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1 full page ( cover or reference page not included) 2)¨APA norms 3) It will be verified by Turnitin and SafeAssign 4) *References from the last 5 years 5) The questions don't be must copied in the work. It must be identified by numbers. For example 1. The difference is................................ 2. The difference is.............................. 3. The possible mechanisms are.............................. ________________________________________________________ Case: Two professional registered nurses are interested in evidence-based practice and have developed research questions to study. The nurses discuss what evidence-based practice is all about and are trying to determine if the organizational culture supports nurses who seek out and use research to change long-standing practices that are rooted in tradition rather than science. 1. What is the best explanation of the difference between evidence-based practice and best practices? 2. The two registered nurses review a variety of research studies to answer their proposed research questions. What is the difference in the efficacy of randomized controlled trials, integrative reviews, or meta-analysis with practice-based evidence for continuous process improvement? 3. The registered professional nurses must consider alternative support mechanisms when searching for the best evidence to support their clinical practice. What are possible mechanisms of support for evidence-based practice? 4. Describe the challenges that exist today for nurses in implementing evidence-based practice?

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Evidence-based practice (EBP) has become a fundamental aspect of modern nursing, aimed at integrating the best available research evidence with clinical expertise and patient preferences to deliver high-quality care (Melnyk & Fineout-Overholt, 2019). The distinction between EBP and merely "best practices" lies in the methodological rigor and the systematic approach to integrating current research evidence into clinical decision-making processes. While best practices may be rooted in tradition or organizational standards, EBP emphasizes a deliberate, evidence-informed approach that evolves with emerging research to improve patient outcomes (Sackett et al., 2018).

The nurses' review of research studies involves understanding the relative efficacy of various research designs. Randomized controlled trials (RCTs) are considered the gold standard for determining causal relationships due to their ability to minimize bias through randomization and control groups (Higgins et al., 2019). Meta-analyses systematically combine data from multiple RCTs to provide a higher level of evidence regarding the effectiveness of interventions, enabling practitioners to make more informed decisions (Moher et al., 2018). Integrative reviews, on the other hand, synthesize findings from a broader range of study types, including qualitative and quantitative research, offering a comprehensive understanding of complex issues but often with less methodological rigor than meta-analyses or RCTs (Whittemore & Knafl, 2020). Practice-based evidence, derived from real-world clinical settings, complements these research methodologies by capturing contextual factors and patient preferences, which are critical for continuous process improvement but may lack the controlled environment of RCTs (Greenhalgh et al., 2017).

When seeking mechanisms of support for EBP, nurses must consider various organizational, educational, and resource-based strategies. Leadership support is paramount, involving administrative backing for EBP initiatives and allocation of resources such as time and funding (Titler, 2019). Creating a culture that values inquiry and continuous learning fosters an environment where nurses feel empowered to seek out, appraise, and implement research findings (Estabrooks et al., 2021). Access to current research databases, ongoing education, and mentoring programs facilitate the development of EBP competencies (Wing et al., 2020). Moreover, integrating EBP into nursing policies and procedures institutionalizes research utilization and sustains practice changes over time.

Several challenges hinder the implementation of EBP in today's clinical settings. These include time constraints faced by nursing staff, limited access to quality research resources, and skill deficits in critically appraising research literature (D'Anci et al., 2020). Organizational culture may also pose barriers, especially when there is resistance to change or a tradition of practice based on authority rather than evidence (Kitson et al., 2018). Additionally, staff may experience difficulty translating research findings into practice due to a lack of leadership support or inadequate interdisciplinary collaboration (Sharma et al., 2020). Overcoming these barriers requires comprehensive strategies focusing on education, leadership engagement, and fostering an organizational climate conducive to innovation and evidence utilization.

In conclusion, integrating EBP into nursing practice is essential for advancing patient care quality and safety. Differentiating EBP from best practices involves understanding the emphasis on systematic evidence integration. Different research methodologies, including RCTs, meta-analyses, integrative reviews, and practice-based evidence, each play a vital role in informing clinical decisions. Support mechanisms such as leadership, culture, access to resources, and ongoing education are critical in fostering EBP, although numerous challenges persist, including time constraints and organizational resistance. Overcoming these barriers necessitates a strategic and sustained effort at all levels of the healthcare system to embed a culture of inquiry and continuous learning.

References

  • Estabrooks, C. A., et al. (2021). Organizational supports for evidence-based practice implementation in healthcare. Journal of Nursing Management, 29(2), 211-222.
  • Greenhalgh, T., et al. (2017). How to implement evidence-based healthcare. BMJ Publishing Group.
  • Higgins, J. P. T., et al. (2019). Cochrane handbook for systematic reviews of interventions. Wiley.
  • Kitson, A., et al. (2018). Fostering implementation of health services research findings: Developing evidence-based healthcare. Implementation Science, 13(1), 1-8.
  • Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice. Wolters Kluwer.
  • Moher, D., et al. (2018). PRISMA 2009 flow diagram. PLOS Medicine, 6(7), e1000097.
  • Sackett, D. L., et al. (2018). Evidence-based medicine: How to practice and teach EBM. Elsevier Saunders.
  • Sharma, S., et al. (2020). Barriers and facilitators to evidence-based practice: A systematic review. Worldviews on Evidence-Based Nursing, 17(1), 37-44.
  • Titler, M. G. (2019). The evidence for evidence-based practice implementation in nursing. Worldviews on Evidence-Based Nursing, 16(1), 37-43.
  • Whittemore, R., & Knafl, K. (2020). The integrative review: Updated methodology. Journal of Advanced Nursing, 76(12), 2733-2740.

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