Translation of Evidence and Application Paper

Translation of Evidence and Application Paper

Evidence-based practice (EBP) is a profound norm that promotes a new paradigm for nursing activities by emphasizing the importance of incorporating the best evidence and proven interventions in medical activities. Although EBP entails a series of steps such as creating a culture of inquiry, setting clinical questions, selecting and appraising external evidence sources, and disseminating information to policymakers and quality improvement teams, the knowledge translation phase remains a prerequisite for effective implementation of evidence-based practices. As an experienced nursing practitioner in the emergency room, I have encountered various contextual challenges that compromise practical translation approaches. Therefore, this paper elaborates on barriers to knowledge translation, roles of DNP-prepared nurses in creating an organizational culture that promotes EBP, and change theories/best practice recommendations for addressing barriers to knowledge translation.

Barriers to Knowledge Translation

Emergency departments are susceptible to multiple challenges that prompt nurses and other healthcare practitioners to embrace evidence-based practice. As an experienced emergency room nurse, I encountered daunting situations where patients endured pain and life-threatening conditions that required individualized care models such as patient-centered care. Other issues prone to emergency departments include overcrowding and physician burnout. These constraints contribute to compromised knowledge translation by resulting in a lack of interdisciplinary collaboration, time pressure for implementing changes, lack of leadership commitment to enact evidence-based practices, and inadequate support from stakeholders. According to White et al. (2019), common barriers to effective implementation of evidence-based practice and diffusion of innovation are the insufficient time to read research findings, workloads that create time constraints to implement new ideas, nurses does not have authority to change patient care procedures and inconsistent institutional culture that discourages the tenets of evidence-based practices. These challenges are prevalent in emergency departments and require healthcare professionals to embrace interdisciplinary collaboration and incorporate appropriate translation frameworks and theories.

ORDER A PLAGIARISM-FREE PAPER HERE

Theories and Best Practice Recommendations for Addressing Barriers to Knowledge Translation

Knowledge translation and diffusion of innovation entail converting suggestions from internal and external evidence to quality improvement initiatives and methods. White et al. (2019) propose various strategies for ensuring effective knowledge translation. These strategies include developing tool kits, conceptualizing practice guidelines, incorporating decision support systems, setting clinical pathways, and academic detailing. Other approaches for translating theoretical knowledge to clinical practices include developing interdisciplinary teams, initiating quality improvement plans and rapid cycle performance improvement (RCPI), and establishing scorecards and dashboards. Although institutions have plenty of options to consider when implementing recommendations from external evidence, they should embrace practical theories and frameworks for tackling barriers to effective knowledge translation.

John Kotter’s change theory provides eight recommendations for implementing quality improvement initiatives. These steps include establishing a sense of urgency, developing coalitions and interdisciplinary teams, developing a vision/strategic plan, communicating objectives and change vision, and empowering employees to embrace change (Carman et al., 2019). Further, the theory proposes the importance of generating short-term wins, consolidating gains and intensifying change, and sustaining/anchoring new approaches to the organizational culture. Undoubtedly, it is possible to group these steps into three tenets; creating a climate of change, engaging and enabling organizations to enact change, and implementing and sustaining change. Eventually, healthcare professionals in the emergency department can utilize Kotter’s 8-step model to address barriers for effective knowledge translation and diffusion of innovation to improve care and promote patient safety.

DNPs’ Role in Creating an Organizational Culture that Embraces Evidence-based Practice and Quality Improvement

As a DNP-prepared nurse, I am responsible for promoting patient safety and guaranteeing their satisfaction by embracing evidence-based practice. According to White et al. (2019), evidence-based practice (EBP) is an effective strategy for fulfilling the triple aims of care; better care, healthy communities, and care affordability (p. 4). With healthcare professionals operating under a renewed vigor of promoting the triad objectives, DNP nurses are central to knowledge translation due to their research expertise and leadership qualities.

The prominent role of DNP nurses is to promote interdisciplinary collaboration by engaging with other healthcare stakeholders such as nurse assistants, physicians, social workers, physical therapists, and patients. According to Aghaei et al. (2020), engaging patients in care delivery practices promotes the human components of care that enhance human dignity, self-healing, and the overall tenets of patient-centered care. Other essentials for DNP-prepared nurses in creating an organizational culture that supports evidence-based practice include providing the necessary leadership and management skills, supporting clinical reasoning, inspiring nursing research, and coordinating quality improvement teams (Rivaz et al., 2021). Undoubtedly, fulfilling these roles poses a challenge to advanced practice nurses due to the underlying impediments within institutional cultures. Therefore, interdisciplinary collaboration remains a profound strategy for creating a culture of evidence-based practice and quality improvement.

Conclusion

Knowledge translation entails extracting meaning and value from internal and external evidence recommendations. In this sense, it entails various methods for implementing evidence-based insights to improve care quality, solve problems, and promote patient safety. As an experienced emergency room nurse, I faced time pressure, increased workloads, and management inconsistencies that were barriers to effective knowledge translation. DNP-prepared nurses should address these challenges by implementing Kotter’s eight-step recommendations that culminate in three primary tenets; creating a climate of change, engaging and enabling organizations to implement change, and enacting and sustaining change.

References

Aghaei, M., Vanaki, Z., & Mohammadi, E. (2020). Watson’s human caring theory-based palliative care: A discussion paper. International Journal of Cancer Management, 13(6), 1-6. https://doi.org/10.5812/ijcm.103027

Carman, A. L., Vanderpool, R. C., Stradtman, L. R., & Edmiston, E. A. (2019). A change-management approach to closing care gaps in a federally qualified Health Center: A rural Kentucky case study. Preventing Chronic Disease, 16. https://doi.org/10.5888/pcd16.180589

Rivaz, M., Shokrollahi, P., Setoodegan, E., & Sharif, F. (2021). Exploring the necessity of establishing a doctor of nursing practice program from experts’ views: A qualitative study. BMC Medical Education, 21(1). https://doi.org/10.1186/s12909-021-02758-w

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2019). Translation of evidence into nursing and healthcare (3rd ed.). Springer.

ORDER A PLAGIARISM-FREE PAPER HERE

Based on your work in previous modules, you will wrap up the course with a discussion on challenges in translating and applying evidence to implement a quality improvement initiative. Draw on your experience in your current or previous healthcare settings to consider specific barriers to address and opportunities to leverage in advocating for evidence-based practice quality improvement.

Photo Credit: steheap / Adobe Stock
To prepare:
• Review the readings in the White, Dudley-Brown, and Terhaar text. With your current health care organization or an organization you are targeting for your DNP Project, in mind, consider the area(s) of greatest challenge with regard to translating and applying evidence for a practice change initiative, e.g., leadership, technology, collaboration, stakeholder buy-in. Focus on the relevant text chapter(s) in your Discussion preparation.
• Consider theories and best practice recommendations for addressing your identified challenges and barriers to translating and applying evidence that would support practice change initiatives.
• Reflect on the philosophy of nursing practice that you developed in Modules 1–2. Consider your role as a DNP in creating an organizational culture that embraces evidence-based practice and quality improvement.
With these thoughts in mind …
By Day 3 of Week 11
Post an explanation of the challenges and barriers to translating and applying evidence for practice change in your target health care organization. Briefly explain your issue(s) of concern and describe specific approaches for addressing these challenges. Explain how you view your role as a DNP in creating a health care culture that promotes translation of evidence for quality improvement and explains why. Then, recommend actions and activities you could model and lead, including through an EBP QI project, to advocate for quality improvement and social change in nursing. Be specific and provide examples.