NUR 590 Benchmark Project Topic 4 Discussion Questions

NUR 590 Benchmark Project Topic 4 Discussion Questions

NUR 590 Benchmark Project Topic 4 Discussion Questions

Topic 3 DQ1 – Significance of Frameworks or Models

EBP encourages the integration of high-quality and quantitative research findings, and clinical expertise to make individualized clinical decision-making to positively influence patient care while reducing the cost of care. For the successful integration of an EBP, there is a need for the existence of a readiness culture through leadership support, availability of resources, and adoption of an appropriate framework. The use of frameworks forms the basis for the generalizable implementation of scientific knowledge through the enhanced description of the problem, guides analysis, and enhances periodic evaluation of implementation efforts (Duff et al., 2020 NUR 590 Benchmark Project Topic 4 Discussion Questions).

NUR 590 Benchmark Project Topic 4 Discussion Questions

Models ensure quick incorporation of the latest research findings into patient care. As a result, the framework guides decisions made throughout the research while guiding perception towards research, analysis, data interpretation. Therefore, organizations must choose models that best fit care context aligning with improvement goals, addressing priority clinical problems, and guiding systematic approach that enhances collaborative change practice.

Failure to adopt an appropriate model in implementing EBP may lead to research bias. Bias results from skewing the intended process by introducing a systemic error tailored towards a specific outcome (van der Steen et al., 2019). Bias can be addressed in terms of information, selection, or confounding bias. Choosing an inappropriate model that fails to align with the research goals will likely distort intended outcomes that may cause errors. Errors in EBP will negatively impair clinical decision-making that negatively affects the quality of care and patient satisfaction.

NUR 590 Benchmark Project Topic 4 Discussion Questions References

  • Duff, J., Cullen, L., Hanrahan, K., & Steelman, V. (2020). Determinants of an evidence-based practice environment: an interpretive description. Implementation Science Communications, 1(1), 85. https://doi.org/10.1186/s43058-020-00070-0
  • van der Steen, J. T., ter Riet, G., van den Bogert, C. A., & Bouter, L. M. (2019). Causes of reporting bias: a theoretical framework. F1000Research, 8, 280. https://doi.org/10.12688/f1000research.18310.2

Topic 3 DQ2 – Framework and Models for Evidence-Based Practice

Several EBP frameworks and models exist, each strives to address different concepts that can be used in integrating an EBP project into practice. Few known models include Lowa Model for EBP to promote quality care, advancing research and clinical practice through the close collaboration model (ARCC), the John Hopkins nursing EBP model, and the promoting action on research implementation in health services (PARIHS) framework (Huybrechts et al., 2021 NUR 590 Benchmark Project Topic 4 Discussion Questions). These models have been used in various settings resulting in tremendous results, with none being superior to either. Each model outlies the importance of a systematic approach to EBP change.

Understanding the needs and importance of each model will help decide the best model for EBP implementation.  For instance, the Lowa model addresses EBP sustainability, implantation of interprofessional change, and patient-centered care by all clinicians while encouraging a multiphase, team-based approach. Spirit of inquiry is essential in identifying a clinical problem and identifying decision points while offering evaluative feedbacks to identify loops to facilitate the implementation of change (Huybrechts et al., 2021 NUR 590 Benchmark Project Topic 4 Discussion Questions). The phases of the model include interprofessional team formation, literature review, critique, and synthesis; carrying out piloting for implantation; continuous evaluation; and dissemination of outcomes.

            My model of choice is the ARCC model. Unlike the Iowa model, this model focuses on resource building and training of mentors who enable implementation and sustaining an EBP within an organization and point-of-care (Melnyk et al., 2017). I believe that training champion nurses to educate and monitor other clinical teams will help in the implementation of daily bathing of central lines as the practice of infection prevention. Furthermore, the model has seven major steps; cultivating a spirit of inquiry; development of PICOT question; collecting, critical appraisal, integrating EBP with patient preference and clinical expertise; and continuous evaluation and dissemination of change practice. These steps provide a well-structured pathway if adhered to can lead to the success of an EBP project.

References

  • Huybrechts, I., Declercq, A., Verté, E., Raeymaeckers, P., & Anthierens, S. (2021). The building blocks of implementation frameworks and models in primary care: A narrative review. Frontiers in Public Health, 9, 675171. https://doi.org/10.3389/fpubh.2021.675171
  • Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A test of the ARCC© Model improves implementation of evidence-based practice, healthcare culture, and patient outcomes: A test of the ARCC© model improves implementation of evidence-based practice. Worldviews on Evidence-Based Nursing, 14(1), 5–9. https://doi.org/10.1111/wvn.12188

Topic 4 DQ1 – Research design and data collection tool

In this project, I would prefer using a quantitative research design over a qualitative design. Quantitative research is feasible because it allows for the systematic collection of information using verified sampling methods such as questionnaires and surveys. In addition, quantitative research helps in measuring variables, analysis, and reporting the relationship between variables by using structured methods on a sample that represents an entire population. Also, quantitative research allows for the use of a larger sample size which can be organized in numerical that is easily quantifiable. Furthermore, quantitative designs are designated to meet specific objectives of understanding the subject matter, analyzing, describing the situation, and making future predictions based on the current results (Hammoudeh et al., 2018). The objectives, logic, numbers, and detailed unchanging data allow for convergent reasoning to make sense out of a situation. Unlike qualitative design, the quantitative design allows the researcher to arrange research statistics into non-textual forms including charts, figures, and tables. These non-textual forms are easy to interpret and offer conclusive information.

  I would prefer using the prospective cohort study that would allow grouping patients into two groups; cases and control. Cases would receive the daily bathing with chlorhexidine, unlike the control who would use normal saline. Each patient bath would be entered in the nursing flow sheet of the patient medical records. Nurses would educate patients on how to bathe as well as the importance of daily bathing.  Both groups would be followed over time to determine the number that developed an infection. Finally, a comparison would be made to determine the effectiveness of the intervention.

On the other hand, the collection of data would be achieved using questionnaires, daily temperature measurements, reviewing medical records, and laboratory tests. Questionnaires are relatively cheap and easy to use while providing a larger amount of information. Closed-ended questions help in the collection of quantitative data that is easy to analyze (Haddadin et al., 2021 NUR 590 Benchmark Project Topic 4 Discussion Questions). The data collected using questionnaires include demographics, immunity status, nurses’ knowledge on EBP, attitude about EBP, indication for central-line, adherence to bathing, and outcome of patients. These data will help come up with numerical figures that will be analyzed to give a relationship between variables.

Daily temperature measurement would be used to detect patients with infections. Those with high temperatures would be subjected to undergo blood culture, complete blood count, and erythrocyte sedimentation rate (ESR). Positive cases would be defined as patients with symptoms with either positive culture growth, elevated neutrophil count on complete blood count, or elevated ESR levels.

References

Topic 4 DQ2 – Statistical Test

The incidence of new infections would be tracked by the infection prevention surveillance system. Then the data collected would be grouped to determine the mean, median, and mode. The data would then be presented in the form of tables, charts, and bar graphs after analysis with a statistical package for social science (SPSS). SPSS is powerful in manipulating and deciphering complex data to facilitate data analysis.

The baseline clinical outcomes of the study groups would be determined by analyzing continuous variables and using the chi-square test for categorical variables. The Chi-square test is important in testing hypotheses; either null or alternate (Mishra et al., 2019 NUR 590 Benchmark Project Topic 4 Discussion Questions). It is also helpful in determining the association between two categorical variables. Furthermore, it tests the probability of dependence of different classified variables. In this case, the test would help determine if there is a correlation between using either chlorohexidine or normal saline with the occurrence of central-line infections.

  A cumulative incidence function curve would be generated using findings from the study groups. Significant bloodstream infections would be determined from patients admitted in the intensive unit until discharge from the ICU. Hospital stay would be used in calculating incidence curves. This is because the development of bloodstream infection is a factor of hospital stay and patient immunity status. Death, discharge, or transfer from the unit would be considered as competing risk. Finally, a P-value of < 5 would be considered statistically significant hence supporting the implementation of the EBP project

References

  • Mishra, P., Pandey, C. M., Singh, U., Keshri, A., & Sabaretnam, M. (2019). Selection of appropriate statistical methods for data analysis. Annals of Cardiac Anaesthesia, 22(3), 297–301. https://doi.org/10.4103/aca.ACA_248_18

Topic 5 DQ1 – Barriers of Implementing an Evidence-Based Project

There are several barriers to implementing evidence-based practice (EBP). These barriers can either be individual-related or institution-related. Individual-related barriers include lack of knowledge about EBP, time constraints, refusal to adopt change, lack of access to EBP information, criticism from colleagues, mistrust in evidence, and misconception of perceiving EBP projects as being tough. Institutional-related barriers include lack of resources, limited champion nurses to implement change, insufficient infrastructure, failure of approval of an EBP project, limited administration support, and organizational feuds (Yoo et al., 2019 NUR 590 Benchmark Project Topic 4 Discussion Questions). All these factors collaborate in various capacities to impact EBP implementation.

One of the major barriers to EBP implementation is the resistance to change. More than often, nurses and other healthcare providers are always resistant to adopting new changes in the health system. This may be attributable to a lack of knowledge about the proposed EBP and may prefer using outdated procedures (DuBose & Mayo, 2020). Furthermore, fear of criticism and uncertainty about the effects of the change may further hinder the adoption of change.

The staff may also perceive the change as overwhelming and unprecedented. As a result of resistance, members are unlikely to be actively involved in implementing change citing a lack of knowledge, morale, and confidence in the proposed change. Therefore, impaired perception to change results in slowed uptake of the proposed change with resultant effects in decision-making. Furthermore, resistance to change may lead to personal and organizational conflict leading to unrest and negatively affecting the quality of services to patients. Finally, impaired implementation of an EBP impairs its effectiveness and relevance to encourage quality care and improve patient outcomes

References

DuBose, B. M., & Mayo, A. M. (2020). Resistance to change: A concept analysis. Nursing Forum, 55(4), 631–636. https://doi.org/10.1111/nuf.12479

Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS One, 14(12), e0226742. https://doi.org/10.1371/journal.pone.0226742

Topic 5 DQ2 – Stakeholder Barriers and Strategies to gain stakeholder support.

Stakeholders are important members of an EBP project as they actively take part through the provision of resources, skills, and knowledge required for the success of an EBP project. Stakeholders include nurse managers, physicians, informaticists, nurses, social workers, and laboratory technicians among others. However, their involvement may either facilitate or act as a barrier to the implementation of an EBP project. For instance, stakeholder barriers include resistance to change, misunderstandings between colleagues, mistrust between members, and internal feuds (Bach-Mortensen et al., 2018). These barriers can severely impair the improvement of the research enterprise, increase clinical uncertainty, limit the implementation, and adoption of meaningful clinical findings.

The importance of stakeholders can not be overlooked in clinical practice, therefore, it is prudent that their support is gained to enhance the EBP project. Various strategies can be put in place to gain support. The first strategy is effective communication; this is achieved through effective listening of stakeholders’ input, considering those input, and providing detailed information regarding the objectives while citing why the proposed change is vital as compared to others (Quanbeck, 2019 NUR 590 Benchmark Project Topic 4 Discussion Questions). Furthermore, illustrative communication should be provided regarding the budget, scope of the project, and required resources to ensure the success of the project. Consistency of the message communicated should be maintained to avoid contradictions that may bring doubt and resistance.  Secondly, integrity and accountability should be upheld at all levels of the project.

 Thirdly, meetings and workshops should be organized for stakeholders who refuse change. During the meetings, their views should be considered while training and education are provided to equip them with knowledge and skills to understand the various aspects of the EBP; this will enable them to understand and adopt the change. Finally, there is a need to use a data management system to summarize key information for ease of understanding and gather support. Therefore, any colleague struggling with stakeholder support should first begin by identifying the correct stakeholders, communicating effectively, listening keenly, involving stakeholders’ input, leading with integrity, encouraging team spirit through working closely, and maintaining consistency of message delivered.  

References

Bach-Mortensen, A. M., Lange, B. C. L., & Montgomery, P. (2018). Barriers and facilitators to implementing evidence-based interventions among third sector organizations: a systematic review. Implementation Science: IS, 13(1). https://doi.org/10.1186/s13012-018-0789-7

Quanbeck, A. (2019). Using stakeholder values to promote the implementation of an evidence-based mobile health intervention for addiction treatment in primary care settings. JMIR MHealth and UHealth, 7(6), e13301. https://doi.org/10.2196/13301

Topic 6 DQ1 – Influence of Gaps on Research

Gaps are missing pieces of information that are under-explored identified from the literature. The identified gaps are used in carrying out future researches while trying to answer the missing pieces (Hempel et al., 2019). During my literature search, I identified some gaps which could prompt future research. For instance, in single-centered studies where the sample sizes were small. The small sample sizes could not be used as a presentation of the entire population or centers with larger sample sizes. Therefore, future researches could focus on doing multi-centered studies with larger sample sizes that can be used to give the real prevalence while improving the surveillance system. Another gap is uncertainty to compliance with the usage of an EBP. Compliance with chlorohexidine, for instance, requires routine daily bathing and using the appropriate technique while applying chlorohexidine. The urge to train and educate nurses on the correct methodology of application and adhering to practice could prompt the development of a research project to address the issue. It is imperative to note that compliance requires periodic reminders, demonstrations, and training on how to carry out the practice. EBP project may target small group training and education on compliance and its effectiveness.

In addition, failure to evaluate the cost-effectiveness of an EBP in different settings is another identifiable gap (Giri et al., 2021). The cost-effectiveness of using chlorohexidine has been evaluated in various critical settings, however, there is a lack of evidence of its cost-effectiveness in non-critical settings. the clinical findings from critical units can not be used as a representation of non-critical settings due to differences in prevalent infections. Therefore, there is prompt to carry out researches to help in the implementation of an EBP in such settings and evaluate its effectiveness

References

Giri, V. K., Kegerreis, K. G., Ren, Y., Bohannon, L. M., Lobaugh-Jin, E., Messina, J. A., Matthews, A., Mowery, Y. M., Sito, E., Lassiter, M., Saullo, J. L., Jung, S.-H., Ma, L., Greenberg, M., Andermann, T. M., van den Brink, M. R. M., Peled, J. U., Gomes, A. L. C., Choi, T., … Sung, A. D. (2021). Chlorhexidine gluconate bathing reduces the incidence of bloodstream infections in adults undergoing inpatient hematopoietic cell transplantation. Transplantation and Cellular Therapy, 27(3), 262.e1-262.e11. https://doi.org/10.1016/j.jtct.2021.01.004

Hempel, S., Gore, K., & Belsher, B. (2019). Identifying research gaps and prioritizing psychological health evidence synthesis needs. Medical Care, 57 Suppl 10 Suppl 3(Suppl 3), S259–S264. https://doi.org/10.1097/MLR.0000000000001175

Topic 6 DQ2 – Difference between Statistical and Clinical Significance

Implementation of an evidence-based project requires the understanding and interpretation of research findings. Therefore, understanding clinical and statistical significance is important in result interpretation and enhancing the implementation of an EBP. Statistical significance implies the likelihood of something happening and not solely happening by chance (Fleischmann & Vaughan, 2019 NUR 590 Benchmark Project Topic 4 Discussion Questions). As a result, statistical significance implies that research findings are likely to be true and not occur by chance.

            The probability value (p-value) is used to illustrate the likelihood of a specific result occurring at random, but not the actual variation between the variables. When the probability value created during the analysis is less than the level of confidence required by the researcher, the results are statistically significant. In research studies including evidence-based practice, probability values are typically set at 0.05, implying a 5% chance that the outcome was not produced by chance and a 95% certainty that the factors evaluated in the study have an actual relationship.

Clinical significance on the other hand verifies the extent to which something is happening. It is essentially a subjective assessment of study findings as relevant to the patient under the care and hence likely to impact healthcare provider behavior (Fleischmann & Vaughan, 2019)When medical specialists believe discovery is significant enough to be medically important, it is referred to as a clinically significant result.

Statistical significance must always be established before clinical significance can be evaluated in evidence-based research. Clinical significance, on the other hand, is frequently a subjective assessment that cannot be determined by a single sensory test. By ensuring that the result is statistically significant, I may leverage clinical significance to support favorable results in my project outcome. This is because the vast majority of statistically significant findings have therapeutic implications.

References

Fleischmann, M., & Vaughan, B. (2019 NUR 590 Benchmark Project Topic 4 Discussion Questions). Commentary: Statistical significance and clinical significance – A call to consider patient-reported outcome measures, effect size, confidence interval, and minimal clinically important difference (MCID). Journal of Bodywork and Movement Therapies, 23(4), 690–694. https://doi.org/10.1016/j.jbmt.2019.02.009

Topic 7 DQ1 – Dissemination of EBP Proposal

Dissemination of an evidence-based practice proposal targets circulation of knowledge to various stakeholders and the organization aimed at acquiring support towards the project. The major objective of disseminating the EBP proposal is to convince stakeholders why the project is feasible and should be supported in terms of fundings. Both external and internal methods of dissemination are applicable.

Effective dissemination of a project requires various considerations including choice of the correct audience, clear communication regarding the objectives, scope, required resources, target population, and anticipated outcomes of the project. In general, dissemination aims at engaging the audience to enhance understanding, awareness, and gather support through motivation to engage in the project (Bulage et al., 2021 NUR 590 Benchmark Project Topic 4 Discussion Questions). Furthermore, extensive knowledge about the project is required to effectively disseminate information that will convince others to support the project. However, various audience needs determine the method or strategy of information dissemination.

I would prefer face-to-face communication while conducting internal communication with stakeholders and the institution board. These stakeholders include nurses, physicians, nurse managers, hospital administration, and pharmacists among others. Face-to-face communication encourages instant feedback while encouraging interaction and enhancing clarification of various issues. However, I would also use online webinars to disseminate information to unreachable members. Consequently, communications ensure that all stakeholders are equally engaged while incorporating their inputs in refining the project.

For external communication in professional conferences such as the American Nurses Association Conference, I would prefer face-to-face. This modality allows for exclusive consultations with nursing professionals who will add their input and give more guidelines towards improving an EBP (Bulage et al., 2021). Comparatively, less formal communication may be used while communicating to hospital colleagues, unlike the professionals who will prefer formal communication. Finally, upon dissemination of the proposal both internally and externally allows for constructive criticism that helps in project improvement before implementation.

References

Bulage, L., Ario, A. R., Kabwama, S. N., Kwesiga, B., Kadobera, D., Kihembo, C., Antara, S., & Wanyenze, R. K. (2021). Documentation and dissemination of scientific evidence by the Uganda Public Health Fellowship Program: experiences and lessons learned, 2015-2020. Human Resources for Health, 19(1), 128. https://doi.org/10.1186/s12960-021-00665-1

Topic 7 DQ2 – Dissemination of EBP Outcomes

Evidence-based practice findings are disseminated by targeting information and treatments to a specific public health or clinical practice audience. The primary goal of dissemination is to increase and encourage the transmission of knowledge about evidence-based interventions to improve their use and patient outcomes. Disseminating evidence-based projects can be done in a variety of ways, both inside and outside. The strategy used, however, must be effective.

 I would use the hospital board as an internal mechanism of disseminating evidence-based practice. Employees of the health organization, such as nurses, physicians, and other professionals are part of the stakeholders involved in patient care, make up the majority of the hospital board of directors. Face-to-face communication is the most effective technique for spreading the EBP to the hospital board. During questioning sessions, the technique allows for more involvement and immediate feedback (Derman & Jaeger, 2018 NUR 590 Benchmark Project Topic 4 Discussion Questions). The information would be presented in form of charts, tables, and pie charts for ease of understanding. In addition, online platforms such as webinars, emails, and WhatsApp could act as additional platforms for information dissemination.

Presentation at professional organization conferences, notably the American Nurses Association, is an external strategy that I would use. The professional association would be an excellent vehicle for disseminating the project to a large number of nurses. Face-to-face consultation and conversation with other nursing experts is the strategy I would employ in the conference.

I must present my evidence-based outcomes to the two groups to foster knowledge and information exchange across the nursing community. This would improve the ability of group members involved in nursing practice to make informed decisions and improve patient outcomes (Derman & Jaeger, 2018). Furthermore, presenting the findings to the groups would allow for a constructive critique of the results, allowing for improvements to be used in future patient care.

References

Derman, R. J., & Jaeger, F. J. (2018). Overcoming challenges to dissemination and implementation of research findings in under-resourced countries. Reproductive Health, 15(S1). https://doi.org/10.1186/s12978-018-0538-z

Topic 8 DQ1 – APA style

Throughout the course, I have used the APA style to format my papers. When I started the project, I knew little about the basic APA requirements. Therefore, I had a tough time with the professor who was always willing to help in improving my skills. I have much about in-text citation and preparing the reference page which was challenging at first. The in-text citation uses the name of the author(s) and the date within the research paper (Sinnott, 2019 NUR 590 Benchmark Project Topic 4 Discussion Questions).  In-text citation supports the written information and helps in avoiding plagiarism. I learned that citations can either be placed within a statement or at the end of a statement. The reference paper is placed at the end to refer to the sources used in the in-text citation.

I have also improved in various steps of AP style. I find it easier to prepare the title page by including the title, author`s name, affiliation, course name, instructor`s name, and due date. Furthermore, I have improved on using correct fonts (Times New Roman), font size (12), inserting page numbers on the upper right-hand corner, and double spacing. I have also improved in writing headings on different levels especially levels 1, 2, and 3. However, I have not included much of level 4 and 5 headings, which I feel inadequate.

I have also interacted with work done by peers. Most of them have mastered the APA style of writing, however, some still struggle in some parts. Some peers fail to apply an indentation of 0.5 for every first line of the paragraph while others fail to use double spacing and numbering pages. On referencing, some fail to start reference on the new page, apply double spacing, and alphabetize entries by the first author`s last names. These are areas I feel need improvement and emphasis to achieve the APA standards.

References

Sinnott, B. (2019). Research guides: APA style: Student paper format checklist. https://towson.libguides.com/apastyle7/paperchecklist

Topic 8 DQ2 – Incorporating EBP into Practice.

Throughout this course, I have understood that incorporating evidence-based practice is a critical part of patient care. EBP not only improves the quality of care but also improves patient outcomes, reduces the cost of care, improves patient satisfaction, increases nurses’ confidence, and reduces hospital stay (Li et al., 2019). EBP also guides nurses on the course of action to be taken and the impact of clinical decision-making. Based on its importance, I would advocate for the incorporation of EBP into nursing practice by including EBP in the nursing curriculum and educating and training nurses to be involved in EBP projects to improve patient care.

The incorporation of EBP follows several strategies and steps. The first strategy is the formation of a clinical question in form of a PICOT. Spirit of inquiry is required to identify the clinical problem that leads to PICOT formation. The clinical question forms the basis under which the study will be one. The second strategy is gathering of best evidence from other researches. The evidence will provide more information about the clinical problem, identify gaps, and improve knowledge about the clinical problem. Having an adequate understanding of the clinical problem will help in coming up with a better understanding of the topic ad help in identifying the right stakeholders. Furthermore, fundings can be channeled towards a project that will benefit the organization and patients as well. 

Analysis of evidence follows after gathering the best evidence. Analysis helps in identifying the strengths and weaknesses of a specific EBP. If an EBP proves to be effective, it will be considered and put into clinical practice. However, if the weakness outweighs its strength, the project is withdrawn. After analysis, the EBP is implemented and put into practice. Implementation requires the efforts of all healthcare providers who will participate in different stages of implementation (Li et al., 2019 NUR 590 Benchmark Project Topic 4 Discussion Questions). Champion nurses for example will be required in training, educate, and monitor the EBP. Finally, the results of EBP should be assessed. Assessment helps in determining both the pros and cons of an intervention. An intervention that leads to improved patient outcomes is considered successful.

References

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses—systematic review. Medicine, 98(39), e17209. https://doi.org/10.1097/md.0000000000017209

NUR 590 Benchmark Project Topic 4 Discussion Questions — Topic 4 Discussion question 1:

Explain whether you would select a qualitative or quantitative design to collect data and evaluate the effectiveness of your evidence-based practice project proposal. Identify which data collection tool you would specifically use and explain why this design is best for your evidence-based practice project proposal.

NUR 590 Benchmark Project Topic 4 Discussion Questions T 4 DQ2:

Identify which statistical test you would use in conjunction with your selected research design from DQ 1 to evaluate the outcomes for your evidence-based project proposal and explain why you selected this test. What kind of information will this test provide about your outcomes?

NUR 590 Benchmark Project Topic 4 Discussion Questions DQ3:

What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing? Explain how at least one of the obstacles you have described could impact the implementation for your EBP project.

NUR 590 Benchmark Project Topic 4 Discussion Questions T5 DQ1:
What are some of the obstacles or barriers to implementing evidence-based practice (EBP) in nursing? Explain how at least one of the obstacles you have described could impact the implementation for your EBP project. NUR 590 Benchmark Project Topic 4 Discussion Questions

NUR 590 Benchmark Project Topic 4 Discussion Questions T5 DQ2:
Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project. What strategies can you implement to gain stakeholder support for the project implementation. Provide a suggestion you would give to a colleague who is struggling with obtaining stakeholder support.

NUR 590 Benchmark Project Topic 4 Discussion Questions T6 DQ1:
When reviewing the literature for your evaluation plan and different types of evidence for your project, what gaps in the findings did you encounter? How could these gaps influence other researchers?

NUR 590 Benchmark Project Topic 4 Discussion Questions T6 DQ2:
Discuss the difference between statistically significant evidence and clinically significant evidence. How would each of these findings be used to advance an evidenced-based practice project?

NUR 590 Benchmark Project Topic 4 Discussion Questions T7 DQ1:
Propose strategies for disseminating your evidence-based practice project proposal. Consider the necessary stakeholders who need to review or approve the proposal (both internal and external) and what methods you will use to communicate.

NUR 590 Benchmark Project Topic 4 Discussion Questions T7 DQ2:
After implementation, dissemination of the evidence-based practice outcomes is essential for evaluating the success of the project for ensuring sustainability. Propose strategies that you could use for disseminating the outcomes of your evidence-based practice project proposal. Consider what information would need to be communicated, which stakeholders would need to be involved and the communication methods that would be needed.

NUR 590 Benchmark Project Topic 4 Discussion Questions T8 DQ1:
For professional writing in nursing and health care, APA style is expected. It is also expected for the remainder of your graduate program and in doctoral programs for nursing. Discuss what you have learned, or how you have improved, by completing the \”APA Writing Checklist\” and from receiving feedback from your instructors. What aspects of APA do you still struggle with? In your response to peers, provide a resource from the Student Success Center (or in addition to something in the Student Success Center) or a suggestion for an area in which someone still struggles.

NUR 590 Benchmark Project Topic 4 Discussion Questions T8 DQ2:
The evidence-based practice (EBP) process is a powerful way of advancing improvements in health care. Identify three strategies that you will now incorporate into your practice based on this course. Explain your rationale.

Discussion question responses should be approx 300 words and include at least 1 reference. Each of the above are discussion questions.