REPLY WITH A COMMENT TO POST 1 AND POST 2 WITH 2 REFERENCES BELOW EACH POST.

POST 1

Brunette

Evidence-Based Practice model and a summary of your practice problem and the rationale for your EBP model selection.

The development of evidence-based practice (EBP)and research study application into the practice addresses a well-planned theoretical remarkable to assist challenges and implement literature methods of evidence to guide nursing care. Handwashing is the significant importance to prevent infection. It is crucial to utilize the appropriate hand washing between nursing professionals and patients. This method defines the guide by interpreting knowledge to reach the therapeutic content to enhance health and responsibility for appropriate clinical judgments and the standard of outpatient consequence in the attention of health. Handwashing is the most perform across the nursing profession to prevent contamination (Przekwas & Chen, 2020).

The purpose of the EBP is to demonstrate the process of recognizing clinical concern and developing experience-based information and research data to design components and achieve a clinical task. The pandemic coronavirus (SARS-CoV-2), a worldwide exhaled droplet respiratory syndrome virus that may occur by touching an infected surface, then touching the face, may cause a route of contamination (Przekwas & Chen, 2020). The application of soap and water when washing hands is crucial to avoid hands to face contamination transmission. The disease transmission knowledge emerges from the face to the nose and the lung (Przekwas & Chen, 2020). This empirical method acknowledges healthcare professionals and patients to prevent the spread of the virus.

Summary of how evidence-based practice differs from clinical research and includes your perception of the role of DNP-prepared nurses in both.

The research application to practice as an integration of the research study method to determine the care in the clinical setting, the knowledge states in the research study apply the middle-range theory to select the problems’ details in the study’s analysis (McEwin & Wills, 2019). Nursing research includes investigating relevant data through qualitative or quantitative research evidence and then applying it to clinical practice. Evidence-based practice (EBP) is an essential process to select practice problems through clinical experience, critical thinking, and theory knowledge to examine the clinical problem and affect clinical practice accordingly. Evidence-based practice (EBP) and nursing research are used to prevent clinical gaps when reviewing the clinical problem and serve as research evidence for best practice.

The doctor nursing practice (DNP) students obtain the basic nursing research and evidence-based practice criteria to be involved in research-related evidence to correct, improve, or change the medical challenge facing the professional nurses and the patients (Laureate Education, 2011). 

Laureate Education (Producer). (2011). Theoretical and scientific foundations for nursing practice: An evidence-based practice model [Video]. Baltimore, MD: Author.

McEwin, M., & Wills, E. M. (2019). Theoretical basis for nursing. (5th ed.) Philadelphia, PA: Wolters Kluwer Health.

Przekwas, A & Chen, C (2020). Washing hands and the face may reduce COVID-19 infection, Medical Hypotheses 144. Retrieved from https://oce-ovid-com.ezp.waldenulibrary.org/article/00002800-201003000-00005/HTML

POST 2

Corine

Corine January, Week 11: Compare evidence-based practice (EBP) models and differentiated between EBP and clinical research.

     According to Zaccagnini and White (2017), designing evidence-based interventions may be generated from quantitative research, qualitative research, outcome studies, patient choices, and clinical judgments (p.110). Nursing research extends from a nursing theory. A theory provides the basis for understanding the reality of nursing. To improve nursing and the quality of patient care, nurses critically appraise literature and synthesize relevant empirical and contextual theoretical information to be applied to practice (McEwen & Wills, 2019, p.435). In other words, theory and practice are not separate entities, and a reciprocal relationship exit. This paper includes information on EBP models, differences between EBP and clinical research, and the roles of the doctor of nursing practice (DNP) nurse.

Evidence-based Models.

     Evidence-based practice (EBP)  includes the integration of the best research evidence, clinical expertise, and patient needs and values (Gray, 2017, p. 11). There are several models that provide a step-by-step guide to help nurses organize and systemically implement and monitor the progress of EBP in the clinical setting. According to Brown (2014), the Stetler Model of research utilization, the Iowa model of EBP, and the Johns Hopkins nursing model are used to implement EBP (p.157). To narrow the scope of this paper, the Iowa model and Johns Hopkins nursing model are briefly described.

     The Iowa model consists of the identification of a problem based on clinical events or new research knowledge, determine the priority of the problem, formulation a team to develop and implement EBP, gather current comprehensive and relevant literature relative to the problem,  determine the intervention to implement, and implementation of a pilot study. Before full implementation across the organization and units, the new EBP change is evaluated for feasibility during the pilot study and after full implementation. (Brown, 2014, pp. 157-158).

      Another well-known EBP model is the Johns Hopkins nursing model described by Dr. Kathleen White (Laureate Education, 2011) and Newhouse et al. (2009).  The Johns Hopkins nursing model consists of 18 steps (Newhouse et al., 2009). According to Dr. Kathleen White, simplifying the Johns Hopkins model by using the PET acronym created a user-friendly tool for nurses at the bedside. Dr. Kathleen White described the steps using the PET acronym as follows,  P for developing the scope and depth of a practice question, E for review of relevant appropriate research to establish evidence for change, and T for translation of evidence into practice. The PET model also involves the use of interdisciplinary teams to define the scope of the problem, quality of the evidence, and recommendations for change (Laureate Education, 2011).

DNP Role in EBP

       The role of the DNP prepared nurse is predicated on the eight essentials for doctor education for advanced nursing practice.  In reference to essential one, the scientific underpinning for practice, the DNP a nurse has met the competencies needed to symmetrically summarize and synthesize research that is used to support, change, or expand the nursing practice.  The DNP prepared nurse has the competence in knowledge to translate research into practice, to evaluate practice, to improve health care practice and outcomes, and to participate in collaborative research (ANA, 2006, p. 11), thereby closing the gap between theory and practice. According to Gray et al. (2017),  the DNP nurse participates in the development, implementation, evaluation, and revision of needed protocols, policies, and evidence-based guidelines in practice. In collaboration with nurse researchers, the DNP nurse also participates in clinical studies. (Gray,2017, p. 4)

Differentiation Between Evidence-based practice and clinical research

     Evidence-based practice is an approach to clinical problem-solving that involves the application of current best evidence that is congruent with direct patient care. The systematic process of EBP includes identifying a practice problem, conducting a comprehensive review of relevant literature about the problem, and determining appropriate interventions based on best practice evidence (McEwen & Wills, 2019, p. 442). Internal and external influences on practice are considered when making clinical decisions based on EBP (Newhouse, et al., 2007, p.4).  

     Clinical research or applied research is empirical research performed in the patient care setting for the purpose of generating information pertaining to practice. Clinical research is used to discover new and better ways to diagnose and treat patients. Applied research in nursing is a scientific investigation conducted to generate the knowledge that is intended to have a direct influence on practice.  (Gray, 2017, p. 42). Nurses participate in clinical research as a patient advocate. 

Which EBP model would best support the exploration of the practice problem you utilized for Application #5? Include a brief summary of your practice problem and the rationale for your EBP model selection.

    One practice problem that is concerning, for me, has to do with nurses inconsistency in sharing patient care information during care transition, yet nurses have adopted the situation, background, assessment, and recommendations (SBAR) framework to use during hand-off reports.  A quality shift report is salient to efficient and safe patient care. Based on the literature, an ineffective hand-off report is prone to producing errors in patient care, creating negative patient outcomes, and can also lead to a patients demise. Nurses engage in intradepartmental and interdepartmental communication about patient care issues and need daily (Stimpson et al., 2020, p. 329).

     The PET model developed from the Johns Hopkins nursing model is appropriate to address the clinical problem.  The primary reason for selecting the PET model is because it is user-friendly, and not all nurses are knowledgeable regarding EBP.  Secondly, the aforementioned problem is germane to nursing as opposed to other disciplines.

Reference

     American Association of Nursing (2006). The essentials of doctoral education for advanced nursing practice. Washington, DC, retrieved

     Brown, CG. (2014). The Iowa model of evidence-based practice to promote quality care: An illustrated example in oncology nursing. Clinical Journal of Oncology Nursing. 18(2), pp. 157-159.

dio: 10.1188/14.CJON.157-159

      Laureate Education, (2011). Theoretical and scientific foundations for nursing practice: An evidence-based practice model [Video]. Baltimore, MD: Author, Interview with Dr. Kathleen White.

     McEwin, M., & Wills, E. M. (2019). The theoretical basis for nursing. (5th ed.). Philadelphia, PA: Wolters Kluwer Health.

     Newhouse, RP., Dearholt, S., Poe, S., Pugh. LC., & White, KM (2007). Johns Hopkins nursing evidence-based practice model and guidelines. Indianapolis, IN Sigma Theta Tau International. Retrieved from Walden University Online Library.

     Gray, J. R., Grove, S. K., & Sutherland, G. S., (2017). Burns and Grove’s The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence, 8th Edition.  Retrieved from vbk://9780323377584

     Stimpson, M., Carlin, K., & Ridling, D, (2020), Implementation of the m-ishaped tool for nursing interdepartmental handoffs. Journal of Nursing Care Quality, 35(4), pp. 329-335. doi: 10.1097/NCQ.0000000000000451.Laureate Education (Producer). (2011). Theoretical and scientific foundations for nursing practice: An evidence-based practice model [Video]. Baltimore, MD: Author, Laureate Education

EXAPLE POST

Good evening. I like your discussion on evidence-based practice. I agree with you that despite several variations between evidence-based practice and clinical research, the two approaches remain crucial in advancing nursing research and practice since they complement each other. As advanced practice nurses like you and I use evidence-based research provided by researchers to carry out our evidence practice.  Our roles as I understand and respect the complementary roles, skills, and abilities of the interprofessional health team and collaborate with other professionals to improve persons or groups’ health status and provide an overview of interprofessional collaboration models in real-world settings (Gray et al., 2017). I equally understand organizational and systems improvement, outcome evaluation processes, healthcare policies, and leadership participate in interprofessional and intraprofessional teams and assume the team’s leadership when appropriate, I understand the need to participate in shared decision making and leadership to meet best the needs of the patient or the population of collaboration, communication, team processes, and administration and bring forth innovative strategies to improve health and healthcare (McEwin & Wills, 2014). Articulate to the public while insurers, policymakers the role that nurses play in promoting positive patient and family outcomes, promoting psychological safety within an organization by providing leadership and recommending resources, and employing strategies that will enhance communication within the interprofessional team setting. Therefore, Evidence-based practice is a conscientious, problem-solving approach to clinical practice that incorporates the best evidence from well-designed studies, patient values and preferences, and a clinician’s expertise in making decisions about a patient’s care.

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove are nursing research practice: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.