Evidence is important in understanding and making decisions regarding public health. Empirical articles serve as credible sources of support because

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Evidence is important in understanding and making decisions regarding public health.

Evidence is important in understanding and making decisions regarding public health. Empirical articles serve as credible sources of support because they provide or describe evidence based on research. Empirical articles describe original research or the results of a study.

Begin by researching major causes and trends in morbidity and mortality in the United States. Once you have completed your research, identify one health issue related to morbidity and mortality. Locate three empirical articles from the GCU Library related to primary, secondary, and tertiary prevention, one for each level of prevention, including health promotion and screening related to the health issue you have identified in your research. Utilize the “PUB-510 Levels of Prevention Matrix” in order to evaluate your chosen articles.

Your selected articles must have been published within the last 5 years, and the information discussed in your matrix must be paraphrased/summarized.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Sample Expert Answer and Explanation

PUB-510 Levels of Prevention Matrix

Criteria and Defining Characteristics	Article 1	Article 2
Citation	Byambasuren, O., Hattingh, L., Jones, M., Obuccina, M., Craig, L., Clark, J., … & Cardona, M. (2023). Two decades of overuse and underuse of interventions for primary and secondary prevention of cardiovascular diseases: a systematic review. Current Problems in Cardiology, 48(3), 101529. https://doi.org/10.1016/j.cpcardiol.2022.101529	Dixit, J., Prinja, S., Jyani, G., Bahuguna, P., Gupta, A., Vijayvergiya, R., & Kumar, R. (2023). Evaluating efficiency and equity of prevention and control strategies for rheumatic fever and rheumatic heart disease in India: An extended cost-effectiveness analysis. The Lancet Global Health, 11(3), e445-e455. https://doi.org/10.1016/S2214-109X(22)00552-6
Abstract	The study addresses the levels of overuse and underuse of services for primary and secondary prevention of cardiovascular diseases (CVD) over the past two decades. The focus will be on understanding how these trends have deviated from clinical practice guidelines and the implications for patient care.	The study focuses on the cost-effectiveness of combined primary, secondary, and tertiary prevention strategies for rheumatic fever and heart disease in India. The study will evaluate the impact of these strategies on different socioeconomic groups.
Introduction:	The study aims to evaluate the adherence to clinical guidelines in the use of medications and procedures for preventing cardiovascular diseases. The scope covers various global regions over two decades. The study’s rationale is based on the significant morbidity, mortality, and financial burden of CVD, making it the leading cause of death worldwide. The study seeks to identify the reasons for overuse and underuse of CVD prevention methods, with a hypothesis that guideline non-adherence is widespread. The study reviews literature on overuse/underuse trends and their implications.	The study’s purpose is to assess the efficiency and equity of combined prevention strategies for rheumatic fever and heart disease in India. The scope includes evaluating costs and health outcomes across different wealth quartiles. The rationale is rooted in the need for efficient resource allocation to prevent and control rheumatic diseases, which have significant public health implications in India. The hypothesis is that combined prevention strategies are cost-effective and beneficial, particularly for poorer populations. The study provides a comprehensive literature review on prevention strategies and their effectiveness.
Methods:	The study samples 13 studies from different global regions, focusing on the adult population receiving CVD preventive care. Data collection involved systematic reviews of existing studies on medication prescription, testing, and lifestyle recommendations. The procedures included screening and analyzing literature for relevance to CVD prevention.	The population sampled includes a hypothetical cohort of 5-year-old children in India. Data collection involved constructing a Markov model to estimate lifetime costs and outcomes. Additional procedures included interviewing 702 patients from a rheumatic disease registry to assess out-of-pocket expenses and quality of life.
Results:	Findings indicate widespread overuse of certain medications and underuse of others, with significant variation across regions. Data was collected through systematic reviews and was supported by tables and charts showing variations in guideline adherence. The analysis reveals a trend of under-prescribing necessary medications and over-prescribing where not indicated.	The study finds that secondary and tertiary prevention strategies are the most cost-effective, particularly in poorer populations. Data was collected through patient interviews and model simulations, with findings presented in tables and graphs. The analysis indicates a significant reduction in rheumatic heart disease cases and out-of-pocket expenses, particularly in the lowest income groups.
Conclusion:	The study concludes that there is significant non-adherence to CVD prevention guidelines, leading to both overuse and underuse of interventions. Future research should focus on understanding the underlying causes of these trends and developing strategies to improve adherence to clinical guidelines.	The study concludes that combined secondary and tertiary prevention strategies are the most cost-effective for managing rheumatic diseases in India. Future research should explore ways to optimize these strategies for broader implementation across various populations.
References	The study uses a total of 59 references. Two examples: Allen-Tice, C., Steinberger, J., Murdy, K., & Zierhut, H. (2020). Pediatric cholesterol screening practices in 9- to 11-year-olds in a large midwestern primary care setting. Journal of Clinical Lipidology, 14(2), 224-230. https://doi.org/10.1016/j.jacl.2020.01.013 Roth, G. A., Mensah, G. A., Johnson, C. O., Addolorato, G., Ammirati, E., Baddour, L. M., Barengo, N. C., Beaton, A. Z., Benjamin, E. J., Benziger, C. P., Bonny, A., Brauer, M., Brodmann, M., Cahill, T. J., Carapetis, J., Catapano, A. L., Chugh, S. S., Cooper, L. T., Coresh, J., . . . Fuster, V. (2020). Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study. Journal of the American College of Cardiology, 76(25), 2982-3021. https://doi.org/10.1016/j.jacc.2020.11.010	The study uses a total of 58 references. Two examples: Watkins, D. A., Johnson, C. O., Colquhoun, S. M., Karthikeyan, G., Beaton, A., Bukhman, G., … & Roth, G. A. (2017). Global, regional, and national burden of rheumatic heart disease, 1990–2015. New england journal of medicine, 377(8), 713-722. https://doi.org/10.1056/NEJMoa1603693 WHO. (2020). Rheumatic heart disease. World Health organization. https://www.who.int/news-room/fact-sheets/detail/rheumatic-heart-disease

Article 3

Eliasson, A., Kashani, M., & Vernalis, M. (2021). Results of a prospective cardiovascular disease prevention program. Preventive Medicine Reports, 22. https://doi.org/10.1016/j.pmedr.2021.101344

The research focuses on the effectiveness of a 12-month lifestyle modification program in preventing cardiovascular disease, focusing on adherence to therapeutic lifestyle changes (TLC) and its impact on cardiovascular risk factors.

The study aims to assess the impact of a year-long cardiovascular disease prevention program focused on therapeutic lifestyle changes (TLC). The scope includes evaluating behavioral and clinical outcomes in a diverse population at risk for CVD. The rationale is based on the potential for TLC to significantly reduce CVD risk in a cost-effective manner. The hypothesis is that structured lifestyle interventions can improve cardiovascular health outcomes. The study reviews the effectiveness of various lifestyle interventions in CVD prevention.

The population sampled includes 965 adults eligible for care in the military health care system. Data collection involved comprehensive health assessments and personalized action plans over 12 months, with both on-site and telephonic coaching. Other procedures included measuring anthropometrics, laboratory tests, and a subset’s carotid intima-media thickness (CIMT).

Findings show significant improvements in dietary habits, exercise, stress management, and cardiovascular biomarkers among participants. Data was collected through health assessments and coaching sessions, with results supported by tables and statistical analyses. The study found substantial reductions in BMI, blood pressure, and cholesterol levels, suggesting the effectiveness of the TLC program.

The study concludes that a structured lifestyle modification program can significantly improve cardiovascular risk factors and overall health. Future research should explore longer-term impacts and include control groups to strengthen the findings.

The study uses a total of 78 references.

Two examples:

Ghisi, G. L. D. M., Chaves, G. S. D. S., Britto, R. R., & Oh, P. (2018). Health literacy and coronary artery disease: A systematic review. Patient Education and Counseling, 101(2), 177-184. https://doi.org/10.1016/j.pec.2017.09.002
Gallagher, R., Marshall, A. P., & Fisher, M. J. (2010). Symptoms and treatment-seeking responses in women experiencing acute coronary syndrome for the first time. Heart & Lung, 39(6), 477-484. https://doi.org/10.1016/j.hrtlng.2009.10.019

References

Byambasuren, O., Hattingh, L., Jones, M., Obuccina, M., Craig, L., Clark, J., … & Cardona, M. (2023). Two decades of overuse and underuse of interventions for primary and secondary prevention of cardiovascular diseases: a systematic review. Current Problems in Cardiology, 48(3), 101529. https://doi.org/10.1016/j.cpcardiol.2022.101529

Dixit, J., Prinja, S., Jyani, G., Bahuguna, P., Gupta, A., Vijayvergiya, R., & Kumar, R. (2023). Evaluating efficiency and equity of prevention and control strategies for rheumatic fever and rheumatic heart disease in India: An extended cost-effectiveness analysis. The Lancet Global Health, 11(3), e445-e455. https://doi.org/10.1016/S2214-109X(22)00552-6

Eliasson, A., Kashani, M., & Vernalis, M. (2021). Results of a prospective cardiovascular disease prevention program. Preventive Medicine Reports, 22. https://doi.org/10.1016/j.pmedr.2021.101344

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Evidence-Based Practice in Healthcare: A Comprehensive Guide

Introduction

Evidence-based practice (EBP) has emerged as the gold standard for healthcare delivery, representing a paradigm shift from tradition-based care to scientifically-informed decision making. As healthcare systems worldwide strive to improve patient outcomes while managing costs, understanding and implementing evidence-based practice has become more critical than ever. This comprehensive guide explores the fundamental aspects of evidence-based practice, its importance in healthcare, practical examples, and the essential components that make it effective.

Understanding Evidence-Based Practice

Evidence-based practice is defined as “integrating the best available evidence with the healthcare educator’s expertise and the client’s needs while considering the practice environment” (NCBI, 2023). This approach ensures that clinical decisions are grounded in the most current and reliable scientific evidence, combined with professional expertise and patient preferences.

The Three Core Components of Evidence-Based Practice

Evidence-based practice includes the integration of best available evidence, clinical expertise, and patient values and circumstances related to patient and client management, practice management, and health policy decision making. All three elements are equally important (American Physical Therapy Association, 2020).

1. Best Available Evidence

The first component encompasses high-quality research findings from peer-reviewed studies, systematic reviews, meta-analyses, and clinical guidelines. This evidence forms the scientific foundation for clinical decision-making and must be current, relevant, and methodologically sound.

2. Clinical Expertise

Clinical expertise represents the healthcare professional’s accumulated knowledge, skills, and experience in practice. This includes the ability to interpret research findings within the context of individual patient situations and apply clinical judgment when evidence may be limited or conflicting.

3. Patient Values and Preferences

The third component acknowledges that patients are partners in their care, bringing unique values, preferences, circumstances, and goals that must be considered in treatment decisions. This patient-centered approach ensures that care is not only evidence-based but also personalized and culturally appropriate.

Why Evidence-Based Practice is Important in Healthcare

Improved Patient Outcomes

Findings indicate that EBPs improve patient outcomes and ROI for healthcare systems (Connor et al., 2023). Research consistently demonstrates that evidence-based interventions lead to better clinical outcomes, reduced complications, and enhanced patient satisfaction.

Enhanced Quality and Safety

Evidence-based practice directly contributes to improved quality of care and patient safety. By following protocols and interventions supported by robust research, healthcare providers can minimize the risk of adverse events and ensure that patients receive the most effective treatments available.

Cost-Effectiveness

Healthcare systems implementing evidence-based practices often experience improved return on investment through reduced readmissions, shorter hospital stays, and more efficient use of resources. This economic benefit is particularly important in today’s healthcare environment where organizations must balance quality care with financial sustainability.

Professional Development

Integrating evidence-based practice (EBP) into the daily practice of healthcare professionals has the potential to improve the practice environment as well as patient outcomes (BMC Nursing, 2020). EBP promotes continuous learning and professional growth among healthcare providers.

Evidence-Based Practice Examples in Healthcare

Nursing Practice Examples

Use of oxygen to help with hypoxia and organ failure in patients with COPD represents one of many evidence-based interventions in nursing practice (American Nurses Association, 2024). Other examples include:

Hand Hygiene Protocols: Implementation of evidence-based hand hygiene practices has significantly reduced healthcare-associated infections across all care settings.
Fall Prevention Programs: Comprehensive fall risk assessments and targeted interventions based on research evidence have dramatically reduced patient falls in hospitals and long-term care facilities.
Pain Management Strategies: Evidence-based pain assessment tools and multimodal pain management approaches have improved patient comfort while reducing reliance on opioid medications.

Medical Practice Examples

Antibiotic Stewardship: Evidence-based guidelines for antibiotic prescribing have helped combat antibiotic resistance while ensuring appropriate treatment of bacterial infections.
Sepsis Bundles: Implementation of evidence-based sepsis recognition and treatment protocols has significantly reduced mortality rates in critically ill patients.
Preventive Care Guidelines: Evidence-based screening recommendations for conditions such as colorectal cancer, breast cancer, and cardiovascular disease have improved early detection and outcomes.

Rehabilitation Examples

Stroke Rehabilitation: Evidence-based early mobilization and task-specific training protocols have improved functional outcomes for stroke patients.
Orthopedic Recovery: Research-supported rehabilitation protocols following joint replacement surgery have reduced recovery times and improved long-term function.

Evidence-Informed Practice Definition

Evidence-informed practice is a broader concept that recognizes situations where high-quality research evidence may be limited or unavailable. In these circumstances, healthcare providers use the best available evidence, which may include expert consensus, case studies, or observational data, combined with clinical expertise and patient preferences to guide decision-making.

This approach acknowledges the reality that not all clinical situations have robust research evidence available, particularly in emerging areas of practice or with unique patient populations. Evidence-informed practice maintains the principles of EBP while being pragmatic about the types of evidence that can inform clinical decisions.

The Five-Step Evidence-Based Practice Process

The five steps are (1) asking the question, (2) acquiring the best evidence, (3) appraising the evidence, (4) applying the findings to clinical practice and (5) evaluating the outcomes of change (PMC, 2023).

Step 1: Ask the Clinical Question

Formulating a well-structured clinical question using frameworks such as PICO (Patient/Population, Intervention, Comparison, Outcome) helps focus the search for evidence and ensures relevance to the clinical situation.

Step 2: Acquire the Evidence

Systematic searching of databases such as PubMed, CINAHL, and Cochrane Library helps identify the best available evidence. This step requires knowledge of search strategies and understanding of different types of research studies.

Step 3: Appraise the Evidence

Critical appraisal involves evaluating the quality, validity, and applicability of the research evidence. This includes assessing study design, methodology, sample size, and potential biases.

Step 4: Apply the Evidence

Implementation involves integrating the appraised evidence with clinical expertise and patient preferences to make informed decisions about patient care.

Step 5: Evaluate Outcomes

Continuous monitoring and evaluation of patient outcomes following implementation helps determine the effectiveness of evidence-based interventions and identifies areas for improvement.

Barriers and Facilitators to Evidence-Based Practice

Common Barriers

Limited time for literature searches and critical appraisal
Insufficient access to research databases and full-text articles
Lack of confidence in research interpretation skills
Organizational culture that doesn’t support change
Inadequate resources for implementation

Key Facilitators

Leadership support and organizational commitment
Access to research databases and librarian support
Education and training in EBP skills
Dedicated time for evidence-based activities
Mentorship and peer support networks

Future Directions in Evidence-Based Practice

The future of evidence-based practice lies in overcoming implementation challenges and expanding its application across all healthcare settings. To move evidence-based interventions into practice, several strategies may be needed. Additionally, what works in one context of care may or may not work in another setting, thereby suggesting that context variables matter in implementation (NCBI Bookshelf, 2020).

Emerging trends include the use of artificial intelligence and machine learning to synthesize evidence, point-of-care decision support tools, and implementation science frameworks that help bridge the gap between research and practice.

Conclusion

Evidence-based practice represents a fundamental shift in healthcare delivery that prioritizes scientific evidence, clinical expertise, and patient preferences in decision-making. By understanding its components, importance, and practical applications, healthcare professionals can contribute to improved patient outcomes, enhanced quality of care, and more efficient healthcare systems. The successful implementation of evidence-based practice requires commitment from individuals, teams, and organizations, supported by appropriate resources, education, and leadership.

As healthcare continues to evolve, the principles of evidence-based practice will remain central to providing high-quality, safe, and effective patient care. Healthcare professionals who embrace these principles and develop the necessary skills will be better positioned to make meaningful contributions to their patients’ health and well-being.

References

American Nurses Association. (2024, February 26). What is evidence-based practice in nursing? ANA Enterprise. https://www.nursingworld.org/content-hub/resources/workplace/evidence-based-practice-in-nursing/

American Physical Therapy Association. (2020, March 23). Components of evidence-based practice. APTA. https://www.apta.org/patient-care/evidence-based-practice-resources/components-of-evidence-based-practice

Connor, L., Dean, J., McNett, M., Tydings, D. M., Shrout, A., Gorsuch, P. F., Hole, A., Moore, L., Brown, R., Melnyk, B. M., & Gallagher‐Ford, L. (2023). Evidence‐based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews on Evidence-Based Nursing, 20(1), 6-15. https://doi.org/10.1111/wvn.12621

National Center for Biotechnology Information. (2020). The evidence for evidence-based practice implementation. In Patient Safety and Quality: An Evidence-Based Handbook for Nurses. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK2659/

National Center for Biotechnology Information. (2023). Nursing professional development evidence-based practice. In StatPearls. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK589676/

Silva, T. M., Costa, L. C. M., Garcia, A. N., & Costa, L. O. P. (2023). Evidence-based practice models and frameworks in the healthcare setting: A scoping review. PLOS ONE, 18(6), e0288518. https://doi.org/10.1371/journal.pone.0288518

Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2020). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate nursing students. BMC Nursing, 19, 96. https://doi.org/10.1186/s12912-020-00522-x

Zhang, Y., Wang, S., Chen, L., & Li, X. (2024). Facilitating evidence‐based practice among nurses in a tertiary general hospital: A six‐year practice of an implementation strategy informed by the i‐PARIHS framework. Journal of Nursing Management, 2024, 8855667. https://doi.org/10.1155/2024/8855667