NURS-6052N-37, Essent of Evidence-Based Pract.2017

Discussion:-1

Nursing Research and Evidence-Based Practice

In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care.

Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).

To prepare:

Consider a recent clinical experience in which you were providing care for a patient.

Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?

What questions have you thought about in a particular area of care such as a procedure or policy?

Review Chapter 2, pages 31–34 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.

Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.

Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.

Learning Resources

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 1, “Introduction to Nursing Research in an Evidence-Based Practice Environment”

This chapter provides an introduction to nursing research, its history, and the evolution of evidence-based practice. It includes an overview of credible sources of evidences and a description of the different paradigms used in nursing research.

Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice”

The focus of this chapter includes an overview of the key aspects of evidence-based practice, a review of how to identify credible research and appraise its value, and, finally, a discussion on how to take the identified evidence and convert it into a practice.

Chapter 3, “Key Concepts and Steps in Qualitative and Quantitative Research”

In this chapter, quantitative and qualitative research models are compared and the major steps in each approach are described. Information is also presented on the different sections of a research journal article and how you can identify the research model that was utilized.

Adams, J. S. (2010). Utilizing evidence-based research and practice to support the infusion alliance. Journal of Infusion Nursing, 33(5), 273–277.

This article examines how evidence-based research and practice supports infusion alliances. The text also specifies the increasing challenges that infusion nurses face.

Mallory, G. A. (2010). Professional nursing societies and evidence-based practice: Strategies to cross the quality chasm. Nursing Outlook, 58(6), 279–286.

This article describes strategies for reducing the gap between research knowledge and practice. The article also details how nursing societies could use these strategies to improve the quality of care.

Newhouse, R. P., & Spring, B. (2010). Interdisciplinary evidence-based practice: Moving from silos to synergy. Nursing Outlook, 58(6), 309–317.

In this article, the authors examine the state of interdisciplinary evidence-based practice (EBP). The authors detail efforts to promote interdisciplinary EBP, academic and clinical training regarding interdisciplinary EBP, and strategies that may facilitate EBP translation across disciplines.

Shaheen, M., Foo, S., Luyt, B., Zhang, X., Theng, Y-L., Chang, Y-K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: Nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229–236.

This article reviews a study that sought to determine nurses’ awareness of, knowledge of, and attitude toward EBP. The article also describes factors likely to promote barriers to EBP adoption.

Shivnan, J. C. (2011). How do you support your staff? Promote EBP. Nursing Management, 42(2), 12–14.

This article explores the role of the nurse manager in supporting evidence-based practice. The article also explains barriers and strategies to promote EBP for a nurse manager.

 Walden Student Center for Success. (2012). Clinical Question Anatomy. Retrieved July 9, 2014, from http://academicguides.waldenu.edu/content.php?pid=183871&sid=2950360

Media

 Laureate Education (Producer). (2012). Timeline of nursing research. Baltimore, MD: Author.

This multimedia piece features a timeline of major events in nursing research. The timeline highlights how historical events and seminal research have contributed to nursing practice.

Discussion:-2

Literature Searches

An important step in the EBP process is reviewing the current body of literature to better understand the subject or topic in which you are interested. By conducting a review of the literature, you are building foundational knowledge about the topic; later, you can use this background to build new insights. Developing a strong grasp of a topic can only be garnered by taking the time to thoroughly search for relevant information and resources.

For this Discussion, you will practice searching the literature to find evidence on a specific topic.

To prepare:

Choose a simple search term(s) relating to a topic of your PICOT question.

Review the information on the evidence hierarchy discussed in Chapter 2 of the course text, in the article, “Facilitating Access to Pre-Processed Research Evidence in Public Health,” and in the multimedia presentation “Hierarchy of Evidence Pyramid,” found in this week’s Learning Resources.

Review the information on the Walden Library’s website, “Levels of evidence.” Take a few minutes to explore the different types of databases available for each level of evidence and focus on the meaning of filtered and non-filtered resources.

Conduct a literature search in the Walden Library on your selected topic using the databases that you reviewed. Use at least one database for each of the three levels of filtered information and at least one unfiltered database. Record the number of hits that you find at each level of the hierarchy of evidence.

Select one article from the results at each level of the hierarchy. Compare the articles based on the quality and depth of information. What would be the value of each resource if you were determining an evidence-based practice?

Please Provide References

Learning Resources

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice” (Review pages 14–31)

Chapter 5, “Literature Reviews: Finding and Critiquing Evidence”

In this chapter, you focus on conducting a literature review. Topics include how to identify the relevant literature on a given topic and then how to critique the strengths and weaknesses of the literature that you have found. Finally, the chapter examines how to synthesize the research findings into a written literature review.

Houde, S. C. (2009). The systematic review of literature: A tool for evidence-based policy. Journal of Gerontological Nursing, 35(9), 9–12.

This article emphasizes the importance of systematic reviews of literature. The authors present an overview of resources that may assist in conducting systematic reviews.

Krainovich-Miller, B., Haber, J., Yost, J., & Jacobs, S. K. (2009). Evidence-based practice challenge: Teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students. Journal of Nursing Education, 48(4), 186–195.

This article reviews the features of the TREAD Evidence-Based Practice Model. In particular, the authors of this article stress how the model emphasizes the use of standardized critical appraisal tools and Level I evidence.

Robeson, P., Dobbins, M., DeCorby, K., & Tirilis, D. (2010). Facilitating access to pre-processed research evidence in public health. BMC Public Health, 10, 95.

This article describes a hierarchy of pre-processed evidence and how it is adapted to the public health setting. The authors identify a range of resources with relevant public health content.

 Walden Student Center for Success. (2012). Clinical Question Anatomy. Retrieved July 9, 2014, from http://academicguides.waldenu.edu/content.php?pid=183871&sid=2950360

Barker, J. (n.d.) Basic search tips and advanced Boolean explained. Retrieved August 3, 2012, from http://www.lib.berkeley.edu/TeachingLib/Guides/Internet/Boolean.pdf

 This resource provides a graphical representation of different approaches to research and gives examples of each.

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

This article reviews the frameworks commonly used to assist in generating answerable research questions. The author recommends considering the individual elements of the frameworks as interchangeable (depending upon the situation), rather than trying to fit a situation to a specific framework.

Walden University Library. (2012). Levels of evidence. Retrieved from http://academicguides.waldenu.edu/c.php?g=80240&p=523225

This guide provides a listing of evidence-based clinical resources, including systematic reviews and meta-analyses, critically appraised topics, background information and expert opinions, and unfiltered resources.

Indiana State University. (n.d.). Database search strategies. Retrieved July 6, 2012, from http://libguides.indstate.edu/content.php?pid=118904&sid=1065428

In this resource, the most common types of database searches are highlighted. It includes topics such as nesting searches, phrase searches, and using synonyms of key words in the search.

 Library of Congress Online Catalog. (2008). Boolean searching. Retrieved from http://catalog.loc.gov/help/boolean.htm

This web page provides a basic overview of Boolean searches and provides simple examples of key search terms.

Walden University. (n.d.b.). Searching and retrieving materials in the research databases. Retrieved August 10, 2012, from http://academicguides.waldenu.edu/foundationscoursedocs/SearchingRetrieving

This resource provides tips for searching in the Walden Library. It includes a guide to keyword searches, an explanation of Boolean searches, and tips on locating specific journals or articles.

 Document: Course Project Overview (Word document)

Note: You will use this document to complete the Project throughout this course.

Media

Laureate Education (Producer). (2012e). Finding resources for EBP. Baltimore, MD: Author.

In this video, Dr. Marianne Chulay identifies sources where nurses can find evidence to support their practices. She provides several examples of resources that provide specific information about best practices in health care.

Laureate Education (Producer). (2012f). Finding sources of evidence. Baltimore, MD: Author.

Dr. Kristen Mauk explains the process of performing a literature review in this video. She provides advice for nursing students in browsing databases and analyzing sources of evidence.

 Laureate Education (Producer). (2012g). Hierarchy of evidence pyramid. Baltimore, MD: Author.

This multimedia piece explains the hierarchy of evidence pyramid. The piece offers definitions and key information for each level of the pyramid.

Discussion:-3

Theory, Research, and Evidence-Based Practice

As they explore the world around them, young children often want to know the “why” and “how” of the things they observe. This is similar to what researchers do when they approach a new problem. Researchers develop new theories or build on old ones to explain the “why” of the world around them. They use models and conceptual frameworks to help explain “how” the processes and events they observe occur. Together, theories and models provide an understanding of the world and allow researchers to explore it in meaningful ways.

Virtually all research questions can benefit from the use of an existing theory or model. Researchers should consider their research questions and select the most suitable theory or model, which then serves as a foundation for the research design. The selection of a theory or model is an important part of the research process.

In this Discussion, you focus on the role of theory and models in research and evidence-based practice.

To prepare:

Review the information in Chapter 6 of the course text. Focus on the various conceptual theories and models that are currently used in nursing research.

Select one of the theories or models described that is of interest to you.

Using the Walden Library, search for and identify a research article that uses the theory or model you selected.

Reflect on how the theory or model provides structure to the research study described in the article.

Now, think about an issue in your practice area that you would be interested in exploring through research.

Review this week’s media presentation and consider strategies for locating and identifying a relevant theory or model for a research study.

Please Provide References

Learning Resources

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice” (Review pages 14–31)

Chapter 6, “Theoretical Frameworks”

In this chapter, you are introduced to the concept of theories, models, and frameworks and how they serve as the foundation for research. The chapter examines key theories for both quantitative and qualitative research. Finally, critiquing frameworks in research reports is detailed.

Cantrell, M. A. (2011). Demystifying the research process: Understanding a descriptive comparative research design. Pediatric Nursing, 37(4), 188–189.

This article discusses the primary aspects of a prominent quantitative research design as used in a specific research study. The author analyzes the advantages and disadvantages of the design, along with the rationale for choosing that design.

Finn, P. (2011). Critical thinking: Knowledge and skills for evidence-based practice. Language, Speech, and Hearing Services in Schools, 42(1), 69–72.

This article responds to the assertion that “rational or critical thinking is an essential complement to evidence-based practice.” The author stipulates how critical thinking is relevant to EBP, what skills and thinking dispositions are important, and how thinking can go wrong.

Tagney, J., & Haines, C. (2009). Using evidence-based practice to address gaps in nursing knowledge. British Journal of Nursing (BJN), 18(8), 484–489.

This article illuminates key barriers to undertaking and implementing nursing research. The authors suggest a framework for improving the implementation of evidence and research.

Media

Laureate Education (Producer). (2012i). Selecting a framework. Baltimore, MD: Author.

This animated video shows the process of selecting a particular research framework. The video follows a specific scenario in which a researcher considers several possible frameworks and selects the most appropriate one.

Discussion:-4

Ethical Dimensions of Research Studies

In the best-selling book, The Immortal Life of Henrietta Lacks (Skloot, 2010), the author highlights the true story of an African-American woman who died in 1951 from cervical cancer. What makes her story unique is that prior to her death, cells from her tumor were removed and successfully grown in a petri dish. This was the first time scientists were able to successfully replicate cells outside the body, and it is estimated that billions of Lacks’ cells have been used in medical research. However, Henrietta Lacks was never asked for permission to take a sample and her family was never made aware of the widespread use of her cells. Although the culturing of her cells has been pivotal for advancing research, strong ethical concerns later arose about using these cells without patient or family approval.

This week’s readings describe historical examples of unethical research, such as a study of syphilis among African-American men in which treatment was withheld and a study in which live cancer cells were injected into elderly patients. Today, stricter controls that seek to protect study participants are placed on researchers, but breaches still occur. Careful attention must be given toward preventing unethical behavior. In this Discussion, you explore ethical considerations and issues in research.

To prepare:

Select a current health-related case involving research ethics. (If none come to mind, browse the Internet to familiarize yourself with recent cases.)

As you review the case that you have selected, reflect on the ethical principles discussed in “What Are the Major Ethical Issues in Conducting Research?” article found in this week’s Learning Resources. Which principles were breached in the case you have identified?

Please Provide References

Learning Resources

Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 3, “Key Concepts and Steps in Qualitative and Quantitative Research” (for review)

Chapter 4, “Research Problems, Research Questions, and Hypotheses”

This chapter focuses on the steps in planning a study to generate evidence. These include developing a research question, identifying variables, articulating a problem statement, and generating hypotheses.

Chapter 7, “Ethics in Nursing Research”

In this chapter, the focus is on the ethical dilemmas that occur when planning and conducting research and the ethical principles that have been enacted for protecting study participants.

Fouka, G., & Mantzorou, M. (2011). What are the major ethical issues in conducting research? Is there a conflict between the research ethics and the nature of nursing? Health Science Journal, 5(1), 3–14.

This article describes a literature review conducted to determine the most important ethical issues that nurses encounter when undertaking or participating in research. The authors detail the results of the review and make recommendations for solving some of the problems highlighted.

Newcomb, P. (2010). Evolving fairness in research on human subjects. Journal of Child and Adolescent Psychiatric Nursing, 23(3), 123–124.

In this article, the author describes some of the ethical controversies that may arise in conducting research in human subjects, especially with respect to ownership of genes. The author also stresses the importance of educating research subjects and their families about the ultimate purpose of research.

Yakov, G., Shilo, Y., & Shor, T. (2010). Nurses’ perceptions of ethical issues related to patients’ rights law. Nursing Ethics, 17(4), 501–510.

The authors of this article detail a study conducted to determine how nursing staff deal with ethical issues in relation to the law. The article emphasizes the difficulty staff had in distinguishing between legal and ethical problems. The authors make several recommendations to deal with legal and ethical problems.

 Delwiche, F. (2008). Anatomy of a scholarly research presentation in the health sciences. Retrieved from http://dana.uvm.edu/Anatomy/

This presentation highlights the primary components of scholarly research articles. The presentation details the distinguishing factors of scholarly journals, the peer-review process, and the definition of “primary literature.”

 American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Retrieved from http://nursingworld.org/DocumentVault/Ethics-1/Code-of-Ethics-for-Nurses.html

This website provides the code of ethics for nurses to be used in carrying out their responsibilities. There is also a detailed explanation of each provision.

 Document: Literature Review Summary Table Template (Word document)

Note: You will use this document to complete the Project throughout this course.

Media

 Laureate Education (Producer). (2012a). Anatomy of a research study. Baltimore, MD: Author.

This multimedia piece explains the “anatomy” of both quantitative and qualitative research studies. In addition, there is a brief quiz at the end of the tutorial to measure knowledge about research articles.

Laureate Education (Producer). (2012d). Evidence-based practice and research. Baltimore, MD: Author.

In this video, Dr. Marianne Chulay talks about the significance of evidence-based practice and research in nursing. She explains how nurses should apply research findings to health care decisions to improve outcomes.

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