A Peer Response must be substantive by bringing information to the discussion or further enhance the discussion. Each Peer Response must have a minimum of ONE reference with citations (the best is a peer-reviewed article). Word count is greater than 75 words or at least 5 sentences in length. Please respond to each discussion separately.
Discussion question/Participation #1
There are many places that would make search for this classes research proposal. I would like to focus on using PubMed and ans CINAHL. Both offer nurses loads of articles, studies, research, and journals about many topics and it is all in one location. Making this time easier and quicker. Since the school offers access to these sites, there are more things available for this project. Sadly, when searching for things on google you may or may not find the full study being offered and only an abstract. This will hinder the search or nurses may be force to pay for these studies if unable to find. PubMed offers people 33 million citation based studies, with Medline being the major part of the site. CINAHL will be useful because they offer full text journals to their subscribers which can be hard to come by on google search, not impossible but it does add a lot of time to researching.
Discussion question/Participation #2
Utilizing the school library databases have served me well over the past year and a half. While I rarely narrow my searches to databases within the library database network, I always advance my searches to include only peer reviewed articles published within the past five years. However, I have noticed that many of the articles I use in my research are found on the CINAHL Complete database. Another valuable database is the Health Source: Nursing/Academic Edition.
The library at Eastern Michigan University (2021) educates students to utilize scholarly sources because they are built upon facts, ideas, and methods. These facts, ideas, and methods can be reproduced by other researchers, drawing the same or similar conclusions – contributing to scientific evidence and, thus, evidence based practice (Majid et al., 2011).
Discussion question/Participation #3
Wolfram Alpha is a better browser in comparison to both google scholar and general internet research since it apathetically calculates outcome to the questions concerning languages by using algorithms to its broad interior database of evidences. The applicants submit requests on computation and questions like “Give the derivative of xx?” “State the Strontium half-life?” through an average a single-line textbox (Gupta & Walther, 2018). Wolfram Alpha with computed outcomes and data in graphical, symbolic, and textual representations. Although Wolfram Alpha may be applied for an extent better than calculus, it ensures a detailed experience and view applied in the teaching of calculus, and in this context the views concerning this database usually take place in the context of the stated views. There may be a universal discussion concerning the wat it is applied through reading the available forum and official blog of Wolfram Alpha using the website of Wolfram Alpha.
The other browser is PubMed as it uses free internet database which was printed by the National Library of healthcare that is applied as a service of indexing for the literature of medicine. The indexes of PubMed indicate of 17 million credentials which is more than 5000 biomedical articles. As a result of the availability of restricted complete-text journals and its examination characteristics, PubMed is now the greatest frequently applied biomedical databases of indexes. Many researchers have illustrated the proportional citation numbers (for instance, the total number of outcomes recovered by recovered database) that is indexed by Google Scholar against other databases applied in indexing. A research conducted by Mecenas et al (2020) tested Google Scholar and PubMed databases, using questions gotten from investigation. It concentrated in studying citations of literature or the ones that had been previously developed in application at the instruction period for research on librarian medicine, in showing in case the same citation number may be recovered between databases.
Discussion question/Participation #4
This goal will always be unreachable because most advances in any field are correlated to the profits a company makes. The problem with this is that studies and waiting periods for EBP hinder profits and companies will take short cuts to make a profit. When it comes to the nurses the biggest barrier of achieving EBP is the time required to fulfill the research needed to be on top of everything. Nurses are overworked and overwhelmed. Many do not want to think of anything related to work post scheduled time. Many nurse are in fact leaving the field due to the stress that Covid-19 has brought (Yong, 2021). This causes problems with us new nurses because we are being placed into the system quickly with little training, or being trained by those that haven’t been around for long. This does not improve the nurses ability to stay up to date with EBP or how to communicate with the hospital management to incorporate new EBP.
Discussion question/Participation #5
I can certainly commisserate with those surveyed by Majid et al. (2011) contributing to findings that nurses want to use evidence based practice, but workloads are simply too heavy to allow nurses to stay up-to-date. At my facility, nurse-to-patient ratios should be 1:5 on day shift. However, this week I was completely overwhelmed when my patient load consisted of 1:7. I definitely want to keep up to date on EBP, but my workload simply does not allow it. For example, this week I was pacing the wall in the PAR for a package of swap caps (orange caps embedded with CHG which are used to cap central lines), but I was unsuccessful. As I was leaving, emptyhanded, I ran into my unit nurse educator, so I asked her to contact central supply to bring some swap caps up to us. She informed me that EBP says we no longer need to use swap caps for central lines. I had no idea – and I’ve yet to check to ensure the EBP really does support this change.
Another barrier to implementing EBP is organizational culture (Arzouman, 2015). The culture at my facility is that someone else does the research, writes a new policy, then sends me an email with a deadline to read and attest to such reading. Quite honestly, receiving such a cold delivery with a hard deadline for completion is disheartening – the culture is begridging, to put it lightly. Adopting EBP in my own practice would be way more fun if the culture surrounding it weren’t so much like a dictatorship.
Discussion question/Participation #6
One barrier may be lack of knowledge and skills to confidently conduct computer-based literature searches and utilize the research process. Even though many nurses are choosing to enhance their education and obtain higher degrees, many nurses still hold an ADN in Nursing. Evidence based practice research is not something that is taught through this program in depth. Many nurses may make errors in researching credible information. Research is seen as too complicated, too scholarly, excessively statistical, ambiguous, and having limited or no relevance to practice (CNA, 2021). Nurses often use their past experiences in health care and education from physicians to guide their education tactics to patients.
A second barrier may be lack of time. When asked what they need more of, busy clinicians will often say time is their priority (Ginex, 2021). Time management is an essential element to caring for patients in a timely manner. Due to staffing ratios and nurse shortage across the United States, Nurses may feel that they do not have the time to research information before educating a patient, therefore they educate on what they already know or what they can find out quickly through verbal communication (Doctors, PA’s, coworkers).
Support from stakeholders, administrators etc., play a significant role in emphasizing the need for evidence-based practice. One of the first and more important things you can do is to engage the appropriate stakeholders (Ginex, 2021). Engaging stakeholders and learning why nurses in their facility or organization are not pursuing evidence-based practice. Once they learn the reason they can then evaluate and implement strategies to make a change. Implementing paid time or paid courses to further educate nurses would be an interesting way to evaluate if this increases the percentage of nurses using evidence-based practice methods.