Please respond with a 150 words per statement. APA format

Question 1

The Institute of Medicine has stated a goal that 90% of practice be evidence-based by 2020. According to HealthyPeople.gov, the United States is currently at approximately 15%. Discuss two barriers that might hold nursing practice from achieving this goal, and suggest ways in which identified barriers may be addressed.

Statement 1

Two barriers to reach the institute of Medicine’s goal of 90% of practices be evidence based would be

1) information access and use

2) lack of time to research and read research

Regarding information access and use, Miller, Graves, Jones, & Sievert, 2010 believe that most nurses do not have the skills to access, manage, and evaluate information effectively. Deciphering what are legitimate sources of information may be the greatest challenge. Miller et al., 2010 supports the use of Information and Communication Technology (ICT) Literacy and studied its effectiveness. The study provided evidence that there was the greatest improvement in what the participants of the study felt was most valuable, learning how to evaluate the credibility of websites. One of the barriers to the new found learned skills in this study was the limited amount of time these nurses had at work to perform these searches, which brings me to number two on the list, lack of time. In a study performed by Majid, Foo, Luyt, Zhang, Theng, Chang, & Mokhtar, 2011 they found that 64% of nurses had positive attitude about using evidence-based practice (EBP) but felt that they lack the time in researching the data citing that more than 53% surveyed stated that the major barrier to their adoption of EBP was lack of time. Although Clinical Nurse Leaders (CNL) are a new addition to advanced nursing practice I think there is much benefit in using them in the education of nurses, having them do the leg work in the research and presenting the data to there staff members. I of course believe that all nurses need to know how to pull their own credible research, but having the CNL implement workshops, providing nurses with the tools they need to be educated in the advancements in healthcare. I feel this would remove the barrier of the time it takes for individual nurses having to do their own research at work. I do not work in a hospital I work in a community clinic and we have a risk and quality department lead by a CNL that does this very thing and it works great! Also my company pays for CME/CEUs that allows us to stay up to date in the latest information.

Respond with 150 word response

Statement 2

Evidence based practice has been a buzzword in healthcare. Many profession as seeking to validate treatments in an effort to optimize time and resources. Certain treatments may not be effective or should be used as a last resort. Evidence based practice can improve patient outcome and allow us to be more systematic in terms of treatment. Resistance can be a significant barrier to evidence based practice (Patient Safety & Quality Healthcare, 2015). It requires an investment of time and multidisciplinary leadership and integrated clinical decision in order to make it work. Sometimes facilities may input policy without thought or with little support. In order to effectively overcome barriers I believe education and in services can be helpful. This can help to break the culture of resistance. Education can also help dispel myths that a new practice is harder than the current practice of the facility. Another factor that limits the opportunity for evidence based practice is the lack of time to implement practice (Shifaza, Evans, & Bradely, 2014). Facilities often try to maximize productivity which can leave little time for discussion of current practice. It require time to educate and to have meeting to discuss issues that are going on. A workgroup can discuss about problem areas this can allow for research to best practice. Allowing for time can also facilitate buy in for those that are resistance to change.

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Statement 3

The goal of implementing 90% of practice from evidence-based research by 2020 is both obtainable and important. The Olsen, Goolsby, and McGinnis (2009) article discusses that even though it is agreed upon by medical professionals, evidence-based practice is not implemented as it should be. I believe one of the biggest barriers to this implementation is the time it takes to change policy and procedures within major corporations. By the time new procedures are established, new or challenging research is being published. Another barrier to the implementation of evidence-based practice is that change is difficult for people, but vital in the healthcare industry.

To overcome these barriers, companies need to expedite changes in a timely matter. This would require personnel to be continuously staying up to date on researching, writing, and teaching new policies and practices. The healthcare culture in the US and individual companies will need to expect this higher standard of care. As change becomes more common, employees will become more receptive. Creating a culture of change is not easy, but important to provide effective and safe care.

Respond with 150 word response