Response one: One of the main issues in adopting evidence-based nursing practice in my organization is the cost factor. I am currently employed for a smaller, for profit organization, so finances are always a big concern. When looking to implement evidence-based practice, an organization must consider the cost of research training, equipment, and the number of hours that will be spent educating staff on the evidence-based intervention. They must figure in the cost of rolling out the evidence-based intervention. This can become costly for organizations which are struggling to remain profitable.
Once the issue of concern is identified, the issue can then be brought to the attention of those who are responsible for the decision-making process to implement change. As for the financial aspect, when looking to gain support for an evidence-based proposal, organizations should be encouraged to use the Institute for Healthcare Improvement framework to calculate the return of investment for a particular proposed evidence-based intervention (Tucker, 2014). The use of this framework takes into consideration the financial reimbursements related to quality control measures. For example, in 2011, the cost of initiating an evidence-based fall prevention bundle was estimated at approximately $15,694. In 2012, an inpatient fall cost a facility an estimated $34,294 per incident (John Hopkins Medicine, 2015). When looking at return of investment data, it would be easy for an organization to see how financially feasible it would be to implement an evidence-based protocol for fall prevention. In the long run, the organization will be more profitable by implementing the proposal.
With all the data surrounding evidence-based nursing practice, most organizations will not have a choice but to adopt it. It should be considered the gold standard to improve patient safety and outcomes. When we improve patient safety and outcomes, healthcare costs will be reduced. This benefits the patient and the organization. While many organizations may remain hesitant to adopt it, in the end, if they donâ€™t, it will only harm their organization.
Galbraith, J. G., Butler, J. S., Memon, A. R., Dolan, M. A., & Harty, J. A. (2011, December). Cost analysis of a falls-prevention program in an orthopaedic setting. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC32102…
John Hopkins Medicine. (2015). Article: Falls Cost U.S. Hospitals $34 billion in Direct Medical Costs. Retreived from https://www.johnshopkinssolutions.com/newsletters/falls-cost-u-s-hospitals-30-billion-in-direct-medical-costs/
Tucker, S. (2014). Determining the Return on Investment for Evidence-based Practice: An Essential Skill for ALl Clinicians. Retrieved from https://sigmapubs.onlinelibrary.wiley.com/doi/full…
Response two: One of the main issues in my organization that prevents the full utilization of evidenced-based practice in nursing would be lack of mentors and short staffing. There seems to be barely enough nurses to cover patient care, let alone having nurses at the bachelorâ€™s level or higher to educate nurses on evidenced-based practice nursing is rare. I feel the hospital must improve upon outside factors before this practice can be used at the utmost potential.
Nursing is a core service in all healthcare. Safe nurse staffing means that an appropriate number of nurses is available at all times across the continuum of care, with a suitable mix of education, skills and experience to ensure that patient care needs are met and that the working environment and conditions support staff to deliver quality care. Safe nurse staffing is a critical issue for patient safety and the quality of care in hospitals, community and all settings in which care is provided. Inadequate or insufficient nurse staffing levels increase the risk of care being compromised, adverse events for patients, inferior clinical outcomes, in-patient death inhospitals and poorer patient experience of care. Having insufficient or inappropriate nursing staff to meet patient needs also results in unsustainable workloads and has a negative impact on the health and wellbeing of staff. Research suggests that investing in safe, effective and needs-based nurse staffing levels can be cost effective, promoting improvement of and preventing deterioration in patientsâ€™ health thereby reducing the duration and intensity of healthcare interventions. Ongoing evidence continues to highlight the importance of safe nurse staffing in relation to patient safety in all healthcare sectors (Marteau, 2009).
Marteau, J. (2009). Evidence-based safe nurse staffing. Retrieved from https://www.icn.ch/sites/default/files/inline-file…
Response three: Nursing implementation of evidence-based practice (EBP) is a crucial factor in delivering high-quality patient care. Institutional leadership, such as nurse managers, plays an integral role in implementing EBP in nursing units. EBP allows nurses to make complex health care decisions based on research reports, clinical expertise and patient perspectives.
I believe that our organization is currently going through ineffective leadership and management issue, which are directly affecting the implementation process of evidence-based practice (EBP) in nursing. We are having high turnover of management, where it takes time to adjust for the new ones. In the research study of Sandstorm, Borglin, Nilsson & William, (2011) leadership role is vital for the process of implementing EBP, also the importance of the culture in the organization where the leaders operate. It would be challenging for the leader to make EBP a norm in an organization. Our organization has high staff turnover issues due to many reasons, where ineffective leadership is also the one, which is holding the organization behind maintaining its culture, especially regarding the maintenance of EBP in practice. Leaders should be able to bring some strategic plans including planning, organizing and implementing to yield staff turnover issues and also maintaining the culture of practicing EBP.
There are many ways how the leader could address the issue, in which the first step towards resolving is to inspire and induce, devote time and share knowledge (Stetler, Ritchie, Raycroft & Charns, 2014). Inspiration and inducing consists of activating, motivating, acknowledging encouraging and engaging regarding the implementation of EBP. Other steps on resolving this issue are educating and to be a role model to other staff, by guiding, mentoring and coaching. Role modeling behavior demonstrates the expected norm and enabled others to learn norms and values by watching, repeatedly hearing and discussing EBP with leaders (Stetler et al, 2014). For example- when I was a new grad, I once got encountered the director of nursing on our floor in the facility where I worked, while she was making her round. The floor was busy, so she helped with one of my patientâ€™s PICC line dressing change. I saw her maintaining an aseptic and sterile technique as needed. She even explained the rationale behind doing every step in the procedure. Myself being the new grad staff, that activity of DON was very encouraging, impressive, motivating to do things right, maintaining and implementing EBP all the time. To learn persistence, perseverance, and willingness, we should have strong leadership and management.
Sandstrom, B., Borglin, G., Nilsson, R. & William, A. (2011). Promoting the implementation of evidenceâ€based practice: A literature review focusing on the role of nursing leadership. Retrieved from https://sigmapubs.onlinelibrary.wiley.com/doi/full/10.1111/j.1741-6787.2011.00216.x
Stetler., Ritchie, J., Rycroft, j. & Charns, M. (2014). Leadership for evidence-based practice: Strategic and functional behaviors for institutionalizing EBP. Retrieved from https://www,ncbi.nlm.nih.gov/pmc/articles/PMC4240461/