Week 2: Discussion

Revisit the practice-related issue of interest that you identified in the week one discussion posting, and respond to the following:

• Describe the practice-related issue and its impact on the nursing profession and/or healthcare delivery.
• How does this issue influence healthcare safety, quality, and/or health outcomes?
• What nursing intervention would you recommend to improve the issue?
• As you conduct a review of literature to better understand the issue and your proposed intervention, what search terms might be most helpful?

Based upon your responses to the above, develop a PICOT statement that conveys the following elements.

• P-Population and Problem – What is the nursing practice issue or problem and who does it affect?
• I-Intervention – What evidence-based solution for the problem would you like to apply?
• C-Comparison – what is another solution for the problem? (Note that this is typically the current practice, no intervention at all, or alternative solutions.)
• O-Outcome – Very specifically, how will you know that the intervention worked? What will be the indicator of success, and how will that outcome be measured?
• T-Timeframe – Target date for outcome achievement.

Use a sentence format to construct your PICOT statement. Here is an example from the educational field (remember, your PICOT will address a nursing practice issue or problem):

Do kindergarteners experiencing learning disabilities (P) who are given a stress ball to squeeze (I) compared to those who don’t have a stress ball (C) experience improved academic performance in class (O) over a 6 week period (T)?
 

Problem – learning disabilities impacting stress and academic performance
Population – kindergartners
I – stress ball
C – no stress ball
O – improved academic performance
T – over 6 weeks

Evidence-Based Practice WEEK 1 DISCUSSION

• What have you seen in the evidence regarding organizational policies? What EBP initiative would you implement?
• Great choice of a change model. Can you think of a nursing theory/theorist that can support this topic as well?

Different organizations have established policies that guide how they use evidence in executing their tasks. To effectively use evidence in nursing, organizations need policies that guide clinicians on how to conduct themselves and use available evidence. It is important to note that organizational policies are practice-related issues or restriction configurations to help tie together a firm’s mission, vision, values, and culture (Melnyk et al., 2011). When implementing Evidence-based practice (EBP), various initiatives can be used. Some of the initiatives I could use include the clinician EBP workshop and internship, leadership EBP workshop, and educator EBP workshops (Hawai’i State Center for Nursing, 2021). The clinician EBP workshop and internship program, is designed to enable clinicians interested in evidence-based practice to engage in projects to acquire enough skills and knowledge relevant to their specialization (Hawai’i State Center for Nursing, 2021). The program will run for one week and involve educative sessions for nurses and interns regarding the importance and methods of EBP in a healthcare facility. 

The other program is the leadership EBP workshop, which will enable nurses to develop their leadership skills. The program will provide managers, directors, clinicians, and other member staff present with a high-level understanding of evidence-based practice and how to use and apply it in their respective roles (Hawai’i State Center for Nursing, 2021). The leadership of EBP emphasizes the positive impact trained nurses will have when implementing the use of EBP. Lastly, the educator EBT workshop program works as the clinician EBP workshop program. The difference is that the educator program will major in specific subjects.

The best choice of a change model to use is the IOWA model that the University of Iowa Hospitals developed and Clinics to provide a framework for improving patient outcomes, nursing practice, and monitoring healthcare costs (Buckwalter et al., 2017). The model facilitates the application of empirical evidence by a practicing nurse. The IOWA model has established a step-by-step guideline on identifying issues, searching for solutions, and implementing a change. The Stetler model is another nursing theory that can support evidence-based practice. The Stetler evidence-based practice model outlines the criteria for determining the feasibility and desirability of applying research on a particular issue (Christenbery, 2019). The criteria of the model involve the current practice and substantiating evidence. However, the implementation of this theory involves five phases, namely: preparation, validation, comparative evaluation and decision making, translation and application, and lastly, the evaluation phase.

Stetler’s model is important because it is designed to encourage critical thinking when conducting research and promote the use of evidence when conducting patient diagnoses (Christenbery, 2019). The model also reduces errors in the decision-making process. Therefore, the theories that could support the topic include the Stetler and IOWA model theories.

References

Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., Rakel, B., Steelman, V., Tripp-Reimer, T., & Tucker, S. (2017). Iowa Model of Evidence-Based Practice: Revisions and Validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182. https://doi.org/10.1111/WVN.12223

Christenbery, T. L. (2019). Evidence-based practice in nursing?: foundations, skills, and roles. Springer Publishing Company.

Hawai‘i State Center for Nursing. (2021). Evidence-Based Practice (EBP) Initiatives. Hawai‘i State Center for Nursing. https://www.hawaiicenterfornursing.org/programs/ev…

 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. American Journal of Nursing, 111(9), 57–60. https://doi.org/10.1097/01.NAJ.0000405063.97774.0E