Discussion: Where in the World Is Evidence-Based Practice?

March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.

When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.

In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.

To Prepare:

· Review the Resources and reflect on the definition and goal of EBP.

· Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).

· Explore the website to determine where and to what extent EBP is evident.

Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples.

About 3 paragraphs with minimum of 3 references and intext citations. 

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 1, “Making the Case for Evidence-Based      Practice and Cultivating a Spirit of Inquiry” (pp. 7–32)

Boller, J. (2017). Nurse educators: Leading health care to the quadruple aim sweet spot. Journal of Nursing Education, 56(12), 707–708. doi:10.3928/01484834-20171120-01

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving patient care through nursing engagement in evidence-based practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. doi:10.1111/wvn.12126

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. doi:10.1111/wvn.12171 

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51–53. doi:10.1097/01.NAJ.0000366056.06605.d2

Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based 

Nursing, 11(1), 5–15. doi:10.1111/wvn.12021

Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in work. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. 

You will develop a syllabus for an 8-week undergraduate nursing course in your area of interest that conveys the essential components of that course to the learner. Schools commonly establish guidelines and formats for information to be included in all syllabi developed for nursing courses. To deter misunderstandings, many institutions require all syllabi to include specific statements about institutional, departmental, and course policies on academic integrity, students with disabilities, and diversity.

For the purpose of this assignment, required information to be included in your course syllabus is minimal. However, syllabi do not have to be simple, typed documents. You may choose to incorporate additional information (graphics photos, comics, or designs) and other creative elements. However, be sure your syllabus includes at least the required information listed under the assignment guidelines section below in order to be considered for full credit.  
 

Please note: You may not copy a syllabus to turn in. Make this syllabus your own ideal of teaching your chosen course. Have fun and be creative with this assignment. You will be utilizing your developed syllabus in weeks 6 and 7 to develop a teaching plan and mini-presentation,

Assignment Guidelines

When preparing your syllabus, pay attention to the organization and layout to ensure it is easy to read. Your syllabus should set the tone for your course and convey enthusiasm for the course topic; show how your course fits into a broader picture; communicate what, when, and how students will learn; clarify what students need to do to be successful; and communicate your expectations of student performance to satisfactorily complete your 8-week course.

Your course syllabus should include:

1. General information about the course: The instructor’s name (you), course title, course number, course credit hours, class days and time period (start and end times), class location (room number), and any prerequisites. You may also wish to include your office hours and contact information.
2. A course description: A description of the course and how students will benefit; this is similar to a catalog description of a course.
3. Course outcome objectives expected: A list of outcome statements describing the knowledge and skills that you expect students to have learned after completing your 8-week course. Your objectives should be: 
   • Appropriate to course and educational level
   • Realistic and clear
   • Stated in measurable terms
4. Required materials and learning resources: Textbook(s), supplies, and anything you may require students to bring to class each day
5. Instructional methods and activities: List the teaching strategies and approaches you plan to use for students to achieve the learning objectives (e.g., lecture, games, inquiry, discussions). If appropriate, you may want to include any special events or activities (e.g., field trips, experiments, guest speakers, projects). Note: This section is a list of your instructional methods and activities and not an explanation or description of how they will be implemented.
6. Classroom policies or rules: This section should include any policies or rules that are specific to your course (e.g., classroom behavior, absenteeism, tardiness, late assignments, makeup work, and tests).
7. Evaluation methods: This section should include all graded course requirements with the percent value (of the total course grade) for each requirement. This is where you list each of the course requirements or means of evaluating student learning (e.g., tests, quizzes, assignments, presentations, group work). 
   • You do not need to provide a rubric for grading each of the course requirements, guidelines, and grading criteria.
   • You do need to provide the total percent value or the grade weight of each requirement.
   • If using tests or quizzes, state the number of tests or quizzes and the grade weight for each.
   • Note: As part of your teaching plan and presentation during weeks 6 and 7, you will provide guidelines and grading criteria (a rubric) for one of your required assignments.
8. An outline and general time line of the course content: This section should be a table or flowchart depicting a schedule of the content to be covered over the 8-week period. In addition to the content, your table or flowchart should include: 
   • Estimated dates for when you plan to cover the content. Specific dates are not necessary, but some time line estimate should be provided (e.g., week 1 or class 1)
   • Any activities, assignments, and tests, etc., with corresponding due dates
   • Required readings for each date and any supplemental or suggested readings you may want to list

Required Resources
Read/review the following resources for this activity:

• Textbook: Chapter 7,8
• Lesson
• Minimum of 2 scholarly sources in addition to textbook and lesson.

Instructions
While our focus in the lesson this week was on the concepts of conformity and obedience, we also studied group processes and dynamics in our readings for the week. For this assignment, select two specific groups to which you personally belong. This could be a church group, sports team, club, department at work, etc. In a slide presentation, address the following for each of the groups you selected:

• Describe the group (membership, purpose, etc.).
• Define the group roles, emphasizing your own role in that group.
• Describe the group norms.
• Analyze the group dynamics – How does the group communicate? How are decisions made? Who evaluates group members’ performance?
• Evaluate how dissension or conflict are managed within the group.
• Select two social psychology group concepts (for example: cohesion, groupthink, social loafing) and apply them to these two groups, comparing and contrasting how the group norms and dynamics impact how the group behaves.

Writing Requirements (APA format)
As you complete your presentation, be sure to:

• Use speaker’s notes to expand upon the bullet point main ideas on your slides, making references to research and theory with citation.
• Proof your work
• Use visuals (pictures, video, narration, graphs, etc.) to complement the text in your presentation and to reinforce your content.
• Do not just write a paper and copy chunks of it into each slide. Treat this as if you were going to give this presentation live to a group of middle school kids – be relevant, engaging, and focused.

Presentation Requirements (APA format) 

• Length: 8-10 slides (not including title, introduction, and references slides)  
• Font should not be smaller than size 16-point  
• Parenthetical in-text citations included and formatted in APA style  
• References slide (a minimum of 2 outside scholarly sources plus the textbook and/or the weekly lesson for each course outcome) 
• Title and introduction slide required