Ebp Culture

In order to develop nursing knowledge and establish evidence-based practice (EBP) in nursing, there needs to be a "concept model, one or more theories and one or more empirical indicators" (Fawcett & DeSanto-Madeya, 2013, p. 26). The theoretical framework can be advantageous in guiding and supporting the design and execution of an EBP change. Using a conceptual model (C) theory (T) and empirical research (E) provides the foundation for an intervention to an identified clinical problem. Known as C-T-E structure, the application of this system in nursing practice involves an elevated level of critical reasoning, which assists in knowing what data is important and how it relates to practice change (Chinn & Kramer, 2011; Fawcett & DeSanto-Madeya, 2013; Mazurek Melnyk & Fineout-Overholt, 2015). The doctoral level of nursing necessitates the need to combine the understanding and knowledge gained from using the C-T-E structure, and then integrate the concepts and theories into daily practice.

The leadership team Mr. Fraser is a part of believes that setting the bar ever higher on quality care, customer service and requiring continuous performance improvement should be deeply ingrained to the culture of the Methodist Health System. All employees are held to the values of the health systems core values, which includes: cultural competence, being patient centered, respect, excellence, teamwork and community service. The leadership team expects that all employees will hold themselves and each other mutually accountable to uphold these standards.

Evidence - Based Nursing, An introduction (2008, p. 285 ) “ The rapidity of change and the reorganization of nursing services within the health care sector presents challenges for the advancement of EBP. Managers and administrators should facilitate the uptake of practice based on current, high-quality research by formalizing the expectation that nurses care be Evidence Based”.

Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model reaffirm that evidence based, is a reality concept in the clinical and educational setting. This model help the nurses at all levels will find clear explanations of the differences between quality improvement, research and evidence-based practice and, as long as they can establish good multidisciplinary team working, this model will be able to apply in the home health care agency to achieve the goal of my project. Also useful strategies for defining evidence-based practices problems and how to develop and implement a correct care plan. This model helps to develop research evidence, and find the correct

Evidence-Base practice (EBP) is defined as: “based on problem identified from the practitioner’s area of practice; a combining of best evidence and professional expertise and an integration of this into current practice; about ensuring patients receive quality care, being part of quality improvement processes; about collaboration and requiring a team approach” (French, 1999). Scott and Mcsherry (2008) supported the French’s assertion, proposing the key elements of EBP are that it is a theory-driven process, which involves the use, evaluation and application of research; identification of best evidence; evaluation of care; problem solving; decision-making; clinical expertise; and requires patient involvement. Evidence-based practice is made of evidence, clinical expertise, patient preference, the context of care (Barker, 2013). In brief, evidence-based practice is the parameter in the nursing practice that it requires that the nurses gather and use clinical evidence to make decision for the patients so that in the nursing process they can deliver the quality of care for the patients (Ellis, 2013). In the other words, in the nursing practice all the nursing procedures performed by the clinical evidence supported.

With the rapid changes in a health care system around the world, healthcare organizations need to develop strategies that will help the organization to sustain with any difficulties that may arise. Healthcare systems expand their cultural leadership strategies in order to gain a thorough understanding of situations (Johnson, 2009) that will effectively improve their operations in community. Healthcare organizations use both the dynamic culture leadership (DCL) and the omnibus leadership as a model for implementation and a strategy for their success (Johnson, 2009).

The John Hopkins Nursing Evidence-Based Practice Model is a powerful problem-solving approach to clinical decision making and is used in research. The model is designed to meet the needs of the practicing bedside nurses and used a three step process called a PET, facilitating nurses in translating evidence to clinical, administrative and education based on evidence. According to Melnyk and Overholt (2015), there are three steps to the JHNEBP model. The first phrase is practice questions: Identification of an EBP question and defines its scope. The second phrase is evidence of internal and external evidence team determine if its feasibility to implement. The final phase is a translation which includes recommended practice for changes and dissemination of findings.

“The cultural perspective of organizational behavior is the most contemporary framework for understanding why people behave the way they do at work. Cultural theorists such as Schein and Zwell describe organizations as having unique, distinctive cultures. The shared values and beliefs of a culture create behavioral norms in the culture. If an individual values autonomy and believes autonomy is earned by following orders, the individual will follow orders. If an individual values autonomy and believes autonomy is earned by advanced education, the individual will acquire advanced education. Professions as well as organizations have unique cultures. Although medicine and nursing both value the well-being of patients, the two professions differ as to their beliefs regarding the definition of well-being and how it is achieved. Although this cultural diversity is a strength within the overall context of the patient's plan of care, these divergent beliefs can result in a dismissing or devaluing of each other's point of view and contribution to the whole. Our professional cultures socialize us into

Health leaders can use different strategies to create a culture for change in the health organization. A health transformation leader would have to be able to create trust, admiration, loyalty, and respect from their followers through the leader’s actions, behaviors exhibited and persona exemplified. Once a culture of change is learned and the pattern is exhibited it is shared by the members about what is right and what is good. Health leaders should be able to develop a predetermined organizational culture

The John Hopkins Nursing Evidence-Based Practice change model used in this paper is, “Practice, the basic component of all nursing activity, reflects the translation of what nurses know into that they do”(Dearholt, S. & Dang, D., 2012. p. 34). This model has steps to incorporate evidence base research into the practice of nursing combined with their education and clinical skills.

Culture is a system of beliefs that are shared and communicated within a certain group of people, along with behavioral expectations and values that provide a framework to live by. No two people practice culture the exact same way. In the healthcare setting, especially in the United States, nurses and other healthcare workers are exposed to many different cultures. Being a culturally competent nurse ensures that individuals, families, and different groups of society get customized care that is well planned and implemented (Taylor, Lillis, & Lynn, 2015).

In the past few decades, many nursing practices were relied on state regulation, cost, or insurance policy. However, evidence based practice (EBP) are increasingly recognized and emphasized to change in nursing practice. For many clinical settings, there are thousands of resources available today. Not only most of nursing practice are made based on a pilot study but also implied to bring most benefits of the care.

The Johns Hopkins Nursing Evidence-Based Practice model (JHNEBP) is an evidence-based practice model (EBP) created by the health professionals of Johns Hopkins Hospital, and the nursing school at Johns Hopkins University (Schaffer, Sandau, & Diedrick, 2013). It was designed as a strategy to promote EBP and EBP projects that introduced and fostered EBP skills in nurses at all levels (Shivnan, 2011). The model serves as a tool to assist nurses with at the bedside care decisions (Schaffer et al., 2013). Reported in 2011, 80 hospitals and nursing schools have used this model (Shivnan, 2011). JHNEBP consists of three main phases: Practice, Evidence and Translation (Schaffer et al., 2013).

Evidence-based practice (EBP) in nursing means making decisions about patient care on the basis of best, current, standardized practice and guidelines. According to an article, written by Dr. Kathleen Stevens, the development of evidence-based practice (EBP) is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care (Stevens, 2013). The author also mentioned in her article that the intended effect of EBP is to standardize healthcare practices to science and best evidence and to reduce illogical variation in care,

The Culture Care Theory was selected because it is important for nurses to embrace, understand, and have an open-mind when it comes to assessing patients, understanding their cultural backgrounds, and creating treatment plans that will promote health amongst the patients. Being biased, judgmental, and narrow-minded are not indicative of the Culture Care Theory. Implementing the Culture Care Theory within the Master’s