Discuss Where Is Evidence-Based Practice
Discussion: Where Is Evidence-Based Practice
Discussion: Where in the World Is Evidence-Based Practice?
Although March 21, 2010 was not the date of EBP’s birth, it may have been the date on which the approach “grew up” and left home to face the world.
When the Affordable Care Act was passed, it included an empirical evidence requirement. EBP research has accelerated significantly. The application of EBP has expanded to include allied health professions, education, and healthcare technology. Health care organizations began implementing and promoting EBP.
In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.
ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Discussion: Where Is Evidence-Based Practice
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 and why or why
NURS 6052 Discussion Where Is Evidence-Based Practice
NURS 6052 Discussion Where Is Evidence-Based Practice
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.
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
Discussion: Where Is Evidence-Based Practice
Evidence Based Practice At The World Health Organization
Nursing knowledge and care has transitioned from being based on traditions, authority and trial and error to relying on research in order to improve soundness of decision-making capabilities (Laureate Education, 2018). Evidence Based Practice (EBD) is the approach to problem solving in regards to health care delivery that considers evidence from research and patient care data and integrates that information with clinician expertise and patient preferences (Melnyk, Fineout-Overholt, Stillwell, & Williamson, 2010). EBP has been embraced not only by nurses and hospitals but also more globally in healthcare organizations (e.g. reimbursement, accreditation bodies and national initiatives) such as The Joint Commission.
The Joint Commission is an independent, not-for-profit organization and the oldest and largest standard setting and accrediting body in health care (The Joint Commission, 2020a). The Joint Commission surveys a healthcare organization through chart review and staff and patient interview to determine if the organization’s provision of care meets certain standards (The Joint Commission, 2020b). Those standards focus on patient safety and quality of care and are updated regularly to match advances in health care and medicine (The Joint Commission, 2020b) and are rooted in evidence-based practice.
Emphasis on The Joint Commission’s commitment to excellence through EBP can be found throughout the website. The standards development process is described to be informed by scientific research and expert consensus that is reviewed by the Board of Commissioners (The Joint Commission, 2020c). However, despite thorough review of the website, no specific research or articles were cited as justification. There are portions that describe research published by the Center for Disease Control and Prevention and other reputable peer reviewed research organizations, but these are not accompanied with citations.
The Joint Commission’s work is grounded in EBP as evidenced by provision of rationale for each National Patient Safety Goal. For instance, in National Patient Safety Goals Effective July 2020 for the Behavioral Health Program (The Joint Commission, 2020d) each goal that is identified includes a detailed and evidence-based rationale. The format of identifying practice goals followed by rationale can be found in every National Patient Safety Goal document in all the specialties that The Joint Commission offers opportunity for accreditation.
Most seasoned health care workers are quite familiar with Joint Commission reviews of their facility. At times, some of the standards seem arbitrary or overly rigid for the bedside care provider. In having reviewed The Joint Commission’s website, I know understand that the attention to minutia is not meant to penalize, but rather to identify areas for improvement or validation of exceptional practice by the staff. Additionally, I was vaguely aware that there was rationale supporting the standards in a Joint Commission review, and the website offers a more comprehensive explanation for the rationale. I do continue to appreciate the importance of accreditation as it demonstrates a facilities adherence to important patient care standards.
The adoption and application of EBP in recent years has impacted health care organizations across the country. There has been a shift from providing care a certain way because of traditions, etc. to focusing on practice that is rooted in evidence. This change can be seen in the standards with rationales required for accreditation by The Joint Commission. Their standards are detailed comprehensively on their website. This is quite beneficial for those implementing policies and procedures at their own facilities, showing that these directives are data driven meets the needs of nurses who provide care based on research and knowledge.
References
Laureate Education (Producer). (2018). Introduction to evidence-based practice and research
[Video file]. Baltimore, MD: Author.
Melnyk, B. M. , Fineout-Overholt, E. , Stillwell, S. B. & Williamson, K. M. (2010). Evidence- based practice: Step by step: The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51-53. doi: 10.1097/01.NAJ.0000366056.06605.d2.
The Joint Commission. (2020a). Joint commission FAQs. Retrieved May 31, 2020 from https://www.jointcommission.org/about-us/facts-about-the-joint-commission/joint- commission-faqs/
The Joint Commission. (2020b). History of The Joint Commission. Retrieved May 31, 2020 from https://www.jointcommission.org/about-us/facts-about-the-joint-
commission/history-of-the-joint-commission/
The Joint Commission. (2020c). About our standards. Retrieved June 1, 2020 from
https://www.jointcommission.org/standards/about-our-standards/
The Joint Commission. (2020d). National patient safety goals effective July 2020 for the
behavioral health program. Retrieved from
file:///C:/Users/lisam/Downloads/NPSG_Chapter_BHC_Jul2020.pdf
Initial Discussion Post:
In this week’s post, I will be discussing the World Health Organization or WHO for short. WHO is a universal health organization that works worldwide to promote overall health and wellbeing, to keep the world safe and healthy, and to serve the vulnerable population. WHO is known as being a credible source of reliable health information and an excellent resource to those who are in need. The WHO works continuously to address many issues pressing the world’s population such as human capital across the life-course, noncommunicable disease prevention, mental health promotion, climate change, antimicrobial resistance, and the elimination and eradication of high impact communicable diseases (Douglas & Murphey, 2020).
On the “About WHO” section under “What we do” on the WHO’s website, a clear goal of the organization is established along with certain visions that the organization has. The website states “Our goal is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and well-being.” (N.A., 2020).
The WHO is certainly grounded in evidence-based practice or EBP. As defined as a conscientious, problem solving approach to clinical practice that incorporates the best evidence from well designed studies, patient values and preferences, and a clinician’s expertise in making decisions about a patient care. EBP is designed to enhance healthcare quality, improve patient outcomes, reduce costs, and empower clinicians (Lange, Lovesth, Teoh, Christensen, 2020). The WHO is designed on these principals to ensure the utmost quality of care worldwide to all people.
The information that I have obtained for this post has made me look differently at the world health organization. To be honest, I was not as informed about this healthcare organization as I now am. I was unaware of what all the WHO provided. I think that it is such a great organization and I am happy that their main focus is towards those in more vulnerable situations. They also are big in addressing health emergencies such as the current COVID-19 pandemic and work diligently with other healthcare organizations such as the CDC in investigating and implementing the best course of action.
References:
Annet H. de Lange, Lise Tevik Løvseth, Kevin Rui-Han Teoh, & Marit Christensen. (2020). Editorial:
Healthy Healthcare: Empirical Occupational Health Research and Evidence-Based Practice. Frontiers in Psychology, 11. https://doi-org.ezp.waldenulibrary.org/10.3389/fpsyg.2020.02236
Douglas, O., & Murphy, E. (2020). Assessing the Treatment of Potential Effect Modifiers Informing World
Health Organisation Guidelines for Environmental Noise. International Journal of Environmental Research and Public Health, 17(1). https://doi-
org.ezp.waldenulibrary.org/10.3390/ijerph17010315
No Author. Retrieved on December 1st, 2020 from https://www.who.int/about/what-we-do
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy
For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
Name: NURS_6052_Module01_Week01_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
Points Range: 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.
Points Range: 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.
Points Range: 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.
Points Range: 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
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3.
First Response
Points Range: 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.
Points Range: 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.
Points Range: 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.
Points Range: 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
Points Range: 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.
Points Range: 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.
Points Range: 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.
Points Range: 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
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 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
EBP Discussion Post 1
Evidence-based practice (EBP) has become an essential component to health care practices and organizations over the past decade. EBP “enhances healthcare quality, improves patient outcomes, reduces costs, and empowers clinicians; this is known as the quadruple aim in healthcare” (Melnyk & Fineout-Overholt, 2018, p. 7). By referring to evidence from past studies as well as using clinical decision making and a well-established knowledge base, doctors and healthcare providers can make educated decisions for their patients.
Organizations, alike, use evidence-based practice to stay up to date and relevant in health care. While reading my textbook, I came across the Patient-Centered Outcomes Research Institute (PCORI). PCORI is a federally funded initiative authorized by Congress in 2010 to “conduct research to provide information about the best available evidence to help patients and their healthcare providers make more informed decisions” (Melnyk & Fineout-Overholt, 2018, p. 15). PCORI works to help patients and consumers by ensuring evidence-based practice is being used for informed decision making. To do this, PCORI works with healthcare stakeholders to identify critical research questions and answer them through comparative clinical effectiveness research focusing on outcomes important to patients (PCORI.org, n.d.).
Evidence-based practice is evident throughout the PCORI website. Under the research tab of the website, “Putting Evidence to Work” is a section to click on with further information on how evidence is used by the organization. Under the impact tab of the website, three subheadings titled “Evidence Updates”, “Evidence Maps and Visualizations” and “Evidence Synthesis” can be clicked on with further, updated information on recent evidence-based studies and their impact on healthcare. The PCORI website is completely grounded in EBP and supports evidence-based practice to the full extent. Reading about the PCORI initiative on its website has changed my perception in a positive light. I fully intend to use evidence-based practice throughout my profession as I believe it leads to improved patient safety and outcomes. The PCORI initiative is an excellent addition in working towards the quadruple aim.
References
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Patient-Centered Outcomes Research Institute (PCORI). (n.d.). Retrieved from https://www.pcori.org/about/about-pcori