Evidence Based Practice Paper

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.

Evidence-based practice is extremely important in health care. It is not only important to know how to perform a certain skill, but why it should be done. There needs to be a standard of care and providers need to know the best way of doing things based on evidence. The article mentions that in the 20th century, many medial decisions were made on doctor assessment and preference (Brower, 2017). Many physicians were practicing dramatically different when compared with one another, which led to the realization that changes needed to be made and Evidence-based practice began to develop. Even though Evidence-based practices have been in play for a while, there is a gap between understanding and applying evidence-based

The process of using Evidence Based Practice in a patients care plan consists of five key stages. Asses the patient and formulate the problems from this you will then need to access the relevant clinical articles. Using this information you should then be able to assess which is the best method of treatment discarding any misleading or ambiguous articles. You then need to incorporate this knowledge into the patients care plan. Finally you need to evaluate and assess the patient during treatment to ensure effectiveness.

Indeed, "new and validated knowledge that forms the basis j Y for evidence-based practice (EBP) most commonly is discovered in academic settings. But findings need to be translated into a protocol or guideline that can be used to guide practice," according to Conner, (2014, p.40). Evidence-based projects have lead to many improved clinical practice changes at the bedside and healthcare in general; and they are highly promoted and supported by different healthcare organizations.

Evidence-based practice is a formulation of ideas, research and conclusions to formulate the best possible health care choice (Hood, 2014). In health care the process of utilizing current information begins with a question can something be done better, can the patients benefit as a result and is it cost effective, EBP seeks new information to replace old or outdated information. When there are doubts if something can be done better a research team collects data on the subject using unbiased information they analyze the data, design interventions that are based on the new evidence and makes their final recommendations on their findings (Hood,

Capital punishment is probably the oldest form of punishment and one of the cruelest. It is known to be used as early as eighteenth-century B.C. in the Code of Hammurabi. Since then, many rulers, from every time period and country, have utilized the death penalty. Although many people think that every ruler executed people in the past, one ruler, William the Conqueror, did not allow executions, except in the case of murder, this was still very different for the times ( eleventh century A.D.). However, William the Conqueror did not begin until the end of the death penalty since the next king continued more harshly.

Evidence-based practice is a decision making process in which you combine scientific data with clinical expertise, patient values and circumstances of the patient. (Hoffmann, Bennett 2017). The World Health Organisation (WHO) defines chronic diseases as those which are caused by non-reversible pathological changes in the body, are permanent and leave a lingering disability, those that require ongoing rehabilitation or care. Indigenous Australians experience very high prevalence, morbidity and mortality from chronic health conditions such as diabetes, cardiovascular, renal and chronic respiratory disease. Multi morbid and comorbid chronic diseases are increasingly placing a greater burden on individuals, communities and health care services

Evidence-based practice is a form of critical thinking at that specific moment when you’re on the job in that specific situation. The first source that I found stated that evidence based practice combines the evidence found with what you know and joins them both to give proper healthcare (Evidence-Based Practice for Health Professionals 2014). The second source I found stated that evidence based practice which is used as EBP for short sometimes is a combination of your clinical knowledge, ethical standards for your patients, and the evidence used into making your final decision to take care of that patient (http://guides.mclibrary.duke.edu). For example, in an emergency a patient comes in the emergency room claiming that he has bad reflux.

The author’s intention is to identify an aspect of clinical practice which lends itself to change at a micro level. The definition of a micro-change is an intervention of change aimed at the individual or the way small teams work. The micro-level change is not to be confused with a service change (Walsh, 2009).

Evidence-Based Practice Proposal Final Paper Usha Kizhakkedan Grand Canyon Final Paper of Evidence Based Proposal NUR-699 Dr. Debbie Long June 1, 2016 Table of Contents Part 1: Organizational Culture and Readiness Assessment 4 • Introduction to Evidence-Based Practice 4 • Barriers to Evidence-Based Practice 4 • Facilitators of Evidence-Based Practice 5 • Integration of Clinical Enquiry 5 • The Survey 6 Part 2: Problem Description 7 • Description 7 • Identification of change agents in the Health care system 8 • PICOT question 8 • Purpose and Objectives 9 • Rationale 10 • Literature support 10 • Research Method 10 Part 3: Literature Support 11 • Research Questions 11 • Search Method 12 • Organization of Literature 12 • Framework 12 • Nursing Rounds- Patient and Family Satisfaction: 13 • Communication: 15 • Management of Pain, Use of Call Lights and Cases of Patient falls 15 • Data Collection 16 Part 4: Solution Description 16 • Objectives 17 • Change Methodology 17 • Implementation Plan 18 • Evaluation 19 Part 5: Change Model 19 • Change Model 20 • Implementing Change 21 • Rationale 22 Part 6: Implementation Plan 22 • Staff Education 23 • Client feedback 23 • Timeframe 23 • Hiring Process 24 • Implementation 24 • Data collection and Evaluation 24 • Progression 24 • Resource Management 24 • Budget Plan 25 • Outcomes and its impact 25 • Summary 26 Part 7: Evaluation of Process 26 • Objectives 26 • Methodology 27 • Procedure 27 • Collection and Analysis of data

Evidence based practice is when recent research is integrated into the clinical setting for maximum delivery of health care. A lot of evidence based practice was developed from research studies conducted by nurses such as decubitis ulcer prevention. Knowing and demonstrating the scientific methods and processes will help to advance nursing care by providing better interventions for patient care. Patient care plans should be developed based on evidence (Dycus, 2009). With monitoring outcomes from evidence based practice it can be determined if the care caused improvement in the healthcare setting. Using quality measures such as charts and diagrams to understand performance.

Evidence based practice is the basis for needed change in practice and function. It is a sound method for scientific, fact-based change. Changes which have no evidence to support them are fragile, unscientific, and subjective. These changes don’t effect real change over time, as they aren’t able to be proven to a more general population.

Evidence-based practice will be extremely helpful among the hospital setting because it will allow for me to learn from reliable resources. Using evidence-based practice thus far has helped for me to learn about different cultures and become more prepared when meeting with patients. I will continue to work within the hospital setting and need to be sensitive of how different cultures feel about the medical system as well as treatment options. At times, I have found myself wondering why my patient does not want to go a certain treatment route and many times I can use evidence-based practice to get a better understanding. Many times evidence-based practice has allowed for me to share articles with coworkers and have dependable evidence to fall back on when advocating for my patient within team meetings.

Over the past forty-years, 1,421 executions have been conducted by thirty-one states and the federal government under the capital punishment sentence (“Facts About the Death Penalty”). Throughout those years however, controversial opinions have aroused on whether the capital punishment should be permitted, its success on reflecting a deterrent effect, and even its morality. Although it is often argued that Capital punishment is appropriate when the crime reaches an egregious extent, the revocation of constitutional securities, discrimination within race and income status, as well as the insufficiency to achieve a deterrent effect prevail over the validation of society’s ultimate punishment–the death penalty.

As I arrived to TALA, I was instantly impressed by the monumental architecture before me. The symmetry of the building was elegant and well complimented by its weathered look. It is difficult to imagined that this very building had once housed the mentally ill. I have never seen such a facility before and thus expected something less remarkable. As I stood admiring the building, I noticed the multitude of windows it contained. Upon further examination, I saw bars surrounding them and suddenly realized that the illusion of paradise was in reality a prison for those who dwelled here. I was surprised to learn how many people were actually housed in this building. I was equally shocked to discovered what passed as mentally insane during the 19th century. The criteria used to determine mental problems were nonexistent and arbitrary. I was extremely concerned when the tour guide mentioned kids being born and raised in TALA. It was also distressing to learn that people who didn’t quality as having mental problems were also placed into such a facility. I was further surprised to learn that the community had openly embraced TALA as part of their home to the extent that a high school prom was held inside the building. This helped me to recognize that TALA was more than just an insane asylum, it was truly home to those living inside and outside of the building. As I progressed through the tour, I discovered that I was unaware of the many practices of insane asylums, especially the