NRS465 Applied Evidence-Based Project and Practicum
Week 1 Discussion
DQ 1 The National Academy of Medicine (formerly the Institute of Medicine) championed the goal that 90% of clinical decisions will be evidence-based by 2020. A recent systematic review of the published literature indicates that evidence-based practice (EBP) implementation remains deficient despite an ongoing effort to increase implementation. Discuss two barriers that might hold nursing practice from achieving this goal and suggest ways in which the identified barriers may be addressed.
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN DQ Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
DQ 2 In preparation for your assignment this week, brainstorm two to three clinical practice problems or issues you can develop into a nursing practice change. What indicates these as clinical issues in nursing practice? Support your discussion with two peer-reviewed journal articles. Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “RN-BSN DQ Rubric” and “RN-BSN Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
ORDER THIS ASSISGNMENT OR ANY OTHER AT A DISCOUNT
DQ 1: Barriers to Evidence-Based Practice Implementation in Nursing
Despite the goal set by the National Academy of Medicine to have 90% of clinical decisions be evidence-based by 2020, evidence-based practice (EBP) implementation in nursing remains deficient. Two key barriers contribute to this challenge: a lack of time and inadequate EBP training among nurses.
Lack of Time: Nurses often face heavy workloads and time constraints, making it difficult to allocate time for reviewing and integrating the latest evidence into clinical practice. The high demands of patient care, documentation, and other administrative tasks leave little room for continuous learning and EBP application. To address this barrier, healthcare organizations could implement strategies such as dedicated EBP time blocks within shifts, access to quick reference tools, or streamlined processes for integrating EBP into daily routines. Additionally, fostering a collaborative work environment where EBP is shared among team members could reduce the individual burden on nurses.
Inadequate EBP Training: Many nurses lack sufficient training in EBP skills, including how to critically appraise research, integrate findings into practice, and apply EBP models effectively. This deficiency can lead to resistance or hesitation to adopt new practices due to a lack of confidence. Addressing this barrier requires investment in ongoing education and training programs that focus on EBP competencies. Incorporating EBP training into nursing curricula and offering continuing education opportunities can equip nurses with the skills needed to implement EBP confidently. Furthermore, having EBP mentors or champions within the healthcare setting can provide support and guidance, promoting a culture of evidence-based care.
References:
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.
Saunders, H., & Vehviläinen-Julkunen, K. (2016). The state of readiness for evidence-based practice among nurses: An integrative review. International Journal of Nursing Studies, 56, 128-140.
DQ 2: Clinical Practice Problems for Nursing Practice Change
In exploring potential clinical practice problems that could be developed into nursing practice changes, two issues stand out: medication administration errors and patient falls in the hospital setting.
Medication Administration Errors: Medication errors are a prevalent issue in clinical practice that can lead to adverse patient outcomes, including increased morbidity and prolonged hospital stays. Contributing factors include high nurse workloads, interruptions during medication administration, and inadequate knowledge of pharmacology. Evidence suggests that implementing technology solutions like barcode medication administration (BCMA) and enhancing nurse training on medication safety can significantly reduce these errors. A study by Keers et al. (2013) highlights the role of systemic factors, such as communication and workflow design, in medication errors, underscoring the need for comprehensive strategies that address both human and system-related causes.
Patient Falls: Falls are a common and preventable issue in healthcare settings, often resulting in serious injuries, increased healthcare costs, and longer hospital stays. Risk factors include impaired mobility, medication side effects, and environmental hazards. The Joint Commission identifies falls as a key patient safety concern and recommends multifaceted interventions, including patient education, environment modification, and use of assistive devices. Research by Cameron et al. (2018) supports the effectiveness of tailored fall prevention programs that involve interdisciplinary teams, which can significantly reduce fall rates among hospitalized patients.
References:
Cameron, I. D., Dyer, S. M., Panagoda, C. E., Murray, G. R., Hill, K. D., Cumming, R. G., & Kerse, N. (2018). Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database of Systematic Reviews, 9.
Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2013). Causes of medication administration errors in hospitals: A systematic review of quantitative and qualitative evidence. Drug Safety, 36(11), 1045-1067.
