Evidence-Based Practice Challenges in Nursing Research & Solutions

This assignment consists of a discussion board post addressing challenges in evidence-based practice (EBP) within nursing research. It includes three questions: The first explores situations where EBP may not be effective due to patient-specific issues, requiring alternative approaches. The response provides a hypothetical scenario where strict cleaning restrictions for a patient with bloody diarrhea were challenged to prioritize hydration and monitoring, leading to a positive outcome. The second question discusses the challenges of translating research into practice within an organization, focusing on the introduction of shorter shifts in a hospital and the difficulties faced by staff in adapting to the change, highlighting the need for management techniques and improved patient satisfaction. The third question considers the role of theory in supporting change within an institution, advocating for the use of theories like Kotter's theory of change to guide employees through transitions, with support from various staff members. The post also includes a reference list of relevant articles.

Evidence Based Nursing Research
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Question 1- When does EBP not work? - Discussion Group 3(80 words in length)
First read the articles, and textbook assignment for this topic. Then answer the following
question - Describe a time when you were planning to use EBP for a patient (as a nurse
practitioner), but because of the patient's issues an EBP response was not helpful and you
had to find another way to address their problem. Please describe what happened and then
how it was resolved, and did you receive any difficulty from your colleagues about your
decision?
If this has never happened to you, imagine how this could happen, and what the outcomes
might be.
Answer: When appointed as a nurse for night shift to a patient, we had been given strict
restriction to clean the patient at a risk of bloody diarrhea (Nice.org, Retrieved on 10th February
2018). The patient while he was admitted was at very high risk of vomiting and dehydration. He
had lost tremendous weight and hydration levels and admitted during night shift. The GI doctor
consulting advised that the patient be kept hydrated and checked all the time for passage of stool
and urine. He was made to move every 2 hours to prevent bed soar or dirtying of the bed. I
would monitor his vitals every two hours that made him recover very fast. The outcome
associated with the patient was good from his chronic diarrhea. The management or other staff
did not intervene in his regime that helped arrive at possible outcomes.
Question 2- Translating Research - Discussion Group 3(80 words in length)
Your textbook in chapter 14 describes the importance of organizational culture and
climate. Read the chapter and then answer the following question:
Translating research into practice in an organization means that you have to propose a
change. That in itself can cause problems, because often people are reluctant to
change. Consider your current (or a past) position, and think about the organizational
culture. How easily is change initiated and accepted in that organization?
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Then answer the following questions:
1) Describe a change that happened while you were working at this site.
2) What was the most challenging part of the change for you and your colleagues?
3) In order to make this change, what had to be unlearned?
4) What had to be learned?
5) What were the benefits of this change for your organization?
Answer: Translating change into practice can raise immense challenge for any organization.
While changes can be challenging, they might be necessary for bringing greater impact on the
organization. A prominent change that happened while working at a site in hospital is
introduction of shorter shifts at the hospital. While we did have three shifts of GI, nurses and
other staffs working, a newer smaller shift was introduced in between to cater to patient. It was
noted that during changes in shift patients were not adequately catered to, thus, working shifts
were asked to extend their timing.
The most challenging part of the change procedure was extension of timing by 30 minutes to
cater to transfer. While other shift staffs used to come, the previous shift staffs kept on working
and handholding procedure. This often imposed stress on some of my colleagues due to extended
time period.
In order for this change to take place we had to learn management techniques.
The benefits of change to the organization was high with patient and patient party satisfaction
levels.
Question 3- Can theory change care? - Discussion Group 3(80 words in length)
Now that you are nearly finished, or finished with your theory paper, let's talk about the
real world:
Knowledge translation and then moving evidence into practice is assisted by the use of a
theory to support the movement into practice. However, changing the behavior of staff,
clinicians and/or patients is a slightly different problem. Please read the relevant posted
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readings and then post your thoughts about the need to use a theory to support change in
an institution.
Would you use one, if you didn't have too? For what types of change? Or is a theory not
necessary? Consider who has to change to make a given intervention successful - i.e.
administration, MD's and NP's, nurses, other ancillary personnel? Justify your answer
with citations from the readings.
Answer: Change often impends immense pressure on organization employees, theory provides
process of transition while change in a smooth manner. While incorporating change within my
institution I adopted Kotter’s theory of change where there were steps to guide employees
through the transition.
MD’s and NP’s along with nurses and other staffs helped in the transition process.
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Reference Lists
Bosch, M. T. (2013). How to define ‘best practice’for use in knowledge translation research: a
practical, stepped and interactive process. Journal of evaluation in clinical practice,
19(5), 763-768.
Nice.org. (Retrieved on 10th February 2018). Diarrhoea and vomiting.
https://www.nice.org.uk/guidance/topic/conditions-and-diseases/digestive-tract-
conditions/diarrhoea-and-vomiting#nice-pathways.
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