RESPONSE DIS
Questions to answer from the discussion below
Ask a probing question, substantiated with additional background information, evidence, or research
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Which EBP model would best support the exploration of the practice problem you utilized for Application #5? Include a brief summary of your practice problem and the rationale for your EBP model selection.
The best EBP model for evaluating and implementing changes to the current practice standards of managing pain in the uterine fibroid embolization patient population in the interventional radiology suite would be the Johns Hopkins model of EBP. the practice problem in question for application #5 is how can nurses provide culturally competent pain management to patients undergoing uterine fibroid embolization for the management of symptomatic uterine fibroids in the interventional radiology unit. The steps used to identify a clinical practice question were used to originate the original PICOT question used to identify a practice gap in the treatment of UFE patients (Johns Hopkins University and Medicine 2020). Successful implementation of the practice changes identified by the PICOT question can follow the steps outlined in the Hopkins PET model of implementation following IRB approval within the healthcare organization.
Provide a summary of how evidence-based practice differs from clinical research, and include your perception of the role of DNP-prepared nurses in both.
There are a myriad of differences between clinical research and EBP yet both are integral to the advancement of nursing practice and science. The role of the DNP prepared nurse in either of these research settings varies based on the level and type of scientific inquiry required, required implementation strategies and necessary methodology (Baker et al., 2014). The greatest limitation of EBP is the need for expert clinical judgement for its application and implementation; this is a key step in the EBP process that DNP educated nurses can employ to effect positive change on clinical outcomes (Fitzpatrick, 2010). Where as clinical research depends on the results of clinical research trials, which are considered to many to be the gold standard of new knowledge generation that influences nursing practice, the role that DNP prepared nurses play in this arena is very different (CHIEN, 2019).
The three attempts to generate and influence practice changes in the clinical environment are quality improvement, EBP and clinical research. Each methodology requires different roles from the DNP educated nurse. I the realm of quality improvement, the DNP can function as a data collector and extractor as well as a generator of the original practice question used to generate the clinical problem in question. the overall purpose of the quality improvement project is to improve individual healthcare system issues and the changes generated by this endeavor are not necessarily able to be translated to clinical practice changes outside of that specific health care setting. EBP applies individual practitioner clinical expertise generated from synthesis of clinical research towards a practice gap. The downside of EBP is that even though a practice gap has been identified, there may not be any research available that fosters improvements in care. Lastly, clinical research is the systematic testing and evaluation of n nursing theories that are later translated into practice by EBP. In truth, these three research and testing methodologies are intertwined and work together to identify and apply best practices to gaps in practice (Newhouse, 2007). The role of the DNP in each venture differs depending on the organization, purpose of study, resources and expertise needed to change clinical outcomes.
Reference:
Baker, K. M., Clark, P. R., Henderson, D., Wolf, L. A., Carman, M. J., Manton, A., & Zavotsky, K. E. (2014). Identifying the Differences Between Quality Improvement, Evidence-based Practice, and Original Research. Journal of Emergency Nursing, 40(2), 195–197. https://doi.org/10.1016/j.jen.2013.12.016
CHIEN, L.-Y. (2019). Evidence-Based Practice and Nursing Research. Journal of Nursing Research, 27(4), e29. https://doi.org/10.1097/jnr.0000000000000346
Fitzpatrick, J. J. (2010). Connecting or disconnecting the dots between research and evidence-based practice. Applied Nursing Research, 23(1), 1. https://doi.org/10.1016/j.apnr.2009.10.001
Newhouse, R. P. (2007). Diffusing Confusion Among Evidence-Based Practice, Quality Improvement, and Research. JONA: The Journal of Nursing Administration, 37(10), 432–435. https://doi.org/10.1097/01.nna.0000285156.58903.d3
Johns Hopkins University and Medicine. (2020) Welch Library Guides: Nursing Resources: JHNEBP Model Resources. Retrieved from:
https://browse.welch.jhmi.edu/nursing_resources/jhnebp