DNP 820-A Topic 8 DQ 2: Evaluate evidence-based methods for implementing and sustaining an evidence-based culture. Describe two and discuss role of the DNP-prepared nurse within this type of culture. Provide two examples.

DNP 820-A Topic 8 DQ 2: Evaluate evidence-based methods for implementing and sustaining an evidence-based culture. Describe two and discuss role of the DNP-prepared nurse within this type of culture. Provide two examples.

DNP 820-A Topic 8 DQ 2: Evaluate evidence-based methods for implementing and sustaining an evidence-based culture. Describe two and discuss role of the DNP-prepared nurse within this type of culture. Provide two examples.

Evidence-based practices (EBP) supports decision-making with a combination of research, quality improvement, expert opinions, and clinical decisions based on the current best practice. EBP supports optimal outcomes, quality of life, standardization of care, equivalent care with a lower cost and/or in less time, improved patient satisfaction, improved clinician satisfaction, and clinician autonomy (Dang et.al., 2022). Multiple organizations have a tremendous growth in EBP, however, there continues to be a push to enhance evidence-based practices. The culture of EBP is implemented by creating and sustaining an EBP-supported environment. The emphasis on quality and safety and national pay-for-performance initiatives has geared organization into developing strategic initiatives to guide, support, implement, and review EBP practices. This begins with the development of an EBP infrastructure and committed organizational leadership, thus transforming and establishing an organizational culture of practice based on evidence (Dang et.al., 2022).  

A doctoral-prepared nurse can guide cultural change as a supportive leader by building a supportive environment, empowering clinicians, encouraging staff to drive change, engaging, and promoting EBP. Furthermore, a committed EBP DNP leader has a positive spirit and dedicates their focus to building EBP inquiries, practices, and enhancing positive outcomes. The success of EBP is directly associated with a leader’s active involvement and a “make it happen” approach. This leadership style is designed to be intentional, planned, and engaged. Altogether, these aspects will ensure EBP is adopted, spread, and sustained (Dang et.al., 2022). The DNP-prepared nurse can serve as a mentor to peers, nursing staff, and clinicians. Nursing staff have perceived beliefs that current and own practices were based on EBP with minimal knowledge regarding the actual practice and process of EBP (Saunders & Vehvilainen-Julkunen, 2016). A support leader and mentor alongside a change champion for each department can provide safe and supportive culture to enable staff to learn skills and competencies influenced by EBP.  

Dang, D., Dearholt, S., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and Guidelines. Sigma Theta Tau International. 

Saunders, H., & Vehviläinen-Julkunen, K. (2016). Nurses’ evidence-based practice beliefs and the role of evidence-based practice mentors at university hospitals in Finland. Worldviews on Evidence-Based Nursing14(1), 35–45. https://doi.org/10.1111/wvn.12189 

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It is true that evidence-based practices (EBP) supports decision-making with a combination of research, quality improvement, and expert opinions. Therefore, healthcare providers and professionals assume that EBP leads to accurate clinical decisions. These right clinical choices are credited to improve patient positive outcome and promotion of patient safety. Most healthcare institutions have expressed their desire to incorporate EBP in their healthcare delivery (Flodgren et al., 2019). Healthcare organizations that have successfully implemented EBP has reported improve organizational performance and patient experience. The positive reporting has attracted other healthcare organizations to incorporate EBP. The emphasis on quality and safety and national pay-for-performance initiatives has geared organization into developing strategic initiatives to guide, support, implement, and review EBP practices (Saunders & Vehviläinen‐Julkunen, 2018). However, other healthcare institutions have failed to implement EBP despite their desires. Various challenges have been attributed to hindering the implementation of evidence-based practice in other healthcare institutions. Inadequate support and high incompetence levels are some of the hindrance to implementing EBP in most healthcare organizations.

References

Flodgren, G., O’Brien, M. A., Parmelli, E., & Grimshaw, J. M. (2019). Local opinion leaders: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6). https://doi.org/10.1002/14651858.CD000125.pub5

Saunders, H., & Vehviläinen‐Julkunen, K. (2018). Key considerations for selecting instruments when evaluating healthcare professionals’ evidence‐based practice competencies: A discussion paper. Journal of Advanced Nursing74(10), 2301-2311.  https://doi.org/10.1111/jan.13802

Evaluate evidence-based methods for implementing and sustaining an evidence-based culture. Describe two and discuss role of the DNP-prepared nurse within this type of culture. Provide two examples.

Evidence-based culture refers to the creation of favorable environmental conditions that favor evidence-based practices with a focus on achieving improved patient outcomes, reduced costs and enhanced quality of care. An evidence-based culture implies a significant shift in both the mindset and process of an organization. The shift occurs away from tradition towards new ideas and ways of doing things (Murray, 2022).

There are two evidence-based methods for implementing and sustaining an evidence-based culture. First, creating a culture in which the nurses and other medical personnel feel comfortable identify opportunities for evidence-based practice and quality improvement. An evidence-based culture is likely to result in some missteps and mistakes. However, these mistakes should be accepted and perceived as learning opportunities with a focus on avoiding future mistakes . DNP-prepared nurses can play a role in overcoming reluctance of other medical personnel to admit ignorance, doubts or mistakes, or to voice potentially controversial ideas. The DNP-prepared nurses can help in establishing a blame-free atmosphere where the mistakes are perceived as learning opportunities (Murray, 2022). For instance, the DNP-prepared nurse can take on a leadership role in modeling the desired behaviors by publicly expressing appreciation when their views are challenged using logical arguments. This creates an ethos that every member is equally responsible for making sure medical practice lives up to the high, jointly held expectations while freeing the members to shift from defensive to problem-solving mode.

Second, encouraging learning about best practices and new evidence. DNP-prepared nurses would act as leader committed to ensuring that patients receive the most up-to-date care while embracing learning as an organizational value. This requires the DNP prepared nurse to create a learning atmosphere where members are encouraged to take advantage of learning opportunities in work tasks (Finkelman, 2019). For instance, the DNP prepared nurse can steer the members towards learning opportunities that allow for a deep dive into specific topics and evidence, or building generalized skills such as quality improvement process or communicating with patients. Overall, the DNP-prepared nurse has a significant role in implementing and sustaining an evidence-based culture.

References

Finkelman, A. (2019). Professional Nursing Concepts: Competencies for Quality Leadership (4th ed.). Jones & Bartlett Learning, LLC.

Murray, E. (2022). Nursing Leadership and Management for Patient Safety and Quality Care (2nd ed.). F.A. Davis Company.

it is the mandate of healthcare organization’s leadership to create evidence-based culture. The culture creates a suitable environment for the implementation and the use of evidence-based practice (EBP).  EBP focuses on improving patient positive outcome. At the same time, evidence-based culture allows promotion of patient safety. An evidence-based culture implies a significant shift in both the mindset and process of an organization (Shelton et al., 2018). The shift occurs away from tradition towards new ideas and ways of doing things. However, some healthcare stakeholders may not be ready and willing to shift their mindset. The fear of the unknown and high incompetent levels among the staff can also thwart the efforts of creating and sustaining evidence-based culture (Jordan et al., 2019). Creating a culture in which the nurses and other medical personnel feel comfortable identify opportunities for evidence-based practice and quality improvement can support evidence-based culture. Healthcare institutions are mandated to use competent healthcare workers to implement the culture. However, these workers’ success will depend on the leadership.

References

Jordan, Z., Lockwood, C., Munn, Z., & Aromataris, E. (2019). The updated Joanna Briggs Institute model of evidence-based healthcare. JBI Evidence Implementation17(1), 58-71. doi: 10.1097/XEB.0000000000000155

Shelton, R. C., Cooper, B. R., & Stirman, S. W. (2018). The sustainability of evidence-based interventions and practices in public health and health care. Annual review of public health.  https://doi.org/10.1146/annurev-publhealth-040617-014731

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