SOLUTION

Solution Description

Deborah K. Gill

Grand Canyon University

NUR 699: Evidence-Based Nursing Practice

Nicolette Estrada, Instructor

May 25, 2011



Solution Description

Critique Measurements for Expected Outcomes (Validity and Reliability)

Limited in its focus and population, this evidence based study will propose intervention and educate the emergency department nursing staff about bullying, thereby increasing their awareness of the extent of the problem within the profession. Questionnaires will be utilized to measure whether focused learning can effectively cause a necessary and needed change in the perceptions of nurses within the emergency department. Owing to its narrowed focus, there is no obvious selection bias because subjects participating in the study are the population in which the study results will apply, thus substantiating its external validity as related to the population studied. The research question and design are compatible. The utilization of questionnaires will directly indicate respondent's previous and post-perceptions of focused learning's effectiveness, therefore, does not immediately demonstrate instrument bias. Since the measurements are limited to respondent's perceptions, responses that reflect learning may not be indicative of any future behavioral changes. Therefore, there may be some loss of external validity; nevertheless, it retains substantial reliability.

Consideration of Patient Values and Clinical Judgment

Melnyk and Fineout-Overholt bear witness to one of the primary principals that guide nursing practice “notions of good are intrinsic to nursing as a socially organized practice. For example, accuracy, not error; attentiveness, not neglect; recognition practices, not depersonalization are notions of good that are internal to being a good nurse” (Melnyk & Overholt 2011, pp. 21). They also indicate that even “the most formal measurements cannot replace the perceptual skills of the nurse in recognizing when a measurement is relevant and what the measurement means, which are at the center of good clinical judgment” (ibid). Nursing is the most noble of professions due to its true altruistic nature. Consideration of the patient's values is a deliberate continuum, wherein the nurse utilizes research, EBP, experience, good clinical judgment. The wealth of such treasured intangibles is insight, thoughtfulness, and intuition to deliver the most professional care that holistically, is optimal for each patient. Despite the complex multiplicities of issues within the realms of academia and clinical, the values of each patient defines and reasonably supersedes practice. Evidence-based practice (EBP) presently is liberally referenced by the nursing education. The progress and assessment of guiding principle and management protocols is the latent for superior participation of clinicians in Evidence-based practice inventiveness. Even as, it is not a general remedy, the local conditions for enhancement of quality, planned progress of practice and continuous learning can be adapted by nurses, to facilitate access to the best available evidence. Evidence shows some of the staff lacks the necessary skills and time required to integrate the facts, even though EBP has been introduced into nursing education and promoted widely in hospitals.

Obstacles or Barriers to Implementing Evidence-Based Practice (EBP)

History shows that when changes are made to a certain form of work there are always problems that impede its implementation, and institutional resistances as people are involved. It is no ...