Evidenced based practice is one way to address a clinical problem by looking at all possible outcomes of that clinical problem, (Laureate Education, 2018). As nurses we base our medical care of a patient on solutions that we have learned and know to be true based on research and implementation of solutions which have improved outcomes in the past.  Health care reform as authorized by the Affordable Care Act is based on a belief that EBP generates cost savings due to the delivery of more effective care, (Rice, 2013, p. 217). Just like nursing, evidenced based practice or EBP is made up of experience and expertise and follows very closely to patient preferences when it comes to their perception of quality care. The following discussion will highlight the Emergency Nurses Association and they’re stance on EBP.

 The Emergency Nurses Association home page allows the user to learn About ENA. In this descriptive paragraph the mission of the ENA lists seven priorities based on the values and beliefs of the organization. In this list of priorities number 5 reads emergency care evolves through lifelong learning and a culture of inquiry for the discovery and integration of evidenced-based research into emergency nursing practice, (ENA, 2020, About ENA). The ENA has also awarded emergency rooms across the nation the Lantern Award which is a recognition award given to emergency rooms that incorporate evidenced-based practice and innovation into the care of the patient. In 2019 a local hospital in my area Inspira Medical Center in Vineland, New Jersey was awarded the Lantern Award for their research and practice advancing the emergency nursing profession through quality research and evaluation of the emergency rooms clinical outcomes.

 The ENA also publishes its own magazine entitled the Journal of Emergency Nursing which is a peer-reviewed publication featuring journal articles that are based on evidenced based research and implementation. Other features of the ENA’s website are in the resource library a feature entitled Clinical Practice Guidelines. Clinical Practice Guidelines or CPG’s are evidenced-based documents that facilitate the application of current evidence into everyday emergency practice, (ENA, 2020, Clinical Practice Guidelines). These guidelines cover an array of emergency medicine topics including Intranasal Medication Administration to Massive Transfusion Scoring Systems.  Listed in the Goals and objectives of the ENA’s website explain that an objective to provide the highest care is to expand the translation of best evidence into emergency nursing practice, this will essentially increase the development and delivery of better patient care while at the same time providing better educational opportunities and trained nursing staff to the emergency room.

 Nurses serve on the frontline of health care and have a unique opportunity to improve patient care through evidence-based practice, (Crabtree, Brennan, Davis, & Coyle, 2016, p. 172). The ENA is emerged in evidenced based practices that guide their standards and resources such as continuing education that is offered to practicing emergency room nurses and other staff. For example, the ENA’s four emergency nursing resources which include family presence during invasive resuscitative efforts are developed from evidenced-based practice research. As stated by Jean Proehl, RN, “the terms standards of care, best practice, and evidenced-based practice are often used interchangeably”, (Journal of Emergency Nursing, p. 217). The ENA as a professional organization has structured both its mission and values of the organization and its publications to fellow emergency nurses and staff based on the foundation of evidenced based research and best practice. I have been a member of the ENA for years and will continue to be a member even after I graduate in a different specialty. 

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving Patient Care Through Nursing

Engagement in Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. https://doi-org.ezp.waldenulibrary.org/10.1111/wvn.12126

Proehl J.A. (2011). EBP, ena, enrs. Journal of Emergency Nursing, 37(3), pp. 217.

DOI: https://doi.org/10.1016/j.jen.2011.03.015.

ENA (2020). About ENA. Retrieved from https://www.ena.org/about

Laureate Education (Producer). (2018). Introduction to Evidence-Based Practice and Research [Video

file]. Baltimore, MD: Author.

Rice, M. J. (2013). Evidence-Based Practice: A Model for Clinical Application. Journal of the American

Psychiatric Nurses Association, 19(4), 217–221.https://doi.org/10.1177/1078390313495563

 

response

This is a good post. According to Melnyk, in order to implement evidence-based practice (EBP) consistently one must cultivate a spirit of inquiry, ask clinical questions, search for the best evidence, appraise the evidence, implement the evidence, evaluate outcomes, and then lastly share the results (Melnyk, 2010). This step by step process is very evident in the organization I chose to explore.

The organization that you focused on is similar to Center for Evidence and Practice Improvement (CEPI). CEPI  that conducts and supports research and evidence synthesis on health care delivery and improvement; advances decision and communication sciences to facilitate informed treatment and health care decision making by patients and their health care providers; explores how health information technology can improve clinical decision making and health care quality; catalyzes and promotes sustainability of improvements in clinical practice across health care settings through research, demonstration projects, and partnership development; and operates the National Center for Excellence in Primary Care Research (CEPI, 2014).”

CEPI consists of five divisions:

  1. Evidence-Based Practice Center Program
  2. U.S. Preventive Services Task Force Program
  3. Division of Decision Science and Patient Engagement
  4. Division of Health Information Technology
  5. Division of Practice Improvement

 

CEPI is also home to AHRQ’s National Center for Excellence in Primary Care Research (NCEPCR). This organization is grounded in EBP and has made me appreciate the organization for what it is and what it stands for.

 

References

Center for Evidence and Practice Improvement (CEPI). (2014, July 15). Content last reviewed January 2017. Agency for Healthcare Research and Quality, Rockville, MD. Retrived May 26, 2019. http://www.ahrq.gov/cpi/centers/cepi/index.html

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51–53. doi:10.1097/01.NAJ.0000366056.06605.d2. Retrieved from http://download.lww.com/wolterskluwer_vitalstream_com/PermaLink/NCNJ/A/NCNJ_165_516_2010_08_23_DGSODKGNM_1651_SDC516.pdf

Discussion: Where in the World Is Evidence-Based Practice?

March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.

When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.

In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.

To Prepare:

  • Review the Resources and reflect on the definition and goal of EBP.
  • Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).
  • Explore the website to determine where and to what extent EBP is evident.

By Day 3 of Week 1

Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples.

By Day 6 of Week 1

Respond to at least two of your colleagues on two different days by visiting the websites they shared and offering additional examples of EBP or alternative views/interpretations to those shared in your colleagues’ posts.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. 

Supported by at least three current, credible sources. 

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. 

At least 75% of post has exceptional depth and breadth. 

Supported by at least three credible sources. 

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)
Responds to some of the discussion question(s). 

One or two criteria are not addressed or are superficially addressed. 

Is somewhat lacking reflection and critical analysis and synthesis. 

Somewhat represents knowledge gained from the course readings for the module. 

Post is cited with two credible sources. 

Written somewhat concisely; may contain more than two spelling or grammatical errors. 

Contains some APA formatting errors.

(0%) – 34 (34%)
Does not respond to the discussion question(s) adequately. 

Lacks depth or superficially addresses criteria. 

Lacks reflection and critical analysis and synthesis. 

Does not represent knowledge gained from the course readings for the module. 

Contains only one or no credible sources. 

Not written clearly or concisely. 

Contains more than two spelling or grammatical errors. 

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
(0%) – 0 (0%)
(0%) – 0 (0%)
(0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings. 

Responds fully to questions posed by faculty. 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. 

Demonstrates synthesis and understanding of learning objectives. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are fully answered, if posed. 

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are answered, if posed. 

Provides clear, concise opinions and ideas that are supported by two or more credible sources. 

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)
Response is on topic and may have some depth. 

Responses posted in the discussion may lack effective professional communication. 

Responses to faculty questions are somewhat answered, if posed. 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

(0%) – 12 (12%)
Response may not be on topic and lacks depth. 

Responses posted in the discussion lack effective professional communication. 

Responses to faculty questions are missing. 

No credible sources are cited.

Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings. 

Responds fully to questions posed by faculty. 

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. 

Demonstrates synthesis and understanding of learning objectives. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are fully answered, if posed. 

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings. 

Communication is professional and respectful to colleagues. 

Responses to faculty questions are answered, if posed. 

Provides clear, concise opinions and ideas that are supported by two or more credible sources. 

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)
Response is on topic and may have some depth. 

Responses posted in the discussion may lack effective professional communication. 

Responses to faculty questions are somewhat answered, if posed. 

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

(0%) – 11 (11%)
Response may not be on topic and lacks depth. 

Responses posted in the discussion lack effective professional communication. 

Responses to faculty questions are missing. 

No credible sources are cited.

Participation
(5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
(0%) – 0 (0%)
(0%) – 0 (0%)
(0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

 

Founded in 1951, The Joint Commission (TJC) is the United States’ oldest and largest standard-setting and accrediting body in health care (TJC, 2020b). Over 22,000 health care organizations and programs across the U.S. are accredited by TJC (TJC, 2020b). Benefits of TJC accreditation include strengthening patient safety efforts, improved risk management, and risk reduction, enhanced staff education, and a framework for organizational structure and management (TJC, 2020d).

Evidenced-based practice is the use of scientific evidence to improve decision-making and provide safe quality care for patients (Li, Cao, & Zhu, 2019). The Joint Commission does not directly mention the use of evidence-based practice in its mission statement. However, many of their National Patient Safety Goals (NPSG). for 2020 reference the use of evidence-based practice. Examples of NPSG that are driven by the evidence-based practice include implementing practices that prevent hospital-acquired infections, infections related to central lines, surgical-site infections, and indwelling catheter-associated urinary tract infections (TJC, 2020c). The Joint Commission uses the latest evidence-based practice regarding infection control and patient safety to shape many of their NPSG.

The standards set for by TJC are developed with input from health care professionals, providers, experts, consumers, and government agencies (TJC, 2020a). These individuals use scientific literature and expert consensus to develop new standards (TJC, 2020a). The Joint Commissions role in assisting health care facilities provide safe quality care is grounded in evidence-based practice. Prior to researching the TJC I, like many others, was intimidated by the thought of The Joint Commission. However, after learning more about the organization I understand how TJC assists health care organizations and health care workers in becoming better providers for patients.

References

The Joint Commission. (2020a). About Our Standards. Retrieved: https://www.jointcommission.org/standards/about-our-standards/

The Joint Commission. (2020b). History of The Joint Commission. Retrieved: https://www.jointcommission.org/about-us/facts-about-the-joint-commission/history-of-the-joint-commission/

The Joint Commission. (2020c). National Patient Safety Goals Effective January 2020. Retrieved: https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/npsg_chapter_hap_jan2020.pdf

The Joint Commission. (2020d). Why Achieve Accreditation. Retrieved: https://www.jointcommission.org/accreditation-and-certification/become-accredited/why-achieve-accreditation/

(39), e17209. https://doi.org/10.1097/MD.000098MedicineLi, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review.

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