Nursing Research and Evidence-Based Practice

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Nursing Research and Evidence-Based Practice


In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care.

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Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).

To prepare:

  • Consider a recent clinical experience in which you were providing care for a patient.
  • Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?
  • What questions have you thought about in a particular area of care such as a  procedure or policy?
  • Review Chapter 2, pages 36—39 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.
  • Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.
  • Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.


an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.

APA format, 2 PAGES.

please write it both in sentence format and as  PICOT format:






Required Resources

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

    • Chapter 1, “Introduction to Nursing Research in an Evidence-Based Practice Environment”

      This chapter provides an introduction to nursing research, its history, and the evolution of evidence-based practice. It includes an overview of credible sources of evidences and a description of the different paradigms used in nursing research.

    • Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice”

      The focus of this chapter includes an overview of the key aspects of evidence-based practice, a review of how to identify credible research and appraise its value, and, finally, a discussion on how to take the identified evidence and convert it into a practice.

  • Chapter 3, “Key Concepts and Steps in Qualitative and Quantitative Research”

    In this chapter, quantitative and qualitative research models are compared and the major steps in each approach are described. Information is also presented on the different sections of a research journal article and how you can identify the research model that was utilized.

Adams, J. S. (2010). Utilizing evidence-based research and practice to support the infusion alliance. Journal of Infusion Nursing, 33(5), 273–277.

Retrieved from the Walden Library databases.

This article examines how evidence-based research and practice supports infusion alliances. The text also specifies the increasing challenges that infusion nurses face.

Mallory, G. A. (2010). Professional nursing societies and evidence-based practice: Strategies to cross the quality chasm. Nursing Outlook, 58(6), 279–286.

Retrieved from the Walden Library databases.

This article describes strategies for reducing the gap between research knowledge and practice. The article also details how nursing societies could use these strategies to improve the quality of care.

Newhouse, R. P., & Spring, B. (2010). Interdisciplinary evidence-based practice: Moving from silos to synergy. Nursing Outlook, 58(6), 309–317.

Retrieved from the Walden Library databases.

In this article, the authors examine the state of interdisciplinary evidence-based practice (EBP). The authors detail efforts to promote interdisciplinary EBP, academic and clinical training regarding interdisciplinary EBP, and strategies that may facilitate EBP translation across disciplines.

Shaheen, M., Foo, S., Luyt, B., Zhang, X., Theng, Y-L., Chang, Y-K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: Nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229–236.

Retrieved from the Walden Library databases.

This article reviews a study that sought to determine nurses’ awareness of, knowledge of, and attitude toward EBP. The article also describes factors likely to promote barriers to EBP adoption.

Nursing Research and Evidence-Based Practice
Essentials of Evidence Based Practice   MAIN POST Introduction             It is estimated that patient falls in hospitals occur among 700,000 to 1,000,000 people in the United States. As well, approximately one third is preventable (Agency for Healthcare Research and Quality [AHRQ], 2013). Fall risk assessment tools, and alarm systems which alert staff when patients attempt to leave the bed or chair unassisted, are two methods among others utilized to reduce falls incidences. Evidence-based practice (EBP) in accordance with patient falls and the applicability to the author’s organization are the topics of this paper. Patient Care Experience             Recently, an 83 year old male with dementia was hospitalized for pneumonia and under my care, on the night shift. As part of the routine admission process, all patients are evaluated for fall risk.  In this patient’s case, a fall risk evaluation tool was one EBP method used to predict and prevent such an incident. High risk status was concluded due to mobility issues, dementia, and incontinence, in accordance with the Hendrich Fall Risk Assessment tool in the electronic health record. Research by Hendrich, Bender, and Nyhuis, in 2003, as cited by Schmidt (2012, April 5) found that intrinsic factors such as “confusion, altered elimination needs and impaired gait and mobility” among others were predictors of falls (para 6). A second intervention used was a bed alarm. Evidence based research for this method showed mixed results. Ward-Smith, Barret, Rayson and Govro (2014) concluded that use of a bed alarm system did not prevent falls, with one reason being the frequency of false alarms caused ignorance by staff, over time. The authors also stated further research in evaluating which patients would be appropriate for the alarm use would be beneficial. Shorr, Chandler, Mion, Waters, Liu, Daniels, Kessler and Miller, (2012), cited a cluster randomized trial which supported a reduction in falls with alarms in use. Still, in searching CINAHL, no studies in the past 5 years were found in support of bed alarms as a fall reduction method.  I surmise the use of bed alarms in my facility came as a result of the elimination of the previous routine practice of waist and vest restraint application. Background and PICOT Questions             Since support of the use of alarm systems was either mixed or nonexistent, and given the previously mentioned in-hospital high incidence of patient fall statistics, more effective measures for reduction must be researched. In formulating an EBP research question, background definitions must be delineated and general knowledge questions answered. For example, in researching best practices for dementia patient fall reduction in acute care hospitals, I would answer the following questions What constitutes a patient fall? What is dementia? What are some common signs and symptoms of dementia? What factors place dementia patients at risk for falling? What are the effects of hourly rounding on the incidence of falls in dementia patients in acute care hospitals? How do patient sitters affect falls in dementia patients? What are the cost factors in an individual institution, associated with patient safety? Preparing a researchable question also involves a population or patient (P), an intervention (I), a comparison (C), an outcome (O) and when appropriate, a time frame (T) (Polit and Beck, 2017, p. 33) . For this issue of falls, I would ask the following research question: What are the effects of hourly rounding versus the presence of patient sitters in reducing the incidence of falls in hospitalized dementia patients on the night shift? (P= hospitalized dementia patients I=hourly rounding C=patient sitters O= reduction of falls T= night shift).  A study by Feil and Wallace (2014) showed a statically significant reduction in fall rates through the use of patient sitters, which included dementia patients. A study by Morgan, Flynn, Robertson, Robertson, New, Forde-Johnston, and McCulloch (2017) noted a 50% reduction in falls through intentional rounding on a neuroscience ward which used a designated nurse for implemented activity engagement, toileting or other patient needs during the study period. The extra nurse was in addition to regular staff. Organizational Factors in EBP              At the present time, dementia patient falls are not usually a problem on my unit. Occasionally, one to one care is employed when such patients are unable to be kept safe by other means. Since I work in a critical access hospital and patient census is low, staff to patient ratio is not frequently a significant issue either.  However, depending on the EBP measure, cost would be a barrier to implementation due to low revenue and volume. I have worked in environments where patient sitters were rarely used due to the cost, and instead, the ward secretary sat at the patient’s bedside with a lap top computer performing order entry and other usual tasks, while simultaneously working to keep the dementia patient safe. Culture might also play a role. Having read the research in support of simulation for critical access hospital nursing education, I approached the Director of Nursing regarding a skills fair. I also offered to plan it and man a station by coming in on a day off if necessary, and work without pay.  I was met with resistance and the instruction that I could create a scenario such as a cardiac arrest, with a less experienced colleague, and fulfill my desire that way. I could not help wondering why there was no support for a unit wide educational endeavor. I attempted to engage a colleague as instructed, but was unsuccessful. As yet, the measure has not been implemented. Since current financial issues are of concern hospital wide, the understanding that there are “bigger fish to fry” may be at work, but what could be more costly than a patient or staff member injury due to a lack of knowledge or skill? EBP Barrier and Conclusion             Shaheen, Foo, Luyt,  Zhang, Theng, Chang, & Mokhtar, (2011) cited a study in which nurses’ complaints of having insufficient authority to implement changes in patient care practices was a barrier to implementing EBP. After a great deal of thought, I realized I might succeed if I asked the emergency department (ED) director for support. Several days prior to this writing, I did just that. Results were positive and specific stations to be included were discussed, but since this manager has an upcoming vacation, further planning will be delayed. In the past, supervisors have spoken of implementing educational offerings on the unit. As of yet, such events have not materialized. My hope is the skills fair idea will not be another statistic.       References Agency for Healthcare Research and Quality.(2013). Preventing falls in hospitals. Retrieved from Feil, M., & Wallace, S.  (2014). The use of patient sitters to reduce falls: Best practices. Pennsylvania Patient Safety Advisory, 11(1), 8-14. Retrieved from http://www.patientsafe   ;11(1)/Pages/08.aspx Morgan, L., Flynn, L., Robertson, E., New, S., Forde-Johnston, C., & McCulloch, P. (2017). Intentional Rounding: a staff-led quality improvement intervention in the prevention of patient falls.  Journal of Clinical Nursing, 26(1-2) 115–124. doi:10.1111/jocn.13401 Polit, D. F., & Beck, C. T. (2017). Evidence-based nursing: Translating research evidence into practice. In Nursing research: Generating and assessing evidence for nursing practice (pp. 25-45). (10th ed.). Philadelphia, PA: Wolters Kluwer.  Schmidt, B. (2015, April 5). AHRQ: Evidence-based methods and tools help reduce risk of falls in hospitals.    Retrieved from Shaheen, M., Foo, S., Luyt, B., Zhang, X., Theng, Y-L., Chang, Y-K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: Nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229–236. doi: 10.3163/1536-5050.99.3.010 Shorr, R., Chandler, A., Mion, L., Waters, T., Liu, M., Daniels, M., Kessler, L., & Miller, S. (2012). Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients. A cluster randomized trial. Annals Of Internal Medicine, 157(10), 692-699. doi: 10.7326/0003-4819-157-10-201211200-00005 Ward,-Smith, P., Barret, L., Rayson, K., and Govro, K. (2015). Effectiveness of a bed alarm system to predict falls in an acute care setting. Clinical Nursing Studies, 3(1). doi: 10.5430/cns.v3n1p1

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