Adopt EBP Models and Frameworks EBP is often viewed as a theoretical concept that is difficult to apply in the “real world,” making it challenging to promote and use. Adopting and implementing a model or framework of EBP throughout an organization can help apply evidence at the point of patient care. Implementation of EBP should also be part of organizational and departmental goals. By using models or frameworks and identifying EBP goals and objectives, clinicians and scholars can work together to use EBP to improve patient care delivery. The goals and objectives should also include clear expectations that EBP is an interdisciplinary approach to be conducted in a collaborative fashion, not as individual departmental strategies (Melnyk & Fineout-Overholt, 2019). For example, the intensive care unit employees may be working on an EBP goal to reduce the incidence of delirium development in their patient population. Employees from nursing, occupational therapy, physical therapy, pharmacy, clinical nutrition, and other departments would be involved in reducing delirium cases by working together as an interdisciplinary team. Promote an interprofessional approach Successful implementation of EBP requires a vibrant interdisciplinary team vision in conjunction with clear expectations (including goals and objectives) from organizational leaders that EBP is the basis of all delivered patient care. EBP should be an essential part of the organization’s vision, mission, and values statements, as well as in the strategic plan. The organization should also make interprofessional continuing education regarding EBP a part of the orientation process and ongoing education for all employees (Melnyk & Fineout- Overholt, 2019). The following are suggestions for implementing EBP.
When applying evidence (research findings) to clinical practice, nurses and their interdisciplinary colleagues should use a problem-solving approach to patient care (Melnyk & Fineout- Overholt, 2019): ● Ask a clinical question. ● Gather the latest and most relevant research to answer the question. ● Analyze the evidence. ● Incorporate personal clinical experience, patient’s situation, available resources, and patient’s preferences and values. ● Evaluate the results. ● Apply the evidence to the delivery of patient care. Henry et. al (2019) developed a model for the swift implementation of EBP. Their model is called Evidence Scanning for Clinical, Operational, and Practice Efficiencies (E-SCOPE) and involves four steps: 1. Conduct quarterly evidence searches to identify newly published scientific evidence. 2. Decide which evidence-based practices to implement with input from the interdisciplinary team. 3. Support implementation of selected practices. Specific responsibility for implementation should be given to qualified individuals. 4. Monitor progress. The progress of implementation should be monitored and regularly evaluated, usually each quarter but more often if needed. Experts in all fields emphasize the importance of applying EBP across the continuum of care. EBP must be established as the basis of healthcare in all settings and by all members of the interdisciplinary team.
NURSING RESEARCH
The language of critical appraisal and research Before further discussing EBP and nursing research, it is necessary to define a few essential terms related to research. The following list is not all-inclusive, but it does provide a basis for discussions concerning EBP and nursing research: ● Validity : The extent to which assumptions made in a research study are accurate and well-founded. When validity is used to describe a research tool, it means the extent to which that tool measures what it is intended to measure (Polit & Beck, 2022). ● Reliability : The extent to which a measurement is free from measurement error. In other words, it is the extent to which study results are the same for repeated measurements (Polit & Beck, 2022). ● Risk : The probability of harm or injury (physical, psychological, social, or economic) as a result of participating in a research study (UCI Office of Research, 2019). ● Outcome : The conclusions investigators reach as the result of the research(Polit & Beck, 2022) In addition to understanding the preceding concepts, nurses must be familiar with additional terms essential to the critical analysis of research articles. The following is a sampling of these terms (Polit & Beck, 2022): ● Abstract : A brief, comprehensive summary of a research study that appears at the beginning of an article. ● Case study : A research method that involves a thorough, in- depth assessment of an individual, group, or another social unit. ● Cause and effect : A relationship in which one event (the cause) makes another event happen (the effect). ● Conceptual framework : The structure of concepts or theories that serves as the foundation for a study. ● Consent : Permission given by a competent person to participate in a research study. Consent is also referred to as informed consent and is an ethical obligation of the researcher. The researcher must obtain voluntary informed consent from research participants after telling them
about both the potential benefits and the possible risks of participating in the study. ● Control group : A group in a research study that consists of participants who do not receive the treatment or intervention under investigation. The outcomes of participants in the control group are compared to those of the participants who receive the treatment or intervention under investigation to establish its effectiveness or ineffectiveness. ● Double-blind study : Neither the researchers nor the participants know the specific details of the experiment. This type of study is used to safeguard against experimental bias. An example of a double-blind study involves a medication trial where trial medications and placebos are administered. At the time of administration, neither group nor the investigators know which group received the placebo and which group received the medication. ● Experimental research group : A group of randomly selected participants from the research group who will receive the experimental treatment, medication, or variable. ● Hypothesis : An educated prediction about the relationship between two or more variables. ● Mean : The average score between two variables or scores. It is the arithmetic average of all scores. ● Random selection : A selection process in which each member of the identified population has an equal and independent chance of being included in the sample. ● Randomization : A method of choosing a sample in which each member of the population has an equal and independent chance of being selected to either the experimental group or the control group. ● Risk : The possible negative consequences of participation in a research study. ● Sample : A sample is a subset of a population that is used to represent an entire group. ● Single-blind study : A study in which the researchers know specific details of the study, but the participants do not.
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