Discussion: Culture of Evidence Based Practice

Week 9 NURS Essent of Evidence-Based Practice RESPONDs Module 5: Evidence-Based Decision Making (Weeks 8-9) • • Learning Objectives Evaluate dissemination strategies Recommend strategies to overcome barriers to dissemination of evidence-based practice changes RESPOND to 2 students: A Culture of Evidence-Based Practice As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP. In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry. Respond to at least two of your colleagues on two different days by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination. Student #1 KP Most likely Methods to use for Dissemination of EBP There are many ways to disseminate evidence-based practice. Discussion: Culture of Evidence Based Practice

“Evidence dissemination has several very broad goals: (1) to increase the reach of evidence; (2) to increase people’s motivation to use and apply evidence; and (3) to increase people’s ability to use and apply evidence”(Communication and dissemination strategies to facilitate the use of health-related evidence,” n.d.) I would tend to use poster presentations and unit presentations at my facility. This is because with poster presentations, information can be easily displayed for nurses and ancillary staff to see as they move throughout the unit. It also gives me an opportunity to speak to people in smaller groups, and allows them to ask questions, express thoughts or concerns, and receive the information without interfering with their day. It allows me as the presenter to have more interaction with my colleagues. The second method I would use is unit presentations or in evidence based clinical rounds. In my facility, we would ask staff to meet in small groups on the unit throughout the day to either participate in the hands on change or to simply discuss the change in practice. I found this to be very effective in communicating information because it did not involve nursing having to come in early or stay late, and it did not interfere with patient care. I have also used this in conjunction with power point presentations that I send out after the clinical rounds are complete, so staff is able to go back and review the information. Methods Least Likely to Use The two methods I am least likely to use are community meetings and professional meetings. Personally, this is something I would be willing to do in the future, however I do not have the time for these at the moment. It also involves collaboration with a large number of people such as laypersons in the medica and other professionals. I also enjoyspeaking to those in my hospital and making changes that affect my unit directly to improve patient care and nursing satisfaction. Barriers to Methods Barriers to both poster presentations and small group clinical rounds are a decreased amount of time and less inclination to pay attention because colleagues are involved in other things. This may prevent the information from being thoroughly communicated, can decrease time for thoughts and questions, and may mean that staff does not fully understand the new practice. For example, a group came in to implement the leaf program in our unit. Discussion: Culture of Evidence Based Practice

Because it was presented in small groups, our nurses are less familiar with all of the adjustments and settings they have the ability to use, which at times makes using the leaf system quite frustrating. How to Overcome Barriers I am not sure how to overcome these specific barriers, because the benefits and the barriers of both of these methods are small time increments, decreased work interference, and staff not adjusting their schedules to accommodate a training session. I think follow-up with a power point presentation after would be beneficial to both types of dissemination of information to reinforce what was taught. References Communication and dissemination strategies to facilitate the use of health-related evidence. (n.d.). Effective Health Care Program. https://effectivehealthcare.ahrq.gov/products/medical-evidencecommunication/research-protocol Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. Discussion: Culture of Evidence Based Practice

STUDENT #2 MD Dissemination and implementation of new technologies in healthcare can be challenging. Finding ways to distribute up to date information based on the latest research requires many strategies, some of which are more effective than others. Some of the tactics below decipher which techniques could work better than others to spread the information. Two Dissemination Strategies to Use Using a poster presentation as an effective method for disseminating evidencebased practice would be an excellent way to promote change. Using infographics to catch people’s attention with the colors and graphics, and easy to understand information is one strategy used by many facilities. Placing the posters throughout the unit, in the stairwells, on the doors, and in bathrooms has shown to be an effective way to pass the information. Seeing the same poster in many areas eventually raises one’s curiosity enough to take time out to read and understand the information on it. Seeing infographics throughout the facility has helped circulate information to keep the staff up to date on specific evidence-based practices (EBP). Along with infographic posters, the implementation of protocols in a healthcare facility is a sure way to create change in practice. The development of protocols to help with the standardization of processes and procedures aids in improving the organization of care (Fischer et al., 2016). Discussion: Culture of Evidence Based Practice

Hospital protocols are the guidelines used by the facility to provide care. Creating a protocol using EBP allows others to implement those guidelines when delivering care. Facility protocols will help disseminate EBP in the organization and guide the care delivered. Dissemination Strategy Least Inclined to be Used Attempting to use unit-level presentations is the least effective method to disseminate information. Expecting healthcare workers to attend a presentation before or after work or on their day off is unlikely to occur. Also, for the staff who attend the presentation before or after work, absorbing and retaining the information from it is questionable. Presentations are often not engaging enough to preserve the information introduced. Two Barriers When Using Dissemination Strategies and How to Overcome them There are many barriers to dissemination strategies, including resilience to change from the old way of things and perception of benefits from clinical practice. In a facility where the culture of resistance to change is present, the barrier to implementing clinical practice guidelines is strong (Jun et al., 2016). One way to overcome this barrier is by peer endorsement of clinical guidelines. Providing approval and praising staff on implementing EBP care could increase compliance. Another obstacle when using dissemination strategies is the staff member’s perception of benefits from the clinical practice. If they believe a method is not valuable, they are less likely to do it. A strategy to overcome the obstacle of perception is to implement protocols. If a protocol is set in place, the staff members are expected to follow it. Although there are barriers to dissemination, there are strategies to get past them. Conclusion In conclusion, disseminating EBP is very important to provide the best care but requires strategizing to accomplish. Adaptation of scientific evidence to practices in implementing care offers the most up to date results (Ulrica von Thiele Schwar et al., 2019). Discussion: Culture of Evidence Based Practice

Using strategies like infographics and protocols can help with the dissemination of EBP. Presentations are also a strategy to help distribute information, although less likely to work. However, many barriers, including perception or resistance to change exist, requiring strategies to overcome them in order to continue on the path of providing EBP care. Moving forward, strategies will continue to need adjustments to disseminate EBP. References Fischer, F., Lange, K., Klose, K., Greiner, W., & Kraemer, A. (2016). Barriers and Strategies in Guideline Implementation—A Scoping Review. Healthcare, 4(3), 36. https://doiorg.ezp.waldenulibrary.org/10.3390/healthcare4030036 Jun, J., Kovner, C. T., & Stimpfel, A. W. (2016). Barriers and facilitators of nurses’ use of clinical practice guidelines: An integrative review. International Journal of Nursing Studies, 60, 54–68. https://doiorg.ezp.waldenulibrary.org/10.1016/j.ijnurstu.2016.03.006 Ulrica von Thiele Schwarz, Gregory A. Aarons, & Henna Hasson. (2019). Discussion: Culture of Evidence Based Practice

The Value Equation: Three complementary propositions for reconciling fidelity and adaptation in evidence-based practice implementation. BMC Health Services Research, 19(1), 1–10. https://doi-org.ezp.waldenulibrary.org/10.1186/s12913-019-4668-y My Discussion (Tutor to read my discussion) Developing a Culture of Evidence-Based Practice Disseminating and sharing evidence-based practice data is a crucial step in ensuring that other people in the community, organization, and industry are informed about research outcomes. There are numerous approaches I could use to disseminate EBP. In my healthcare organization, I would prefer to use reports and posters which would engage staff on different levels. I would create a poster that summarized the EBP and is visually appealing to capture the attention of other staff and place it on the noticeboard. When disseminating EBP, a major factor to consider is how to tailor the message to the audience based on their characteristics and their interests (Melnyk & Fineout-Overholt, 2018). In my observation, many of the staff members in the hospital are often too busy to read articles. Therefore, a short poster would easily capture their attention and communicate the message. The poster would display links to the main report which I would upload to the organizational website. This would provide follow-through and referencing which are important in engaging the audience and proving that the EBP outcomes are credible (Astroth & Hain, 2019). This approach to disseminating EBP would be effective at the organizational and departmental level and hence I would use it internally. A different approach would be necessary for disseminating EBP outside the healthcare organization. I would present my findings in conferences of professional organizations and associations such as the American Nurses Association (ANA). Targeting the audience for the EBP requires positive engagement (LoBiondo-Wood & Haber, 2017). In this instance, I would ensure positive engagement with nurses through face-to-face presentations in conferences. I find this method faster and more effective than publishing in a Journal because it presents direct interactions with nurses and other professionals. I could also publish the EBP report in a journal after I have shared my research in the conference. The aim of dissemination is to ensure that the information reaches the target audience and they are informed on the newest EBP outcomes. Choosing the right strategy for dissemination is thus paramount. References Astroth, K. S., & Hain, D. (2019). Disseminating scholarly work through nursing presentations. Nephrology Nursing Journal, 46(5), 545-550. LoBiondo-Wood, G., & Haber, J. (2017). Nursing research-e-book: methods and critical appraisal for evidence-based practice. Elsevier Health Sciences. Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. Rubric grading (Tutor to check) Main Post: Timeliness 10 (10%) – 10 (10%) 0 (0%) – 0 ( First Response 17 (17%) – 18 (18%) 13 (13%) – Response exhibits synthesis, critical thinking, and application to practice settings. Discussion: Culture of Evidence Based Practice

Response Posts main post by day 3. R esponds fully to questions posed by faculty. Responses professiona Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Responses posed. Demonstrates synthesis and understanding of learning objectives. Response few or no c Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. Second Response 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. . 12 (12%) Response Responds fully to questions posed by faculty. Responses professiona Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Responses posed. Demonstrates synthesis and understanding of learning Response objectives. few or no c Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. Participation 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days. 0 (0%) 0 (0%) Total Points: 100 Name: NURS_6052_Module05_Week09_Discussion_Rubric Learning Resources Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. Required Readings Melnyk, B. M., & Fineout-Overholt, E. (2018). Discussion: Culture of Evidence Based Practice

Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. • • • Chapter 10, “The Role of Outcomes on Evidence-based Quality Improvement and enhancing and Evaluating Practice Changes” (pp. 293–312) Chapter 12, “Leadership Strategies for Creating and Sustaining Evidence-based Practice Organizations” (pp. 328–343) Chapter 14, “Models to Guide Implementation and Sustainability of Evidence-based Practice” (pp. 378– 427) Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidencebased practice, step by step: Implementing an evidence-based practice change. American Journal of Nursing, 111(3), 54–60. doi:10.1097/10.1097/01.NAJ.0000395243.14347.7e. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2011/03000/Evidence_Based_Practice,_Step_by_Ste p_.31.aspx 0 (0%) – 0 ( Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. Journal of Nursing Administration, 37(12), 552– 557. doi:0.1097/01.NNA.0000302384.91366.8f Note: You will access this article from the Walden Library databases. Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice. Nursing Administration Quarterly, 36(2), 127–135. doi:10.1097/NAQ.0b013e318249fb6a Note: You will access this article from the Walden Library databases. Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidencebased practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. American Journal of Nursing, 111(9), 57–60. doi:10.1097/01.NAJ.0000405063.97774.0e Note: You will access this article from the Walden Library databases. Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A test of the ARCC© model improves implementation of evidence-based practice, healthcare culture, and patient outcomes.

Worldviews on Evidence-Based Nursing, 14(1), 5–9. doi:10.1111/wvn.12188 Note: You will access this article from the Walden Library databases. Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidencebased practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. American Journal of Nursing, 111(9), 57–60. doi:10.1097/01.NAJ.0000405063.97774.0e Note: You will access this article from the Walden Library databases. Week 9 NURS 6051 Transf Nursing Tech RESPONSES to 2 STUDENTS Module 5: The Nurse Leader and the System Development Life Cycle (Weeks 9-10) Learning Objectives Students will: • • Analyze how inclusion of the nurse in the purchasing of health information technology systems impacts healthcare organizations Analyze the impact of nurse inclusion on each step of the systems development life cycle Respond to at least two of your colleagues* on two different days, by offering additional thoughts regarding the examples shared, SDLC-related issues, and ideas on how the inclusion of nurses might have impacted the example described by your colleagues. Student #1 SL C OLLA PSE Wk 9 Main Post The improvement of a technology project is dependent on quality; the construction of the systems of development life cycle model is designed to promote this (Usman & Nonyelum, 2018). There are seven steps in the SDLC concept: planning, design, development, testing, implementation, and maintenance (McGonigle & Mastrain). SDLC provides the framework that information technology systems through analysis for the unique organization (McGonigle & Mastrian, 2017)

. The recommendation is that different healthcare personnel with nursing be the most prominent part of the model’s design, as experts in their field nurses that are involved in the implementation of technology assist information technology specialists a better understanding of how efficient the technology within the facility (Weckaman & Janzen, 2018). Implementing a new system following the SDLC model should meet the healthcare providers’ needs that use the technology. (Laureate Education, 2018) Nursing role in SDLC Within the hospital, the nurse is with the patient the most and is constantly documenting every patient interaction. Their role becomes more emphasized in conjunction with the SDLC model. Everyone involved in a patient’s care should have easy access to any information needed. Physicians need access to lab and imaging regardless of where they are to use the highest level of interpretation for medical treatment (laureate education 2018). Imaging and laboratory results are essential. Just as important are the nursing notes and assessments documented by nursing and other treatment team members. This information provides critical communication that leads the plan of care for patients. The person who spends the most time with a patient is the nurse, who uses various systems. Documenting the patients’ care and treatment plan throughout the daily activities is a major part of upgrading and improving patients’ outcomes. As experts in the technology field, technology specialist understands the process of the new technology. Just as nurses are experts in their field with understanding the flow of patient care, the frequency of interactions that is needed between all the healthcare providers, the nurse is in the middle of the whole treatment team (Weckman 2009). The most efficient systems are a symbiotic relationship between healthcare providers and the technology needed that improve patient outcomes, Importance of including nursing Organizations that are planning to upgrade a system or completely implement something new in nursing should be included. The development of a multidisciplinary team is crucial to a successful rollout. Flaws are easier to spot with many different eyes upon the project, the benefits of this is feedback is provided in real-time. My health organization uses EPIC documentation. Before any new change comes from the development team, nurses are consulted to discuss the ease of us … Discussion: Culture of Evidence Based Practice