NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them

NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them

Evidence-based practice (EBP) is vital in the nursing profession because it allows nurses to provide high-quality, safe, and cost-effective care to patients. By effectively incorporating evidence-based research findings into practice and clinical decision-making, patient outcomes and satisfaction will significantly improve. Using EBP ensures that patients receive the most up-to-date, scientifically proven, and effective treatments. There are multiple Evidence-Based Practice (EBP) models used in the healthcare profession.  The Johns Hopkins Evidence-Based Practice Model for Nurses and Health Care Professionals, for example, uses three interrelated components- inquiry, practice, and learning. The JHEBP Model is considered an inquiry-based learning framework, in which interprofessional teams control their own learning to gain knowledge and expand on existing knowledge (Dang et al., 2021). The overall goal of all EPB models and guidelines is to expedite the transfer of knowledge from education and research and integrate that information into practice (DeNisco, 2024).

The EBP process typically consists of first formulating clinical questions by identifying problems or challenges in practice or patient conditions. No matter which model of evidence-based decision-making and practice is chosen, the first step in the process is to frame the clinical question in the PICOT format (Gallagher & Melnyk, 2019). Using the widely accepted PICOT framework ensures that the identified clinical problem can be translated into a searchable, answerable question (DeNisco, 2024).  The next step in the EBP process after developing a PICOT question is gathering current evidence. To locate sources of information researchers should access peer-reviewed journals, published studies, articles, etc. These documents are housed in databases such as Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Online (MEDLINE), and PubMed (DeNisco, 2024). Each database can be used to locate different documents depending on what the researchers’ aim is. These research studies should be analyzed and critiqued to determine the scope of evidence. Peer review is the gold standard of ensuring quality information is disseminated. Through peer review, authors will submit their work to an editor, who will then forward it to experts in the field where it will be put through the peer review process (Zimmerman, 2017). Once articles have been found, the researcher must begin the process of critiquing them for relevance and credibility. One way to achieve this is by implementing the CRAAP test. The final step in the EBP process is implementing the research into practice. The most important factor of EBP implementation is collaboration with key stakeholders, developing action plans, conducting pilot tests, and establishing timelines for implementation.  To effectively apply evidence-based practice, it requires a complex process of creating and spreading knowledge, which involves various systems and individuals who are invested in it.

NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them

Describe the steps of the evidence-based research process and the importance of using them. In the initial stages of an EBP project, where do nurses in your specialty go to locate sources of information that help them to determine whether or not a practice problem is appropriate for an evidence-based practice change proposal. Include two specific sources on information in your discussion.

Re: Topic 7 DQ 1

Identifying a clinical problem or concern is the first stage in the Evidence Based Practice (EBP) process. Sounds simple enough, however this problem or queries must be answerable. The PICOT approach is extremely beneficial for guiding the development of research questions (DeNisco & Barker, 2016). The “P” is for the target population, the “I” stands for the intervention or variable that is being studied, the “C” stands for a comparison of with and without said intervention or variable, the “O” stands for the outcome, and the “T” stands for the time it takes to attain an outcome.

The following step in EBP is research. After creating a PICOT, you should look for all existing and current evidence on your issue. There are also steps linked to research. You must have inclusion and exclusion criteria, which are frequently tied to the age of the study. You must explore relevant databases and properly evaluate the evidence types. There is a significant contrast between data from a systemic review or meta-analysis including randomized trials and evidence from observational descriptive or qualitative investigations. The AACN, according to DeNisco and Barker, has developed a new evidence leveling system that effectively evaluates the evidence (2016, p. 476). Analyzing the new evidence critically is necessary to establish whether the research is valid, of high quality, and useful to your EBP. A variety of frameworks, checklists, and grading systems are available to aid in the critical analysis and arrangement of evidence (DeNisco & Barker, 2016). There are various databases that can be used to conduct research. The GCU nursing library page provides several nursing databases that are excellent for the early phases of EBP and research (GCU Library, n.d.). Here are a few examples: CINAHL Complete is a wonderful place to start because it covers a wide range of specialties and is extremely nursing-specific. PubMed is another one with a massive database that is free to use. And the COCHRAN library is a fantastic one because it has seven different databases devoted to providing medical professionals with high-quality, independent research that can aid in care decision making.

Following the collection and critical evaluation of new evidence, one must decide whether the new evidence is strong enough to support an intervention or change in practice, or if more evidence and additional research are required. If an intervention or implementation is carried out, it must be quantifiable, and the effectiveness of those actions must be assessed. According to DeNisco and Barker, “evaluating practice and changes in practice is critical to the effective implementation of any quality improvement or evidence-based practice effort.” “Evaluation is a continuous process that must begin early and continue throughout a project” (2016, p. 522). These results can then be compared to national benchmarks; benchmarking is essentially comparing your results on a continuous basis to the industry’s “gold standard,” or the best of the best. Benchmarking is a technique for ensuring that existing practices continue to be relevant in comparison to those of other firms or competitors.

Also Read: NUR 513 Topic 7 DQ 2 What are some of the major ethical issues in conducting research that impacts the advanced registered nurse?

NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them References

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.

GCU Library, (n.d.). Nursing & health sciences: Evidence-based practice. https://libguides.gcu.edu/Nursing/ebp

RESPOND  HERE (150 WORDS, 2 REFERENCES)

Hello ,

I agree with you that in the process of coming up with an EBP topic of research it is imperative for the nurse to develop a PICOT analysis that will be crucial in identifying the feasibility of the problem of research. The nurse requires adequate information about the topic of research in order to understand the greater scope of area of study and be able to build on the already existing knowledge available on a given a chosen research topic. These checks have to be made before conducting the EBP so that the research work generated has a practical application in promoting quality care among the target population (Li et al., 2019). Some of the pertinent questions considered in the PICOT include; will the target population benefit from the findings of the study? will the finding be applicable to the practice? Will the finding support an existing concept or practice or it will build a new theory? Will the finding support the existing nurse theory or will provide evidence for change of existing nurse theory? These are the key areas that the research problem in EBP should address, if not then the problem has to be re=examined and adjusted in order for it to have a clinical relevance and importance to the nurse practice (Duff et al., 2020).

NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them References

Duff, J., Cullen, L., Hanrahan, K., & Steelman, V. (2020). Determinants of an evidence-based practice environment: an interpretive description. Implementation Science Communications, 1(1). https://doi.org/10.1186/s43058-020-00070-0

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice. Medicine, 98(39), e17209. https://doi.org/10.1097/md.0000000000017209

Re: Topic 7 DQ 1

Evidence-based practice (EBP) unites research evidence with clinical expertise and encourages individualized care by including patient preferences (Stevens, 2013). A major paradigm shift in the way nurses began to think about research results, framed the context for improvement, and employed change to transform healthcare was apparent with EBP on the scene. Patient care outcomes substantially improve with the use of EBP and tested interventions.

Two nursing educators and researchers, Melnyk and Fineout-Overholt, suggest seven steps in the EBP process, all proving vital for effective implementation and integration into the clinical setting (Melnyk & Fineout-Overholt, 2011, as cited in DeNisco & Barker, 2016, p.465). In the past, it has taken years to transfer new knowledge into practice, so speed is the primary goal for EBP models (DeNisco & Barker, 2016). Many models exist and common aspects include: identifying a problem and having a spirit of inquiry, asking practice questions, reviewing the latest evidence, critically appraising the evidence, integrating personal expertise and patient preferences in and grading, and finally organizing pieces in a meaningful way.

In the initial stages of locating information, I would start searching in PubMed because it is a free database accessible from any mobile device (DeNisco & Barker, 2016). Begin with a researchable and answerable question is essential. The PICOT question formulation method is widely used for clinical problems. Searching databases such as CINAHL, The Cochrane Library, or MEDLINE would be my next approach. The CINAHL database provides access to over 3,000 nursing and allied health journals yet, a subscription is required for access.

Nurses within leadership have an unprecedented opportunity as mentioned by Stevens (2013), to step forward and transform healthcare from a systems perspective, focusing on EBP for patient safety, patient engagement, and clinical effectiveness. The “next big ideas” in EBP focus on making systems improvements and transforming healthcare. Moving beyond the individual and shifting the focus on groups, health systems, and the community is one part. Dissemination and implementation of strategies to assure effective and safe patient care are delivered rapidly is the second part. While there are benefits to the evidence gathered and applied, the true benefit goes to the patient.

NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them Resources

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession. Jones & Bartlett Learning.

Stevens K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. Online Journal of Issues in Nursing, 18(2), 4.

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Hello

I agree with you that the nurse leaders and nurse managers have a responsibility of driving change in the nursing practice by promoting the successful implementation of the EBP project findings into the nurse practice. However, for the EBP project to have significant relevance to the nurse practice it is imperative that all the steps required in conducting an EBP are properly adhered to. The problem of research should be a clinical or a nursing area of concern whose solution can be arrived at through carrying out a viable research project that will generate new knowledge and nurse practice or build on the already existing bulk of knowledge (Li et al., 2019). The research objective should be SMART, that is, it should be specific, and target specific area of nursing or population, measurable, achievable, relevant to the area of practice and time bound. I do also agree with you that there are a number of sites that one can use when doing research on the topic or nursing area of research to focus on. The nursing data bases such as CINAHL, EMBASE, ERIC, MEDLINE via PUBMED or via Ovid, Cochrane Library, HAPI and Nursing Reference Centre Plus. These databases contain sufficient nursing research work that one can build on when developing and EBP research question to ensure its relevance and usefulness in the nursing practice (Hopia & Heikkilä, 2019).

NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them References

Hopia, H., & Heikkilä, J. (2019). Nursing research priorities based on CINAHL database: A scoping review. Nursing Open, 7(2). https://doi.org/10.1002/nop2.428

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice. Medicine, 98(39), e17209. https://doi.org/10.1097/md.0000000000017209

Re: Topic 7 DQ 1

The steps of the evidence-based research process include asking a clinical guided question, searching for appropriate evidence, analyzing the evidence, integrating the evidence into clinical practice, evaluating outcomes, and distributing the outcomes (University of Saint Mary, 2019). The evidence-based research process steps are systematic.

The first step of the process involves asking clinical guided questions. Based on the identified clinical problems found, the researcher forms what is called a PICOT statement (DeNisco & Barker, 2016). PICOT is an acronym where P- means patient or population problem, I- means intervention, C- means comparison, O- means Outcome, and T- means time frame (DeNisco & Barker, 2016). The second step allows researchers to search for evidence to determine whether a practice problem is appropriate for an evidence[1]based practice change proposal by using scholarly library databases, such as Cochrane Library, and PubMed. In the third step, the evidence is analyzed by completing a thorough investigation of the collected evidence before coming to conclusion. The fourth step is based on the conclusion of the investigation where the researcher will decide if the evidence can then be applied to clinical practice (DeNisco & Barker, 2016). The fifth step is when the researcher evaluates the outcome to see if the expected results was achieved or not. In the sixth step which is the final step of the evidence-based research process the evidence is made availability for distribution and use in the healthcare industry (University of Saint Mary, 2019).

It is important to incorporate all the steps of the evidence-based research project to produce an effective result for quality improvement in the healthcare industries by meeting individual patient’s needs (DeNisco & Barker, 2016).

NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them References

DeNisco, S. M., & Barker, A. M. (2016). (3rd ed.). Advanced practice nursing: Essential knowledge for the profession. Burlington, MA: Jones & Bartlett Learning

University of Saint Mary. (2019). 6 steps of the evidence-based practice process. Retrieved from https://online.stmary.edu/msn/resources/evidence-based-practi*ce-for-the-busy-nurse-practitioner.

RESPOND HERE

Hello,

I agree with you that in order to carry out an effective EBP it is imperative to carry out all the six necessary steps so that the entire process is complete and meets the required standards of clinical research process. This is the key to transforming the nursing practices into more efficient, effective and safe for the patients (Stevens, 2020). The EBP in nursing is crucial in developing new ideas or practices or improve on already existing knowledge. As a nursing student, I do believe the EBP is an essential and crucial part in the nursing curriculum that will equip me with adequate skills and knowledge on how best to improve on my nurse practice and experiences. The steps in formulating an evidence-based practice helps the nurse student appreciate and realize the need to incorporate all the steps in their EBP project. Each step is crucial and cannot be by passed. It is well conducted EBP research projects that has helped in the improvement of the quality of nurse care and promoted better patient outcomes (Lehane et al., 2018).

NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them References

Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., O’Connor, M., Corrigan, M., Burke, F., Hayes, M., Lynch, H., Sahm, L., Heffernan, E., O’Keeffe, E., Blake, C., Horgan, F., & Hegarty, J. (2018). Evidence-based practice education for healthcare professions: an expert view. BMJ Evidence-Based Medicine, 24(3), 103–108. https://doi.org/10.1136/bmjebm-2018-111019

Stevens, K. (2020). The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas. Nursingworld.org. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html

Evidence-Based Practice Proposal: Health Informatics – Medication Error 

Evidence-based practice (EBP) is the careful and well-advised application of contemporary best evidence in concurrence with clinical knowledge and patient ethics. One of the examples of EBP is the piloting of health care determinations through the use of health informatics in mitigating medication errors. The evidence-based practice procedures have five cardinal stairs: Constructing the clinical question, where the nurse constructs applicable and an accountable clinical question based on the patient’s manifestation (Escoffery et al., 2019).  Similarly, at the second step of probing for the best available and accessible evidence, the nurse chooses helpful resources and performs a search. At stage three, an astute analysis of evidence to ascertain rationality and practicality are done to determine the validity and the practicality of the research. In addition, the fourth stage involves the amalgamation of the appraisal with personal clinical knowledge and the patient’s predisposition to make a decision to mitigate a patient’s case. Further, the last step of assessing the process to improve it (Iowa Model Collaborative et al., 2017).

The Importance of Using the Steps of Evidence-Based Practice

The application of evidence-based practice makes certain clinical practices based on solid evidence and patients have satisfaction. In addition, using evidence-based practice translates into more harmonious clinical suggestions and practice over the health system. Besides, the evidence-based practice also recognizes that patient ethics, choices, and situations are taken into account to increase the probability of good services results and not harm. (Fisher & Bloomfield, 2019). In the initial stages of an EBP project, nurses in the specialty of health informatics locate sources of information from online patient portals and electronic medical records (Fisher & Bloomfield, 2019). Examples of specific sources of information include American Health Information Management Association (AHIMA) and American Nurses Association portal, among others.

NUR 513 Topic 7 DQ 1 Describe the steps of the evidence-based research process and the importance of using them References

Escoffery, C., Lebow-Skelley, E., Udelson, H., Böing, E. A., Wood, R., Fernandez, M. E., & Mullen, P. D. (2019). A scoping study of frameworks for adapting public health evidence-based interventions. Translational behavioral medicine, 9(1), 1-10. https://doi.org/10.1093/tbm/ibx067

Fisher, M. J., & Bloomfield, J. (2019, May). Understanding the research process. Journal of the Australasian Rehabilitation Nurses Association, 32 (2). https://search.informit.org/doi/10.3316/informit.500673642524420

Iowa Model Collaborative, Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., … & Authored on behalf of the Iowa Model Collaborative. (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

Evidence based practice (EBP) projects can be put into seven different steps (Melnyk et al., 2010). The first step to any EBP is to have a spirit of inquiry, the person leading the EBP must want to change and must have an investigative personality to understand how to change a process. The next step is to ask a clinical question in PICOT format. PICOT format is characterized by population (P), intervention (I), comparison (C), outcome (O), and time (T). After forming a question, one must search for evidence to back up the change being made. After that you must critically appraise the data, typically in a literature review format, using tools such as the CRAAP test. After making sure your research is correct, you must integrate your evidence into practice. After that you will evaluate if your implementation actually changed anything. Finally, the above information is disseminated to other clinicians to see if the EBP is worth doing again or maybe needs changes to work.

There are different types of information and evidence that can be gathered for EBP projects. There are seven different levels of evidence starting with a level 7, animal studies, level 6 is case reports and expert opinions, level 5 is case control studies, level 4 is cohort studies, level 3 is randomized control studies, level 2 is meta-analysis systematic reviews, level 1 is clinical practice guidelines (Research guides: Nursing & health sciences: Searching nursing databases). All of these studies can be found by doing scholarly research through library databases such as CINAHL and Cochrane library.

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step: The seven steps of evidence-based practice. AJN, American Journal of Nursing, 110(1), 51–53. https://doi.org/10.1097/01.naj.0000366056.06605.d2

Research guides: Nursing & health sciences: Searching nursing databases. Searching Nursing Databases – Nursing & Health Sciences – Research Guides at Grand Canyon University. (n.d.). https://libguides.gcu.edu/Nursing/journals