Develop a 3–5 page scholarly paper in which you explain the diagnosis you researched for Assessment 1, and then apply the steps of an EBP model to your search for evidence to address your diagnosis issue.
The goal of using evidence-based research findings is to enhance safety and quality of patient care and ensure optimal outcomes are achieved. It is not uncommon to hear a nurse say, "why change it as we’ve always done it this way." However, this is no longer acceptable in today's practice environment. The profession of nursing has evolved, and the expectation is that the professional nurse has a scientific foundation to support the care that is provided. As the profession of nursing continues to evolve and engage in healthcare transformation, baccalaureate-prepared nurses are expanding, taking on leadership roles that include incorporating EBPs. To be able to do this, the nurse needs to understand the criteria that make a resource credible, as this is crucial when deciding if the research is valid and reliable for implementation into healthcare settings. The nurse will need to incorporate the use of EBP models.
EBP models are designed to assist the nurse in developing a plan to gather evidence to answer a practice problem or question. It is a systematic approach to direct the user to incorporate scholarly findings into current practice. These EBP models lead the nurse through the decision-making process of evaluating the literature to determine the best practice evidence for the practice issue or question.
Professional Context
As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, healthcare systems, and nursing practice outcomes are positively impacted.
Preparation
Review all resources for this assessment, as well as the scoring guide for details of how this assessment will be graded. You will use the specific diagnosis or health issue you selected for Assessment 1. You can refer to the overview of common EBP models in the Evidence-Based Practice Models media for help in choosing the most appropriate EBP model for your issue.
Instructions
Complete the following:
Consider your diagnosis from Assessment 1.
Explain an issue associated with this diagnosis that could benefit from an EBP approach.
Choose the EBP model you wish to implement.
Describe each step of the EBP model of your choice.
Apply the steps of the model to your search for evidence for your diagnosis issue, and describe how you applied them.
Locate at least three separate resources of evidence to assist with your diagnosis issue.
Analyze the credibility and relevance of each resource as it relates to your diagnosis.
This is a paper and should be 3–5 pages, not including the title page or reference page. The paper must be in APA format.
Full Answer Section
The Diagnosis and Associated Issue
For the purpose of this scholarly paper, the chosen diagnosis is "Risk for Falls in Hospitalized Older Adults." This is a prevalent and serious concern in acute care settings. Falls are the most common adverse events in hospitals, leading to significant patient harm, including fractures, head injuries, increased length of stay, higher healthcare costs, and even death (Agency for Healthcare Research and Quality [AHRQ], 2021). Beyond physical injury, falls can erode patient confidence, leading to fear of falling, reduced mobility, and a decline in functional independence.
The critical issue associated with this diagnosis that could profoundly benefit from an EBP approach is the
inconsistent application of standardized fall prevention strategies by nursing staff. Despite the existence of numerous evidence-based guidelines and institutional policies, actual practice at the bedside often varies. This inconsistency can stem from several factors, including:
- Lack of awareness or understanding of the most effective interventions.
- Time constraints and high workload.
- Reliance on outdated or anecdotal practices ("we've always done it this way").
- Insufficient staff education and training on comprehensive fall risk assessment and tailored interventions.
- Poor communication among interdisciplinary team members regarding a patient's fall risk status and implemented precautions.
This variability in practice directly contributes to preventable falls, compromising patient safety and undermining the quality of care provided. An EBP approach offers a systematic method to identify, implement, and sustain the most effective, research-supported fall prevention strategies, thereby standardizing care and reducing fall rates.
The Iowa Model of Evidence-Based Practice to Promote Quality Care
To address the issue of inconsistent fall prevention practices, the
Iowa Model of Evidence-Based Practice to Promote Quality Care has been selected.
This model is a widely recognized and practical framework that guides healthcare professionals through the process of integrating research evidence into clinical practice. It is particularly well-suited for problem-focused triggers within an organization, making it ideal for a quality improvement initiative like fall prevention.
The Iowa Model emphasizes a systematic approach, multidisciplinary collaboration, and the importance of organizational context and resources.
The steps of the Iowa Model are as follows:
- Identify Trigger (Problem-Focused or Knowledge-Focused): This initial step involves recognizing a trigger for change. A problem-focused trigger arises from a clinical problem (e.g., high fall rates), while a knowledge-focused trigger originates from new research findings.
- Form a Team: A multidisciplinary team is assembled to investigate the practice problem or question.
- Assemble, Appraise, and Synthesize Body of Evidence: The team conducts a comprehensive search for relevant literature, critically appraises the quality of the evidence, and synthesizes findings to determine the strength of the evidence.
- Pilot the Change in Practice: If sufficient evidence supports a change, a pilot implementation is conducted in a specific clinical area to test the new intervention and gather feedback.
- Evaluate Outcome: The effects of the piloted change are rigorously evaluated to determine if the desired outcomes (e.g., reduced fall rates) have been achieved.
- Disseminate Results: The findings from the pilot and evaluation are shared with relevant stakeholders within the organization.
- Integrate Change into Practice: If the pilot is successful, the change is integrated into broader organizational policies, procedures, and clinical practice.
Application of the Iowa Model to Fall Prevention
Step 1: Identify Trigger (Problem-Focused)
- Application: The trigger for this EBP initiative is a problem-focused one: a review of incident reports on our unit reveals a higher-than-acceptable rate of patient falls among hospitalized older adults, despite existing (but inconsistently applied) fall prevention protocols. Anecdotal reports from staff also indicate confusion about which interventions are most effective for different patient populations.
Step 2: Form a Team
- Application: A multidisciplinary EBP team would be assembled. This team would include:
- Nurse Manager: To provide leadership, resources, and organizational support.
- Staff Nurses (from various shifts): To provide frontline perspective, identify practical barriers, and champion the change.