NR 451 Week 1 Discussion 1,

NR 451 Week 1 Discussion 1, Types of Nursing Models and Frameworks of EBP What are some of the models and frameworks of EBP currently in use? How does the strength of the evidence determine translation into practice? Why is it important to integrate both evidence-based practice and patient and family preferences? What is the nurse's responsibility when EBP and patient and family practice do not match? Response 1 The medical field is constantly evolving and changing. It is crucial for nurses to always stay current on the newest research as it can affect their patient's care. Evidence Based Practice (EBP) uses current best conclusions or evidence produced by current research efforts to make decisions about patient's care (CCN, 2017). Nurses play a huge role in EBP as well as the delivery of care. "The recommendation that nurses lead inter professional teams in improving delivery systems and care brings to the fore the necessity for new competencies, beyond evidence-based practice, that are requisite as nurses transform healthcare" (Stevens, K. R. 2013). The John Hopkins Nursing Evidence-Based Pratice (JHNEBP) model is a powerful problem solving approach to clinical decision-making, and is accompanied by user friendly tools to guide individual or group use. It is designed specifically to meet the needs of the practicing nurse and uses a three step-process called PET; practice qustion, evidence, and translation. As a nurse your patient's health and happiness should be your top priority. You want to deliver the very best care possible to your patient all while making them happy doing so. Therefore, when the patient or families preference does not meet the current EBP it can cause some issues. It is crucial for the nurses to find the balance needed to provide not only the treatment the patient wants but the treatment that is best for the patient. Leigha, I strongly agree with your opening statement. Nursing, and healthcare in general, are constantly changing as new developments are made. As nurses we not only need to keep up, but also stay ahead of the game. That is why research, EBP, and QI are all equally important. As stated in our lesson this week, this usually starts with the bedside nurse “recognizing that a situation exists” (CCN, 2017). In fact, who better to identify issues and potential barriers then the caregivers who spend the most time with the patients? Our book talks about when nursing occurs. It states that nursing occurs “when there are retrospective circumstances requiring analysis and action, including root cause, risk factors, lifestyle, familial, cultural, genetic, environmental predispositions, or loss” (American Nurses Association, 2015). As you can see there are many factors to consider. Despite the EBP out there and the need for implementation, it cannot always be used into every practice setting. Out book states that this can often be challenging (American Nurses Association, 2015). This is especially true when the patient and families beliefs, preferences and values differ from that of the process being used. In these cases, I believe nurses should educate patients on the evidence and associated outcomes, and provide evidence based care that best fits the patient’s preferences. As we move more towards patient centered care it is important to implement a shared decision making process which includes “providing care that is respectful of and responsive to individual patient preferences, needs, and values, ensuring that patient values guide all clinical decisions” (Applying Evidence for Patient-Centered Care). References American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author. Applying Evidence for Patient-Centered Care: Standards and Expectations. (n.d.). Retrieved May 04, 2017, from Chamberlain College of Nursing. (2017). Establishing Differences in Research, Evidenced- Based Practice, and Quality Improvement Projects [Online lecture]. Retrieved from Response 2 Evidence based practice serves as a practice tool for nursing staff in efforts to improve the over-all quality of care being provided to patients. Evidence based practices aids in implementing research findings into practice adoption, implementation of new policies and procedures, serve an educational purpose as well as assisting in the field of research. Nursing models provides direction and is what is used to change nursing practice (Chamberlain College of Nursing). This week’s lesson supports,’’ nursing models help guide nurses into planning EBP or change projects in the most productive manner’’ (CCN, 2016). Small reports,’’when enough evidence is available, the practice should be guided by research evidence in conjunction with patient values and clinical expertise’’ (May 2011, p 6). Once that change is incorporated into practice it then becomes a standard of care. The ACE Star Model of Knowledge Transformation is one nursing model that closely resembles the nursing process. In this model, there are 5 areas in which knowledge is obtained, reviewed and implemented into practice. Knowledge discovery, evidence summary, translation into practice recommendations, integration into practice, and evaluation are the 5 stages within this nursing model (). This model incorporates both old and new concepts to provide a framework in which EBP may be organized. The nursing process along with nursing models provides nurses with Standards of Practice while addressing other practice issues or concerns. Since the nurse is responsible for holistic care of patients, which includes emotional, spiritual cultural and familial factors, the nurse must advocate for concerns, rights