Nursing & Health Sciences Research Essay
Read the article What’s in a Name and give a brief summarize the article and include any key points you find important and interesting.
Word count: 250 minimum – 500 maximum Nursing & Health Sciences Research Essay
References must be in APA format
Participants of the Institute of Medicine’s
Roundtable on Evidence-based Medicine have
identified that “by the year 2020, 90 percent of clinical
decisions will be supported by accurate, timely, and upto-date clinical information, and will reflect best
available evidence” as a goal (Institute of Medicine,
2009). The committee felt every American should have
as an expectation, at a minimum, this level of
performance with health care delivery. Using resources
already available to them, each organization should be
able to motivate and track their progress.
One of the challenges healthcare providers have in
meeting the IOM’s 2020 goal is a difficulty
differentiating between performance improvement
(PI), evidence-based practice (EBP), and research. The
terms performance improvement, evidence-based
practice, and research are frequently used inaccurately
and interchangeably with evidence-based practice
appearing to be the most misused of the three terms.
The common goal between PI, EBP, and Research
is to provide care to patients based on scientific
evidence and meet the patient’s needs. The final result
is the same; they all should lead to improving clinical
outcomes. Determining which process to use will be
defined by what one wants to know. Questions that
seek to answer a system issue, evaluate processes of
care, or improve care delivery are addressed using
quality improvement processes. Those that focus on
how well existing science is used in care are evidencebased processes and those generating new knowledge
about under-explored areas are answered using
research methodologies. Nursing & Health Sciences Research Essay The purpose of this article is
to review the distinction between performance
improvement, evidence-based practice, and research.
The Centers for Disease Control and Prevention
(2015) indicated that hospitals use a variety of terms to
address similar principles (i.e., continuous quality
improvement, quality improvement, performance
improvement, six sigma, and total quality
management). Performance improvement (PI) is
comprised of systematic and continuous activities that
result in measurable improvement in health care
services and the outcomes of an identified group of
patients (Health Resources and Services
Administration, 2011). Donabedian (1966) proposed
three components of health care quality when evaluating the quality of health care; structure, process, and
outcome. He defined structure as the settings,
qualifications of providers, and administrative systems
through which care takes place; the organization’s
resources. Process is defined as the components of care
delivered; how the system works and specific measures
for aspects of care. Outcome is defined as recovery,
restoration of function, and survival; the final product
or outcome. (Donabedian, 1966). These concepts
remain the foundation of quality assessment today.
There are several defined methodologies used to
conduct PI projects. Our organization most commonly
uses the plan, do, check, act or PDCA cycle which is
based on Demming’s PDSA (plan, do, study, act)
Model (The W. Edwards Deming Institute®, 2016).
This is a four-step model of facilitating change usually
depicted in a circle representing no end; it should be
repeated again and again for PI and monitoring
sustainability. The Agency for Healthcare Research and
Quality (2013) defines the steps in the PDSA cycle as:Nursing & Health Sciences Research Essay
Prentiss and Butler: What’s in a Name: Performance Improvement, Evidence-Based Practic
Published by Scholarly Commons @ Baptist Health South Florida, 2018
Step 1: Plan—Plan the test or observation,
including a plan for collecting data. In order to
determine what should be done to correct the problem
you would need to identify the problem and analyze the
problem determining the root causes.
Step 2: Do—try out the test on a small scale.
Identify recommendations by the team to correct the
problem. Put the plan into action on a small scale.
Collect data and track successes or make changes to the
plan as necessary.
Step 3: Check—set aside time to analyze the data
and study the results. The question you want to ask is,
has the improvement been sustained? If not further
actions may be required.
Step 4: Act—refine the change, based on what was
learned from the test. Communicate results to
stakeholders. If changes are required repeat the PDCA
cycle until the desired results are achieved.
The following is an example of a PI question. For
patients who develop a hospital acquired pressure ulcer,
was there consistent implementation of the skin care
There are numerous definitions of evidence-based
practice (EBP) with most of them very similar.
Evidence-based practice has been defined as “a
science-to-service model of engagement of critical
thinking to apply research-based evidence (scientific
knowledge) and practice-based evidence (art of
nursing) within the context of patient values to deliver
quality, cost-sensitive care (2014 Magnet® Application Manual, p. 67). Apel and Self (2003) describe
evidence-based practice as the marriage of research and
clinical services. It is about translating the evidence
and using it to make patient-care decisions
(Connor,2014). The majority of the best evidence
comes from the research; however, it may come from
patient/family preferences and values, clinical
expertise, and experts in the field.
Multiple EBP models are available to guide nurses
through implementation of an evidence based practice
change including the John Hopkins Nursing EvidenceBased Practice Model (Dearholt & Dang, 2012), the
Iowa Model (Titler et al., 2001), and the Star Model of
EBP: Knowledge Transformation (Stevens, 2012).
Baptist Health South Florida (2011) has developed its
own model to guide practice changes, Clinical
Excellence Through Evidence-Based Practice
(CETEP). This model mirrors Sackett et al. (1996) five
steps to EBP and contains the necessary components to
be considered when making a practice change (Figure
1).Nursing & Health Sciences Research Essay
The CETEP model is comprised of five steps
Step 1: Define the clinical practice question. It is
important for nurses to formulate a searchable question
that focuses on the population of interest (P), the
intervention that you are interested in knowing more
about (I), a comparison intervention if applicable (C)
and lastly, the outcomes you hope to achieve (O).
Using PICO to guide your question development will
result in finding research applicable to your topic. An
example of a searchable question using the PICO
format is: For medical/surgical nurses (P) will
implementation of a pet visitation program (I) decrease
Step 2: To assess the critical appraisal components.
Using the PICO question, the next step is to search for
and critically appraise the literature. The BHSF
medical library is a tremendous resource for nurses
wanting to make an EBP change. A request for a
literature search can be sent to the library staff using the
PICO question. Within 24-48 hours the library will
send a list of abstracts based on your PICO question.
From the abstracts you will select the most pertinent
articles and request from the library the full text article.
A systematic assessment of the research evidence is
then conducted to determine if the study is valid,
relevant to your setting, as well as what the results mean
for your population? The research then needs to be
combined to determine if they come to similar
conclusions supporting the EBP practice change.
Journal of Nursing and Health Studies (ISSN: 2574-2825) is an open access journal which provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy and research methods relevant to nursing, midwifery and other health related professions.Nursing & Health Sciences Research Essay
Journal of Nursing and Health Studies aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. Journal of Nursing and Health Studies focus on topics related to Healthcare Online Services, Health Literacy, Malpractice Risk, Patient Safety, Diagnostic Accuracy, Healthcare Financing, Nursing, Healthcare Materials, Health Informatics, Healthcare Policies, Health Promotion.
The journal particularly welcomes studies that aim to evaluate and understand complex health care interventions and health policies and which employ the most rigorous designs and methods appropriate for the research question of interest. The journal also seeks to advance the quality of research by publishing methodological papers introducing or elaborating on analytic techniques, measures, and research methods.Nursing & Health Sciences Research Essay
Authors may submit their manuscript via online tracking system through https://www.imedpub.com/submissions/nursing-health-studies.html or as attachment to email@example.com
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