’s potential benefits and harms. This program emphasis on researches. For example, research on assessment of prevention, diagnosis and treatment options. This research compares the outcomes of two or more healthcare options, addressing gaps in the current evidence base. The study also compares clinical services known to be effective or in wide spread use because of perceived effectiveness. Also, they invite studies of variation in outcome across relevant patient groups (pcori, n.d). Pcori has several studies focusing to help individual patients. This proves that this organization emphasis on evidence-based practice.

In general, the reason for not implementing EBP includes lack of knowledge, resources and information, rituals, beliefs, and lack of work force. The successful achievement of the EBP aims requires highly effective organizations. The backbone of any effective health care system is an engaged and productive workforce (Sikka, Morath, & Leape, 2015).

I was impressed with the information provided by this organization. The research and result given is clear and concise. Normal people can easily access and understand the information provided. From my experience around 15-20 years back, decision making during a critical situation was very difficult. During that time technology was not developed compared to present. We have to depend on experienced health professional to get opinions. I remember we were approaching different physicians for second and third opinions before making a decision. But now organizations and their data based on empirical evidence are really an asset. For instance, the website of pcori has information based on classification of disease. So, normal people can even access it in easy way. As health care professional we can guide the communities to get the information. Also, as a responsible health care worker we should raise queries based on our clinical practice. This will lead to produce newer evidence-based solutions. This will force organizations to begin researches and find solutions. For example, to overcome the covid 19 pandemic, those who are directly involved has a great role in reporting the evidence-based data. This will help the researchers to find the treatment modalities. Melnyk & Fineout (2018) says when a clinical problem generates with multiple clinical questions, priority should be given to those questions with the most important consequences or those that occurs most frequently. So as a valuable health care professional we should be able to make changes focusing our society from different perspective.

Evidence based practice can bring many changes in health care system. As per Crabtree et al. (2016) organizational cultures can be transformed through implementation of EBP knowledge and skills. Utilization of EBP resources can improve the knowledge and resources. It also creates opportunities for nurses to participate in development of scholarly product. So, evidence-based practice not only make changes but also results in professional growth and development.

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.

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.

Pcori (n.d), pcori.org/about-us, http://www.pcori.org.

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

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.

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.

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)

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.

http://download.lww.com/wolterskluwer_vitalstream_com/PermaLink/NCNJ/A/NCNJ_165_516_2010_08_23_DGSODKGNM_1651_SDC516.pdf.

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. Retrieved from https://sigmapubs.onlinelibrary.wiley.com/doi/full/10.1111/wvn.12021.

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. Retrieved from https://qualitysafety.bmj.com/content/qhc/24/10/608.full.pdf

RE: Discussion – Week 1

Collapse

Globally various health care professionals are aware that evidence-based practice (EBP) improves healthcare quality, reliability, and patient outcomes and reduces care and cost (Melkyn et al., 2014). In the nursing field, EBP is instilled early on in our educational careers, and encouragements to continually cite or use the most current evidence-based practices for care are frequently provided. It is due to this dedication; that the profession of nursing has been a leader in catalyzing the adoption of EBP and using it as a marker of excellence(Stevens, 2013). However, EBP not only impacts nursing care but health organizations as a whole. Niklaus Children’s Hospital has a detailed section relating to nursing publications and innovations, which details the hospital’s reliance on EBP.

For instance, Miami Children’s encourages nurses to initiate or use Evidence-Based Practice (EBP) protocols to process improvements to nursing care and nursing research throughout the organization independently. Niklaus Children’s Hospital integrates evidence-based best practices and nursing research into clinical and operational processes to align with the Nursing Department’s commitment to provide high-quality care associated with positive patient outcomes. Therefore EBP plays a significant role in the health care organization’s distribution of patient-centered care and on their expectation of nursing professionals. Having discerned the importance of EBP to Niklaus Children Hospital has shifted my perception in a positive direction and reassured me that patient care is meeting the most up to date standards and policies.

References

Melkyn, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overhalt, 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. Sigma, 11(1), 5–15. https://doi.org/10.1111/wvn.12021

Niklaus Childrens Hospital. (2019). Nursing Publications. https://www.nicklauschildrens.org/medical-professionals/nursing/science-of-nursing/evidence-projects-publications

Stevens, K. R. (2013). The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas. The Online Journal of Issues in Nursing, 18(2). https://doi.org/10.3912/OJIN.Vol18No02Man04

Discussion: Where Is Evidence-Based Practice

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6052_Module01_Week01_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
13 (13%) – 14 (14%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
12 (12%) – 13 (13%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_6052_Module01_Week01_Discussion_Rubric

Thank you for such a well-written and concise post to our first discussion, I enjoyed reading your interpretation and ideas. As you explained throughout your post, evidence-based practice (EBP) is essential for optimal results and it was made clear that the World Health Organization (WHO) foundation is based upon this. EBP “is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values” ( Melnyk et al.,p.52, 2010). There are 50 times more health researchers in high-income countries than in low-income countries per the WHO database, and 0.2 percent of research grants were rewarded to low-income countries by international funders of health research, leaving a vast amount of area for improvement around the globe (Global Observatory, 2021).

Reviewing the analyses of Global Observatory on Health Research I was not impressed with the data or comprehensive source of information. It is important to put the money where we preach, priorities to new investments in research and knowledge will lead to EBP that is what needs to be implemented across the globe. As Boller pointed out in a report, all health professionals are better equipped to keep patients safe, by requiring the need to have competencies in patient-centered care, interprofessional collaboration, EBP, quality improvement, and informatics.

The overview you discussed regarding WHO I agree and enjoyed the details you laid out regarding the foundation of EBP found within this particular organization. The importance of practitioners to implement EBP is profound for improving the future of quality/optimal health care.

References

Boller, 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/10.3

928 /01484834-20171120-01

Global Observatory . (2021, November 29). World Health Organization. Retrieved 2021, from https://www.who.int/observatories/gl

obal/observatory-on-health-research-and-development

Melnyk, B. , Fineout-Overholt, E. , Stillwell, S. & Williamson, K. (2010). Evidence-Based Practice: Step by Step: The Seven Steps of Evidence-Based Practice. AJN, American Journal of Nursing, 110 (1), 51-53. doi: 10.1097/01.NAJ.0000366056.06605.d2.

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