Future Use of Evidence-Based Practice: NR 505 Week 8 Discussion
The lesson for Week 8 asks you to objectively reflect on your current use of evidence-based practice. Throughout this course you have worked hard and created a template for an EBP project proposal. Rather than look to the past, this discussion asks you to look to the future—your future as an MSN-prepared advanced practice nurse!
You are a nurse leader in your future advanced practice track-based setting. You notice that although nurses say they use evidence-based practice (EBP), you find very few examples of this. As the leader, you decide to develop an environment that fosters EBP. Please respond to each of the following topics.
How would you role model EBP in your future advanced practice setting? Be specific!
How would you foster an organizational culture that promotes EBP? How would you promote EBP throughout the entire organization?
You have one staff member who constantly says, “We have never done it this way—why change?” What actions would you take to change him or her from a distracter to a promoter of EBP?
Scholarly references to support your response are required.
Future Use of Evidence-Based Practice SAMPLE APPROACH
What are your thoughts about integration a pilot to test ebp in your workplace?
I work in the emergency room and during my shifts I come across at least one person whose chief complain is related to chronic pain.
For the most part, the primary care providers provide them with some sort of analgesic in order to manage their pain. We definitely have our regulars who come in at least once a week demanding morphine or dilaudid. PCP’s have a constant pressure to maintain high patient satisfaction scores and feel the need to negotiate the plan of care with these patients. However, many are reluctant to order or prescribe opioids or controlled substances even though because they don’t see it as appropriate to chronic pain management. Nonetheless, if these patients don’t get the drugs they seek, one knows they will be unsatisfied with their care. As mentioned by Henson and Jeffrey (2016), pilot studies can provide a better insight of the developing research, they assess sample size, data collection and clarify many questions before the implementation process.
Pilot studies tend to foretell what one must expect from the actual study, therefore providing one with the opportunity to alter and adjust one’s methods. Implementing a pilot study in the ER will be challenging for me. For the most part the ER consist of pharmacological intervention and in this fast phase setting it would be difficult to implement nonpharmacological interventions. Currently, in my ER we divide our patients in two sections. One section is for our acute patients whom need to be seen by a PCP as soon as possible or whom will require numerous resources such as blood draw, xray, radiology, etc. The other section is our “fast track”, this portion of the ER sees nonemergent cases or those whom will require one to two resources such as those whom need small sutures or medication refill. Many time, some of the patients whom are complaining of chronic pain will go to the fast track section, medication will be provided, and they will be discharged. Given this setting is less acute and patients are more stable, I believe I could integrate nonpharmacological teaching and interventions. Nonetheless, in order to intergrade a pilot study, one must take many things into consideration.
Thank you for the great post as always. I have enjoyed reading your posts this class as you always provide great insight on the discussions. I also work in the emergency setting and see many of the same issues as you. We have a similar set up in our ER including a fast track area. It works well moving non-acute patients quickly. I like your idea regarding implementing non-pharmacological interventions for patients with chronic pain. Last week, there were discussion posts explaining the value of physical therapy for those with chronic pain. This is one of my favorite interventions to discuss with patients with chronic pain as it has the capacity to alleviate pain as well as provide overall health benefits. The pressure on providers to prescribe narcotic pain medications is a huge issue and very unfortunate. I can see why many feel pressured to give out medications for fear of being negatively criticized. We have had many discussions in our ER regarding this issue and found that through working together as a group and being consistent, our level of pain medication disbursement has gone down significantly. It began with our medical director speaking to all physicians on our new goal and continued with nursing managers and staff providing constant education to the public that things were changing and why they were changing. Overtime, we saw many patients who frequented our ER seeking pain medications for chronic issues had less visits thus lowering our overall disbursements of narcotics. Thank you again and good luck in your studies!