Concisely define evidenced based practice, the evolution of EBP and how barriers to EBP can be overcome. Briefly give an example of a compelling clinical question that piques your interest
Week 1: Discussion Question – What is Evidence-Based Practice?
Discussion Prompt
Concisely define evidenced based practice, the evolution of EBP and how barriers to EBP can be overcome. Briefly give an example of a compelling clinical question that piques your interest.
Expert Answer and Explanation
Evidence-based practice (EBP) is a problem-solving approach to healthcare that uses the best available clinical expertise, evidence, and patient preferences or values to make clinical decisions. EBP helps to ensure that patients receive the most effective and appropriate treatments, which can lead to improved health outcomes (Melnyk & Fineout-Overholt, 2022). EBP helps to ensure that patients receive the most current and effective treatments, which can lead to a better quality of care. Evidence-based practice also involves the systematic review and critical appraisal of research findings, and the integration of these findings with clinical expertise and patient preferences to make informed decisions about treatment and care.
In healthcare, the evidence-based practice involves using the most up-to-date and scientifically validated information to guide clinical decision-making (Melnyk & Fineout-Overholt, 2022). This may include the use of randomized controlled trials, systematic reviews, and meta-analyses to identify the most effective treatments for particular conditions.
As a result, there is a need for an efficient dissemination method that can be used to increase the awareness of the method among all facilities. Disseminating EBP in healthcare requires a culture of inquiry and a systematic approach to finding, appraising, and applying the best available evidence (Melnyk & Fineout-Overholt, 2022). It requires collaboration among healthcare professionals, patients, and researchers and active engagement in the process of inquiry and discovery. It is an ongoing process that requires critical thinking, self-reflection, and continuous learning (Mathieson et al., 2019).
Be that as it may, the evidence-based practice emphasizes the importance of using the best available evidence to inform decision-making, while also taking into account individual circumstances, preferences, and clinical expertise.
References
Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary health care research & development, 20, e6.
Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Week 2: Discussion Question – PICOT Question
Discussion Prompt
Post a clinically relevant research question using the PICOT format. How did you arrive at this topic and question? Why is it important?
Expert Answer and Explanation
PICOT Question
In the general nursing unit (P), what is the effect of using periodical nursing education programs (I) in comparison to the implementation of internal policies (C) on reducing the conflicts in conducting ward rounds (O) to be completed over three months (T)?
Obtaining the Question
Coming up with the question made use of the various components of the PICOT question to determine the required intervention and comparison mode of care. To begin with, the population in this care the PICOT Question is the general nursing unit. The question is aimed at addressing the conflicts within the nurses and strategies for resolution. Identifying the the population makes it easier to understand the problem and ways of resolution. On the other hand, the intervention is the use of periodical nursing education programs. The use of educational programs was the preferred mode of intervention since it increases interactivity and is evidenced to be the most effective way to resolve nursing issues (Grubaugh & Flynn, 2018).
The intervention is essential as it offers the most preferred solution to the issue that the PICOT question suggests as a remedy to the issue at hand. The comparison is the use of internal policies. While the application of healthcare policies can be used to help solve the issues, it has a limited impact as there would not be a proper understanding of the magnitude of the issue and why it is important to both the nurses and the facility as a whole. In comparison to education, policies do not engage with the population and might be an alternative but not the most effective intervention
The outcome of the question is reducing the conflicts in conducting ward rounds. The purpose of the intervention is to help address the conflicts that can arise from nurses being reluctant to conduct nursing rounds. Education on the importance of the rounds and their essence can help the nurses attain the desired outcome (Walton et al., 2019). The time focuses on the timeframe of the education and overall implementation of the intervention. Overall, the question is important since it identifies a problem and recommends way to address them for a better nursing experience.
References
Grubaugh, M. L., & Flynn, L. (2018). Relationships Among Nurse Manager Leadership Skills, Conflict Management, and Unit Teamwork. JONA: The Journal of Nursing Administration, 48(7/8), 383–388. https://doi.org/10.1097/nna.0000000000000633
Walton, V., Hogden, A., Long, J. C., Johnson, J. K., & Greenfield, D. (2019). How Do Interprofessional Healthcare Teams Perceive the Benefits and Challenges of Interdisciplinary Ward Rounds. Journal of Multidisciplinary Healthcare, 12, 1023–1032. https://doi.org/10.2147/jmdh.s226330
Week 3: Discussion Question – Appraising the Literature
Discussion Prompt
Once you have selected a PICOT question discuss your strategies for conducting a systematic search/review of the literature in order to answer your question. Explain how you will critically appraise the literature you have selected to determine the best evidence for this assignment.
Expert Answer and Explanation
Conducting an effective systematic search is efficient in answering the PICOT question in a more accurate and succinct manner. Some of the struggles that ought to be addressed include the identification of relevant databases, the development of search strategies, and undertaking the research among others. The first step of the strategy is to identify the databases within the field of nursing such as PubMed, CINAHL, or Cochrane Library (Gunnell et al., 2020).
These databases contain peer-reviewed research articles and other sources related to the topic. The other step is to identify a preferred search strategy through the use of relevant keywords and MeSH terms that are related to the PICOT question. The search phrases will help in the identification of relevant literature when conducting the search (Gunnell et al., 2020). Screening to the literature can also be used to complement the search phrases to eliminate studies that do not meet the needs of the PICOT question.
Critical appraisal of the literature involves evaluating the quality, relevance, and validity of the research studies or articles that have been identified through a systematic search. One way to critically appraise the literature is to use established tools or checklists to assess the quality of the studies (Miller et al. 2019). This can include assessing the study design, sample size, intervention, outcomes, and potential biases or limitations.
It is also important to consider the relevance of the studies to the research question, the appropriateness of the statistical methods used, and the generalizability of the findings. Additionally, it is important to evaluate the credibility and expertise of the authors and to consider potential conflicts of interest. Overall, critical appraisal of the literature requires a systematic and rigorous approach to evaluate the quality and validity of the studies and to inform evidence-based practice.
References
Gunnell, K., Poitras, V. J., & Tod, D. (2020). Questions and answers about conducting systematic reviews in sport and exercise psychology. International Review of Sport and Exercise Psychology, 13(1), 297-318.
Miller, J. D., Vize, C., Crowe, M. L., & Lynam, D. R. (2019). A critical appraisal of the dark-triad literature and suggestions for moving forward. Current Directions in Psychological Science, 28(4), 353-360.
Week 4: Discussion Question – Statistical Tests
Discussion Prompt
Select one of the more common statistical tests used in nursing research. State which statistic you selected. What level of measurement is required for using your selected statistical test? Provide an example of how your selected statistical test could be used in a nursing research study.
Expert Answer and Explanation
The statistical test that I selected for this discussion is the Analysis of Variance (ANOVA) test. ANOVA is a commonly used statistical test in nursing research since it can be used to compare means among three or more groups (Stoker et al., 2020). The level of measurement required for using ANOVA is at least interval-level data, although ratio-level data is preferred. This means that the data must have equal intervals between each value, and there must be a meaningful zero point.
The level of evidence would help shape the nature on which the data is manipulated and correlated to identify the variance among the various variables (Stoker et al., 2020). The use of ANOVA helps determine the statistical difference between the different groups created by the levels of the independent variables. Understanding the statistical tests and how it works makes it possible to know how to interpret the outcomes and ensure a quality outcome.
An example of how ANOVA could be used in a nursing research study is research examining the effects of three different types of pain management interventions on postoperative pain levels. In this regard, the ANOVA test will need to evaluate different forms of interventions. The three interventions being compared are non-pharmacological interventions, opioid medications, and non-opioid medications.
In this study, participants would be randomly assigned to one of the three intervention groups, and their pain levels would be measured at multiple time points following surgery (such as hourly basis post-op). The data would then be analyzed using ANOVA to determine if there are statistically significant differences in pain levels among the three intervention groups at each time point (van den Bergh et al., 2020). The variance among the results would help shape the nature in which the outcome is interpreted based on the best results and most preferred intervention.
Reference
Stoker, P., Tian, G., & Kim, J. Y. (2020). Analysis of variance (ANOVA). In Basic Quantitative Research Methods for Urban Planners (pp. 197-219). Routledge.
van den Bergh, D., Van Doorn, J., Marsman, M., Draws, T., Van Kesteren, E. J., Derks, K., … & Wagenmakers, E. J. (2020). A tutorial on conducting and interpreting a Bayesian ANOVA in JASP. LAnnee psychologique, 120(1), 73-96.
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