NURSING SCIENCE-Evidence Based Practice

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The influence of evidence-based practice (EBP) has reached across nursing practice, education, and science. Forward-thinking healthcare systems empower their frontline staff with the autonomy to effect change by identifying research that supports best practices through the performance improvement process. This is done with an aim of improving patient outcomes. In order to complete such a task, EBP combines continuous quality improvement, research, performance improvement, and change theory. In this task, you will identify a healthcare problem and develop a question that can be informed by research evidence.

Requirements:

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

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The rubric provides detailed criteria for evaluating your submission. You are expected to use the rubric to direct the creation of your submission. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

A. Write a brief summary (suggested length of 2–3 pages) of the significance and background of a healthcare problem by doing the following:
1. Describe a healthcare problem.
2. Explain the significance of the problem.
3. Describe the current practice related to the problem.
4. Discuss how the problem impacts the organization and/or patient’s cultural background.

B. Complete the attached “PICO Table Template” by identifying all the elements of the PICO.
1. Develop the PICO question.

C. Describe the search strategy (suggested length of 1–2 pages) you used to conduct the literature review by doing the following:
1. Identify the keywords used for the search.
2. Describe the number and types of articles that were available for consideration.
a. Discuss two research evidence and two non-research evidence sources that were considered (levels I–V).

D. Complete the attached “Evidence Matrix” to list five research evidence sources (levels I–III) from scholarly journal sources you locate in major medical databases.

Note: Four different authors should be used for research evidence. Research evidence must not be more than five years old.

Note: You may submit your completed matrix as a separate attachment to the task or you may include the matrix within your paper, aligned to APA standards.

E. Explain a recommended practice change (suggested length of 1–3 pages) that addresses the PICO question within the framework of the evidence collected and used in the attached “Evidence Matrix.”

F. Describe a process for implementing the recommendation from part E (suggested length of 2–3 pages) in which you do the following:
1. Explain how you would involve three key stakeholders in the decision to implement the recommendation.
2. Describe the specific barriers you may encounter in applying evidence to practice changes in the nursing practice setting.
3. Identify two strategies that could be used to overcome the barriers discussed in F2.
4. Identify one indicator to measure the outcome related to the recommendation.

G. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.

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Course Mentor Suggestions:

Select articles that support one intervention, for example intentional rounding to prevent falls. The I (intervention) in the PICO should be supported by the 5 research studies included in the matrix. Do not choose a best practice for your PICO.

A1. Healthcare Problem/ A2. Significance of Problem/ A3. Current Practice / A4. Impact on Background
Write 1-2 paragraphs for each response. You may want to include in text citations to support these sections. The current practice should relate to the C in the PICO. Discussion on how the problem impacts either the workplace culture OR the patient’s culture is required.

B. PICO Table Download the table from Taskstream or just include a 4 row/2 column table in the paper and use the PICO toolkit as a guide (attached additional material).

B1. PICO Question Construct the question that relates to the PICO elements in the table using the PICO Question Development toolkit as a guide

C1. Keywords. This is just a list of the search terms used.

C2. Number and Types of Articles. Describe the number and research types/subtypes of the articles you find in your search. They may include research articles, quality improvement, practice guidelines, pieces written to educate/inform, expert opinion, and more. This is a bare-bones description of the number and types of articles you find. For example, you might begin by stating the number of articles that came up (10,000) and the number you reviewed (20) then give a breakdown of the types you reviewed (5 RCT, 5 Reviews, 5 Quality Improvement projects, 5 Qualitative). (1 paragraph)

C2a. Research and Non-Research Evidence. This will be 4 paragraphs describing the 2 research (Level I-III) and 2 non-research (Level IV-V) studies found during the search. Each paragraph should include the in-text citation for that article, for example:

The first research study found …example: (Smith & Jones, 2014).

Then write a few sentences about that research study and do the same for the other 3 articles. Review the research evidence appraisal toolkit and the research evidence articles. Review the non-research evidence appraisal toolkit and the non-research evidence articles.

D. Evidence Matrix. Enter the 5 research articles in the table using the level and quality guide toolkit to determine the correct level. The research design/type should be quantitative, qualitative, or mixed methods. Be sure not to include quality improvement projects in the table (Additional materials).

E. Recommended Practice Change. Discuss one single intervention that the 5 research studies support with evidence and use in-text citations from all 5 studies in the matrix. (1-2 paragraphs)

F1. Key Stakeholders. A stakeholder is anyone who has something to win or lose from this change. Also, think about those whom you need to engage in the process to make it a lasting change by involving them in the decision to make the change. They can be floor nurses, nurse educators, nurse managers, nurse administrators, etc. You will need to mention at least 3 and describe how you would involve each in the decision to change the procedure, for example collaborating to lead research education sessions that will spark discussion on updating current procedures, etc. Think about how you would do this in a real life situation. For each of the 3 stakeholders mentioned, write one sentence on how you would get them involved in the decision to change the procedure. (1-2 paragraphs)

F2. Barriers. This section is a discussion of the barriers to change. You may want to talk about change, delegation of tasks, training/education, funding, and attitude toward research as these are areas that cause barriers to initiation and continuing compliance with a practice change. For example, nurses may feel that research is not relevant to practice or not understand research or resist change, etc. Mention one barrier related to change and one barrier related to translation of research into practice. (1 paragraph)

F3. Strategies for Barriers. This section will discuss 2 strategies to overcome the identified barriers in section F2. (1 paragraph)

F4. Indicator to Measure Outcome. An indicator is something that can be measured. For example, if the I in the PICO is “hourly rounding to prevent falls” the outcome measure would be the number of falls.

G Sources. Remember to include 5 in-text citations in section E from the 5 research studies in the Evidence Matrix. Also, remember that the reference page should include all 7 studies mentioned in the paper, assuming the 2 research studies in C2a are also included in the Evidence Matrix.
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Book resource for course:
Dearholt, S. L., & Dang, D. (2012). Johns Hopkins Nursing Evidence-Based Practice: Models and Guidelines (2nd Edition). Indianapolis, IN, USA: Sigma Theta Tau International. Retrieved from http://www.ebrary.com

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