Institute of Health and Management Nursing Research Article Review

This report is a comprehensive review of a nursing research article by Melnyk et al. (2014), focusing on evidence-based practice (EBP) competencies for registered nurses (RNs) and advanced practice nurses (APNs). The review covers the introduction, methodology, design, data collection, sampling design, data analysis, findings, discussion, and recommendations of the original article. The study utilized both qualitative and quantitative methods, including a Delphi survey, to identify and establish EBP competencies in real-world clinical settings. The findings highlighted 13 competencies for RNs and 11 additional competencies for APNs, emphasizing the importance of EBP in improving healthcare quality, patient outcomes, and reducing costs. The review also discusses the limitations of the study and provides a conclusion that reinforces the significance of EBP in enhancing the skills and competencies of the nursing workforce. The report concludes with references to the cited articles.

Running head: Nursing Research Paper
Nursing Research Paper: Article Review
Name of Student:
Name of University

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Table of Contents
Chosen Article:................................................................................................................................3
Introduction......................................................................................................................................3
Methodology and Design.................................................................................................................4
Data Collection and Sampling Design.............................................................................................7
Data Analysis, Findings, discussion and recommendations............................................................7
Conclusion:......................................................................................................................................8
References........................................................................................................................................9

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Chosen Article:
Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The
establishment of evidence‐based practice competencies for practicing registered nurses and
advanced practice nurses in real‐world clinical settings: Proficiencies to improve healthcare
quality, reliability, patient outcomes, and costs. Worldviews on Evidence
‐Based Nursing, 11(1),
5-15.
Introduction
The title of the article provides a superficial idea regarding the subject of the research. It first
provides an idea that the registered nurses and the advanced practice nurses need competency in
developing evidence-based practice. Secondly, the title provides an idea that these practices have
professional implications in the improvement of nursing practice. In the background, the
researchers discuss the concept of evidence-based practice in the healthcare industry is known to
the professionals for a long time (Melnyk et al., 2014). The authors also pointed out that not
many nursing professionals practice evidence-based practice despite research supporting that the
patient outcome, reliability, quality and reduction of cost of treatment is reduced in the
healthcare sector (Rousseau, & Gunia, 2016). The authors hypothesized that the adoption of the
EBP or evidence based practice is importance in the advanced practice nurses in healthcare care
institutes. The purpose of the research as per the authors is to indicate the competitiveness of the
EBP in case of the APN and the registered nurses which will improve the quality of services in
healthcare institutes. The background considerations of the author indicate that a large amount
of previously published literature was considered for the theoretical understanding of their
concept. The authors also developed the steps of the evidence-based practice from their

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theoretical studies into seven separate stages which would promote the better quality of
healthcare service in the healthcare setting (Melnyk et al., 2014). Research specifically is
referred o as the systematic and rigorous exploration for answering the queries and resolving
issues. It deals with the advancement of knowledge through refinement and discovery
(Bradshaw, Atkinson & Doody, 2017). A key component of professionalism is the development
of research to improve the specialised knowledge base. In the case of nursing practice the
practice of research is essential for the increasing of the highest quality of knowledge and
providing the best possible care quality to patients. It provides the up to date knowledge
regarding the nursing practices in terms of the treatment procedure and associated issues that
might impact the health of the client. EBP provides the perspectives of the patient into
consideration which help in refining the current nursing practices in healthcare institutes.
Evaluation of the research journal provides insight into the quality of the research and in
extension its reliability.
Methodology and Design
The authors contacted leaders of the EBP who developed the competencies for the APN and
registered nurses in the United States. The second approach was to adopt a Delphi survey for
interviewing the 80 mentors in EBP across the US for the determination of clarity and agreement
for the competency development.
There are two dominant research paradigms known for the support of research experiments. Both
the qualitative and the quantitative paradigms have a specific ontology which is the philosophical
consideration of the existence of reality (Leavy, 2014). The quantitative paradigm of research
methodology is gained from the philosophy of realism. As per the realists, the notion that the

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truth is present in an undiscovered state is common. Relativism is the philosophy of the
qualitative paradigm of the research methodology (Aliyu et al., 2014). As per the believers of
this theory, there is a possibility of the existence of multiple perspectives of one reality. The
relationship between the researcher and the research is defined as the epistemology. Therefore
the epistemologies of each of the two paradigms are different from one another.
In the case of quantitative research, realist ontological beliefs provide the researchers with a
positivist approach to knowledge gathering. In this regard, the researchers undertake the Etic
perspective to discover knowledge (Olive, 2014). The researchers, in this case, take an external
perspective of finding the objective within the research. Studies that have quantitative approach
are usually directed by the adoption of a scientific method in experimental or non-experimental
techniques. The goal of such studies is to discover the truth using an objective approach.
Contrastingly the qualitative approach is also called the naturalist approach since the relativist
ontological beliefs are embedded in its philosophy. According to these researchers, there is no
fixed reality just a difference of perspective and that the increasing proximity between the
researchers and the research, the knowledge regarding the particular topic is maximised. In this
case, the internal consideration or the Emic approach to obtaining knowledge is preferred which
believes that co-construction of reality is important (Olive, 2014). Qualitative studies also
comprise of the constructive paradigm focussing on acquiring the subjective which only
uncovers the existing perception of the truth. Qualitative researchers are generally inductive in
nature whereas quantitative research is deductive in nature. The journal article used both
qualitative and quantitative methods to answer the hypothetical query of the research.
Consensus Building Process-

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In the case of the journal article, the researchers adopted inductive and Emic approach or
qualitative approach into finding the possible nursing competencies for EBP. This can be used to
state that since the researchers divided the sample into focus groups and performed in-depth
interviews to gather the necessary observation for analysing the collected data (Clarke, Apesoa-
Varano & Barton, 2016). This is why the authors used the consensus-building approach to
develop the stages of EBP adoption and its specific stages in nursing competency. As per the
nature of the qualitative research models and themes of learning are developed. This was done in
as of the authors of the journal to develop the lists of the EBP practices and competencies. In this
approach of the authors, there are methods of design in phenomenology, grounded theory and
ethnography. In terms of phenomenology the consideration of the lived experiences, small
sample scale, in-depth conversations and the theoretical understanding of books are considered.
This can be suggested from the selection of the academic and clinical leaders in healthcare
settings for developing the competency list. The small sample size and the purposive nature of
the approach indicate that phenomenological considerations were taken in this regard. This
approach also satisfied the ethnographic consideration of the selection of ten participants. In the
journal, they belonged to the healthcare industry, who had previous experience in EBP and
mentored the upcoming nursing sample.
Delphi method – quantitative
In the second half of the research, the quantitative approach was selected for the findings using
the Delphi technique. The idea of the Delphi technique is to forecast the process framework
based on the analysis of the found results of questionnaires sent to a panel of experts in a field.
Diamond et al. (2014) opined that originally the development of the Delphi technique was done
to aid the qualitative method. However, the implications and the forecasting of the quantitative

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methods can be useful in analysing the implications of the result. In this regard, the descriptive
nature of the data collection would be used to draw an inference of the found data. Generally, in
quantitative methods, the variables of the research are controlled with larger sample sizes. In this
case, the adoption of the questionnaires and the surveys are used for determining the results of
the experiment. The deductive approach in quantitative studies facilitates the statistical learning
of the research resolution. Surveys are useful in developing measures for understanding the
quantifiable concepts in research.
Data Collection and Sampling Design
The researchers in the journal used an inclusion criterion for the Delphi Survey among
participants who attended the continuous intensive education course. The EBP mentors identified
through this program over the course of seven years were identified to have in-depth knowledge
regarding EBP skills. In the case of this study the limitation highlighted by the authors was that
the selection of the sample of nursing participants already enlisted in EBP technique. There was
also another limitation that the response rate for the participation of the survey was 25% out of
315 invites. The normal standards for the participation agreement are between 51% to 80% for
the different components of the survey and its participation (Henry et al., 2016). The researchers
contacted the participants of the study through e-mail invite and anonymously took part in the
Delphi survey. The participants were provided with informed consent, and the initial introduction
of the study was provided in the e-mail invite.
Data Analysis, Findings, discussion and recommendations
The findings of the research provided the list of 13 competencies identified for the registered
nurses, and the 11 additional competencies were identified for the APN from the research. The

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authors found that the adoptions of EBP in healthcare institutes support the education and skills
of both RN and APNs through learning programs and in turn affect the better quality of services
being provided to the patients. The development of reliable nursing equipment and valid
techniques need to be assessed by using the EBP techniques to increase the competency of the
nursing workforce. Durable organisational policies need to be developed in order to make EBP
an organisational standard. It is the duty of the supervisors and the administrative body to ensure
that EBP practices are incorporated in the daily work of the existing nurses. The foundation of
practice as per the authors should be through education. The authors recommended that the
promotion of the organisational culture that supports EBP, establishing EBP performance
management and sustenance of the EBP practices within the healthcare organisation might be
effective in providing a better quality of healthcare service.
Conclusion:
From the above analysis of the article, it becomes quite clear that the use of EBP is importance to
enhance the skills and competencies of nursing workforce. Viewpoint from different authors
have proved that the research approach and design adopted in the research in two half of the
research done in the particular article is quite effective in understanding the importance of EBP
in nursing workforce skill improvement.

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References
Aliyu, A. A., Bello, M. U., Kasim, R., & Martin, D. (2014). Positivist and non-positivist
paradigm in social science research: Conflicting paradigms or perfect partners. J. Mgmt.
& Sustainability, 4, 79.
Bradshaw, C., Atkinson, S., & Doody, O. (2017). Employing a qualitative description approach
in health care research. Global qualitative nursing research, 4, 2333393617742282.
Clarke, S., Apesoa-Varano, E. C., & Barton, J. (2016). Code Blue: methodology for a qualitative
study of teamwork during simulated cardiac arrest. BMJ open, 6(1), e009259.
Diamond, I. R., Grant, R. C., Feldman, B. M., Pencharz, P. B., Ling, S. C., Moore, A. M., &
Wales, P. W. (2014). Defining consensus: a systematic review recommends
methodologic criteria for reporting of Delphi studies. Journal of clinical
epidemiology, 67(4), 401-409.
Henry, J., Pylypchuk, Y., Searcy, T., & Patel, V. (2016). Adoption of electronic health record
systems among US non-federal acute care hospitals: 2008-2015. ONC data brief, 35, 1-9.
Leavy, P. (Ed.). (2014). The Oxford handbook of qualitative research. Oxford library of
psychology.
Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The
establishment of evidence‐based practice competencies for practicing registered nurses
and advanced practice nurses in real‐world clinical settings: Proficiencies to improve

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healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence
‐
Based Nursing, 11(1), 5-15.
Olive, J. L. (2014). Reflecting on the tensions between emic and etic perspectives in life history
research: Lessons learned. In Forum Qualitative Sozialforschung/Forum: Qualitative
Social Research, 15 (2).
Rousseau, D. M., & Gunia, B. C. (2016). Evidence-based practice: The psychology of EBP
implementation. Annual Review of Psychology, 67, 667-692.