You have to have both aspects of EBP to base your practice on it successfully. If a nurse has the mindset of EBP but does not participate in any activity to further their research and knowledge, what good is it? Likewise, nurses who do not have the mindset of EBP and are just doing research out of obligation will not be truly invested in it.

Abelsson et al. (2022. p. 143) discuss the “organizational culture impacts the mindset of all co-workers, including managers.” In Abelsson et al. (2022, p. 146), some managers stated that “evidence was always present in primary care due to the fact that they adhered to the given guidelines and policies.” Managers acknowledged the importance of EBP but stated barriers to it were budgets and scarce resources (Abelsson et al., 2022).

An organization that promotes EBP will take action and provide resources and time for nurses and managers to perform the activity of EBP. Nurse managers should receive EBP training to promote it to their staff. EBP does not “just happen.” The nurse must be an active participant to research and disseminate evidence for best practices.

Reference

Abelsson, T., Karlsson, A.-K., & Morténius, H. (2022). A Feeling of Ambiguity: A Qualitative Content Analysis of Managers’ Experiences of Evidence-Based Practice in Swedish Primary Care. Journal of Healthcare Leadership, 14, 143–153. https://doi.org/10.2147/JHL.S371643

Response 2

What are some of the key differences between EBP, research and quality improvement?

(Grys, C., 2022) “EBP is used to care for individual patients, address operational and systemic questions, or improve safety or quality outcomes” (p. 48) EBP as noted in this article show research and quality improvement share similar goals for patient outcomes as well as differences amongst each subset. Research and EBP are both founded on principles from evidence backed from documented literature. Whereas research and quality improvement are based on development and posing of questions to determine what are the problems needing attention and finding solutions for the problems or concerns to improve EBP. (GRYS, C., 2022) By evaluating currently used EBP staff nurses as well as those in leadership roles or specialty committees have opportunities to incorporate research to find quality improvement strategies.

There are many ways to promote positive outcomes in patient-centered care. To provide a hypothetical example, a staff nurse upon caring for his or her specific patient population observes an increase in urinary catheter associated infections (CAUTI). We as nurses are all aware of the multitude of negative impacts any hospital acquired infection (HAI) can have on a patient in regards to length of stay, prolonged antibiotic use, changes in mentation or electrolyte imbalance which in turn can result in an increase in falls. (Taha, R. et al, 2017) states, “CAUTI is one of the most common healthcare associated infections. It is a leading cause of secondary blood stream infection resulting in increased morbidity and mortality with an estimated 13,000 attributable deaths annually, increased length of stay by 2-4 days and increased healthcare costs with additional cost $1200-2400 per case.” (p. 1) These of course are just a few factors or negative events that can result from a CAUTI. This observation of increase in infectious process leads the staff nurse to question the safe process on his/ her unit and if EBP is being followed. In aim for improvement, the nurse can promote change by involving his/ her management team or a unit practice committee.

Research in this case my begin by tracking who has been caring for the patients that have succumbed to such infections. Is there a common denominator in which nurses or techs were involved in patient care of those inflicted and have they been utilizing the documented policy/ procedural standards? The likelihood of a staff nurse being able to follow through with such data collection due to heavy patient assignments does not allow time needed to dedicate to the matter. The role of nurse management/ leadership would be to conduct research of current hospital EBP, comparing such with most recently documented literature. The next step would be to evaluate data collected from the questioning and resulting answers to incorporate changes needing to be made for quality improvement strategies.

To review, although EBP, research, and quality improvement appear to be similar and intertwined, the role of each are different. EBP is the follow through or guiding principles on which we carry out our daily practice as nurses. Research is the data that has been collected via study and published literature to assist in the development of EBP policies. Quality Improvement is the utilization of accumulated research information to expand upon current practice to enhance EBP and promote positive patient outcomes.

References

Grys, Crystal A. MSN, RN. Evidence-based practice, quality improvement, and research: A visual model. Nursing 52(11):p 47-49, November 2022. | DOI: 10.1097/01.NURSE.0000889812.89287.45

Taha H, Raji SJ, Khallaf A, Abu Hija S, Mathew R, Rashed H, Du Plessis C, Allie Z, Ellahham S. Improving Catheter Associated Urinary Tract Infection Rates in the Medical Units. BMJ Qual Improv Rep. 2017 Apr 6;6(1):u209593.w7966. doi: 10.1136/bmjquality.u209593.w7966. PMID: 28469893; PMCID: PMC5387977.