NUR 590  Importance Of  “Spirit Of inquiry” In EBP Culture

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NUR 590  Importance Of  “Spirit Of inquiry” In EBP Culture

NUR 590  Importance Of  “Spirit Of inquiry” In EBP Culture

After reviewing the PICOT presented by my classmates, the one that is most likely and can be similarly implemented in my current organization is the one submitted by Jessy Kariakose which is on CLABSI. Although in dialysis, we have the hemodialysis catheter, which is still a central venous line, it is also associated with a higher rate of morbidity and mortality among dialysis patients who have catheters versus those that have Arteriovenous fistula (AVF) or graft as their access for dialysis. Despite documented complications associated with catheter use, there is still a high rate of catheter use upon initiation of dialysis and underutilization of the AVF (Tang et al., 2019). Therefore, the early removal of the hemodialysis catheters and establishing a vascular access team that will focus on interventions related to the promotion of AVF use and early removal of catheters is also an EBP proposal that can be implemented in our organization.

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Reference:

Tang, T., Levin, M., Ahya, S., Boobes, K., Hasan, M. (2019). Initiation of maintenance hemodialysis through central venous catheters: Study of patients’ perceptions based on a structured questionnaire. BMC Nephrol 20 (270). https://doi.org/10.1186/s12882-019-1422-y

Explain the importance of a “spirit of inquiry” in an evidence-based culture and what you can do as an advanced registered nurse to encourage this within your practice or organization. In response to your peers, compare the role and implementation of EBP in your specialty area with another advanced registered nurse specialty.

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Science teaches us to explore and question. In medicine, it the same. There is always something to explore in medicine, whether its to improve upon interventions or to learn complex diseases. Throughout my career as a nurse and nursing student, it was always expressed to me that in order for me to become a successful nurse I would need to engage in continuing education for the life of my career. In life, we should always strive for continuing education for personal development and growth. The future of nursing will require nurses to question, explore and take initiative making decisions on patient care, interventions, in leadership and public health.

“Explain the importance of a spirit of inquiry in an evidence-based culture and what you can do as an advanced registered nurse to encourage this within your practice or organization. In response to your peers, compare the role and implementation of EBP in your specialty area with another advanced registered nurse specialty” (National League of Nursing, 2014, para. 1). The COVID-19 pandemic was a wake up call in that we as a nation need to focus on improving our nursing practice.

Nurses will need to be encourage and pushed into leadership roles, executive positions and in the areas a research and development. Many nurses took the lead in saving their patients and hospitals as the pandemic ravaged hospitals throughout the country. There was also a spike in people researching how to get into the field of medicine (particularly in nursing and nursing research). There became a fascination into epidemiology, public health and medical research as people and nurses became curious about vaccine development and how outbreaks of disease and virus happen.

As a advanced registered I would encourage evidence based culture by being an example of someone who uses EBP and work in collaboration with other staffers to implement EBP research into the real world. During the heigh of the pandemic, EBP research was used to help patients as other interventions and methods failed.

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Implementing EBP

In the field of advanced nursing practice, there are various ways advanced nurses implement EBPs. Nurse practitioners implement and EBP “when she/he prescribes a treatment for a patient that is substantiated by scientific research; Often, nurse practitioners look for an experimental study that compares the efficacy of a treatment with an untreated control group” (Nurse Practitioner Schools, 2021).

Certified mid-wifery

For nursing midwives, EBP is are used to enhance the lives of the mother, child and community. Mothers are the backbone of communities and the health and safety of woman determines the health and safety of their respective communities. Areas of challenges are identified and EBP are used to improve the lives of women in order to safely carry, deliver and raise children.

NUR 590  Importance Of  “Spirit Of inquiry” In EBP Culture References:

Spirit of inquiry is defined as a continuous sense of wonder that guides both learning and practices. Nurses can be highly influenced by the spirit of inquiry practices in a beneficial way. In nursing, the spirit of inquiry will raise questions, challenge established and existing practices, and look for new ways to solve problems.

When asking the right questions in the right way, obtaining the best available evidence, and determining what practice changes are needed are all part of addressing a clinical problem through evidence-based practice (EBP) (National League for Nursing, 2021). Developing nurses with an inquiry mindset within a culture that promotes a systematic approach to asking clinical questions is a critical component of the EBP journey.

When conducting an evidence-based study or question, utilizing the spirit of inquiry supports the ongoing curiosity of evidence that would dictate a clinical decision. As a nurse, it is essential to understand if an intervention is necessary, beneficial for the client, and supported by evidence-based practice. Nurses and collaborative team members work to improve clinical problems by using clinical reasoning or judgment.

The spirit of increased exit and the first step of the evidence-based process will begin. The overall outcome or goal in predictable patient care settings, nurses will use evidence, tradition, and patient preferences in collaboration with health care team members to promote optimal health status.

NUR 590  Importance Of  “Spirit Of inquiry” In EBP Culture Reference

Evidence-based practice for nursing is driven by the influence and motivation to seek more information that would support interventions and practice. The spirit of inquiry is the term given to this motivation as nurses continue to question current practices and knowledge for evidence-based practice. Without it, research would go stale and would not produce any change that could significantly increase positive outcomes in health care or practice.

Evidence-based culture is dependent on those who nurses who seek to explore more possibility in practice, patient care and health knowledge so that health care not only constantly improving but also evolving to meet changes in health demands and technologies. Advanced registered nurses can encourage inquiry in their respective areas of practice where they feel that although there is good outcomes, better ones can be produced with a change in evidence-based practice.

This would require extensive research which those advanced nurses must have the motivation to thoroughly examine through the evidence-based research process. Giving opportunity to make changes to how they practice and how it affects the patients will produce professional rewarding as well as personal ones too which is why nudging and leading other nurses to participate in change can greatly improve patient outcomes from interventions (Arzouman, 2015).

Nurse Informaticists utilize evidence-based communication and technology integration techniques so that patient care and information systems are beneficial to all parties involved. Utilization of nursing experience in order to enhance communication or health records can streamline patient care so that efficiency can reach maximum potential.

Leadership is also important to nursing informatics and communication when implementing evidence-based practice interventions. Having knowledge of communication barriers and having implementing creativity in overcoming them provides valuable resources to patient care and health (Farokhzadian, Jouparineiad, Fatehi & Falahati-Marvast, 2021).

NUR 590  Importance Of  “Spirit Of inquiry” In EBP Culture References:

  • Arzouman, J. (2015). Evidence-Based Practice: Share the Spirit of Inquiry. MEDSURG Nursing, 24(4), 209–211.
  • Farokhzadian, J., Jouparinejad, S., Fatehi, F., & Falahati-Marvast, F. (2021). Improving nurses’ readiness for evidence-based practice in critical care units: results of an information literacy training program. BMC Nursing, 20(1). https://doi-org.lopes.idm.oclc.org/10.1186/s12912-021-00599-y

Having an evidence-based culture is important in nursing and having one that possesses a spirit of inquiry is even more important. Having a spirit of inquiry within an evidence-based culture helps to support a systematic process for asking clinical questions related to a clinical problem (Wyant, 2018). Spirit of inquiry is the beginning step in the evidence-based practice (EBP) process.

This is where one has the curiosity of what the best evidence is to help guide one in clinical decision making for a problem that they are trying to address (Wyant, 2018). You know when a spirit of inquiry exists within a work culture when you have nurses collaborating on ways to improve clinical problems through using clinical reasoning and judgement (Wyant, 2018).

To encourage a spirit of inquiry as an advanced registered nurse within my practice or organization is to model it. By leading and supporting this culture, will help to encourage others to trust each other and encourage the change process. By doing this, it will help get rid of the “it’s the way we have always done it mentality” and move towards the thinking of what does the evidence show when looking at clinical problems.

This will help create a collaborative culture among a team and when the team starts seeing the benefits from it, it will be the go-to process when looking into changing clinical processes. It is important that leadership supports implementation research and practice so that it fosters a culture of collaboration and organizational climate for implementation science (Nelson-Brantley & Chipps, 2021).

NUR 590  Importance Of  “Spirit Of inquiry” In EBP Culture References:

Once a search is carried out to find relevant articles within a chosen topic, a literature review helps bring together what is already known about a topic, facilitating new learning opportunities (Watts, 2020). Gaps in current knowledge can be identified, or theories and academic opinions may raise new research areas during critical analyses.

The initial question asked may evolve or change altogether when researching a posed question. Other themes or questions that may surface during the research journey, adding curiosity to what should be researched next. This “spirit of inquiry” is essential to our knowledge base and our peers well.

Nurse leaders have considerable influence on implementing evidence-based practice (EBP) in their departments, units, and organizations; however, resistance to change can stall innovations (Tucker & Mazurek Melnyk, 2019). Effective leadership requires an understanding of change theory, how change is facilitated and blocked, successful change steps, and strategies to promote each step. Implementation for promoting EPB falls into seven categories: leadership, coaching, communication, reinforcements, recognition, measurement, and reporting.

Different strategies may be needed at each stage of change to promote and sustain the change. Nurse leaders can successfully implement EBP changes by being knowledgeable about a proposed change, partner with staff, engage the help of mentors or change agents, work with senior leaders, thank and celebrate all staff in the process, and disseminate findings.

NUR 590  Importance Of  “Spirit Of inquiry” In EBP Culture References

  • Tucker, S., & Mazurek Melnyk, B. (2019). A leader’s guide to implementing evidence-based practice: Lead the way to healthcare quality and safety. American Nurse Today, 14(6).
  • Watts, K. (2020). How to conduct a literature review. Podiatry Review, 77(1), 14–15.

Summary and Discussion Questions

Summary of Course Content Knowledge

The course content has been designed in a manner that enhances our knowledge acquisition and competency development as nurses.  I have some knowledge on weekly objectives that include scholarly writing, searching for evidence-based information, and professionalism in nursing. I also have knowledge how to ensure academic integrity by avoiding plagiarism and the application of different theories into nursing and practice. I can rate my knowledge in these objectives to be adequate since I have been reading different materials about them.

I do not have prior knowledge on topics such as critique of evidence-based sources, use of different citation tools, and implementing evidence-based practices in nursing. I also do not have prior knowledge on evaluating evidence-based interventions. I would like to discuss topics that include professionalism, research, and interprofessional collaboration with my classmates and instructor.  I would also wish to learn from my colleagues the different citation tools they use and seek their support. I would also request my instructor to guide me in the process. Some of the questions that  I have related to the course include those related to translation of evidence into practice, best practices to strengthen interprofessional collaboration, and principles of evidence-based practice. I also would like to seek more information about how to undertake literature review in a manner that provides the most accurate data about a research problem. The last question relates to the creation of an organizational culture that supports evidence-based practice interventions.

Topic 1 DQ 1

The PICOT question for my project is; among hospitalized patients aged 65 years and above at risk of falls (P), does the use of automated fall detectors (I), as compared to usual care (C), reduce the rates of falls by 50% (O) within six months (T)? The intervention proposed for the PICOT question entails the use of automated fall detectors among hospitalized patients aged 65 years and above who are a risk of falls to prevent falls. Hospitalized elderly patients are highly at a risk of falls due to factors such as confusion, drug interactions, and comorbidities. The risk is even higher in patients with a history of falls. Recent evidence has supported the use of technologies such as bedside alarms and sensors to detect and prevent patient falls. The technology provides additional close monitoring, detection, and prevention of falls, besides the actions that nurses implement. The rates of falls in the practice setting have risen over the past few months. The impacts of patient falls have been evident as seen from injuries to patients, prolonged hospitalizations, increased care costs, and poor quality of life for the affected (Mishkhal et al., 2020; Visvanathan et al., 2022). As a result, the adoption of the intervention would help improve the quality, safety, and efficiency of care by eliminating falls.

The selected problem is amenable to a research-based intervention using the PICOT format because it is a nursing issue. The comparison for the project will be the outcomes seen in the provision of usual care to the elderly patients at risk of falls. The intervention is realistic for investigation in nursing since its results can be compared with those associated with usual care with ease. Previous studies have also proven the feasibility of utilizing technology to address the clinical problem of patient falls (Cortés et al., 2021; Visvanathan et al., 2022). Accordingly, the evidence in these studies demonstrate that technology incorporation into fall prevention could result in enhanced outcomes as compared to usual practice or no intervention.

NUR 590  Importance Of  “Spirit Of inquiry” In EBP Culture References

Cortés, O. L., Piñeros, H., Aya, P. A., Sarmiento, J., & Arévalo, I. (2021). Systematic review and meta-analysis of clinical trials. Medicine, 100(41), e27467. https://doi.org/10.1097/MD.0000000000027467

Mishkhal, I., Kareem, S. A. A., Saleh, H. H., & Alqayyar, A. (2020). Deep Learning with network of Wearable sensors for preventing the Risk of Falls for Older People. IOP Conference Series: Materials Science and Engineering, 928(3), 032050. https://doi.org/10.1088/1757-899X/928/3/032050

Visvanathan, R., Ranasinghe, D. C., Lange, K., Wilson, A., Dollard, J., Boyle, E., Jones, K., Chesser, M., Ingram, K., Hoskins, S., Pham, C., Karnon, J., & Hill, K. D. (2022). Effectiveness of the Wearable Sensor-based Ambient Intelligent Geriatric Management (AmbIGeM) System in Preventing Falls in Older People in Hospitals. The Journals of Gerontology: Series A, 77(1), 155–163. https://doi.org/10.1093/gerona/glab174

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.

Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.

One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.

I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.

As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an underastanding of the content or critical analysis of the content.

It is best to paraphrase content and cite your source.

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Lopes Write Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should inclu

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