As a DNP-prepared nurse, you will have a significant voice in your healthcare setting to advocate for evidence-based practice (EBP). Understanding how evidence can inform better nursing care and improve patient outcomes is fundamental to successful advocacy.
Blogs help facilitate a meaningful and more informal classroom environment—one that fosters dialogue, interaction, and the dissemination of ideas in a functional platform (Kuo et al., 2017). Blogs also promote community building and a collaborative learning approach through the sharing of ideas. Although this blog may function somewhat like a Discussion, its aim is to be more open ended and informal in terms of sharing perspectives, thoughts, and experiences on a given prompt.
For this Blog entry, you will observe a healthcare organization with which you work currently (or if that is not possible, an organization with which you worked previously) to identify examples of EBP, as well as examples for which EBP is needed.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare
Review the Learning Resources for this week related to EBP.
Consider the conditions that support EBP within healthcare organizations.
Observe a healthcare organization with which you work currently (or if that is not possible, an organization with which you worked previously) to identify examples of EBP that have been successful.
Observe a healthcare organization with which you work currently (or if that is not possible, an organization with which you worked previously) to identify examples of nursing practices that lack an evidence base and have been less than successful.
Note: Be sure to review the grading rubric for this Blog so you fully understand what is expected of you. To access the rubric, click on the three dots that appear at the upper right of the Blog Assignment page. Choose Show Rubric.
By Day 3 Of Week 4
Address the following in your Blog entry:
Describe one example you observed in which evidence-based practice (EBP) has been utilized. Explain why it has been successful.
Describe one example you observed in which EBP has not been utilized. Explain why it has not been successful. Then, explain how utilizing evidence could help make the nursing practice more successful.
Read a selection of your colleagues’ posts.
By Day 6 of Week 4
Respond to at least two of your colleagues, on different days, by comparing their observations and evaluations of evidence-based practice (EBP) with your own and offering suggestions or recommendations to advance EBP in one or both settings.
Note: Your responses should enrich the initial post by supporting and/or adding a fresh viewpoint and be constructive, enhancing the learning experience for all students.
Return to this Blog to read the responses to your initial entry. Note what you have learned and/or any insights that you have gained because of your colleagues’ comments.
Learning Resources
Required Readings
McEwen, M., & Wills, E. M. (2022). Theoretical basis for nursing (6th ed.). Wolters Kluwer.
oChapter 12, “Evidence-Based Practice and Nursing Theory” (pp. 261–281)
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2024). Translation of evidence into nursing and healthcare (4th ed.). Springer.
oChapter 1, “Evidence-Based Practice” (pp. 1–25)
Note: Pay special attention to information about the PET model on pages 9–11.
oChapter 2, “The Science of Translation and Major Frameworks” (pp. 25–53)
oChapter 8, “Methods for Translation”
“Quality Improvement and Rapid Cycle Performance Improvement” (pp. 174–176)
oChapter 9, “Project Management for Translation” (pp. 191–220)
Jones-Schenk, J., & Bleich, M. R. (2019). Implementation science as a leadership and doctor of nursing practice competencyLinks to an external site.. The Journal of Continuing Education in Nursing, 50(11), 491–492. https://doi.org/10.3928/00220124-20191015-03
Rew, L., Cauvin, S., Cengiz, A., Pretorius, K., & Johnson, K. (2020). Application of project management tools and techniques to support nursing intervention researchLinks to an external site.. Nursing Outlook, 68(4), 396–405. https://doi.org/10.1016/j.outlook.2020.01.007
PowerPoint Resources
Document: College of Nursing PowerPoint Template (PowerPoint presentation) Download College of Nursing PowerPoint Template (PowerPoint presentation)
Microsoft. (n.d.). Microsoft 365 for Mac quick startsLinks to an external site.. https://support.office.com/en-us/article/office-for-mac-quick-starts-5bccb480-0e5b-4b51-b072-66d3793ccad8
Note: If you are a Mac user and have never experienced PowerPoint before, this source will guide you through the basics of how to use PowerPoint. The time estimate for this resource is approximately 20 minutes.
Microsoft. (n.d.). PowerPoint for Windows trainingLinks to an external site.. https://support.office.com/en-us/article/powerpoint-for-windows-training-40e8c930-cb0b-40d8-82c4-bd53d3398787
Note: If you are a PC user and have never experienced PowerPoint before, this source will guide you through the basics of how to use PowerPoint. The time estimate for this resource is approximately 20 minutes.
Walden University Academic Skills Center. (n.d.). How do I create a strong PowerPoint presentation?Links to an external site. https://academicanswers.waldenu.edu/faq/72804
Walden University Academic Skills Center. (n.d.). MS PowerPoint resources: Getting startedLinks to an external site.. https://academicanswers.waldenu.edu/faq/330533
Required Media
IRL – Research and Science Course. (2019, August 30). What is implementation science?Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=Cvk-cpDptOc
IRL – Research and Science Course. (2019, August 30). Theories and frameworks in implementation scienceLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=fdaTFgX0II0
OASIS. (n.d.). Locate evidence-based practiceLinks to an external site. [Interactive media]. Walden University. https://rise.articulate.com/share/Vse0q3v0-5hp4rEsu9dzBI_5Ndiq26XV#
Walden University. (2021). DNP glossaryLinks to an external site. [Interactive media]. Walden University Canvas. https://waldenu.instructure.com
Walden University, LLC. (2011). An evidence-based practice model [Video]. Walden University Canvas. https://waldenu.instructure.com
Note: In this video, Kathleen White discusses the PET model.
Also Note: This resource is seminal to the field.
Kathleen White Video transcript just in case it’s needed
You really do need to choose
some type of a model or framework as a foundation
to your evidence-based practice. female narrator:
Dr. Kathleen White describes the importance of using an evidence-based
practice framework and the role of the DNP graduate in implementing evidence
into practice. – DNP graduates
are certainly gonna be those who are involved in implementing
evidence in the practice and would be important
for those initiatives. Back in the early 2000s, as faculty member at the
Hopkins School of Nursing, I had the wonderful opportunity
to participate with a group of five leaders
from the School of Nursing and from the
Johns Hopkins Hospital in evaluating evidence-based
practice models, because we had a dilemma
at the time: How did we know whether
we were implementing the best practices? That we’re producing
the best outcomes? How do we know whether
all of the procedures and protocols
were evidence-based? And so we reviewed
a lot of frameworks that were out there
that were being developed for implementing
evidence-based practice, and none of them really met
the needs that we had. They had a lot of strengths. There were a lot of
common themes among the models, but we decided
that in order to have an evidence-based
practice foundation for staff nurses
that was practical and could be used
over and over again without a lot of coaching from clinical specialists
or educators that we needed to really think
about developing our own model. And so we set forth to put forth
a conceptual model that used the practice,
education, and research triangle, levels of evidence,
including five levels that we identified– level one being
randomized controlled trials; level two being
quasi-experimental, level three, non-experimental; level four being practitioner
expertise in consensus groups, so groups that are basing their
recommendations on evidence; and finally, a fifth level that was local practitioner
expertise. And we put
these five levels together within the practice, education,
research triangle and looked at internal
and external factors that affect the implementation
of evidence, drew a conceptual model
and then defined a process that we affectionately call
the PET process. First is the development
of a practice question, whereby practice questions
get generated right at the bedside
by staff nurses, questioning
traditional practice, that something that has been
long held dear to nursing: Why are we doing something
the way we are? Our first pilot
asks the question, Why does an ambulatory
surgical patient have to void prior to discharge
from the PACU, from the Post Anesthesia
Care Unit? A long-held tradition
within nursing, that a patient
always needs to be– has to void after surgery
before discharge, and yet it was providing
a lot of dissatisfaction not only to patients
but also to nurses, especially in
adult ambulatory settings where patients have
shorter surgery times, they’re in the PACU
for a short time and are discharged–want to be
discharged quickly to the community and go home. So we took the nurses
in the PACU through an evidence-based
practice project looking at the evidence, which is the “E” part
of the PET process: They search the evidence. They came up with their set
of articles to review. They reviewed the level
and quality of them, and then came up with a “T,” which is the translation
or recommendation from the evidence. So the Johns Hopkins
evidence-based practice model and guidelines
includes the practice question, the evidence search,
and the translation. And so we tested the model through about
a year-and-half period of time with five different
implementations, and it was very interesting
that the model was very well-received
by the staff. So the Hopkins model,
you might say, “Okay, academic medical center,
a big facility, “able to–their staff nurses
are able to do that because they have lots
of supports.” Well, I can tell you
from personal experience, having had a faculty practice
at a small community hospital, we were able to implement
the Hopkins EBP model there, and it is being used
all throughout the country because it is practical, uses the forms
that have been developed, so that a nurse doesn’t get
to a point in thinking about, “Well, now what?
Now what’s next?” in the process of trying
to answer a practice question, search the literature, and provide for some kind
of a translation based on that evidence. Let me give you an example
of an evidence-based practice project
that was done at one of the
community hospitals that we worked with where they were noting
a variation in practice. And so that can also be
another reason why EBP questions get generated: high volume, high cost,
high-risk problems, variations in practice, a difference
from the community standards, or when you learn about a piece
of new knowledge that either you’ve read about
or gone to, you know, a national meeting and thought, “Wow, we need to evaluate this,
you know, for possible implementation
in our organization.” And so this particular
organization saw a variation in practice in dealing
with their newborns in the newborn nursery with babies who were born
with what that layperson
would call tongue-tie– and so for those of you
who may be either OB nurses or nursery nurses, you probably
know it as ankyloglossia, and so it’s where
the tongue underneath is attached more and the baby has a hard time
latching on to breast-feed on the mother’s breast. And it’s painful for the mom, and the child can’t get
the milk that they need. And so there is a procedure,
called frenotomy, where they snip the tie
underneath the tongue, and it’s usually done
at a very early age, you know, two days old, prior to discharge
from the hospital. And so some pediatric practices
embrace this, and others don’t. And when they don’t embrace it,
they generally say, “Well, I wait until the mother
comes back to the office “with the baby
for their first well checkup, and then we see
if it’s really a problem.” Well, the lactation specialists
were saying that, well, by that the time, the mom has stopped
breast-feeding because the baby isn’t satisfied
and the mom is having pain, and so it generally
isn’t a problem, and so the frenotomy
then is not done. The lactation specialist
wanted the pediatricians to evaluate whether frenotomy
was a best practice in dealing with ankyloglossia. Well, that’s an interesting
practice question. When they put their multi– or their interprofessional
team together, which included
the pediatricians, they said, “Well, that’s not
what we’re interested “in knowing about. “We want to know what
are the risks and benefits of performing frenotomy
for ankyloglossia in a newborn.” And so when you think about how a practice question
gets designed, if you’re doing it only
from the nursing perspective, you may not think about
what the other professionals are interested in
and knowing about. So early on in putting your
interprofessional team together, you have to get agreement on the scope
of the practice question and what you’re really
dealing with. so it was quite interesting. So they searched the literature
on the risks and benefits of performing frenotomy
for ankyloglossia, and the literature suggested
that there were not may risks and that the benefits
were there, and so they–the nursing staff and the pediatricians
that they worked with– put a presentation together
and presented it to the Department of Pediatrics in order to inform them
about this evidence, the level and quality of it,
the strength of the evidence, so that there could be given
more consideration to those discussions. And the practice change
that was so important that came out
of this EBP project was the implementation
of an assessment tool for the newborn to implement
the practice change, where they were early on
identifying that frenotomy and then making the referral
to the pediatricians for consideration of it in order to hopefully have more satisfied mothers
and babies and so a more
a satisfied OB service at their organization. So lots of opportunities
to affect policy based on evidence-based
practice work.
NURS_8114_Week4_Blog_Rubric
NURS_8114_Week4_Blog_Rubric
Criteria Ratings Pts
Main Posting: Idea and Content (25 points) 25 to >19 pts
Excellent
• Thoroughly responds to the blog prompt/s. • Post provides comprehensive insight, understanding, or reflection about the topic through a focused analysis of the topic supported by personal experiences and/or examples. • Personal opinions are expressed and are clearly related to the topic, activity or process identified in blog prompts. • The post reflects in-depth engagement with the topic. • Detailed reply to faculty.
19 to >14 pts
Good
• Responds to all of the blog prompt/s. • Post provides insight, understanding, or reflection about the topic through a reasonably focused analysis of the topic supported by personal experiences and/or examples. • Personal opinions are expressed and are but not fully developed to align with blog prompts. • The post reflects moderate engagement with the topic. • Appropriate reply to faculty.
14 to >9 pts
Fair
• Partially responds to the blog prompt/s. • Posts are typically short and may contain some irrelevant material. • The post is mostly description or summary without connections or analysis between ideas. • The post reflects minimal engagement with the topic. • Brief response to faculty with minimal effort.
9 to >0 pts
Poor
• Does not respond to the blog prompt/s or entries lack insight, depth or are superficial. • The entries are short and are frequently irrelevant to the events. • They do not express opinion clearly and show little understanding. • The post does not reflect engagement with the topic. • Fails to respond to faculty inquiries. / 25 pts
First Response: (15 points) Post to classmate’s main blogpost shows evidence of insight, understanding, or reflective thought about the topic. 15 to >11 pts
Excellent
• Presents a focused and cohesive viewpoint in addressing this response. • Response includes focused questions or examples related to classmate’s post. • Response stimulates dialogue and commentary. • Posts on separate day.
11 to >7 pts
Good
• Presents a specific viewpoint that is focused and cohesive. • Response includes at least one focused question or example related to classmate’s post. • There is some attempt to stimulate dialogue and commentary. • Posts on separate day.
7 to >3 pts
Fair
• Presents a specific viewpoint but lacks supporting examples or focused questions related to classmate’s post. • The posting is brief and reflects minimal effort to connect with classmate. • Posts on separate day.
3 to >0 pts
Poor
• Response lacks a specific viewpoint and supporting examples or focused questions related to classmate’s post. • The post does not stimulate dialogue or connect with the classmate. • Posts on same day. / 15 pts
Second Response: (10 points) Post to second classmate’s blog post shows evidence of insight, understanding, or reflective thought about the topic. 10 to >7 pts
Excellent
• Presents a focused and cohesive viewpoint in addressing this response. • Response includes focused questions or examples related to classmate’s post. • Response stimulates dialogue and commentary. • Posts on separate day.
7 to >4 pts
Good
• Presents a specific viewpoint that is focused and cohesive. • Response includes at least one focused question or example related to classmate’s post. • There is some attempt to stimulate dialogue and commentary. • Posts on separate day.
4 to >1 pts
Fair
• Presents a specific viewpoint but lacks supporting examples or focused questions related to classmate’s post. • The posting is brief and reflects minimal effort to connect with classmate. • Posts on separate day.
1 to >0 pts
Poor
• Response lacks a specific viewpoint and supporting examples or focused questions related to classmate’s post. • The does not stimulate dialogue or connect with the classmate. • Posts on same day. / 10 pts
Total Points: 0
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