NRS 493 Topic 1 DQ 2 The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020

NRS 493 Topic 1 DQ 2 The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020

NRS 493 Topic 1 DQ 2 The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020

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Topic 1 DQ 2
Apr 18-22, 2022
The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020.
According to HealthyPeople.gov, the United States is currently at approximately 15%. Discuss
two barriers that might hold nursing practice from achieving this goal and suggest ways in which
identified barriers may be addressed.
Lydia Kwofie
Posted Date
Apr 23, 2022, 3:29 AM
Replies to Lydia Kwofie
Evidence-based practice (EBP) has become the new approach to care delivery in the healthcare
sector. Liu et al. (2019), regarded EBP as the care practice that entails searching current literature
and trends on a given healthcare issue and evaluating the highest quality findings or solutions to
implement hence improving care delivery, patient experience, and outcome. At the same time,
the Institute of Medicine has stated that the goal is to attain 90% and above practice in nursing
EBP by 2020; only 15% has been achieved in the United States. Evidence-based practices have
been linked with quality care, knowledge acquisition and generation, and improved patient
outcomes. However, adopting the EBP into practice is not a straightforward case. This essay
discusses challenges or barriers holding nursing practice from achieving the 90% goal of
evidence-based practice and strategies to address the challenges
The barriers to the Adoption of EBP in Nursing Practice
EBP has been identified as the method to obtain the highest level of care for patients (Thoele et
al., 2020). Barriers to EBP adoption can be organizational or individual-based. One barrier is the
lack of adequate resources to facilitate evidence-based research, limiting nurses from actively
participating in generating evidence or knowledge to be used in care delivery. Lack of resources
resulted in research inaccessibility, hence was difficult to collect data and make effective
statistical analyses. This obstacle has limited nurses and care providers to the old and traditional
care practices, curtailing the research of modern or evidence-based care practices.
Secondly, lack of time, knowledge, and resistance to change. Nurses have been recognized as the
key players in the health sector. Nurse shortage in the country has subjected the available ones to
be busy with their care delivery work. Time limitations have often limited nurses’ indulgence in
implementing EBP. More so, limited knowledge about the EBP process has also limited its
adoption into nursing practice. Concerning limited knowledge and time, healthcare professionals
have resisted the notion of change, ‘citing it has always been done this way,’ an obstacle to
organizational culture change towards EBP.
Strategies to Address the Barriers

Despite the barriers to adopting and utilizing evidence-based practices in nursing, it has become
inevitable to ignore the EBP paradigm (Mahmoud & Abdelrasol, 2019). Healthcare
organizations have been forced to assimilate into the EBP practices slowly. One approach to
foster the adoption of EBP is an organizational investment into evidence-based support tools
such as research centers and libraries, enabling nurses to participate in the research process
actively. Financial support can be aligned with administration support. In addition to the
provision of needed tools, the administration support fosters positive culture change within an
organization, resulting in a higher acceptance rate for evidence-based practices.
The second approach is through nurse training and collaboration approach to adopting EBP.
According to Mathieson et al. (2018), culture change success is determined by the collaboration
input among the various stakeholders. Nurses' training allows or motivates them to learn the
application of the new evidence. It helps them link their practice to the best or quality patient
care and experience. Collaboration and engaging the stakeholders help build trust and motivate
nurses and other caregivers to learn and adopt evidence-based practices.
In conclusion, EBP is changing the way care delivery is done. However, this has not been an
easy case as it needs planning resources, perseverance, and stakeholders’ willingness to adopt the
change. Lack of resources, limited time knowledge, and time and resistance to change has
curtailed the rate of EBP adoption; measures such as collaboration among stakeholders, worker
training, and administration indulgence have helped revert the trend towards successful adoption
and utilization of EBP in nursing practices.

References
Liu, Y., Zupan, N. J., Swearingen, R., Jacobson, N., Carlson, J. N., Mahoney, J. E., Klein, R.,
Bjelland, T. D., & Smith, M. A. (2019). Identification of barriers, facilitators and system-based
implementation strategies to increase teleophthalmology use for diabetic eye screening in a rural
US primary care clinic: A qualitative study. BMJ Open, 9(2) http://dx.doi.org/10.1136/bmjopen-
2018-022594

Mahmoud, M. H., & Abdelrasol, Z. F. M. (2019). Obstacles in employing evidence-based
practice by nurses in their clinical settings: a descriptive study. Frontiers of Nursing, 6(2),
123–133. https://doi.org/10.2478/fon-2019-0019

Mathieson, A., Grande, G., & Luker, K. (2018). Strategies, facilitators and barriers to
implementation of evidence-based practice in community nursing: a systematic mixed-studies
review and qualitative synthesis. Primary Health Care Research & Development, 20.
https://doi.org/10.1017/s1463423618000488

Thoele, K., Ferren, M., Moffat, L., Keen, A., & Newhouse, R. (2020). Development and use of a
toolkit to facilitate implementation of an evidence-based intervention: A descriptive case
study. Implementation Science Communications, 1, 1-12. http://dx.doi.org/10.1186/s43058-020-
00081-x

Myphuong Westmoreland
replied toLydia Kwofie
Apr 23, 2022, 9:05 AM
Replies to Lydia Kwofie
You are absolutely correct Lydia,  resistance to change ,and not only in the nursing field.
Instead of being a people that wants to learn and gain new knowledge, we are a people
that just want to never change, and I am not talking about politics. How can we implore
the public to embrace change? I am interested to hear what you think, and anyone else
that would like to take on this question. Change is hard, but as nurses, we need to be able
to change and be appreciative of change, change is what brings about positive patient
outcomes. Just think if we didn't embrace change, we would still be autoclaving our
needles and reusing glass bottles for our IV medications. Can you imagine doing this
today!?
Medicine as a whole is always changing and being updated. I know it can be time
consuming but as nurses our main priority is to provide the best care we are capable of to
our patients and try to improve their outcomes. If we are resistant to changing the way we
do things then our patients are not receiving the most up to date care which is not in their
best interest.
Great post Lydia!
Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes,
implementation, facilitators, and barriers among community nurses-systematic review.
Medicine, 98(39), e17209. https://doi.org/10.1097/MD.0000000000017209
 Coraline Powell
replied toLydia Kwofie
Apr 23, 2022, 6:00 PM(edited)
Replies to Lydia Kwofie
Hello Lydia,
In my research, I did establish that education played a key role in determining how
conversant and competent nurses were in terms of evidence-based practice. Nurses that
has extra certification and advanced education were more competent in EBP (Yoder et

al., 2022). This therefore does confirm that your suggestion to train nurses would be a
great way to not only improve competency, but also ensure that nurses contribute to the
development and implementation of EBP. For instance, EBP can be included in
continuing education in order to improve the competency of the nurses engaging in it.
Cognizant of  the role that training plays when it comes to improving a nurse’s
competencies in EBP and thus empowering them to contribute to the development of
EBP, here are certain strategies that can be undertaken from both an organizational level,
to the larger professional level. At the organizational level, the organization can organize
for opportunities where their nurses can get trained on evidence based practice. On the
greater professional levels, professional bodies such as the ANA and the ANCC have

NRS 493 Topic 1 DQ 2 The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020
NRS 493 Topic 1 DQ 2 The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020

developed certification program for nurses. By including components of evidence based
practice  in the certification exams, this ensures that nurses will prepare and apprise
themselves on EBP and thus, in order to earn the certification, they will have to be
competent in EBP. Alternatively, the institutions can include a whole different
certification for EBP, where nurses will specifically be trained on EBP, tested on the
same and thus, their competency will be proven by their certification. This will ultimately
improve their ability to participate in the development and implementation of EBP.
References
Yoder, L. H., Cengiz, A., Hinkley, T., Hertel, R. A., Gallagher-Ford, L., & Koshy
Thomas, B. (2022). Medical-surgical nurses' EBP beliefs and competencies. Worldviews
on evidence-based nursing, 19(2), 149–159. https://doi.org/10.1111/wvn.12567

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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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