NURS 6052 Wk 9 Discussion: Developing a Culture of Evidence-Based Practice SAMPLE

NURS 6052 Wk 9 Discussion Developing a Culture of Evidence-Based Practice

RE: Discussion – Week 9

Implementing evidence-based practices can be difficult. A lack of mentors, a lack of understanding of EBP, and a lack of respect for EBP are examples of these (Melynk., el al, 2017). Creating committed mentors to aid in bringing about a culture shift within an organization is one approach I would take to address the issues raised in NURS 6052 Wk 9 Discussion Developing a Culture of Evidence-Based Practice. Furthermore, I would persuade management and administration of the importance of EBP in helping a company by enhancing job satisfaction and decreasing people turnover (Melynk et al.,). Departments will spend less on training as staff turnover decreases.

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Another technique I would use to propagate EBP is to encourage the use of peer-reviewed journals that provide examples of evidence-based practice. However, some employees may not have the time to access EBP principles or conduct research. One strategy I would use to increase EBP at a company is to distribute flyers and posters to employees. Flyers and posters would serve to remind people about the history and significance of EBP in healthcare. Furthermore, it would provide employees with better access to the changes the company intends to implement in response to EBP. In NURS 6052 Wk 9, Melynk and Fineout-Overholt argue that “a multiplicity of interventions are required, including a culture and an environment that fosters and sustains EBP.” Discussion Resources for Creating an Evidence-Based Practice Culture (2018). While supporting the culture change, signage and posters can act as a reminder to adopt tried-and-true approaches. Change may not be possible with fliers and posters. Training, such as modules or practical exercises, could be provided in combination with the flyers and posters. Employees can benefit from training to prepare them for the EBP change.

On-site journal clubs are one strategy I would not use. “Journal clubs allow physicians to communicate and learn about evidence-based techniques in their professional setting,” Melykn and Fineout-Overholt add (2018). (P. 565). Employees, in my experience, do not want to stay at a job for any longer than is absolutely necessary. An online journal club would be better to enable journaling from home while eliminating the requirement to attend in-person journal club meetings. It may be difficult to find a practitioner with advanced training who is willing to participate in on-site groups. Interaction with the organization is also limited due to the vast number of COVID patients.

Evidence based practice has multiple benefits when at a facility. Research has shown that can improve patient outcomes, provide a safer environment, and bring better quality healthcare (Melnyk et al 2017). A challenges with evidence-based practice is finding ways to implement EBP in an organization. One strategy that I would use to implement evidence-based practice at a facility is to have

NURS 6052 Wk 9 Discussion Developing a Culture of Evidence-Based Practice

organizational level presentations given by EBP mentors. By focusing on EBP at an organizational level, mentors have an opportunity to bring data that can help change policies. Melynk et al., (2011) explain…..”Measurement of outcomes(internal evidence) plus rigorous research( external evidence) results in the best evidence-based organizational policies to guide the highest quality of care in healthcare institutions”(P.4).

Discussion: Developing a Culture of Evidence-Based Practice

The dissemination of evidence-based practice (EBP) information and data on cancer care to different target audience including healthcare organisations, patients, government authorities, professionals and the general public can play a fundamental role in enhancing both population and patient health. Christenbery (2017) established that the creating and sustaining a culture of evidence-based practice requires the use of systematic and appropriate dissemination strategies and interventions to help in the sharing of information and knowledge on cancer. Unit-level presentations are primarily focused on ensuring the identification and response to issues affecting the healthcare unit within a healthcare facility through defining the context under which EBP is realised through communication of unit-based information and data to be used for attaining superior healthcare outcomes for cancer patients (Jolley, 2020). At the local level, podium presentations are widely considered effective in enabling the dissemination of EBP information and knowledge to the various local stakeholders, and hence the greater need to gain a better understanding of the context, realities and conditions under which to implement EBP. Moreover, the publication of evidence-based findings in peer-reviewed journals is also widely considered an important and popular dissemination strategy when communicating EBP amidst concerns over the reduced turnout for major stakeholders due to the growing requirements for subscription (Ramanadhan, 2020). Jolley (2020) insisted that all healthcare professionals including advanced practice nurses must receive proper training and education on EBP, right from methods of data generation and analysis, dissemination, knowledge use and falsification. Personally, I would primarily opt to use unit-level presentations to communicate to my fellow workmates and other key stakeholders within the unit as the appropriate dissemination strategy to share my knowledge, competencies and skills on the burden of cancer with the intention of contributing to sustained improvements in cancer care.

References

Christenbery, T. L. (2017). Evidence-based practice: A culture of organizational empowerment. Evidence-Based Practice in Nursing.

Jolley, J. (2020). Evidence-based practice. Introducing Research and Evidence-Based Practice for Nursing and Healthcare Professionals, 63-88.

Ramanadhan, S. (2020). Translating research into practice—implementation science. Oxford Handbook of Public Health Practice, 292-302.

Also Read:

NURS 6052 Wk 9 Discussion Developing a Culture of Evidence-Based Practice 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.

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Sustaining Evidence-Based Practice Through Organizational Policies and an Innovative Model. AJN American Journal of Nursing, 111(9), 57–60. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NAJ.0000405063.97774.0e

Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A Test of the ARCC© Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes. Worldviews on Evidence-Based Nursing, 14(1), 5–9.

RE: Discussion – Week 9

Evidence-based practice focus on essential elements that can help create a highly integrated environment where it is possible to attain better outcomes. The evidence-based practice focuses on a specific problem where the findings can be compared with other results previously obtained. Dissemination of evidence-based practice findings can be evaluated based on different settings, mainly where the practice will be applied. The work of evidence-based practice (EBP) is a stringent process that requires practitioners to continuously provide evidence in support of their decision-making process and policy/practice changes. Healthcare workers may use the EBP model to initiate and implement policy changes that will improve patient care. During the procedure, practitioners must present their appeals to the lawmakers, providing evidence of why the changes happen. There are several ways of disseminating the evidence. Melnyk and Fineout-Overholt (2018) define dissemination as “the process of distributing or circulating information widely.”

Two dissemination strategies that I would be most inclined to use

Unit-level presentations and local dissemination are the best dissemination strategies in my opinion (Harvey & Kitson, 2015). Unit-level dissemination is only successful if the issue has been considered in order to improve the underlying problem within the unit. Different units within a given setting may assess the operational environment differently. This implies that the context in which the evidence-based practice is implemented must be considered. As a result, ensuring that the engagement is strategic can help ensure that the intervention implemented is unit-based based on the results (Brownson et al., 2018). Organizations strive to implement critical aspects of performance improvement. However, evidence-based practice eliminated the risk of uncertainty, which is critical in achieving better results.

Local dissemination involves significant local players, which is a positive aspect that contributes to a strong emphasis on institutional development (Hall & Roussel, 2016). However, it is critical to ensure that the dissemination of results takes place in an environment with adequate resources and technical capability to achieve better results. The population’s skills and knowledge are likely to be a barrier to successfully implementing the developed practice. It is necessary to manage the needs of existing stakeholders, which aids in organizational planning and service delivery. Implementing evidence-based practice should result in a profoundly transformed environment in which positive change is easier to implement. As a result, training is critical in enabling stakeholders to implement evidence-based practices (Brownson et al., 2018).

Least Inclined Dissemination Strategies to be used

The least inclined dissemination strategies to be used in communicating EBP are poster presentations and podium presentations. The poster presentations may not give enough information, and the display may not look engaging and exciting, thereby losing the exhibition’s aim. The podium presentation, on the other hand, may encounter a low turnout of participants. There could be poor publicity of the expression leading to low attendance.

Barriers to be Encountered and Overcoming These Barriers

The barrier that could expect from the unit level presentation is the lack of interest from staff. An example is staff resistance when a change is to be implemented that they do not like or want. One way to overcome this barrier is by getting staff involved in the presentation. For instance, they are making a member of the team one of the speakers at the exhibition. In that way, they will be very interested in their presentation. The barrier that could be encountered in using peer-reviewed journals is the lack of access to the journals. An example are journals that mandates a subscription fee, which often puts off many readers. One way to overcome this barrier is by giving such journals free access to online readers.

NURS 6052 Wk 9 Discussion Developing a Culture of Evidence-Based Practice References

Brownson, R. C., Colditz, G. A., & Proctor, E. K. (Eds.). (2018). Dissemination and implementation research in health: translating science to practice. Oxford University Press.

Hall, H. R., & Roussel, L. A. (Eds.). (2016). Evidence-based practice. Jones & Bartlett Publishers.

Harvey, G., & Kitson, A. (2015). Implementing evidence-based practice in healthcare: a facilitation guide. Routledge.

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 10, “The Role of Outcomes on Evidence-based Quality Improvement and enhancing and Evaluating Practice Changes” (pp. 293-312)
Chapter 12, “Leadership Strategies for Creating and Sustaining Evidence-based Practice Organizations” (pp. 328-343)
Chapter 14, “Models to Guide Implementation and Sustainability of Evidence-based Practice” (pp. 378-427)

Gabriella, your response to the discussion topic has shed light on other ways to inform and implement evidence-based practices (EBP). While reading your reply, I became intrigued with the use of unit-level presentations. “An effective evidence-based presentation begins with an understanding of audience characteristics and needs, conference characteristics and presentation guidelines, and topical focus” (Melnyk and Fineout-Overholt, 2018, p. 548). Unit-level presentations have a smaller audience, with allows for questions and further explanations. A presentation of this type would allow for a more focused participation group.

Although unit-based presentations are a good idea when it comes to the implementation of EBPs, I do agree with your statement about experiencing a reduced turnout for significant stakeholders. If the stakeholders feel the implementation does not benefit them or their patients, they will not attend the presentation. “Carlos, Rebecca, and Chen reach out to the key stakeholders to tell them about the RRT project by meeting with them in their offices or calling them on the phone…. Each team member is able to meet with a stakeholder in person, fill them in on the RRT project, describe the purpose of an RRT, discuss their role in the project, and answer any questions” (Gallagher-Ford et al., 2011, para. 4). I believe this intervention would help solve the issue of stakeholders not attending the presentation.

Reference

Gallagher-Ford, L., Fineout-Overhold, E., Melnyk, B.M. & Stillwell, S.B. (2011). Evidence-based practice step-by-step: Implementing an evidence-based practice change. American Journal of Nursing, 111(3), 54-60.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice(4th ed.). Philadelphia, PA: Wolters Kluwer.

Gabriella, thanks for sharing this exciting post.

Universally, Evidence-Based Practice (EBP) is known as the foundational component of healthcare professional education. Delivering high-quality and safe patient care has been the supreme prerogative of all regulatory agencies. Moreover, EBP leads to high-quality care, enhanced patient outcomes, and lessened expenses. As you have stated, disseminating evidence-based practice (EBP) information and data on various medical conditions, such as cancer care to different other target groups such as healthcare organizations, patients, government authorities, professionals, and the general public plays an essential role in enhancing both population and patient health. Incorporating EBP into an organization’s culture is elongated and demands leadership sponsorship and aids.

Nonetheless, maintaining EBP is not precise, and many obstacles dissuade clinicians from unfailingly enforcing EBP, including insufficient aptitudes and wisdom. However, there is no magic bullet for translating what is known from research into a routine. Lehane et al. (2019) believe that attaining competency in this field has poised as a challenging task, which is reflected by disparities between “best EBP and actual clinical care.” Nevertheless, understandably, enhancing education and understanding of EBP practice is a remarkable thing to get a clear vision of the culture of this practice. To achieve optimum patient care outcomes, it is fundamental that hospitals foster a culture of clinical effectiveness by using EBP as their cornerstone. Furthermore, this can be done through “clinical effectiveness processes including evidence-based practice (EBP), clinical guidelines, clinical practice guidance, implementation science and clinical audit” (Lehane et al., 2021, p 2).

References

Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., … & Hegarty, J. (2019). Evidence-based practice education for healthcare professions: an expert view. BMJ evidence-based medicine, 24(3), 103-108.

Sam, A. M., Cox, A. W., Savage, M. N., Waters, V., & Odom, S. L. (2020). Disseminating information on evidence-based practices for children and youth with autism spectrum disorder: AFIRM. Journal of autism and developmental disorders, 50(6), 1931-1940.

Culture of Evidence-Based Practice

Developing a more comprehensive “solutions-focused” strategy, which includes strategic dissemination of findings, is critical for enhancing the translation of health research findings into clinical practice. Public health researchers can disseminate findings to diverse audiences using a community-engaged approach by communicating essential messages through various mechanisms, such as community forums, health profiles and videos, and a media event, and with dedicated planning, staff, and funding. (Monnard, Benjamins, Hirschtick, Castro, & Roesch, 2019).

Least Inclined Strategy to utilize

The dissemination practice that I would least utilize is publishing through a peer-reviewed journal. Although clinical research findings are frequently published in peer-reviewed journals or shared through clinical trial registries, the majority of clinical study data is rarely made publicly available, which can make it difficult for patients, physicians, researchers, and policy-makers to make informed decisions about their care. (Vasquez, et al., 2021). According to research, programs that have been published in scientific publications, have been extensively evaluated, and have been confirmed to be effective circulate far more slower than programs that are dispersed through other channels (e.g., marketing materials, summaries, and implementation guidance provided by Federal agencies) (Williams, Jessica, Caceda-Castro, Lizbeth, Dusablon, Tracy, & Stipa, Melissa, 2016).

Two dissemination strategies most inclined to use

The dissemination strategy that I intend to use is through an organizational-level presentation and a public forum. Starting on an organization and community level will promote active participation from the target audience. Nurses can use podium presentations to teach and disseminate knowledge, educating and persuading colleagues to adopt new ways of working and involving patients and colleagues in clinical projects (Foulkes, 2015). Nurse leaders must possess exceptional communication skills in order to improve health care at the institutional, community, national, and global levels.

Another strategy that I intend to utilize are printed educational materials such as an informational packet. In studies, participants stated that they interacted with others and shared the packet with others in their organization, regardless of whether they were directors or service providers. In addition to promoting talks about EBPs across different levels of staff, this peer sharing of knowledge helps to develop open dialogue and a consistent language about the organizational adoption process, which is an important aspect (Williams, Jessica, Caceda-Castro, Lizbeth, Dusablon, Tracy, & Stipa, Melissa, 2016).

Barriers and ways to Overcome

Fear of public speaking and unexpected problems, such as technical difficulties, are the potential roadblocks I may face in implementing a presentation as a dissemination plan. I want to conquer my public speaking apprehension by rehearsing, researching, and preparing thoroughly in the days leading up to the presentation. When it comes to technical difficulties, I will solve them by conducting a dry run to check that the materials are in working order before presenting. As for barriers regarding dissemination via Printed educational materials are concerned could be the readability of written material. To address this issue, I will research the target audience and adjust the material accordingly to avoid loss of understanding, failure to increase knowledge, and inability to follow instructions offered in printed work.

References

Foulkes, M. (2015, February). Presentation skills for nurses. Nursing Standard , 29(25). doi:10.7748/ns.29.25.52.e9488

Monnard, K., Benjamins, M., Hirschtick, J., Castro, M., & Roesch, P. (2019). Co-Creation of Knowledge: A Community-Based Approach to Multilevel Dissemination of Health Information. Health Promotion Practice, 22(2), 215-223. doi:10.1177/1524839919865228

Vasquez, E., Gouraud, H., Naudet, F., Gross, C., Krumholz, H., Ross, J., & Wallach, J. (2021, August). Characteristics of available studies and dissemination of research using major clinical data sharing platforms. Clinical Trials. doi:10.1177/17407745211038524

Williams, Jessica, Caceda-Castro, Lizbeth, Dusablon, Tracy, & Stipa, Melissa. (2016, June). Design, development, and evaluation of printed educational materials for evidence-based practice dissemination. International Journal of Evidence-Based Healthcare, 14(2), 84-94. doi:10.1097/XEB.0000000000000072

References

Foulkes, M. (2015, February). Presentation skills for nurses. Nursing Standard , 29(25). doi:10.7748/ns.29.25.52.e9488

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