NR 451 Week 1 Discussion Types of Nursing Models and Frameworks of EBP

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Types of Nursing Models and Frameworks of EBP

What are some of the models and frameworks of EBP currently in use? How does the strength of the evidence determine translation into practice? Why is it important to integrate both evidence-based practice and patient and family preferences? What is the nurse’s responsibility when EBP and patient and family practice do not match?

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I have always been one of those people who constantly ask why. I feel that knowing why I do a skill or why I give a medication is important. More importantly, I hate not having a consistent and steadfast reason when a patient asks why I am doing a skill a certain way or giving a medication. After reading your post, I was inspired to research the case of Lorenza Somera. Somera was a new graduate nurse in Manila in the Philippines. The doctor ordered cocaine injections for a tonsillectomy patient. Somera followed those orders and subsequently, the patient died. The order should have been for procaine injections. The courts found the doctor not guilty and ruled that Somera should have questioned the physician’s order. The courts charged Somera with manslaughter. It is appalling that a new graduate nurse was charged with manslaughter for following a physician’s order. Nurses now are taught to question any orders that do not feel comfortable executing. In 1929, that was not the case. Nurses at that time were educated that allegiance to the doctor meant that the patient was better served. “The Somera case sparked worldwide protests from nurses and served to push nursing toward independent practice and accountability” (Mason, et. al., 2016, p. 31).

After the Somera case, nurses began to continuously pursue new guidelines for practice. Autonomy and patient advocacy were the forefront for this protest. Even with this push for independence and patient advocacy, it wasn’t until 1978 that the ANA code of Ethics announced that “In the role of client advocate, the nurse must be alert to and take appropriate action regarding any instances of incompetent, unethical or illegal practice(s) by any member of the health care team or the health care system itself, or any action on the part of others that is prejudicial to the client’s best interest” (Mason, et. al., 2016, p. 32).

The Somera case brought to light many issues regarding the patriarchal relationship between nurses and doctors. It is unfortunate that Somera was charged with manslaughter but, the circumstances surrounding Somera’s involvement brought about changes that were drastically needed in nursing. If this case would have never happened, where would we be now? We would not be discussing evidence-based practice from a nursing standpoint.

One of the most common ways that nurses utilize evidence-based practice is with patient safety. Per Titler, “Evidence-based practice (EBP) is the conscientious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide health care decisions” (Titler, 2008, p. 113). It is vital to involve the patient and his / her family in the plan of care for the best conceivable outcomes. The patient must be aware of all possible choices and options related to care before deciding which route to take.

To choose the best possible evidence-based practice for my unit, I should do more research. I must read the articles because none seem to relate to an adult only ED except maybe hospital readmissions. I look forward to learning new information as I research the topics.

References:

Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (Eds). (2016). Policy & politics in nursing and healthcare (7th ed.). Retrieved from https://books.google.com/books?id=NGGuLinks to an external site.CAAAQBAJ&pg=PA31&lpg =PA31&dq=1929+nurse+in+philippines+ charged +with+manslaughter &source=bl&ots=57JsKKMO-K&sig=qzyQExee8go9sy 0ZYA5rv_CICro&hl =en&sa=X&ved=0ah UKEwjiioaynfzVAhXK4CYKHcu9Dcw Q6AEILTAB#v =onepage&q=1929%20nurse%20in%20philippines%20charged%20with%20manslaughter&f=false

Titler MG. The Evidence for Evidence-Based Practice Implementation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 7.Available from: https://www.ncbi.nlm.nih.gov/books/NBK2659/Links to an external site.

NR 451 Week 1 Discussion Types of Nursing Models and Frameworks of EBP

Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements *per discussion thread*	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement *per discussion thread*	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

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