BLOG: OBSERVATION OF EBP

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

Learning Resources

Required Readings

· Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (4th ed.). Sigma Theta Tau International.

· Chapter 5, “Searching for Evidence” (pp. 99–128)

Note: You previously purchased this text for NURS 8002.

· McEwen, M., & Wills, E. M. (2022). Theoretical basis for nursing (6th ed.). Wolters Kluwer.

· Chapter 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.

· Chapter 1, “Evidence-Based Practice” (pp. 1–25) Note: Pay special attention to information about the PET model on pages 9–11.

· Chapter 2, “The Science of Translation and Major Frameworks” (pp. 25–53)

· Chapter 8, “Methods for Translation”

· “Quality Improvement and Rapid Cycle Performance Improvement” (pp. 174–176)

· Chapter 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.

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.

RESPOND TO THIS DISCUSSION POST

PR NW

As a registered nurse working in a correctional facility, I have had the opportunity to observe the application of evidence-based practice (EBP) within a challenging and often resource-limited environment. EBP, which integrates clinical expertise, patient values, and the best available research, plays a crucial role in enhancing the quality of care and patient outcomes (Melnyk & Fineout-Overholt, 2019). In correctional healthcare settings, where individuals often present with complex health conditions and limited access to traditional healthcare resources, the effective implementation of EBP can significantly improve the health and well-being of incarcerated individuals. This entry will discuss an example of successful EBP implementation, an instance where EBP has not been fully utilized, and how addressing these gaps could improve nursing practice and patient outcomes in a correctional facility.

· Successful EBP Implementation:

· One area where EBP has been successfully applied in the correctional healthcare setting is the management of hypertension. The correctional facility where I work follows established, evidence-based clinical guidelines to assess, treat, and monitor inmates with hypertension. This includes routine blood pressure monitoring, appropriate pharmacologic interventions (such as ACE inhibitors and calcium channel blockers), lifestyle modification counseling, and regular follow-up visits (Whelton et al., 2018). Research supports the effectiveness of these strategies in controlling hypertension and reducing the risk of cardiovascular complications, such as stroke and heart disease (Poulter et al., 2015).

· This approach has been successful for several reasons. First, it standardizes care, ensuring that all patients with hypertension are managed according to the latest evidence. Second, the regular monitoring of blood pressure allows for early identification of uncontrolled hypertension, facilitating timely intervention and adjustment of treatment regimens. Third, the integration of lifestyle modifications, such as dietary counseling and exercise recommendations, aligns with evidence showing that such changes can have a significant impact on managing hypertension (Whelton et al., 2018). This comprehensive, evidence-based approach has led to improved blood pressure control within the facility, demonstrating the effectiveness of evidence-based protocols in chronic disease management.

· EBP Gaps in Opioid Withdrawal Management:

· Despite the successes in hypertension management, there are areas where EBP has not been as fully integrated, particularly in the management of opioid withdrawal. Inmates withdrawing from opioids often experience a range of physical and psychological symptoms that require careful management to alleviate suffering and prevent complications (Strang et al., 2019). While medications such as clonidine and methadone are sometimes used, there is a lack of a consistent, standardized protocol for assessing and managing opioid withdrawal symptoms. For example, the Clinical Opiate Withdrawal Scale (COWS), an evidence-based tool used to assess the severity of withdrawal symptoms, is not always implemented, leading to variability in the care provided to patients (Jasinski, 2003).

· This inconsistency in care is concerning because research has shown that standardized withdrawal management protocols significantly improve outcomes, including reducing the duration and severity of withdrawal symptoms (Strang et al., 2019). Without using an evidence-based tool like the COWS, healthcare providers may miss the opportunity to tailor treatment plans to the individual needs of each patient, potentially leading to inadequate symptom management or unnecessary use of medication. The implementation of a consistent, evidence-based approach to opioid withdrawal would not only enhance the quality of care but also improve patient satisfaction and reduce the risk of complications.

· Conditions Supporting EBP in Healthcare Organizations:

· Several factors contribute to the successful integration of EBP within healthcare organizations. One key factor is access to the latest research and clinical guidelines, which is often facilitated by institutional support for continuing education and evidence-based resources (Melnyk & Fineout-Overholt, 2019). In a correctional setting, however, challenges such as limited access to academic journals or digital databases can hinder the effective dissemination of current research. Therefore, ensuring that staff have the tools and resources they need to engage with evidence is critical for fostering an EBP culture.

· Moreover, effective EBP implementation requires strong leadership support. Leaders in healthcare organizations must prioritize EBP by creating a culture that encourages the use of research to guide clinical decisions. This includes providing opportunities for staff training and reinforcing the importance of EBP through organizational policies (Melnyk & Fineout-Overholt, 2019). Collaboration among interdisciplinary teams, including nurses, physicians, and mental health professionals, is also essential in fostering a comprehensive approach to patient care and ensuring that evidence-based interventions are appropriately applied across different patient populations (Melnyk & Fineout-Overholt, 2019).

· Conclusion:

· The integration of evidence-based practice in correctional healthcare has the potential to greatly enhance the quality of care and patient outcomes. The example of hypertension management demonstrates how evidence-based guidelines can lead to improved patient outcomes through standardized care and regular monitoring. In contrast, the lack of a consistent, evidence-based protocol for opioid withdrawal management highlights a critical gap where EBP could improve care. By adopting standardized protocols based on current research, such as the COWS assessment tool, healthcare providers in correctional settings can improve patient comfort, reduce the severity of withdrawal symptoms, and ultimately promote better recovery outcomes. As healthcare continues to evolve, it is essential for correctional facilities to prioritize the use of EBP in all aspects of care, ensuring that patients receive the highest standard of treatment based on the best available evidence.

· References:

· Jasinski, D. R. (2003). Opiate withdrawal and the clinical opiate withdrawal scale (COWS). Journal of Substance Abuse Treatment, 24(4), 441-444. https://doi.org/10.1016/j.jsat.2003.07.001

· Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.

· Poulter, N. R., MacMahon, S., & Spence, D. (2015). Blood pressure and the risk of cardiovascular disease. The Lancet, 365(9455), 939-948. https://doi.org/10.1016/S0140-6736(05)71064-7

· Strang, J., McCambridge, J., & Best, D. (2019). Effective interventions for managing opioid withdrawal: A systematic review. The Lancet Psychiatry, 6(1), 1-8. https://doi.org/10.1016/S2215-0366(18)30294-1

· Whelton, P. K., Carey, R. M., & Aronow, W. S. (2018). 2017 American College of Cardiology/American Heart Association high blood pressure treatment guidelines. Hypertension, 71(1), 126-134. https://doi.org/10.1161/HYPERTENSIONAHA.117.10874

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