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Furthermore, implementation of ebp were significantly predicted by rn knowledge (p<0.001), beliefs (p<0.001) and readiness (p<0.001).

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Responses to Other Students: make separate Respond to the 2 of your fellow classmates with at least a 250-word reply about their Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following questions:
What did you learn from your classmate’s posting?
Cindy Killingsworth’s Post:
We learn from our mistakes this is why I feel evidence-based practice is one of the best ways for us to validate the accuracy of our healthcare decisions. Evidence-based practice is based on trial and error this is based on knowledge from others who have already walked the miles to try to figure out what’s going on with the patient. This is the same path we travel in our personal lives. We learn from our mistakes in our every day lives as well. But as we continue to work in healthcare, we are able to become experts in some fields based on our knowledge. We learn from each other, and teach each other we all work as a team. As clinicians, we have to be aware of changes and be willing to change along with medicine. I remember when I was first in nursing school, and I felt like I knew nothing. I thought I had to know every type of medicine’s side effects and use. I felt like all nurses and doctors knew everything about the body from head to toe, inside and out. I was very scared, however, I wanted to learn as much as possible. Over the years, I have learned no one knows everything.“The main goal of EBP is the optimization of healthcare based on the integration of clinical expertise, patient values, and well-thought-out quality of scientific evidence that is followed in a clinical setting regarding a disease or a condition by all medical professionals, including NP [47]. The quality of evidence is based on the availability of scientific data and often described as the EBM triangle that demonstrates the build-up of evidence from observational studies up to meta-analysis data for clinical appraisal” (Spanakis, M., Patelarou, A. E., & Patelarou, E.)(2020)
I see now why doctors specialize in certain things instead of one physician doing everything like in the past. Continuing my education has been the number one thing for me to learn. I have learned the most from evidence-based practice and reached out to others with experience and knowledge. “Evidence-based practice is the use of the most relevant empirical evidence from research, clinician expertise, and patient values and preferences (Ackermann, Porter O’Grady, & Melnyck, 2018)” When I research a disease, I’ll make sure that I look for information and accredited journalist. Scholarly articles and peer-reviewed information or two of the things I look for in my research. With the years of experience that I have, I can pretty much diagnose a patient when they come in to triage at the hospital. 95% of the time, we know what’s wrong with them, but it’s just their symptoms without having to run a new test. After we do our test, we know exactly what’s wrong 99 percent of the time.. As healthcare providers, we can pick out a kidney stone or appendicitis by patients presenting symptoms.This is done by our clinical experience and knowledge. We are fortunate enough now to have the World Wide Web to give us the best access to verifying necessary information instead of going back and looking through a medical textbook. “The education of NP should be adjusted to the requirements of modern medicine. “(Spanakis, M., Patelarou, A. E., & Patelarou, E.)(2020) The use of computer programs assist with staying up to date.”Evidence-based practice (EBP) is an approach that guides the decision-making of healthcare personnel to use the best available research evidence along with clinical expertise, and the unique values and preferences of the patient .”(Patelarou, A., Schetaki, S., Giakoumidakis, K., Lialiou, P., & Patelarou, E. (2021))
Janice Arevalo’s Post:
Unit 1 – Discussion Board 2 Like Post
Being a lifelong learner has worked well in my chosen profession of nursing. I’m constantly learning at school, work, and in my personal life. I learn and gain knowledge in a variety of ways from print such as textbooks, journals, and magazines; to electronic methods such as websites, social media, and videos; to people such as teachers, coworkers, and friends. With so many ways to gain and obtain knowledge, it’s important to ensure the information is legitimate and accurate. In general, I determine the validity of information based on the credibility, timeliness, and evidence from the source. According to Melnyk and Fineout-Overholt (2018), evidence or the best information can be obtained by utilizing the PICOT question for guidance, PICOT standing for population, intervention or issue, comparison, outcome, and time for the intervention to attain the outcome.
The hierarchy of evidence model lists levels of evidence, with lower risk for bias and generalized evidence/ broader group at the first level and continues downward to least reliable (Melnyk and Fineout-Overholt, 2018). The highest, most reliable level of evidence can be obtained at the first level of systematic reviews. Following that is level two, which includes randomized controlled trials; level three, which are non-randomized controlled studies; level four, which includes controlled cohort studies; and level five, which are uncontrolled cohort studies. Level six includes case studies, qualitative/ descriptive studies, and evidence-based practice (EBP) implementation/ quality improvement (QI) projects. The lowest level of evidence, level seven, is expert opinion.
In my professional role as a nurse, I prefer to obtain information from systemic reviews. However, most of the time I acquire knowledge and information from randomized/ non-randomized controlled trials and controlled/ uncontrolled studies because there appears to be more of them compared to systemic reviews. I find this to be the case as I conduct most of my research online through databases such as EBSCOhost, UpToDate, and health organizations. I know the information is accurate because they are within the upper levels of the hierarchy of evidence model, are peer-reviewed, from scholarly journals, and current within five years. For example, when providing patient education, I find it best to obtain information from trials or studies. I had patients inquire about lowering their cholesterol with red yeast rice (RYR) instead of statins and was able to provide them with evidence-based information supporting the success of RYR. I can reference the data from Ruscica et al. (2019), who conducted a 12-week randomized, double-blind, placebo-controlled study of 30 participants that showed significant improvement of participants’ lipid panel with the use of an RYR/ Bifidobacterium longum BB536 probiotic combination (p<0.0001).
When caring for a patient with a disease or medication that I need further knowledge on, I utilize UpToDate to gather data on presentations, treatment, and medication administration. For my personal life as an individual, I gain knowledge through lower levels because the information I seek are normally basic things that don’t require systemic reviews or studies, such as disease symptoms and lab interpretations. I seek information from expert opinions and health organizations such as the Mayo Clinic and Centers for Disease Control and Prevention (CDC). For example, when I receive personal lab results that are abnormal, I use Mayo Clinic’s website as my source for interpretation and treatment options. Another example is regarding Covid-19. I use the CDC to gather the latest information on testing guidelines and isolation precautions. Lastly, I also gain knowledge through continuing education courses.
A best practice to gain knowledge, specially in the nursing field, is to follow the five A’s of EBP. This includes asking a question, acquiring information, appraising and applying the evidence, and assessing the outcome (Colorado Technical University College of Nursing, 2022). For EBP to succeed, organizations should create that culture in practice. Yoo et al. (2019) studied 521 registered nurses (RNs) from a hospital in Korea to determine staff knowledge, beliefs, readiness, and factors to implement EBP successfully. Utilizing questionnaires, their results show RNs had positive levels of beliefs; but their knowledge, readiness, and implementation level were not sufficient. Furthermore, implementation of EBP were significantly predicted by RN knowledge (p<0.001), beliefs (p<0.001) and readiness (p<0.001). They conclude administrators should reduce barriers, increase implementers, and training when initiating and establishing EBP.


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