NUR 3643-Deliverable 6-Evidence-Based Practice Proposal

NUR 3643-Deliverable 6-Evidence-Based Practice Proposal

Practice Issue

 The lack of a standard approach to addressing unique patient issues not discussed in their manuals or institution’s policy often leaves nurses to render their service based on their general and sometimes insufficient knowledge. The lack of established and recognized Evidence-Based Practices in healthcare institutions leaves physicians and nurses stranded when they have to make innovative real-life decisions to avoid diagnosis, medical or care errors. According to Lehane et al. (2019), EBP stakeholders such as expert practitioners, patients, and national policymakers must be involved in EBP curriculum development. Therefore, there is a need to have a standard procedure and guidelines that would inform the clinician’s decision-making when faced with unique medical dilemmas. The necessity to utilize research to inform the health care givers’ decisions, considering professional ethics, patient preference and use of the individual practitioner’s skills, could not be overemphasized.

Research Question

Question: What is required to develop a guide for clinicians to apply current scientific knowledge and match it to patient preferences to increase medical and diagnosis accuracy and overall patient satisfaction?

This proposal focuses on developing a holistic EBP model based on the Revised Iowa model of EBP, focusing on patient engagement, utilizing the individual’s experience, and using external evidence of scientific research to improve healthcare decisions and outcomes. Considering that the EBP model development requires cooperation from the healthcare stakeholders, the proposal outlines the role of each stakeholder under evidence retrieval, evidence appraisal, plan for implementation, plan for evaluation, and the plan to sustain evidence change.

Evidence Retrieval

 Evidence retrieval is an essential link in EBP that ensures that the correct scientific research information is chosen. Evidence retrieval in EBP practice includes EBP curricula development, peer-reviewed article analysis, and seeking expert opinion. Analysis of Peer-reviewed articles entails external data necessary to collect. In contrast, specialist opinion from senior healthcare personnel and collecting preference information from patients and other healthcare stakeholders constitute internal data collection. According to Lehane et al. (2019), the provision of EBP at the undergraduate and postgraduate levels also ensures that clinical decisions would demand to be based on current clinical data, resulting in the best clinical outcomes. Additionally, analysis of the peer-reviewed articles and use of expert opinions enable clinicians to produce an effective evidence-based diagnosis, adhere to safety practices, and sustain changes in the healthcare practice.

Evidence Appraisal

 Evidence appraisal in EBP requires the efforts of all the stakeholders, such as librarians, physicians and nurses. For instance, librarians must train nurses to effectively access quality and valid research materials within their institutions. According to Fowler and McCarthy (2019), the evidence appraisal in EBP should consider the evidence’s quality, quantity, consistency, and risk aspects. The EBP appraisal process follows a phase path: forming a clinical question, researching for the evidence, conducting an evidence analysis, applying the evidence identified as effective and efficient, and assessing the outcome to inform future decisions (Dolezel, 2021). The appraisal of the scientific research on the subject matter and expert opinions should guide the clinician’s decisions and actions. Therefore, this proposal emphasizes that nurses should always confirm the quality, validity, and consistency of the scientific evidence used to make decisions.

NUR 3643-Deliverable 6-Evidence-Based Practice Proposal

Plan for Implementation

 This report proposed that the afore-lined-up processes and procedures and data collection from the healthcare stakeholders should be conducted, reviewed, examined, interpreted and implemented within six months. Some of the data collection methods to be used in the proposal include expert interviews through Zoom within the first two weeks of the program. Secondly, in the third week, researchers should hold qualitative interviews to collect data and clinicians’ opinions regarding the proposed EBP. Lastly, the filling of questionnaires by the patients is scheduled for the third month. Later in the program, the proposal suggests that findings be analyzed for reliability in informing the study, sorted, and the data analysis and evaluation should follow. Participant researchers should publish their research on the subject and set the implementation process of the study’s proposals in motion.

Plan for Evaluation

 The evaluation of the EBP is necessary to inform the proposal’s progress through the analysis of the data collected. The primary goal of this proposal is to develop a guide for clinicians to apply current scientific knowledge and match patient preferences to increase satisfaction. Secondly, the proposal aims to reach the clinicians’ expertise with the changing healthcare practice through collecting and analyzing healthcare stakeholders. Lehane et al. (2019) state expert interviews are best evaluated using qualitative content analysis, such as transcribing, reading, paraphrasing, coding, and thematic comparison. Also, the data provided by the patients in the questionnaires are analyzed for five days in the fifth month to evaluate the patient’s preferences and develop effective patient engagement. Lastly, return interviews would be conducted to assess the validity of including the expert opinion in the proposal during the last week of the fifth month. This process ensures that proposed actionable steps are reliable and informed by credible and accurate findings.

Plan to Sustain Practice Change

 The success of sustaining change in EBP needs collaboration from healthcare stakeholders. A significant resource that the proposal would use to maintain permanent change involves setting up a strategic planning system covering the management of the changes and a guide for the nurses to implement the change. For instance, the difference in EBP requires strategic planning and a competency-based approach from the lower levels of healthcare to the senior clinicians. In contrast, leadership should take a top-down approach (Fisher et al. 2016). Therefore, in the proposal, it is vital to plan to implement the competency-based strategy that encourages lower-level healthcare givers to initiate EBP by collecting scientific research information.

The plan also encourages the nurses to seek guidance and expert opinions from senior colleagues across fields, further promoting workplace collaboration. Furthermore, planning to produce a manual detailing all the practice changes and distributing it to the stakeholders to familiarize themselves with them before the scheduled implementation is crucial to ensuring success. Also, the manual will contain a continuous quality improvement form that records the stakeholders’ feedback and checks implementation progress. The information feeding on the manual would be done monthly to ensure sustainability and accountability long after the initial implementation processes kick-off.

References

Dolezel, J., Zelenikova, R., Finotto, S., Mecugni, D., Patelarou, A., Panczyk, M., … & Jarosova, D. (2021). Core evidence‐based practice competencies and learning outcomes for European nurses: Consensus statements. Worldviews on Evidence‐Based Nursing.

Fisher, C., Cusack, G., Cox, K., Feigenbaum, K., & Wallen, G. R. (2016). Developing Competency to Sustain Evidence-Based Practice. The Journal of Nursing Administration, 46(11), 581–585. https://doi.org/10.1097/NNA.0000000000000408

Fowler, C., & McCarthy, A. M. (2019). Iowa model revised: Research and evidence-based practice application.

Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., … & Hegarty, J. (2019). Evidence-based practice education for healthcare professions: an expert view. BMJ evidence-based medicine, 24(3), 103-108.

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NUR 3643-Deliverable 6-Evidence-Based Practice Proposal

In this area, provide an introduction that provides an overview of the evidence-based proposal.

Practice Issue

 This section is due in Module 8. Provide an introduction of the identified practice issue, including:

• a detailed description of the problem aligned with organizational priorities
• the setting for the practice issue
• The rationale why you selected this problem and why a practice change is necessary with supporting internal and external data.

Research Question

This section is due in Module 8. State a research question using the PICO format. Break the research question into four paragraphs, describing each component in detail.

• P= Population
• I=Intervention
• C=Comparison Intervention
• O=Outcomes

Evidence Retrieval

This section is due in Module 9. Describe interprofessional and interprofessional team members you would select to assist with gathering and appraising evidence. Include rationales supporting your choices for team members

.Discuss the search strategy to locate evidence related to the practice issue, including critical words, databases used, and the number and types of articles found.

Evidence Appraisal

 This section is due in Module 9. Summarize and synthesize the evidence found in the search to establish the significance of the practice issue and support the proposed evidence-based practice solution.

Plan for Implementation

 This section is due in Module 10. The implementation plan for the proposed evidence-based practice solution includes:

• Description of key stakeholders
• Proposed timeline

Plan for Evaluation 

This section is due in Module 10. The evaluation plan for the proposed evidence-based practice solution must include:

• At least two goals written in the SMART format <link to http://rasmussen.libanswers.com/faq/212524>
• Description of types of internal and external data necessary for evaluation
• Description of the timeline for data collection
• Description of methods for data analysis

Plan to Sustain Practice Change

This section is due in Module 10. Plan for sustained practice change must include:

• Description of at least two resources needed to maintain permanent change
• Definition of at least two critical indicators for continuous quality improvement
• Plan for reinfusion.