NURS6052: ESSENTIALS OF EVIDENCE BASED PRACTICE

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NURS6052: ESSENTIALS OF EVIDENCE BASED PRACTICE

NURS 6052: ESSENTIALS
OF EVIDENCE BASED PRACTICE

Module 1:
Evidence-Based Practice and the Quadruple Aim (Week 1)

Discussion: Where in the World Is Evidence-Based Practice?

March 21,
2010, was not EBP’s date of birth, but it may be the date the approach “grew
up” and left home to take on the world.

When the
Affordable Care Act was passed, it came with a requirement of empirical
evidence. Research on EBP increased significantly. Application of EBP spread to
allied health professions, education, healthcare technology, and more. Health
organizations began to adopt and promote EBP.

In this
Discussion, you will consider this adoption. You will examine healthcare
organization websites and analyze to what extent these organizations use EBP.

To Prepare:

·
Review the Resources and reflect on the definition and goal of
EBP.

·
Choose a professional healthcare organization’s website (e.g., a
reimbursing body, an accredited body, or a national initiative).

·
Explore the website to determine where and to what extent EBP is
evident.

By Day 3 of Week 1

Post a
description of the healthcare organization website you reviewed. Describe
where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or
goals of the healthcare organization, or in other locations on the website).
Then, explain whether this healthcare organization’s work is grounded in EBP
and why or why not. Finally, explain whether the information you discovered on
the healthcare organization’s website has changed your perception of the healthcare
organization. Be specific and provide examples.

Assignment:
Evidence-Based Practice and the Quadruple Aim

Healthcare organizations
continually seek to optimize healthcare performance. For years, this approach
was a three-pronged one known as the Triple Aim, with efforts focused on
improved population health, enhanced patient experience, and lower healthcare
costs.

More recently, this
approach has evolved to a Quadruple Aim by including a focus on improving the
work life of healthcare providers. Each of these measures are impacted by
decisions made at the organizational level, and organizations have increasingly
turned to EBP to inform and justify these decisions.

To Prepare:

·
Read the articles by
Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle
(2016); and Kim et al. (2016) provided in the Resources.

·
Reflect on how EBP might
impact (or not impact) the Quadruple Aim in healthcare.

·
Consider the impact that
EBP may have on factors impacting these quadruple aim elements, such as preventable
medical errors or healthcare delivery.

To Complete:

Write a brief analysis
(no longer than 2 pages) of the connection between EBP and the Quadruple Aim.

Your analysis should
address how EBP might (or might not) help reach the Quadruple Aim, including
each of the four measures of:

·
Patient experience

·
Population health

·
Costs

·
Work life of healthcare
providers

 

Module 2: An Introduction to Clinical Inquiry and Research
Methodologies (Weeks 2-3)

Assignment:
Evidence-Based Project

Is there a difference
between “common practice” and “best practice”?

When you first went to
work for your current organization, experienced colleagues may have shared with
you details about processes and procedures. Perhaps you even attended an
orientation session to brief you on these matters. As a “rookie,” you likely
kept the nature of your questions to those with answers that would best help
you perform your new role.

Over time and with
experience, perhaps you recognized aspects of these processes and procedures
that you wanted to question further. This is the realm of clinical inquiry.

Clinical inquiry is the
practice of asking questions about clinical practice. To continuously improve
patient care, all nurses should consistently use clinical inquiry to question
why they are doing something the way they are doing it. Do they know why it is
done this way, or is it just because we have always done it this way? Is it a
common practice or a best practice?

In this Assignment, you
will identify clinical areas of interest and inquiry and practice searching for
research in support of maintaining or changing these practices. You will also
analyze this research to compare research methodologies employed.

To Prepare:

·
Review the Resources and
identify a clinical issue of interest that can form the basis of a clinical
inquiry.

·
Based on the clinical
issue of interest and using keywords related to the clinical issue of interest,
search at least four different databases in the Walden Library to identify at
least four relevant peer-reviewed articles related to your clinical issue of
interest.

·
Review the results of
your peer-reviewed research and reflect on the process of using an unfiltered
database to search for peer-reviewed research.

·
Reflect on the types of
research methodologies contained in the four relevant peer-reviewed articles
you selected.

Part 1: An Introduction
to Clinical Inquiry

Create a 4- to 5-slide
PowerPoint presentation in which you do the following:

·
Identify and briefly
describe your chosen clinical issue of interest.

·
Describe how you used
keywords to search on your chosen clinical issue of interest.

·
Identify the four
research databases that you used to conduct your search for the peer-reviewed
articles you selected.

·
Provide APA citations of
the four peer-reviewed articles you selected.

Part 2: Identifying
Research Methodologies

After reading each of
the four peer-reviewed articles you selected, use the Matrix Worksheet template
to analyze the methodologies applied in each of the four peer-reviewed
articles. Your analysis should include the following:

·
The full citation of
each peer-reviewed article in APA format.

·
A brief (1-paragraph)
statement explaining why you chose this peer-reviewed article and/or how it
relates to your clinical issue of interest, including a brief explanation of
the ethics of research related to your clinical issue of interest.

·
A brief (1-2 paragraph)
description of the aims of the research of each peer-reviewed article.

·
A brief (1-2 paragraph)
description of the research methodology used. Be sure to identify if the
methodology used was qualitative, quantitative, or a mixed-methods approach. Be
specific.

·
A brief (1- to
2-paragraph) description of the strengths of each of the research methodologies
used, including reliability and validity of how the methodology was applied in
each of the peer-reviewed articles you selected.

 

Module 3: Advanced Clinical Inquiry and PICO(T) Questions
(Weeks 4-5)

Discussion:
Searching Databases

When you
decide to purchase a new car, you first decide what is important to you. If
mileage and dependability are the important factors, you will search for data
focused more on these factors and less on color options and sound systems.

The same
holds true when searching for research evidence to guide your clinical inquiry
and professional decisions. Developing a formula for an answerable,
researchable question that addresses your need will make the search process
much more effective. One such formula is the PICO(T) format.

In this
Discussion, you will transform a clinical inquiry into a searchable question in
PICO(T) format, so you can search the electronic databases more effectively and
efficiently. You will share this PICO(T) question and examine strategies you
might use to increase the rigor and effectiveness of a database search on your
PICO(T) question.

To Prepare:

·
Review the materials offering guidance on using databases,
performing keyword searches, and developing PICO(T) questions provided in the
Resources.

·
Review the Resources for guidance and develop a PICO(T) question
of interest to you for further study.

By Day 3 of Week 4

Post your
PICO(T) question, the search terms used, and the names of at least two
databases used for your PICO(T) question. Then, describe your search results in
terms of the number of articles returned on original research and how this
changed as you added search terms using your Boolean operators. Finally,
explain strategies you might make to increase the rigor and effectiveness of a
database search on your PICO(T) question. Be specific and provide examples.

Assignment:
Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and
Systematic Reviews

Your quest to purchase a
new car begins with an identification of the factors important to you. As you
conduct a search of cars that rate high on those factors, you collect evidence
and try to understand the extent of that evidence. A report that suggests a
certain make and model of automobile has high mileage is encouraging. But who
produced that report? How valid is it? How was the data collected, and what was
the sample size?

In this Assignment, you
will delve deeper into clinical inquiry by closely examining your PICO(T)
question. You also begin to analyze the evidence you have collected.

To Prepare:

·
Review the Resources and
identify a clinical issue of interest that can form the basis of a clinical
inquiry.

·
Develop a PICO(T)
question to address the clinical issue of interest for the Assignment.

·
Use the key words from
the PICO(T) question you developed and search at least four different databases
in the Walden Library to identify at least four relevant peer-reviewed articles
at the systematic-reviews level related to your research question.

·
Reflect on the process
of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels
of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide
PowerPoint presentation in which you do the following:

·
Identify and briefly
describe your chosen clinical issue of interest.

·
Describe how you
developed a PICO(T) question focused on your chosen clinical issue of interest.

·
Identify the four
research databases that you used to conduct your search for the peer-reviewed
articles you selected.

·
Provide APA citations of
the four peer-reviewed articles you selected.

·
Describe the levels of
evidence in each of the four peer-reviewed articles you selected, including an
explanation of the strengths of using systematic reviews for clinical research.
Be specific and provide examples.

Module 4: Critical Appraisal, Evaluation/Summary, and
Synthesis of Evidence (Weeks 6-7)

Assignment:
Evidence-Based Project, Part 4: Critical Appraisal of Research

Realtors rely on
detailed property appraisals—conducted using appraisal tools—to assign market
values to houses and other properties. These values are then presented to
buyers and sellers to set prices and initiate offers.

Research appraisal is
not that different. The critical appraisal process utilizes formal appraisal
tools to assess the results of research to determine value to the context at
hand. Evidence-based practitioners often present these findings to make the
case for specific courses of action.

In this Assignment, you
will use appraisal tools to conduct a critical appraisal of published research.
You will then present the results of your efforts.

To Prepare:

·
Review the Resources and
consider the importance of critically appraising research evidence.

·
Reflect on the four
peer-reviewed articles you selected in Module 2 and analyzed in Module 3.

·
Review and download the Critical
Appraisal Tools document provided in the Resources.

The Assignment (Evidence-Based Project)

Part 4A: Critical
Appraisal of Research

Conduct a critical
appraisal of the four peer-reviewed articles you selected and analyzed by
completing the Critical Appraisal Tools document. Be sure to include:

·
An evaluation table

·
A levels of evidence
table

·
An outcomes synthesis
table

Part 4B: Critical
Appraisal of Research

Based on your appraisal,
in a 1-2-page critical appraisal, suggest a best practice that emerges from the
research you reviewed. Briefly explain the best practice, justifying your
proposal with APA citations of the research.

 

Module 5: Evidence-Based Decision Making (Weeks 8-9)

Discussion: Patient Preferences and Decision Making

Changes in
culture and technology have resulted in patient populations that are often well
informed and educated, even before consulting or considering a healthcare need
delivered by a health professional. Fueled by this, health professionals are
increasingly involving patients in treatment decisions. However, this often
comes with challenges, as illnesses and treatments can become complex.

What has
your experience been with patient involvement in treatment or healthcare
decisions?

In this
Discussion, you will share your experiences and consider the impact of patient
involvement (or lack of involvement). You will also consider the use of a
patient decision aid to inform best practices for patient care and healthcare
decision making.

To Prepare:

·
Review the Resources and reflect on a time when you experienced a
patient being brought into (or not being brought into) a decision regarding
their treatment plan.

·
Review the Ottawa Hospital Research Institute’s Decision Aids
Inventory at https://decisionaid.ohri.ca/.

o
Choose “For Specific Conditions,”
then Browse an alphabetical listing of decision aids by
health topic.

NOTE: To
ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or
any information that might identify the patient or organization/practice.

By Day 3 of Week 8

Post a brief
description of the situation you experienced and explain how incorporating or
not incorporating patient preferences and values impacted the outcome of their
treatment plan. Be specific and provide examples. Then, explain how including
patient preferences and values might impact the trajectory of the situation and
how these were reflected in the treatment plan. Finally, explain the value of
the patient decision aid you selected and how it might contribute to effective
decision making, both in general and in the experience you described. Describe
how you might use this decision aid inventory in your professional practice or
personal life.

Assignment:
Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change

The collection of
evidence is an activity that occurs with an endgame in mind. For example, law
enforcement professionals collect evidence to support a decision to charge
those accused of criminal activity. Similarly, evidence-based healthcare
practitioners collect evidence to support decisions in pursuit of specific
healthcare outcomes.

In this Assignment, you
will identify an issue or opportunity for change within your healthcare
organization and propose an idea for a change in practice supported by an EBP
approach.

To Prepare:

·
Reflect on the four
peer-reviewed articles you critically appraised in Module 4.

·
Reflect on your current
healthcare organization and think about potential opportunities for
evidence-based change.

The Assignment: (Evidence-Based Project)

Part 5: Recommending an
Evidence-Based Practice Change

Create an 8- to 9-slide
PowerPoint presentation in which you do the following:

·
Briefly describe your
healthcare organization, including its culture and readiness for change. (You
may opt to keep various elements of this anonymous, such as your company name.)

·
Describe the current
problem or opportunity for change. Include in this description the
circumstances surrounding the need for change, the scope of the issue, the
stakeholders involved, and the risks associated with change implementation in
general.

·
Propose an
evidence-based idea for a change in practice using an EBP approach to decision
making. Note that you may find further research needs to be conducted if
sufficient evidence is not discovered.

·
Describe your plan for
knowledge transfer of this change, including knowledge creation, dissemination,
and organizational adoption and implementation.

·
Describe the measurable
outcomes you hope to achieve with the implementation of this evidence-based
change.

·
Be sure to provide APA
citations of the supporting evidence-based peer reviewed articles you selected
to support your thinking.

·
Add a lessons learned
section that includes the following:

o
A summary of the critical appraisal of the peer-reviewed articles
you previously submitted

o
An explanation about what you learned from completing the
evaluation table (1 slide)

o
An explanation about what you learned from completing the levels
of evidence table (1 slide)

o
An explanation about what you learned from completing the outcomes
synthesis table (1 slide)

 

Module 6: Changing the World Through Evidence-Based
Practice (Weeks 10-11)

Discussion: Developing a Culture of Evidence-Based Practice

As your EBP
skills grow, you may be called upon to share your expertise with others. While
EBP practice is often conducted with unique outcomes in mind, EBP practitioners
who share their results can both add to the general body of knowledge and serve
as an advocate for the application of EBP.

In this
Discussion, you will explore strategies for disseminating EBP within your
organization, community, or industry.

To Prepare:

·
Review the Resources and reflect on the various strategies
presented throughout the course that may be helpful in disseminating effective
and widely cited EBP.

o
This may include: unit-level or
organizational-level presentations, poster presentations, and podium
presentations at organizational, local, regional, state, and national levels,
as well as publication in peer-reviewed journals.

·
Reflect on which type of dissemination strategy you might use to
communicate EBP.

By Day 3 of Week 10

Post at
least two dissemination strategies you would be most inclined to use and
explain why. Explain which dissemination strategies you would be least inclined
to use and explain why. Identify at least two barriers you might encounter when
using the dissemination strategies you are most inclined to use. Be specific
and provide examples. Explain how you might overcome the barriers you
identified.

Assignment:
Evidence-Based Capstone Project, Part 6: Disseminating Results

The dissemination of EBP
results serves multiple important roles. Sharing results makes the case for
your decisions. It also adds to the body of knowledge, which creates
opportunities for future practitioners. By presenting results, you also become
an advocate for EBP, creating a culture within your organization or beyond that
informs, educates, and promotes the effective use of EBP.

To Prepare:

·
Review the final
PowerPoint presentation you submitted in Module 5, and make any necessary
changes based on the feedback you have received and on lessons you have learned
throughout the course.

·
Consider the best method
of disseminating the results of your presentation to an audience.

To Complete:

Create a 5-minute, 5- to
6-slide narrated PowerPoint presentation of your Evidence-Based Project.

·
Be sure to incorporate
any feedback or changes from your presentation submission in Module 5.

·
Explain how you would
disseminate the results of your project to an audience. Provide a rationale for
why you selected this dissemination strategy.

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