Assignment: Evidence-Based Practice Research Paper

Assignment: Evidence-Based Practice Research Paper

Organizational culture is a critical determinant of successful implementation of evidence-based practice in any health organization. It is therefore important that nurses and other healthcare providers undertake an assessment of their organizations to determine their readiness to support evidence-based practice. The tool for evidence-based practice that was utilized for this task was obtained from the book by Cameron and Quinn (2011). The tool comprises of now and preference questions. The now questions examines the current situation of the organization while preference questions examines what an ideal organization should be. The average scores for the now questions was 75% out of 100%. The average score for the preferred questions was found to be 85% out of 100. The results show that the organizational culture in our hospital can support the implementation of evidence-based practice to promote quality nursing care.

The survey tool pointed out some of the facilitators as well as barriers to evidence-based practice in our organization. Some of the facilitators include leadership support, teamwork, trust, and encouraging of innovation and risk taking behaviors in the organization. It also included aspects such as the use of management styles that encourage independence and leadership that focuses on mentorship, nurturing, and facilitation of knowledge and skills development among the staffs. The survey identified potential barriers to the implementation of evidence-based practice, which include lack of organizational support, staff low-level of awareness towards evidence-based practice, and the high workload in the organization. Therefore, despite the organization being ready to implement evidence-based practice, it should explore different ways in which it can address the potential barriers to successful use of evidence-based practice by its staffs.

Section B: Proposal/Problem Statement and Literature Review

The refined PICOT statement from the proposed intervention is as follows:

In African-American patients with major depressive disorder, will the use of combined intervention involving cognitive behavioral therapy and antidepressants reduce severity of complications when compared to the use of antidepressants alone within 12 months?

The need for this intervention arose from two factors. Firstly, evidence has consistently shown that individuals from African-American backgrounds are least affected by major depressive disorder. However, the complications associated with the condition among them are high. As a result, it increases the need for a study examining effective methods of managing the disorder among this population. Secondly, the management of major depressive disorder relies mainly on the use of antidepressants. However, the use of non-pharmacological interventions has also proven effective in managing the disorder. Therefore, it raises the need to investigate the outcomes associated with the combined therapy when compared to monotherapy in the treatment of the disorder.

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Some studies have been conducted in the past to determine the efficacy of combined therapy vs. monotherapy in the management of

major depressive disorder and reduction of the severity of symptoms associated with the disorder. A meta-analysis by Boschloo et al., (2019) explored the efficacy of using antidepressants vs. cognitive behavioral therapy in treating depression. The researchers examined results reported in 17 randomized controlled clinical trials, which investigated the efficacy of the two treatments. Symptoms that include depressed mood, feelings of guilt, suicidal thoughts, and general somatic symptoms were improved with the use of medications and cognitive behavioral therapy. However, this research is associated with the limitation of failing to use study participants in investigating the topic. Despite this weakness, the researchers recommended the use of the combined therapy since it could result in improved outcomes with the treatment.

Corruble et al., (2016) conducted a study that examined the effectiveness of telephone-administered psychotherapy with antidepressant in the treatment of major depressive disorder. The researchers used 221 adults with major depressive disorder who were assigned randomly to eight sessions of weekly treatment with psychotherapy and antidepressants. The control group was administered with intensive clinical management of the disorder using agomelatine. The outcomes showed that there was a high response rate with the use of the combined treatment when compared to antidepressants alone. Despite the study having used human subjects, it had the weakness of being conducted over a short period (Corruble et al., 2016). Kamenov et al., (2017) conducted a meta-analysis to examine the efficacy of pharmacotherapy, psychotherapy, and their combination on quality of life as well as functioning in patients with depression. The researchers used 153 outcome trials that involved 29, 879 participants. The outcomes of the review showed that combined therapy has significant health outcomes as evidenced by reduction in severity of the symptoms of the disorder as well as enhanced quality of life (Kamenov et al., 2017). While this study did not use human subjects, its utilization of many trials as its source of evidence raises the credibility of its findings. According to Kamenov et al., (2017), few clinical trials have been conducted to examine the effectiveness of the combined therapy in the treatment of major depressive disorder. As a result, this proposed intervention will bridge the gap in evidence on the topic.

In order to formulate your evidence-based practice (EBP), you need to assess your organization. In this assignment, you will be responsible for setting the stage for EBP. This assignment is conducted in two parts: an organizational cultural and readiness assessment and the proposal/problem statement and literature review, which you completed in NUR-550.
Section A: Organizational Culture and Readiness Assessment
It is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization’s readiness.
Develop an analysis of 250 words from the results of the survey, addressing your organization’s readiness level, possible project barriers and facilitators, and how to integrate clinical inquiry, providing strategies that strengthen the organization’s weaker areas.
Make sure to include the rationale for the survey category scores that were significantly high and low, incorporating details or examples. Explain how to integrate clinical inquiry into the organization.
Submit a summary of your results. The actual survey results do not need to be included.
Section B: Proposal/Problem Statement and Literature Review
In NUR-550, you developed a PICOT statement and literature review for a population quality initiative. In 500-750 words, include the following:
Refine your PICOT into a proposal or problem statement.
Provide a summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations.
General Guidelines:
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

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