Nurses' Role in Evidence-Based Practice (EBP), Assignments of Nursing

Download Nurses' Role in Evidence-Based Practice (EBP) and more Assignments Nursing in PDF only on Docsity! NR 451 Week 1 Discussion 2 Nurse's Role in EBP (graded) NR 451 RN Capstone Course - Chamberlain College of Nursing Evidence based practice dates back to Florence Nightingale, yet it took a long time for nurses to conduct nursing research. Why is it important for nurses to have their own body of knowledge? Give a specific example of how bedside nurses contribute to nursing research? Class, you may begin posting in this TD on Sunday, May 3, 2015 for credit Respond This section lists options that can be used to view responses. Collapse All Print View Show Options Responses Responses are listed below in the following order: response, author and the date and time the response is posted. Sort by Read/Unread Sort by Response Sorted Ascending, click to sort descending Sort by Author Sort by Date/Time* (an instructor response) Collapse Mark as Read Introductory Post Instructor Card Email this Author 4/22/2015 11:11:05 AM Considering the nurse's role in evidence-based practice - what are the responsibilities of the nurse in evidence-based practice, and what are some ways the work environment can be structured or modified to encourage the use of EBP? Again. please share examples from your practice if you can so that we can learn from each other. Respond Collapse Mark as Read RE: Introductory Post Jillian Hoover Email this Author 5/6/2015 2:58:44 PM Professor and Class, As Plato said, "necessity is the mother of invention." As the nurse's working environment is already structured improvements can be made by the application of knowledge that is learned by caring for patients everyday. However, the workplace is not especially conducive to implementing EPB. As a medical surgical nurse, there have been many EPB projects stared on our floor. Education on these subjects are not what it should be, especially with staff coming and going as frequently as they do on med-surg floors. When those who are expected to implement the EBP do not understand or see the benefit of changing their routine, it is hard to motivate them to become part of the EBP team. Jillian Respond (an instructor response) Collapse Mark as Read RE: Introductory Post Instructor Card Email this Author 5/7/2015 2:47:33 PM Good discussion regarding the nurses role in EBP Jillian - you have shared a good example of the need for strong leadership in utilizing EBP and providing the motivation to do so. Respond Collapse Mark as Read RE: Introductory Post Lisa Hunt Email this Author 5/6/2015 8:52:31 PM Hello all, The role of the BSN prepared nurse in research is to have a basic understanding of the process, understand the elements of EBP and to join with team member on the research team. EBP allows the nurse to have guidelines for best practice and ensures that we as nurses are giving care that has been proven effective. A nurses responsibility is to be aware of EBP and participate. We have a responsibility to our patients to be informed of best practices. In my organization it is best practice to do bedside report. It was found that bedside reporting not only allows the nurse to see the patient as they are receiving report but includes the patient in the plan of care and allows the patient to be an active member of the team. Much resistance was met because the nurses felt uncomfortable if the patient had a room mate. We had many barriers to cross but kept emphasizing it was best practice and gave the reasoning to why. Bedside reporting is also an expectation of Renee Respond Collapse Mark as Read RE: Introductory Post Parulben Patel Email this Author 5/9/2015 8:55:40 PM Saynetta I agree that annual wellness visit and screening detects early sign and symptom of diseases. Nurses play crucial role to encourage people to visit for routine check up which is cost effective for health insurances, employers and prevents many chronic diseases. People who do not go for wellness visit often find their illnesses at last stage or turned out in chronic illnesses. For example, hypertension is a silent killer and many people lives with that condition and they do not know they have it. High blood pressure has no warning signs or symptoms, and many people do not know they have it(CDC,2014). The only way to know if you have it is to measure your blood pressure have a doctor or other health professional measure it. Often time people find out when they end up in emergency room with symptoms like stroke, headache and vomiting. Evidence supports regular screening, diet, exercise , education on prevention and regular wellness visit can prevent complications. Prevention is better than cure and it is only possible by routine check-up. Parul Reference: http://www.cdc.gov/bloodpressure/about.htm Respond Collapse Mark as Read Nurses Role in EBP Erin Pyatt Email this Author 5/4/2015 12:14:35 AM Professor and Class, Nursing Research is used by the Nursing profession to gain information to give evidence based care to our patients. The text defines "Nursing research: as A systematic process of inquiry that uses rigorous guidelines to produce unbiased, trustworthy answers to questions about nursing practice." (Houser 2015, pg 5) Evidence Based Practice is when the Nursing or Medical Profession follows certain protocols or guidelines when caring for patients following proper research and information. A team conducts an unbiased study to determine the new best way to do something in Nursing care for the better of the patient. An example of EBP in my work place is the discontinuation of the procedure of testing the foley balloon. EBP showed that inflating the balloon to test prior to inserting resulted in more CAUTI. Since the study the hospital changed policy and dropped the procedure of inflating the balloon. The text defines " Evidence-based practice guideline: A guide for nursing practice that is the outcome of an unbiased, exhaustive review of the research literature, combined with clinical expert opinion and evaluation of patient preferences. It is generally developed by a team of experts." (Houser 2015, pg 9) With out the bedside Nurse carrying out these practices to see if they are effective the study is just something on a peice of paper with noone to carry them out. References Houser, J. (2015). Nursing research: Reading, using, and creating evidence (3rd ed.). Sudbury, MA: Jones & Bartlett. Respond Collapse Mark as Read RE: Nurses Role in EBP Dawn Nelis Email this Author 5/6/2015 11:30:38 PM Hi Erin! Interesting Post. I work on a GYN/URO Med/Surg unit where we have discontinued the same practice. We no longer inflate the balloons pre insertion as well. I did not know why... until now. Good To know! We are very focused on the reduction of CAUTIs as well. Bedside nursing is the frontline of health care. We are the ones that utilize a systematic way of healthcare delivery that allows us to report the outcomes good or bad of any bedside practice. This is why it is important to utilize our own body of knowledge. When I first went into nursing ( awhile back) it was normal to leave urinary catheters in patients for days. It would take the bedside nurse to collect data such as UA c&s, vitals, blood collection that would indicate if a patient had a UTI. The advent of Evidence based practice has done good in that urinary infections have decreased with newer practices such as removal of these urinary caths immediately post op. Respond Collapse Mark as Read RE: Nurses Role in EBP Courtney Gregware Email this Author 5/7/2015 7:43:22 PM Dear Erin, The work that has been done on CAUTI is a great example of how we have looked at what we do and changed it because it was not best for the patient. It is interesting however-to try to disseminate the knowledge and change in practice to an entire organization. My organization got this change out to front line staff members by having nurses complete a competency on how to insert a foley. They trained many nurses who volunteered to act as Skills Ambassadors to sign off nurses on several competencies, including CAUTI. This was a great, concrete way to show and explain the new practice and why the change is being made. It is interesting however how resistant some were to this. We do get comfortable doing things a certain way and it is necessary to be open to learning about and adopting new practices for our patients. Courtney Respond Collapse Mark as Read Nurse's Role in EBP Lenora Charnovesky Email this Author 5/4/2015 7:51:03 AM Hello Professor Card and class, “Much of nursing lags incorporating evidence-based practice because many nurses lack the time and the knowledge of how to obtain EBP research, and often they lack education on how to fully understand research articles,” (Nurse Managers, 2011). One of my close friends works at a relatively new rehab facility. She has 20 patients in her care. These patients are sent from the hospital to the facility. She is responsible for documentation, Respond Collapse Mark as Read RE: Nurse's Role in EBP Erin Pyatt Email this Author 5/8/2015 7:06:01 PM Lenora, I can't believe to read that one Nurse could be responsible for that many patients a night. I cannot imagine having to take care of that many patients and actually deliver quality care. I understand these patients are not in an acute setting but how can this even be legal. I do believe that with the changing ways of healthcare currently this will not be able to go on much longer. When places like Nursing Homes and rehab centers switch to Electronic charting this won't be possible. The EMR is a beauty because everything is time. No one individual is handing out medications to 20 people in the hour that your are supposed to. I suspect that many of these medications are not being given at their scheduled time because the Nurse is over worked and cannot physically make that happen for all twenty patients. With this evidence of how unsafe it is for Nurses to work being severely understaffed, It is important for every Nurse to not accept that this is just how it is and to continue to educate for a better future for Nurses. Respond Collapse Mark as Read Nurse's Role in EBP Janice Sikorski Email this Author5/4/2015 5:37:18 PM Professor and class, Today, the importance of evidence-based practice is widely accepted. Its roots go back to Florence Nightingale and her book Notes on Nursing (1860). Her emphasis on principles related to cleanliness and the environment, as well as collection and analysis of data, were cutting-edge at a time when there were no schools of nursing We have made many advances since Nightingale’s time, but more still needs to be accomplished. We must insist that evidence-based practice be consistently applied at the point of care (Thompson, 2009) A recently published evidence-based project describes the potential benefits of discontinuing the routine practice of listening to the bowel sounds of patients who have undergone elective abdominal surgery. After reviewing the literature, the authors evaluated a new practice guideline: clinical parameters such as the return of flatus and first postoperative bowel movement were more helpful than bowel sounds in defining the return of GI mobility after abdominal surgery. There did not seem to be negative patient outcomes from this new practice. ~janice References: Beyea, RN, PhD, FAAN, S. C., & Slattery, RN, MS, M. J. (2006). Evidence-Based Practice in Nursing: A Guide to Successful Implementation. Retrieved from http:/http://hcmarketplace.com/supplemental/3737_browse.pdf Thompson, P. E. (2009). Evidence-based practice: A shared responsibility. Reflections of nursing leadership, 35(3). Retrieved from http://www.reflectionsonnursingleadership.org/Pages/Vol35_3_Col_CEO.aspx Respond (an instructor response) Collapse Mark as Read RE: Nurse's Role in EBP Instructor Card Email this Author 5/4/2015 9:04:40 PM This is a good discussion of the nurses role in utilization of EBP and how Florence Nightingale used her observations to improve care Janice - thanks for sharing this example regarding post-op care after abdominal surgery. Respond Collapse Mark as Read RE: Nurse's Role in EBP Dianne Johnson Email this Author 5/5/2015 6:40:30 PM Modified:5/5/2015 6:46 PM Janice, That was some really interesting data, regarding the fact that the return of bowel sounds don't have the impact that we used to go by for allowing return of a diet, having not been out on the regular post op nursing units for many years. It just proves that without active bedside nursing personnel participating in the evidenced based process by research and studies, new knowledge can't be generated that acts to give credibility to these decisions, whereby improving nursing practice, Houser (2015), p.5. Our lesson speaks of internal data collection in addition to the outside sourced data that can be compared by those who do a similar service and by determining best outcomes should cause a change in how we do things in our practice, CCN (2015). There is a fear in the change aspect, but evidence based practice will give credibility in our profession because we are backing out decision to change on real scientific, tested research. I enjoyed your post! Dianne Houser, J. (2015). Nursing Research: Reading, using, and creating evidence (Third ed.). Sudbury, MA: Jones & Bartlett. Chamberlain College of Nursing (2015). NR451. Establishing Evidenced-Based Practice in a Variety of Nursing Settings [Week 1 Lesson]. Respond Collapse Mark as Read nurses role in EBP Christine Gill Email this Author 5/4/2015 8:32:20 PM I think the responsibility of the nurse in evidence based practice is to know the reason behind everything we do. According to our text, many nurses are very task oriented, but evidence based practice encourage nurses to ask “why” and then guides them in making the best decisions for their patients (Dearholt & Dang). I find this a difficult question because everything we did in our hospital was evidence based and we had 8000 protocols to follow. According to our administration, following protocols ensured we were following EBP, but unfortunately, our hospital did not do a good job of explaining the reasons behind anything. Administration made new policies sound as if Joint commissions mandated it and “we have to do it.” It was never encouraged to ask questions and more frequently the answer to any questions was” it is evidence based practice.” I think it is extremely important to follow protocols, but knowing the reasons behind the protocols is valuable to nursing and the patients. ICU conducted a research on tight glycemic control (TGC) and presented the result to the inter- disciplinary team to solicit their collaboration. The ICU Head Intensivist supported the TGC championed by nursing and nurses implemented it as evidence-based best practice in the unit. During our monthly meeting the Unit Manager proudly reported that ICU met the goal for glycemic control and the intervention resulted to positive outcomes. Another example, nursing noted functional decline of patients in ICU. Based on evidence early ambulation prevents functional decline, falls and pressure ulcer. So, nursing incorporated early mobility in the evidence-based best practice on ICU patients. This EBP resulted to shortened hospital stay, increased functional mobility and maintenance of skin integrity (Kleinpell, Fletcher & Jennings, 2009). References Hood and Lucy. Leddy & Pepper's Conceptual Bases of Professional Nursing, 8th Edition. Lippincott Williams & Wilkins, 2013. VitalBook file. Houser, Janet. Nursing Research: Reading, Using, and Creating Evidence, 3rd Edition. Jones & Bartlett Learning, 2013. VitalBook file. Kleinpell, Fletcher & Jennings (2009). Chapter 11 Reducing Functional Decline in Hospitalized Elderly. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK2629/ Respond (an instructor response) Collapse Mark as Read RE: Nurse's Role in EBP Instructor Card Email this Author 5/5/2015 1:00:43 PM This is a good discussion of the nurses role in utilization of EBP Bernardita - thanks for sharing these two examples of how EBP improved care in your facility. Respond Collapse Mark as Read RE: Nurse's Role in EBP Christine Gill Email this Author 5/6/2015 9:46:39 AM Bernadita, What a great example you just gave. I never even thought about the many times we would call a doctor (I worked telemetry) to mention the blood sugar was 250 and the doctor would say "That is fine". At that time I did not know enough about EBP, but now I would question it, research it and provide the information to the proper people. Great post. Respond Collapse Mark as Read RE: Nurse's Role in EBP Jacklyn Paul Email this Author 5/6/2015 9:52:49 PM Bernadita, I agree with your post and I can identify with your last paragraph. I am an admission coordinator for rehab and I consult on patients all over the hospital.Initially I did not accept patients from the ICU but earlier this year we have begun a program where we assign physical therapists to begin therapy with those patients as the evidence shows that early mobility is beneficial to the patients physically, psychologically and financially to the institution and the insurance companies.Their rehab stay is much shorter as they have already have had a head start. As mentioned before nurses are with the patients all the time and can detect subtle changes and we need to continue to collect evidence so beneficial changes can be made for the patients. Respond Collapse Mark as Read RE: Nurse's Role in EBP Shelly Smith Email this Author 5/8/2015 6:12:21 PM Hi Bernardita, Great post, I can count how many times I have heard a nurse or physician say that a patient's blood sugar is only high because they are admitted so ignore it. Having too much sugar in the blood for long periods of time can cause serious health problems if it's not treated for example hyperglycemia can damage the vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke and kidney disease (Akron, 2015). When Blood Sugar Is Too High - Akron Children's Hospital. (2015). Retrieved from https://www.akronchildrens.org/cms/kidshealth/a89365e359972895/ Respond Collapse Mark as Read Nurse's Role in EBP Jessica Quinn Email this Author 5/5/2015 5:43:31 PM According to Dearholt and Dang, “Because of their unique position and expertise at the bedside, nurses often play a pivotal role in generating questions about patient care and safety” (Dang & Dearholt, 2012, pg. 12). Bedside nurses spend the majority of the day with their patients: completing assessments, prevention of complications, administering medication and performing clinical interventions. Therefore, they know what best practices are specific for their patients. Nurses also see different problems with patient care that administrative nurses cannot visualize and can voice the need for improvement. Another important factor in EBP is outcome measurement and effectiveness. Bedside nurses utilize evidence based practices and can measure firsthand whether it is making a difference for their patients or not. For example, turn and repositioning every 2 hours to prevent pressure ulcers, early ambulation to prevent post op pneumonia and VTE, and bedside nursing report. These are just a few of the evidence based practices in which are being used in patient care every day. Nurses also see firsthand different patient groups and can specify the needs for each group. They can bring their concerns to nurse managers and educators and find a solution. Due to the current changes to healthcare, evidence based practices are important to know and will allow nurses to deliver safe and efficient care for their patients. In the hospital, Nurses are very busy and see different patients each day, so it is important for Nurse Managers to reinforce the importance of different Evidence-based practices and how they will help the patients. Nurse Managers can also have staff meetings each month and allow their staff nurses to discuss certain issues in the clinical area and how we can fix this by using EBP. Reference Dearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Model and guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International. Collapse Mark as Read RE: Nurses Role in EBP Alfred D'Albero Email this Author 5/10/2015 12:51:40 PM Professor, I did not think about that, but that is really interesting. Thanks for providing me with this information! Respond Collapse Mark as Unread Nurse's Role in EBP Deborah Interlicchio Email this Author 5/6/2015 8:32:42 AM Patient safety and improved outcomes are critical today in healthcare. Evidence based practice is a useful tool that can improve the safety and outcomes of our patients (Chamberlain College of Nursing, 2015). It is important for nurses to have their own body of knowledge because the nurse is the one at the bedside with the patient and he/she is the one who needs to have the knowledge base to take care of their patients. Bedside nurses can contribute to nursing research by gathering specific patient data at the bedside while taking care of their patients. One specific evidence based practice I can think of, which is an ongoing issue on our unit, is prevention of pressure ulcers while in the hospital. As we all know. Turning every 2 hours prevents pressure ulcers in our patients. Our hospital is always incorporating evidence based practice in how to prevent pressure ulcers. We are always looking for new techniques and equipment for prevention of pressure ulcers. Nurses are at the front line of care at the bedside and we are incorporate evidence based practice in our every day care. Reference: Chamberlain College of Nursing (2015) RN Capstone Course. Week 1 Lecture. Online Publication. Respond Edit (an instructor response) Collapse Mark as Read RE: Nurse's Role in EBP Instructor Card Email this Author 5/6/2015 5:17:03 PM Good points regarding the nurses role in EBP Deborah - you have discussed how bedside nurses can both use and contribute to nursing research well for improved patient care. Respond Collapse Mark as Read Nurse's Role in EBP Erica Bonner Email this Author 5/6/2015 11:41:30 AM It is important for nurses to have their own body of knowledge in nursing especially when it comes to evidence-based practice. According to the lesson, “Healthcare professionals must be educated to deliver patient-centered care while functioning as members of interdisciplinary teams”. Nurses play an important role in recognizing a need for change instead of relying on the ways that things have always been done. When the need for change is recognized, research should begin. With enough evidence, new ways of nursing practice can be established and better outcomes can be discovered. Bedside nurses contribute to nursing research. They are implementing care based on ways that have been effective in the past, but research ways that will make outcomes in patient care better. Week 1 Lesson (2015). Establishing Evidence-Based Practice in a Variety of Nursing Settings. Retrieved from http://nursingonline.chamberlain.edu Respond Collapse Mark as Read RE: Nurse's Role in EBP Bernardita Aberin Email this Author 5/6/2015 12:22:13 PM Erica, I agree with you, Erica, "The way we were" though with best intentions were not the best practice. New technology and research improved the quality of care and safety in healthcare system. Before we used to deeply sedate ventilated patients to ensure that they are rested and slept for long period in order to reduce the metabolic rate and stress to the organs. Research revealed the impact from this past practices such as patients lost 18% of baseline body weight at discharge; muscle wasting resulted to profound functional limitations; most patients on ventilator more than 6 days became totally dependent in their ADLs. Rethinking Critical Care was initiated to improve the quality of care of critically ill patients. The new approaches address the problem from head to toe such as CAM-ICU to assess for delirium, SAT/SAB for early liberation from the ventilator, Early Exercise/Progressive Mobility to prevent severe functional decline and other complications related to prolonged bed rest. The new practice are evidence based and proven to improve patient outcome, decrease morbidity and mortality, shortened hospital stay, early recovery and cost effective (Adams, 2015). EBP is the way things are done today. Thank you for your post. Adams, C. (2015). Rethinking Critical Care. Retrieved from: http://www.qihub.scot.nhs.uk/media/780827/carmen%20adams_rethinking%20critical %20care_mar_2_2015.pdf Bernardita Respond Collapse Mark as Read Bedside for EBP Donna Cobedesh Email this Author 5/6/2015 12:17:51 PM The medical field is always changing with new inventions and ideas. We are always striving to give the optimal care for our patients and at the best cost. One example of bedside EBP was for a product that we use called Cath Care. We did an EB study to see if Cath Care worked better for foley care instead of soap and water. It was used in a nationwide study. The patients new that the study was in process and were willing to participate. We focused on patients with long term catheters that had a history of multiple UTIs. The study did show a decrease in UTIs for those patients. Now, the entire facility uses this product on the patients. The Cath Care is more expensive than soap and water, but it is cheaper than the readmissions on the patients. Here is an example were bedside EBP not only helped patents but helped the facilities to save money at the same time. Many studies have been done to come up with the best catheter care for residents. Articles have been wrote tha showed the evidence of proper catheter care to reduce infections in the urinary tract system, Magers (2013). Magers, T. (2013). Using Evidenced Based Practice to Reduce Catheter Associated Urinary Tract Infections. American Journal of Nursing. Retrieved From: http://journals.lww.com/ajnonline/Fulltext/2013/06000/Using_Evidence_Based_Practice_to_Reduc e.27.aspx Collapse Mark as Read Nurse's Role in EBP Parulben Patel Email this Author 5/6/2015 9:27:46 PM Professor Card and Class According to our week 1 lesson, Integration of evidence-based practice (EBP), quality improvement approaches, and informatics is critically important for patient safety and improved outcomes (Chamberlain, 2015). It is very important for nurses to have their own body of knowledge because, many important aspects of care have transformed over the years as new information becomes available. Nursing knowledge comes from a variety of sources including both theoretical and practice perspectives .Clinical decisions should be based on what is evidence rather than just opinion or belief. The aim for the profession should be to improve practice by questioning findings from all sources. Many nurses are very task oriented, but evidence based practice encourage nurses to ask “why” and then guides them in making the best decisions for their patients (Dearholt & Dang). An example of EBP at my work place is when there is change in patient mental status, screen patient for Urinary tract infection first, instead of using psychotropic drugs to manage behavior. Due to facility practice and staff awareness, we are very successful to find UTI at early stages in elderly patient. This way, we avoid use of psychotropic drugs and prevent hospitalization related to sepsis and acute change in mental status. Gaining knowledge raises an awareness of personal and professional accountability and the dilemmas of practice. Knowledge is what improves care if the nurse is aware of the best knowledge or evidence to use in practice. The need for nursing knowledge is of course influenced by patients. Patients are becoming more informed and ask nurses increasingly about aspects of health and care that affect them. Nursing knowledge should remain central to research, practice and teaching because it is essential in ensuring the provision of high-quality care for patients. Parul Reference: Chamberlain College of Nursing. (2015). Establishing Evidence-Based Practice in a Variety of Settings. Retrieved from http://frameset.next.ecollege.com Dearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: model and guidelines (2nd ed.). Indianapolis: Sigma Theta Tau International Respond (an instructor response) Collapse Mark as Read RE: Nurse's Role in EBP Instructor Card Email this Author 5/8/2015 4:46:58 PM Good points regarding nurses' responsibility to ask why Parul - thanks for sharing this example form your practice. Employers should also be interested in research and EBP, and help their staff to access and utilize it. Respond Collapse Mark as Read Nurse's Role in EBP Katherine Goffin Email this Author 5/6/2015 11:18:12 PM Hi Class, Nurses need to have their own body of knowledge and research because we have a unique job that involves the assessment, treatment, intervention, and education of patients. This weeks’ lesson discusses need for change, which is accomplished by assessing situations and conducting research in order to find evidence based practices that can be used by other nurses. Bedside nurses play a large role in nursing research because they are the people that are with the patients the most. Bedside nurses know their patients well and can see what is working and what isn’t. These nurses can assess situations and see whether a particular practice was effective. Bedside nurses also play a crucial role in assessing whether goals are being met. According to Dearholt and Dang (2012), “Because of their unique position and expertise at the bedside, nurses often play a pivotal role in generating questions about patient care and safety”. -Kate References Chamberlain College of Nursing (2015). NR 451 Capstone: Week 1 Lesson. Online Publication Dearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Model and guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International Respond Collapse Mark as Read RE: Nurse's Role in EBP Bernardita Aberin Email this Author 5/7/2015 3:32:41 AM Modified:5/7/2015 3:36 AM Kate, I agree with you that nursing practice needs change. Healthcare professionals like the nurses are well educated and highly skilled but the healthcare system continues to be troubled by quality and safety issues. Healthcare errors occur at an alarming rate and rank as the eight leading cause of death in healthcare industry. The IOM reported that there are about 40,000 incidents of medical errors every day. The Institute of Medicine called for a new framework that would prepare all health professionals with core competencies to improve the quality of care and patient safety. The Quality and Safety Education for Nurses (QSEN) project was implemented to raise the bar of knowledge, skills and competencies of professional nurses; QSEN presented new mindset for quality and safety that redefine the nurses’ roles in practice (Sherwood & Zomorodi, 2014). The nurse leaders in our facility reexamine the nursing practices and approaches in the unit. As part of the change, Rethinking Critical Care was initiated, which brought in new evidence-based approaches and incorporated with the unit’s best practice and patients’ preferences and values. For example CAM-ICU, SAT/SBT, Core Measure, Bundles, Workplace Safety, Informatics, NKE etc. Thank you for sharing your insight. Reference In addition to being the first line providers for patients, we are also patients' advocates. By having our own body of knowledge, we are better able to advocate. When armed with best practices that are evidence based, we can ensure our patients receive the best care. This weeks lesson states "(a)dditionally, nurses collect and analyze internal data and then compare these data with external data." (CCN, 2015) By remaining up to date on most current best practices, and analyzing the practices of our units, we can ensure the best care for patients. Heather Chamberlain College of Nursing. 2015. RN Capstone Course. Week 1 lesson. Respond (an instructor response) Collapse Mark as Read RE: Nurse's Role in EBP Instructor Card Email this Author 5/8/2015 4:48:32 PM Good points regarding how nurses act as patient advocates when using evidence based practices to improve patient outcomes Heather. As you noted, it is a nursing responsibility to remain up to date with current EBP for their area of practice. Respond Collapse Mark as Read RE: Nurse's Role in EBP Janice Sikorski Email this Author5/9/2015 10:04:20 AM Professor, Heather and class In my new role as a Case Manager, I find that more so now than ever before, even in ICU, am I expected to act as an advocate for my patients. There are several times a day when I find myself rejecting an idea to send someone home when I feel very strongly that that is not the safest plan for him or her. I can count on one hand the times this week that families have gotten angry with me for suggesting Hospice as the right path for their family member at this point in their life, only to decide 24 hours later that I was right. The things that I have seen, learned and done over the past 25+ years have led me to this. I continue daily to learn new ways to treat patients and their illness and it is all part of the learning process we have come to know. As our text points out, “Nurses are accountable for the interventions they provide, and EBP provides a systemic approach to decision making that leads to best practices and demonstrates such accountability.”(Dearholt & Dang, 2012) Evidence based practice has gotten a lot of publicity in the past several years as the way to do things as opposed to “the way they have always been done”. Technology I believe has so much to do with this. Without the Internet, we had books, literature and journals to learn from, but the instant gratification that the Internet offers has enhanced our practice exponentially thus hopefully improving our accountability for our patients well being. ~janice~ Refrences: Dearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Model and guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International. Respond (an instructor response) Collapse Mark as Read Research in EBPInstructor Card Email this Author 5/7/2015 2:37:54 PM Why is ethical research important in evidence- based practice? How can all nurses participate in nursing research? Respond Collapse Mark as Read RE: Research in EBP Shelly Smith Email this Author 5/7/2015 6:54:28 PM Hi Professor I think ethical research is important in nursing because it helps to advance the science of nursing therefore improving patient care and their overall well-being. As in every aspect of nursing ethics is important and is no different in research, beneficence, justice, and respect for persons and community applies during any medical research also. “To influence patient care from an ethical perspective, a nurse also needs an understanding of ethical principles and models. Knowledge of ethical principles, such as autonomy and beneficence, arms the nurse with power to be a major player in the decision-making process regarding patient care. A nurse who understands ethical principles, and can use this understanding to influence the health care team to apply these principles, has successfully used power by influencing the action and behaviors of others” (Parker, 2007). Nurses should all be involved I research and stay up to date with new information by being apart of research teams, journal clubs and individual research. Parker, F., (Nov. 26, 2007) Ethics Column: "The Power of One" OJIN: Online Journal of Issues in Nursing. Vol. 13, No. 1. DOI: 10.3912/OJIN.Vol13No01EthCol01 Respond Collapse Mark as Read RE: Research in EBP Lisa Hunt Email this Author 5/8/2015 8:48:07 PM Hello all As nurses we must apply all aspects of the definition of ethics to the research approach. The definition of ethics entails putting the patient first by respecting their rights, being an advocate, being truthful, informing the patient of all aspects of their care, keeping their care confidential and being accountable for our actions. When we keep this in the front we are ensuring best practice. Nurses can participate in research by joining research committees in their organizations, completing