DNP 820 Topic 5 DQ 2

Comparative effective research is important in translating research. Describe one study that used comparative effective research. What were the findings and were they translated into practice?

How does the incorporation of evidence-based practice competencies lead to higher quality health care and better outcomes for population health? How do you suggest these types of competencies be assessed? How can clinician and patient outcomes serve as an indicator of successful competency implementation? Provide examples and support your response with relevant literature.

According to Evidenced-based practice, Melnyk (2014) is a problem-solving asset to the delivery of quality health care by the integration of best evidence with patients’ values, preferences, and clinician’s expertise. This includes internal evidence obtained from patients’ data. Competencies which is the ability to do something well or be competent are mechanisms supporting health professional to provide high-quality safe care. Competencies can be assessed holistically by their clinical contexts and attributes which include knowledge, psychomotor skills, and affective skills Incorporation of evidenced-based competencies promotes high-value health care, enhance the quality and reliability of health care, and improves health outcomes while reducing variations in costs and care.

The development of evidenced-based competencies included technical skills and praising literature, clinical reasoning in decision making, and problem-solving to make recommendations for practice changes and the ability to adapt to variations in the environment.  A successful competency is evaluated from the health professional’s high quality of care, by the culture or environment in which the nurses practice. Also, by the level of performance relayed to patients by registered professionals (Laura et al 2022).

Laura Caramanica, Lynn Gallagher-Ford, Lynda Idelman, Diana Mindrila, Sally Richter, Bindu Koshy Thomas, Establishment of Nurse Manager Leadership Competencies to Support Clinicians in Evidence-Based Practice, JONA: The Journal of Nursing Administration, 10.1097/NNA.0000000000001099, 52, 1, (27-34), (2022).

Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The establishment of evidence‐based practice competencies for practicing registered nurses and advanced practice nurses in real‐world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15.

RESPOND HERE

IRENE I agree with you that evidence-based practice is a problem-solving assets for healthcare providers aiming to provide reliable healthcare services to their patients. The factual information provide accurate guidelines to critical decision-making process. As a result, healthcare professionals are limited to making wrong decisions that may expose patients to dangers. Evidence-based practice incorporates best evidence with patients’ values, preferences, and clinician’s expertise. Patients’ data provides internal evidence (Torous et al., 2018).  Occasionally, healthcare experts may be required to go beyond patient’s data when handling other healthcare issues. The integration of internal and external sources of evidence improve the quality of decisions in healthcare settings. Competencies in applying evidence-based practice supports health professional to provide high-quality safe care. Incorporation of evidenced-based competencies promotes high-value health care (Oliver et al., 2019). Furthermore, EBP enhances the quality and reliability of health care. The value of evidence-based practice has attracted most healthcare providers to integrate the practice in their routines. The development of evidenced-based competencies included technical skills and praising literature, clinical reasoning in decision making.

References

Oliver, K., Kothari, A., & Mays, N. (2019). The dark side of coproduction: do the costs outweigh the benefits for health research?. Health research policy and systems, 17(1), 1-10.

Torous, J., Nicholas, J., Larsen, M. E., Firth, J., & Christensen, H. (2018). Clinical review of user engagement with mental health smartphone apps: evidence, theory and improvements. Evidence-based mental health, 21(3), 116-119. http://dx.doi.org/10.1136/eb-2018-102891

It has been challenging to effectively and efficiently translate findings from study into practice and has limited the use of evidence-based solutions that could have improve the quality of care. Nurses have been a leading force in the provision of healthcare services that are fragmented, costly, and never evidence-based grounded (Naylor, 2018). Key to understanding translational research in practice is understanding the difference between translational science and evidence-based practice. Naylor (2018) noted that translational science aims to identify strategies that are more effective in promoting the uptake and use of evidence compared to evidence-based practice (EBP) that refers to the application of proven intervention in a setting guided by expert clinical professionals. Emerging fields in translation entails scientist use common language and models to effectively collaborate, build upon each other’s work, address gaps in knowledge, and communicate findings for use by clinical partners. Addressing challenges of populations, overall and within distinct subgroups, is a significant priority for a society, and nurses play a critical role in the design, testing, and implementation of important lasting solutions.

Attempts have been made to improve the development and delivery of health services. This, notwithstanding, it is clear that there are gaps and differences that could lead to poor patient outcomes (Banner et al., 2019). It is also important to stress that there are research being conducted that does not meet the need of users of healthcare services. This means that shared approach to research is imperative, and this is where integrated knowledge translation comes into play. “Integrated knowledge translation (IKT) is a research approach that brings together researchers, along with other stakeholders that have knowledge about a particular healthcare issue” (Banner et al., 2019, p. 1). At some point, it was that patients and members of the public could be part of this approach to see how this collaborative approach close the gap between research and practice

References

Banner, D., Bains, M., Carroll, S., Kandola, D. K., Rolfe, D. E., Wong, C., & Graham, I. D. (2019). Patient and Public Engagement in Integrated Knowledge Translation Research: Are we there yet? Research Involvement and Engagement, 5https://doi.org/10.1186/s40900-019-0139-1

Naylor, Mary D, PhD,R.N., F.A.A.N. (2018). Overview and Summary: Translational Research: From Knowledge to Practice. Online Journal of Issues in Nursing, 23(2), 1-3. https://doi.org/10.3912/OJIN.Vol23No02ManOS

RESPOND HERE

JENEVEVE it is true that some healthcare professionals have struggled to practice evidence-based routines. Some professionals have indicated their inability to translate findings from study into practice as the primary challenge.  As a result, other healthcare organizations has limited the use of evidence-based solutions that could have improve the quality of care due to the fear of committing medication errors (Martin et al., 2019). However, evidence-based evidence has transformed healthcare experiences in healthcare sectors. Therefore, healthcare providers with limited use of factual information have been compelled to improve their workforce’s competence in using evidence-based routines. Nurses have been a leading force in the provision of healthcare services that are fragmented, costly, and never evidence-based grounded (Stamatakis et al., 2019). Nurses are expected to be involved in research. Therefore, nurse practitioners should be willing and competent to use evidence-based practice. At the same time, nurses should display their ability to translate research findings to practice. It is important to stress that there are research being conducted that does not meet the need of users of healthcare services. Healthcare professionals can detect and disregard these studies.

References

Martin Ginis, K. A., Van Der Scheer, J. W., Latimer-Cheung, A. E., Barrow, A., Bourne, C., Carruthers, P., … & Goosey-Tolfrey, V. L. (2018). Evidence-based scientific exercise guidelines for adults with spinal cord injury: an update and a new guideline. Spinal cord, 56(4), 308-321.

Stamatakis, E., Ekelund, U., Ding, D., Hamer, M., Bauman, A. E., & Lee, I. M. (2019). Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings. British Journal of Sports Medicine, 53(6), 377-382. http://dx.doi.org/10.1136/bjsports-2018-099131

Evidence-based practice is the ability to review, analyze and translate the latest research into clinical practice. The individual is also expected to use their clinical experience and consider patients’ preferences. Incorporating these practices leads to a higher quality of care as they can reduce incorrect or unnecessary workplace activities and improve the process of health services or patient care (Sonğur et al., 2018). For example, while working in inpatient care, it was part of standard care to turn a patient every two hours. An old colleague recently advised that hospitals are no longer advocating this. Currently, the timing of turning a patient is based on the conditions and possible risks. Patients can be scheduled to be turned every 15 minutes or every 3 hours if clinically considered appropriate. This change in the standard of care is based on patient-specific consideration and clinical experience that turning a patient every two hours does not assure a majority of positive clinical outcomes.

Competencies should be assessed by the identification that it results in benefits versus harm. The process in which nursing theories are used to implement correctly and effectively. Literature should also be presented and critically appraised before implementation to ensure patient safety and feasibility. Chen et al. (2022) explain that it is essential to increase knowledge and to have the ability for innovation and independent learning. Competencies can be demonstrated with the ability to acquire, apply, and innovate learning (Chen et al., 2022). In terms of identification of patient outcomes that can indicate successful competency would entail an increase in patient satisfaction scores and clinical outcomes. For example, the decrease in deep vein thrombosis or pneumonia complications in patients with early ambulation, thus decreasing their length of stay and hospital cost. Positive outcomes in both parties are the best indicator of successful implementation. With evidence-based practices, employees will have the tool to decrease unnecessary tasks, potentially increase work satisfaction and decrease sentinel events. Positive experiences in the work placed allow for a positive work culture. It is important to remember that everything in life is a cause and effect. Positive outcomes often cause positive lateral effects just as adverse outcomes will produce harmful dominos catastrophes.

References:

Chen, X., Song, Q., Wu, J., Fang, Z., & Sui, G. (2022). The Application Effect of Evidence-Based Care in Gastrointestinal Surgical Pipeline Nursing. BioMed Research International, 1–9. https://doi.org/10.1155/2022/5027024

Sonğur, C., Özer, Ö., Gün, Ç., & Top, M. (2018). Patient safety culture, evidence-based practice and performance in nursing. Systemic Practice and Action Research, 31(4), 359–374. https://doi.org/10.1007/s11213-017-9430-y

RESPOND HERE

ELIZABETH it is true that evidence-based practice is the ability to review, analyze and translate the latest research into clinical practice. The procedural process enables healthcare professionals to make right decisions.  Incorporating evidence in healthcare delivery improves the quality of healthcare services and patient outcomes.  Similarly, evidence-based practice enhances patient safety (Shelton et al., 2018). Various benefits of evidence-based practice has enticed healthcare organizations to implement EBP. Unfortunately, other healthcare professionals have limited the use of evidence-based practice due to their limited understanding. Clinical experience and consider patients’ preferences are part of the component of evidence-based practice. Healthcare professionals should have adequate information about their patients to tailor suitable healthcare services (Rosen et al., 2018). Nurses can engage patients in interviews to get adequate information that will guide healthcare services delivery. Ignoring patient’s tastes and preferences may reduce the impact of evidence-based practice on clinical experience.  The procedural process in evidence-based practice ensures that healthcare services meet the expected targets.

References

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433. https://doi.org/10.1037/amp0000298

Shelton, R. C., Cooper, B. R., & Stirman, S. W. (2018). The sustainability of evidence-based interventions and practices in public health and health care. Annual review of public health.  https://doi.org/10.1146/annurev-publhealth-040617-014731