The Discussion: Where in the World Is Evidence-Based Practice?

Discussion: Where in the World Is Evidence-Based Practice?

The health care organization website that was reviewed for the purpose of this main post discussion was the Det Norske Veritas and Germanischer Loyd (DNV GL) website.  In 2008, DNV-GL was approved by the Centers for Medicare and Medicaid Services (CMS) to deem acute care hospitals and critical care access hospitals in compliance with the Conditions of Participation (CoPs) for hospitals (DNV GL, 2020).  DNV GL proposed an accreditation model focused on continuous improvement and sustainability (DNV GL, 2020).

DNV GL’s purpose is to safeguard life, property, and the environment (DNV GL, 2020).  The DNV GL does not speak to evidence-based practice directly on their website, but it is reflected in their accreditation and certification programs.  Annual DNV GL accreditation and certification programs are designed to allow organizations to be innovative, have less prescriptive standards, and to involve the entire organization in the quality management system.  Best practice only occurs when staff continually ask questions about treatment and care (Crabtree, Brennan, Davis, & Coyle, 2016).  Having less prescriptive standards allow frontline staff to implement best practice so that it may be adapted for the unique workflow of the hospital, leading to sustainability. Melnyk and Fineout-Overholt (2018) stated that evidence-based practice is a lifelong problem-solving approach to clinical decision making that involves the use of the best available evidence combined with acquired experience and or expertise along with patient preference to improve outcomes.  DNV GL reflects this description well by accounting for the uniqueness of staff and patient preferences when it is related to accreditation standards.

My perception of DNV GL has not changed after reviewing their website.  DNV-GL is an accreditation organization that encourages communication across the organization, with everyone being accountable for the quality of care provided.  Annual surveys led to continual improvement and readiness for a survey, and continued internal audits involve many front- line staff to create and sustain quality improvements for their area of expertise.

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References

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016).  Improving patient care through nursing engagement in evidence-based practice.  Worldviews on Evidence-Based Nursing, 13(2), 172-175.  doi: 10.1111/wvn.12126

DNV GL. (2020). Retrieved February 24, 2020 from https://www.dnvgl.com/healthcare/index.html

Melnyk, B. M., & Fineout-Overholt, E. (2018).  Evidence-based practice in nursing & healthcare:  A guide to best practice (4th ed.). Philadelphia, PA:  Wolters Kluwer.

Discussion: Where in the World Is Evidence-Based Practice?

March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.

When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.

In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.

To Prepare:

  • Review the Resources and reflect on the definition and goal of EBP.
  • Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).
  • Explore the website to determine where and to what extent EBP is evident.

By Day 3 of Week 1

Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples.

By Day 6 of Week 1

Respond to at least two of your colleagues on two different days by visiting the websites they shared and offering additional examples of EBP or alternative views/interpretations to those shared in your colleagues’ posts.

 

Evidence-based practice (EBP) is a lifelong analytic process to clinical practice that combines external evidence from research, evidence-based theories, clinical expertise, and patient preferences and values (Melnyk & Fineout-Overholt, 2018). EBP strengthens healthcare quality, provides positive patient outcomes, lowers costs, and empowers clinicians (Melnyk & Fineout-Overholt, 2018). Hence, EBP has acquired demand in healthcare due to its potential to effectively deliver quality health care to certain groups by using critically researched and methodically proven evidence (Majid, Foo, Luyt, et al., 2011). Thus, health organizations began to adopt and promote EBP. One of the professional healthcare organizations that promotes EBP is The National Institutes of Health (NIH). NIH is a part of the United States Department of Health and Human Services (HHS) that is focused on the country’s medical research for pivotal discoveries that will improve health and save lives (U.S. Department of Health & Human Services [HHS], National Institutes of Health [NIH],2017). The NIH explores the basic and essential knowledge about the nature and behavior of living systems and applies the knowledge to improve health, prolong life, and lessen illness and disability ( HHS, NIH, 2017). Furthermore, the Office of Disease Prevention (ODP) is the lead office of the NIH which is in charge of assessing, assisting, and promoting research in disease prevention, and spreading the results of this research to improve public health (HHS, NIH, ODP, n.d.). Finally, prevention is the best in treatment, and research on disease prevention is vital to the NIH. Therefore, the knowledge learned from the research directly leads to stronger clinical practice, health policy, and community health programs  (HHS, NIH, ODP, n.d.).

Mission and Vision

 The NIH OPD’s mission “ is to improve public health by increasing the scope, quality, dissemination, and impact of prevention research supported by the NIH (HHS, NIH, ODP, n.d.).The vision, on the other hand, is to extend its value as a resource to the NIH and the wide prevention research community by:

  • Providing guidance in prevention research methodology (HHS, NIH, ODP, n.d.).

  • Identifying gaps in existing evidence and facilitating coordination of new activities to address those gaps (HHS, NIH, ODP, n.d.).

  • Increase the impact and visibility of prevention research (HHS, NIH, ODP, n.d.).

 The NIH ODP promotes dissemination and implementation (D & I) research on how evidence-based practices, interventions, and policies are successfully rendered to and used today such as in hospitals, schools, and communities (HHS, NIH, ODP, 2019). The frameworks, theories, and models provide a way for the researchers to better understand, utilize, and evaluate evidence-based interventions, in particular, situations (HHS, NIH, ODP, 2019).

 The information that I have learned from the healthcare organization website has positively changed my perception. I have learned that organizations such as the NIH play a vital role in improving the quality of healthcare through evidence-based care from research. An example is that the NIH has evidence-based practices and programs that can help identify evidence-based disease prevention methods that could possibly transform public health (HHS, NIH, ODP, 2019). Also, NIH uses strategies and interventions such as practical tools, databases, and registries to help identify and utilize research findings and evidence-based prevention services in their work and communities (HHS, NIH, ODP, 2019). The NIH OPD promotes EBP by providing evidence from research to improve the quality of healthcare.

Reference

Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y., Chang, Y., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: nurses’ perceptions, and barriers. Journal of the Medical

Library Association: JMLA, 99(3), 229-236. Retrieved from https://doi.org/10.3163/1536-5050.99.3.010

Melnyk, B.M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

U.S. Department of Health & Human Services, National Institutes of Health, Office of Disease Prevention (n.d.). About the ODP. Retrieved from https://prevention.nih.gov/about-odp

U.S. Department of Health & Human Services, National Institutes of Health (2017, July 27). Mission and Goals. Retrieved from https://www.nih.gov/about-nih/what-we-do/mission-goals

U.S. Department of Health & Human Services, National Institutes of Health, Office of Disease Prevention (2019, October 21). Research Priorities. Retrieved from https://prevention.nih.gov/

research-priorities/dissemination-implementation/evidence-based-practices- programs

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

(0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
(0%) – 0 (0%)
(0%) – 0 (0%)
(0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

(0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response
16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

(0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation
(5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
(0%) – 0 (0%)
(0%) – 0 (0%)
(0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

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