Application of EBP

Application of EBP

Application of EBP

NURS-6052 Module 5: Evidence-Based Decision Making (Weeks 8-9)

NURS-6052 Module 5: Evidence-Based Decision Making (Weeks 8-9)

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Laureate Education (Producer). (2018). Evidence-based Decision Making [Video file]. Baltimore, MD: Author.

Learning Objectives – NURS-6052 Module 5: Evidence-Based Decision Making (Weeks 8-9)

Students will:

• Analyze the impact of patient preferences on clinical decision making
• Analyze decision aids
• Analyze opportunities for change within healthcare organizations
• Recommend evidence-based organizational changes using an evidence-based practice approach to decision making
• Recommend strategies for effective dissemination of information
• Identify measurable outcomes addressed by evidence-based changes

Photo Credit: Caiaimage/Robert Daly/Getty images

Learning Resources – NURS-6052 Module 5: Evidence-Based Decision Making (Weeks 8-9)

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

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 7, “Patient Concerns, Choices and Clinical Judgement in Evidence-Based Practice” (pp. 219–232)

Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186

Note: You will access this article from the Walden Library databases.

Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396

Note: You will access this article from the Walden Library databases.

Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483

Note: You will access this article from the Walden Library databases.

Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.x

Note: You will access this article from the Walden Library databases.

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/.
  • 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.

By Day 6 of Week 8

Respond to at least two of your colleagues on two different days and offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids on situations like the one shared.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 8

To participate in this Discussion:

Week 8 Discussion

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:
  • A summary of the critical appraisal of the peer-reviewed articles you previously submitted
  • An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides).NURS-6052 Module 5: Evidence-Based Decision Making (Weeks 8-9)

By Day 7 of Week 9

Submit Part 5 of your Evidence-Based Project.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK9Assgn+last name+first initial.(extension)” as the name.
• Click the Week 9 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 9 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.
• Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.

Grading Criteria

To access your rubric:

Week 9 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 9 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 9

To submit your Assignment:

Week 9 Assignment

To go to the next week:

Module 6

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Discussion Week 8 – NURS 6052: 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 (See below references and attached PDF documents) and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.

· 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.

Instructions:

1. Post at least two dissemination strategies you would be most inclined to use and explain why.

2. Explain which dissemination strategies you would be least inclined to use and explain why.

3. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use.

4. Be specific and provide examples.

5. Explain how you might overcome the barriers you identified.

** At least 3 References**

Resources from School – References (attached documents)

Gallagher-Ford, Lynn MSN, RN, NE-BC; Fineout-Overholt, Ellen PhD, RN, FNAP, FAAN; Melnyk, Bernadette Mazurek PhD, RN, CPNP/PMHNP, FNAP, FAAN; Stillwell, Susan B. DNP, RN, CNE Evidence-Based Practice, Step by Step: Implementing an Evidence-Based Practice Change, AJN, American Journal of Nursing: March 2011 – Volume 111 – Issue 3 – p 54-60 doi: 10.1097/10.1097/01.NAJ.0000395243.14347.7e

Newhouse, R. P. , Dearholt, S. , Poe, S. , Pugh, L. C. & White, K. M. (2007). Organizational Change Strategies for Evidence-Based Practice. JONA: The Journal of Nursing Administration, 37(12), 552-557. doi: 10.1097/01.NNA.0000302384.91366.8f.

Melnyk, B. M. (2012). Achieving a High-Reliability Organization Through Implementation of the ARCC Model for Systemwide Sustainability of Evidence-Based Practice. Nursing Administration Quarterly, 36(2), 127–135. doi: 10.1097/NAQ.0b013e318249fb6a.

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

Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A Test of the ARCC (c) Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes. WORLDVIEWS ON EVIDENCE-BASED NURSING, 14(1), 5–9. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12188

INSTRUCTIONS: Respond to your colleague by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.

**At least 2 references per reply, and they need to support information in the reply**

Main Post – Donique McClinton

COLLAPSE

Top of Form

Main Post

Dr. Frazer and Classmates

Dissemination Strategy 1 and its Possible Barrier

          Agreeing with Melnyk & Fineout-Overholt (2018), creating awareness and interest should be the first strategy to disseminate evidence-based practice within an organization. To prepare an organization for change, leadership is essential (Newhouse et al., 2007). Leadership must gather their staff and explain that modifications are necessary and required to be utilized.

          Spreading awareness and interest can present challenges as many employees may ignore the announcements, advertisements, and newsletters that were utilized. As employees enter the organization, many focus on the task at hand and not the bigger picture. Those employees may only view the attended EBP as “if the job wants us to work a certain way, they will tell us personally.” This way of the employees’ thinking is a barrier to diffusing awareness and interest of EBP. 

Dissemination Strategy 2 and its Possible Barrier

          According to Melnyk & Fineout-Overholt (2018), an additional strategy to disseminating EBP can build knowledge and commitment. Conducting a transdisciplinary team training in which leadership and employees learn about the EB and how to accomplish it (Melnyk, 2012) will lead to all staff being in unity.

           Along with building knowledge and commitment of the EBP, barriers can emerge. Some colleagues may disagree and disapprove of the need for the new EBP, as many seasoned colleagues are too familiar with how tasks were performed in the “old days.” Those colleagues require further education and explanation, by leadership, on how the EBP can improve topics.

Least Inclined Dissemination Strategy

            I believe that the least persuasive strategy can be pursuing integration and sustained usage. Melnyk & Fineout-Overholt (2018) described this strategy includes celebrations of the local unit’s progression, public acknowledgment, and individualized memos to staff. This comes in the form of the famous repetitive pizza parties given by management, that many staff are appreciative of but wishfully think they deserve more. 

            This strategy requires improvement to fully grasp the staff’s attention to show the organization’s appreciation properly. Pay-for-performance incentives have placed organizations under pressure to increase their level of care and avoid sentinel incidents (Melnyk, 2012), which may be a more persuasive strategy than a nutriment incentive. 

References

Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of the evidence-based practice. Nursing Administration Quarterly, 36(2), 127-135. Doi: 10.1097/NAQ.0b013e318249fb6a 

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

Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. Journal of Nursing Administration, 37(12), 552-557. Doi: 0.1097/01.NNA.0000302384.8f 

INSTRUCTIONS: Respond to your colleague by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.

**At least 2 references per reply, and they need to support information in the reply**

Ethel Uzoma 

RE: Discussion – Week 9 Main post

COLLAPSE

Top of Form

Evidence-Based Decision Making

Dissemination is the act of sharing and distributing information through different materials to a specific audience to increase their reach for evidence and effectively use evidence-based literature. It occurs through various channels, social contexts, and settings spreading knowledge of evidence-based practice (EBP) interventions on a wide scale within or across practice settings.

Dissemination Strategies I would be most inclined to use and why

I would be most bent on using passive and active dissemination strategies. Passive strategies include sending mass emails and information publications or posting details about evidence to a website and scientific publications in a searchable database for an untargeted audience (Vedel et al., 2018). The approach is less costly in terms of translating knowledge and is highly feasible. In contrast, active dissemination strategies comprise efforts that spread knowledge to a targeted group through practical guidance, prompts, and information media campaigns (Melnyk et al., 2011). I would use active dissemination to increase the reach of motivation and people’s ability to apply and use evidence. Both strategies would be effective in ensuring widespread EBP use on various clinical practices and interventions.

Dissemination Strategies I would be least inclined to use and why

The dissemination strategy that I would be least inclined to use is passive because it involves untargeted information dissemination. Here, the message is untailored, and the delivery is unplanned or uncontrolled. Hence, it is generally ineffective and only results in minimal practice changes. 

Two Barriers I might Encounter when using the Dissemination Strategies, I am most inclined to use.

 I would be most inclined to use active dissemination because it involves communicating facts actively by targeting a specific audience.  Lack of EBP knowledge and fear of the unknown is the most critical barrier in using the approach, making it hard to convince colleagues to come on board and understand the process (Brownson et al., 2018).

How I might Overcome the Barriers I identified

To overcome this barrier, it is critical for the strategy to include resources for learning about EBP, which should be emphasized and taught through nursing schools and selected development centers. Active dissemination is also costly and time-consuming, leading to burnout and stress (Gallagher-Ford et al., 2011). However, this can be overcome by increasing resources and the number of personnel involved in dissemination. 

                                    References

Brownson, R. C., Eyler, A. A., Harris, J. K., Moore, J. B., & Tabak, R. G. (2018). Getting the word out: New approaches for disseminating public health                science. Journal of Public Health Management and Practice, 24(2), 102–111.  https://doi.org/10.1097/PHH.0000000000000673

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Implementing an evidence-                  based practice change. The American Journal of Nursing, 111(3), 54–60.  https://doi.org/10.1097/10.1097/01.NAJ.0000395243.14347.7e

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Sustaining evidence-based                    practice through organizational policies and an innovative model. The American Journal of Nursing, 111(9), 57–60.                                                               https://doi.org/10.1097/01.NAJ.0000405063.97774.0e

Vedel, I., Le Berre, M., Sourial, N., Arsenault-Lapierre, G., Bergman, H., & Lapointe, L. (2018). Shedding light on conditions for the successful                            passive dissemination of recommendations in primary care: A mixed methods study. Implementation Science, 13(1), 1–12.                                               https://doi.org/10.1186/s13012-018-0822-x

Name: NURS_6052_Module05_Week09_Discussion_Rubric

Name: NURS_6052_Module05_Week09_Discussion_Rubric

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Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

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Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

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Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

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I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

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The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

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Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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