QSEN EBP- Nursing

QSEN EBP- Nursing

1. Read the EBP resource of the competency summaries attached below and use it to answer the question.
2. Discuss how QSEN is dealing with the problems that were originally identified in the book, ‘To err is human’. You need not write a report only a summary of what catches your eye as a good idea and what you want to share with your colleagues.
3. Answer the questions as thoroughly and concisely as possible.
   • Be sure to reference any works that you utilize in answering the questions (Be sure that references are in APA format). Use attached as reference.

     AACN, QSEN Evidence Based Practice

     1

     Evidence Based Practice Competency Resource Paper

     Jane H. Barnsteiner, PhD, RN, FAAN

     Professor of Pediatric Nursing

     University of Pennsylvania, School of Nursing

     Philadelphia, PA 19104-4231

     Revised December, 2010

     AACN, QSEN Evidence Based Practice

     2

     Definition Integrating best current evidence with clinical expertise and patient/family

     preferences and values for delivery of optimal health care.

     Key Message Safe, effective delivery of patient care requires the use of nursing practices

     consistent with the best available knowledge. This includes use of clinical expertise and patient

     preferences and values in addition to current best research evidence.

     Learner Objectives

     1. Define Evidence Based Practice and Translation Research 2. Describe activities in research synthesis 3. Describe how to evaluate merit and usability of existing research. 4. Describe the process from research generation, dissemination, implementation and

     evaluation.

     5. Analyze personal and patient preferences/values implementing research findings.

     Introduction

     We are living in a fast-moving world where our understanding of what can be achieved in

     healthcare is constantly being reframed by advances in science and technology. A major

     challenge in health care is valuing the continual discovery of new knowledge, assessing it for

     appropriateness for inclusion in care delivery and putting into practice the knowledge that exists.

     It is said that it takes 10 to 20 years for scientific findings to be integrated into practice and that

     only 20% or less of health care is based on research (Hughes, 2008; Kirchoff, 2004; Leape,

     2005). The challenge we face is how to increase the rate of adoption and continue the movement

     from a profession based on ritual and tradition to using a wide range of evidence. It is estimated

     that 30 – 40% of patients do not receive treatments of demonstrated effectiveness, whereas 20 –

     25% receive treatments that are not needed or are potentially harmful (Halm, 2010). Evidence-

     based practice (EBP), integrating best current evidence with clinical expertise and patient/family

     preferences and values for delivery of optimal health care, provides the direction for the way to

     think about clinical practice and lead practice change (Cronenwett et al., 2007; Cronenwett et al.,

     2009).

     Students need an appreciation and understanding of the role of evidence, which includes how to

     select an evidence-based practice, and how clinical expertise and patient values and preferences

     should form the basis for nursing intervention (Estabrooks, 2006; Rycroft-Malone et al., 2004). It

     incorporates the development of skills in how to frame a question, locating knowledge, critical

     thinking and clinical discernment. An EB approach to clinical decision making is embedded with

     an appreciation for the continuous generation of knowledge and a philosophy of life-long

     learning (Craig & Smyth, 2007).

     Evidence-based practice was first systematically introduced in nursing with the Conduct and

     Utilization of Research in Nursing (CURN) project in the late 1970’s by Horsley and Crane

     (Haller, Reynolds, & Horsley,1979). They reviewed the research on 10 common nursing

     procedures including Structured Preoperative Teaching, Preventing Decubitus Ulcers, and

     Reducing Diarrhea in Tube-fed Patients. The project developed research-based clinical protocols,

     systematically implemented them into practice, and measured the outcomes. Applying the

     AACN, QSEN Evidence Based Practice

     3

     framework of Everett Rogers, they developed a guide that described, from an organizational

     perspective, how to advance nursing practice via use of research findings. The CURN project

     demonstrated that synthesized research put into clinical protocols would be used by clinicians

     with beneficial results to patients (Haller et al., 1979). Many of the current approaches to EBP

     draw on this model (Barnsteiner, et al 2010). Today we have progressed from research utilization

     to EBP and translational research. Faculty and students need an understanding of the process of

     getting to EBP and the potential for positive impact on patient care.

     Definitions

     A variety of terms are used interchangeably with EBP. These include research utilization,

     research implementation science, dissemination, diffusion, research use, knowledge transfer,

     uptake, knowledge to action, and translational research. Tetroe and colleagues (2008) reported

     more than 33 different terms in use to describe EBP and translational research. Each of these fits

     into the schema of EBP and it is important to have a clear understanding of the differences

     among the conduct of research, research utilization, EBP and translational research.

     Research conduct is the systematic investigation of clinical phenomenon or the generating of

     new knowledge. Research Utilization (RU) was a term used in the 1980’s and 90’s to describe a

     2 step process of dissemination and implementation. Dissemination is the systematic efforts to

     make research available and implementation is the systematic implementation of scientifically

     sound, research-based innovation. EBP as is noted above builds on RU and integrates clinical

     expertise and patient/family preferences and values.

     Translational research consists of the activities to transform ideas, insights and discoveries

     generated through basic science inquiry and from clinical or population studies into effective and

     widely available clinical applications (Mitchell, et al 2010). It includes the testing of the effect of

     interventions aimed at promoting the rate and extent of adoption of EBP by healthcare providers

     (Titler et al., 2001; Titler, 2006).

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