Research guides our practice and build knowledge through theory In any discipline, science is the result of the relationship between the. which allows the nursing student to apply all of his theoretical knowledge in a clinical the ever so growing rift between nursing theory and nursing practice which has been But it has also been made clear through servals studies that new nurse . studied the relationship between the different variablessuch as the Type of. Despite an accumulating body of knowledge about the effectiveness of some . The gap between research and practice is not merely the consequence of nurses failing to keep up to date. Chicago: American Medical Association,
Patient-Centered Outcomes Research As evidence mounted on standard medical metrics Another recent and swooping change in healthcare research emerged with a focus on patient-centered outcomes research PCOR. As evidence mounted on standard medical metrics mortality and morbidityit was noted that metrics and outcomes of particular interest to patients and families such as quality of life were understudied.
Inattention was drawn to the need to produce evidence on patient-centered outcomes from the perspective of the patient. These calls encourage early and meaningful engagement of patients and other stakeholders in stating the research question, conducting the study, and interpreting results AHRQ, The Next Big Ideas Two additional federal initiatives exemplify what may be called the next big ideas in EBP—each underscoring evidence-based quality improvement.
The initiatives call for better use of the knowledge that may be gained from quality improvement efforts. Both initiatives emanate from the NIH and both focus on generating evidence needed to make systems improvements and transform healthcare. Because of the central role that nurses play across all healthcare settings and clinical microsystems, research in this field is highly relevant to the profession.
This field of science moves beyond the individual provider as the unit of analysis and focuses on groups, health systems, and the community. For example, one emphasis in the field is discovering and applying the evidence for the most effective ways to speed adoption of evidence-based guidelines across all health care professionals in the clinical unit and in the agency. Improvement Science Research Network The overriding goal of improvement science is to ensure that quality improvement efforts are based as much on evidence as the best practices they seek to implement.
In many instances, studies about single innovations on Star Point 4 were often not rigorous or broad enough to produce credible and generalizable knowledge Berwick, As a new field, improvement science focuses on generating evidence about employing evidence-based practice, providing research evidence to guide management decisions in evidence-based quality improvement.
The overriding goal of improvement science is to ensure that quality improvement efforts are based as much on evidence as the best practices they seek to implement.
Recognizing that pockets of excellence in safety and effectiveness exist, there is concern that local cases of success in translating research into practice are often difficult to replicate or sustain over time.
Factors that make a change improvement work in one setting versus another are largely unknown. The ISRN is an open research network for the study of improvement strategies in healthcare. The national network offers a virtual collaboratory in which to study systems improvements in such a way that lessons learned from innovations and quality improvement efforts can be spread for uptake in other settings.
The ISRN supports rigorous testing of improvement strategies to determine whether, how, and where an intervention for change is effective. The following shortcomings in research regarding improvement change strategies have been noted: The primary goal of the network is to determine which improvement strategies work as we strive to assure effective and safe patient care.
Through this national research collaborative, rigorous studies are designed and conducted through investigative teams. Foundational to the network is the virtual collaboratory, fashioned to conduct multi-site studies and designed around interprofessional academic-practice partnerships in research.
The ISRN offers scientists and clinicians from across the nation opportunities to directly engage in conducting studies. ISRN Research Priorities were developed via stakeholder and expert panel consensus and are organized into four broad categories: The research collaboratory concept has proven its capacity to conduct multi-site studies and is open to any investigator or collaborator in the field. These will provide the scientific foundation for the rapidly expanding efforts to make healthcare better.
Nurses will take advantage of these EBP advances to address opportunities and challenges. Much has been done to make an impact; much remains to be accomplished.
From this admittedly selective overview of EBP, it is seen that the story of EBP in nursing is now long, with many successes, contributors, leaders, scientists, and enthusiasts.
Opportunities and challenges exist for clinicians, educators, and scientists. Those leading clinical practice have willing partners from the academy for discovering what works to improve health care. Such evidence to guide clinical management decisions is long overdue Yoder-Wise, While there are benefits to both as the evidence is gathered and applied, the true benefit goes to the patient. Clinical leaders have unprecedented opportunity to step forward to transform healthcare from a systems perspective, focusing on EBP for clinical effectiveness, patient engagement, and patient safety.
Those leading education have great advantages offered from a wide variety of educational resources for EBP. The rich resources offer students a chance to meaningfully connect their emerging competencies with clinical needs for best practices in clinical and microsystem changes.
Those leading nursing science have access to new funding opportunities to develop innovative programs of research in evidence-based quality improvement, implementation of EBP, and the science of improvement.
Readiness of the clinical setting for academic-practice research partnerships brings with it advantageous access to clinical populations and settings and an eagerness for utilization of the research results.
Nurses’ perspective of the research-practice gap in nursing
The challenges for moving EBP forward spring from two sources: Therefore, adopting the following habits hold promise for moving us ahead: Persistence in educating the future workforce, and retooling the current workforce, with awareness, skills, and power to improve the systems of care.
Laying aside comfortable programs of research and picking up programs of systems research. Insistence on multiple perspectives and sound evidence for transforming healthcare. The nursing profession remains central to the interdisciplinary and discipline-specific changes necessary to achieve care that is effective, safe, and efficient. New in our vernacular and skill set are systems thinking, microsystems change, high reliability organizations, team-based care, transparency, innovation, translational and implementation science, and, yes, still evidence-based practice.
Let us move swiftly to make these new ideas and skills commonplace.
The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas
Additional information has been added at the request of the author. Her multi-site research on team collaboration and frontline engagement in quality improvement is conducted through the national collaboratory, the ISRN. The science of improvement. Journal of the American Medical Association, 10 Dissemination and implementation research in health: Translating science to practice. Oxford University Press, Inc.
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Implications of the IOM reports for nursing education. A strategy for quality assurance. To err is human: Building a safer health system. Crossing the quality chasm: A new health system for the 21st century. A bridge to quality. It can be claimed that information literacy is a framework for EBP. In fact, it is vital for nurses to be able to utilize new clinical evidence to develop and improve their professional life 16.
It is believed that information literacy plays a key role in nursing, especially in EBP, and is a starting point for clinical practice based on research and evidence 7.
Shiraz E-Medical Journal
Hence, information literacy should be the main focus of nursing education 6. Nurses with a considerable level of information literacy have shown greater understanding and utilization of research evidence in clinical decisions 9.Part 1 - Evidence-Based Practice: Improving Practice, Improving Outcomes
Using evidence-based practice is on the basis of the idea that science is an ideal source of knowledge and can guide clinical decisions Nowadays, skilled nurses agree that the best type of practice in nursing is evidence-based nursing It is essential for the nurses to have updated as well as skill- and evidence-based knowledge 13 Various studies showed that EBP improves the consequences for the patient, the quality of care, and the skills of care providers.
It also reduces the cost of care Researchers found that nurses experience a poor level of EBP 1416 The findings of researchers showed that as a result of lacking information literacy, nurses are not ready enough for EBP 18 Also Pravikoff et al.
The study by Farokhzadian et al. There is an evident association between information literacy and EBP in designing nursing education programs. Considering the importance of EBP in nursing and preparation for its implementation in practice, it is necessary to identify variables that contribute to this subject. Methods The present study was a descriptive-correlative research.
In order to determine the sample size, the limited population formula was used. Samples were randomly regardless of the shift of work selected from seven public central hospitals of Tehran University of Medical Sciences, Iran.
Hospitals were selected if they had a critical care unit. The goals of health care at critical care units are patient safety and quality patient outcomes, which are more vital than other units. The EBP is viewed as a tool to achieve these goals. Therefore, nurses from these units were selected to participate in the current study.
The tool used was a questionnaire with three parts: The information literacy questionnaire was based on information literacy standards of the Association of College and Research Libraries. The tool consisted of 26 phrases in 5 sub scales: The face and content validity of the tool was confirmed by seven academic faculty members of the department of Information Science and Knowledge Studies at Tehran University of Medical Sciences.