NR 505 Week 8: Future Use of Evidence-Based Practice

NR 505 Week 8: Future Use of Evidence-Based Practice

I work in the emergency room and during my shifts I come across at least one person whose chief complain is related to chronic pain. For the most part, the primary care providers provide them with some sort of analgesic in order to manage their pain. We definitely have our regulars who come in at least once a week demanding morphine or dilaudid. PCP’s have a constant pressure to maintain high patient satisfaction scores and feel the need to negotiate the plan of care with these patients. However, many are reluctant to order or prescribe opioids or controlled substances even though because they don’t see it as appropriate to chronic pain management. Nonetheless, if these patients don’t get the drugs they seek, one knows they will be unsatisfied with their care. As mentioned by Henson and Jeffrey (2016), pilot studies can provide a better insight of the developing research, they assess sample size, data collection and clarify many questions before the implementation process. Pilot studies tend to foretell what one must expect from the actual study, therefore providing one with the opportunity to alter and adjust one’s methods. Implementing a pilot study in the ER will be challenging for me. For the most part the ER consist of pharmacological intervention and in this fast phase setting it would be difficult to implement nonpharmacological interventions. Currently, in my ER we divide our patien

ts in two sections. One section is for our acute patients whom need to be seen by a PCP as soon as possible or whom will require numerous resources such as blood draw, xray, radiology, etc. The other section is our “fast track”, this portion of the ER sees nonemergent cases or those whom will require one to two resources such as those whom need small sutures or medication refill. Many time, some of the patients whom are complaining of chronic pain will go to the fast track section, medication will be provided, and they will be discharged. Given this setting is less acute and patients are more stable, I believe I could integrate nonpharmacological teaching and interventions. Nonetheless, in order to intergrade a pilot study, one must take many things into consideration.


Henson, A., & Jeffrey, C. (2016). Turning a clinical question into nursing research: the benefits of

a pilot study. Renal Society of Australasia Journal, 12(3),99-105.

This weeks discussion looks forwards and asks about the future use of evidence-based practice in our workplace setting.  We are to imagine ourselves as nursing leaders in the advance practice setting and answer the listed questions above.  To begin, i would role model evidence-based practice in my future setting by basing decisions and practices on the latest research.  This can be achieved by using transparency with co-workers as to why a certain change was implemented and needed.  At my current place of employment, certain protocols such as sepsis bundles were rolled out to staff in this manner.  The need for a change to old protocols was first identified using current data at the time that showed a delay in our implementation of sepsis treatments as well as data showing our patient outcomes compared to others.  Then, the latest research was shown to staff showing how effective new sepsis bundles were for patients and this was used as the reason for needed changes.  Committee’s were also formed so that any staff member that wanted to participate in the research and changes could do so.  The successful implementation of EBP is a dynamic process dependent on a number of va

NR 505 Week 8 Future Use of Evidence Based Practice

riables. Individual experiences, bias and attitudes alongside professional, organisational and workplace factors can act as hurdles or barriers to the translation of empirical knowledge into practice and as such this process can take many years. (Williams, Perillo, & Brown, 2015).  In order to foster a culture of EBP for an organization, it takes time, competence and motivation.  Members of the organization from top to bottom must lead by example and show that they also value this type of culture.  An open-door, non-punitive  policy to new ideas for needed changes is a great method to promote this.  Asking staff to openly search for areas of improvements and forming committee’s to research how to resolve problems is another method that allow staff to become part of the process for researching and implementing changes.  If a staff member is stating that things have never been done this way, they may be resistant to change.  I would offer them to participate in a committee or current project as well as educate them on the importance of EBP in the workplace.

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Williams, B., Perillo, S., & Brown, T. (2015). Review: What are the factors of organisational culture in health care settings that act as barriers to the implementation of evidence-based practice? A scoping review. Nurse Education Today35e34-e41. doi:10.1016/j.nedt.2014.11.012

In my future practice as and APN I plan to role model EBP in the clinical setting my showing articles, gathering, researching information for myself. I would like to be role model for other nurses so they can see that with research things can change and improve patient care and outcomes. It is important to follow your passion and coming up with new ways to do things can be a perfect example of that. I would foster an organizational culture that promotes EBP as a great place to work and something that is worth being involved in as everyone has different thoughts and ideas on how things can be done to improve upon patient care. Promoting EBP throughout the entire organization could be difficult but it could be done by involving everyone  in some aspect or assigning research to certain groups and make it fun for the organization. Say who ever comes up with the best research idea and ways to implement could win a prize or something like that. Maybe more people in the organization will get involved.

When you have staff members that can be objective  change it is important to remember to try and stay positive. Maybe say try it this way for one month and see how you like and if you don’t like it then maybe you could come up with a new or different way that you feel may work better and then this could be voted on to see how it would work. I think by always keeping everyone involved and being positive can help to change those people from a distracter to a promoter. Integrating EBP in healthcare require attention to both individuals and the organizational context to be successful.The leader of the EBP must be knowledgeable, skillful, visionary, nimble, and flexible in order to address the healthcare EBP needs at any time during the implementation process ( Gallagher-Ford, 2014).

Gallagher-Ford, L. (2014). Implementing and sustaining EBP in real world healthcare settings: a leader’s role in creating a strong context for EBP. Worldviews On Evidence-Based Nursing11(1), 72-74. doi:10.1111/wvn.12022