QUALITY NURS 6052 Week 11 Discussion

QUALITY NURS 6052 Week 11 Discussion


NURS 6052 Week 11 Essay Discussion: Creating a Culture of Evidence-Based Practice

An abundance of evidence can be found on almost any medical issue or health topic. Often, the availability of information is not the concern, but rather nurses struggle with how to convey the evidence to others and change practices to better reflect the evidence. Deep-rooted organizational cultures and policies can make some resistant to change, even to changes that can vastly improve the quality, effectiveness, and efficiency of health care. However, there are many strategies that nurses can employ to bring about changes to practice.

In this Discussion, you focus on how to create an organizational culture that supports evidence-based practice.

To prepare:

Review the information in this week’s Learning Resources. Examine the various suggestions for promoting an organizational culture that embraces the use of EBP.

Reflect on your own organization’s (or one in which you have worked) support of evidence-based practice. Examine how culture and policies impact the adoption of changes to practice based on evidence. What barriers exist?

Consider the models and suggestions for promoting evidence-based practice featured in this week’s Learning Resources. Identify models and suggestions that would work well in your organization.

Reflect on the significance of evidence-based practice in health care. What responsibility do nurses have to promote EBP and change practices to better reflect evidence and research findings?

Reflect on how nurses can disseminate findings from evidence-based practice research.

By Day 3

Post an evaluation of your organization’s use of EBP and how it is furthered or hindered by organizational culture and policies. Describe how you could disseminate the findings. Propose a strategy for strengthening the culture of EBP within the organization. Discuss a nurse’s responsibility to further the use of EBP, providing a rationale supported by specific information from the Learning Resources.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own review of the literature in the Walden Library.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Though rewarding, implementing Evidence-based nursing practice (EBNP) is not easy. It requires a top down approach, and resources.

First, you need to break down some personal barriers

The main barriers to implementing EBNP are the perception that it takes up valuable time, problems with access to information resources, skepticism and reluctance from practitioners who believe they are already practicing best practice despite their training being some time ago.

You can counter negative views by demonstrating the positive impact of EBNP using your own patient population or evidence from other services that have already implemented it. Partnering with an academic institution can improve your access to researchers and research methods.

Simple training sessions – face-to-face, webinars or other methods – can provide assurance and skills to nurses who may need to improve their evidence-based and accessing information resources. It’s important that this training is provided at all levels of the chain of command.

Your institution needs to change too

The culture of “nurses eat their young” – insensitive treatment of new nurses by their more experienced colleagues – needs to evolve. New nurses’ evidence-based training must be combined with seasoned practitioners’ experience:

  • EBNP can be included in new staff inductions to create a generation of, “This is how we do it” coming up through the ranks
  • Seasoned care-givers – who didn’t encounter EBNP in their nursing training – can be invited to apply their practical knowledge to evidence sourced by newer nurses, to allow both nurses to bring something to the team and reduce resistance to evidence-based practice

Mentoring plays a strong role in a solid EBNP implementation and practitioners from other services with successful EBNP implementations may be able to play a role here.

Your organization must encourage curiosity and inquiry, supporting experimentation and innovation and replacing “this is how we’ve always done it” with “evidence shows this is the best way to do it”.

EBNP is top-down, so leadership is important

Commitment starts at the top, with clinical leaders and managers.

Planning for EBNP must include clear goals and measurement criteria, and a strategic plan that shows how EBNP will be integrated into the organization.

Leaders need to commit their budgets and influence to provide resources, tools and skills to support EBNP. Guidelines must be clear and well communicated so that practitioners can successfully request resources as repeated knock backs will kill enthusiasm. This includes encouraging staff to attend conferences and bring back learning to share with the organization through posters, information sessions and training. Your implementation plans should include this.

A multi-level approach to implementing EBNP has been shown to be effective, and it is convenient to use the existing hierarchy of your organization to support it.

The plan must include clear goals, with a shared commitment to achieving them across the hierarchy of the hospital. And, of course, the clearest of all goals must be to integrate evidence into practice which results in a measurable improvement in care of patients, families, communities and the population.

Finally, evidence shows that the more people who participate in the change the greater the change will be – so include everyone for everyone to benefit.

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