Running head: EBP & RESEARCH 1

EBP and Research

There are many different definitions of evidence-based practice (EBP) as well as quality

improvement and research. Here I will discuss some differences and clarify their definitions as I

see them with the hope that it will help me further my career in advanced practice nursing

(APN). I will then delve into the importance of EBP with APN and how to implement it into the

career field. Furthermore, I will discuss database searching and some different EBP models. To

adequately and safely provide patient care as an APN, it is pivotal to understand and be able to

utilize EBP in every-day practice.

Differences

To best be able to understand EBP you must first understand that it stems from research

and leads to quality improvement. All three concepts are used chronologically but also

intermittently intertwined. Since research is the foundation let’s begin by defining it. Although

there are several definitions according to Tracy and O’Grady (2019), “Research is a systematic

investigation designed to generate or contribute to generalizable new knowledge to healthcare or

advanced practice nursing” (p. 231). The definition leads us into understanding that in order to

gain new knowledge and become a better APN, one must use research appropriately in order to

get to utilize it in EBP.

Evidence-based practice (EBP) is the act of using said research in order to have

substantial backing to the practice. In order to provide safe and effective patient care it is

important to have the “best evidence” and best research available (Polit & Beck, 2017). EBP is

the action that follows the evidence-based research itself. Without proper research, the practice

would be inadequate.
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Last comes the quality improvement. We first need research; from there we have the

action of evidence-based practice which then leads to quality improvement. Polit Beck (2017)

summarize simply that quality improvement is the action of putting research into practice. As

you can see, this demonstrates chronology to research, evidenced base practice and quality

improvement.

The value of EBP

The value of EBP in advanced practice nursing is endless. In all work environments you

can utilize evidence-based research in implementation of quality improvement (QI). For

example, where I work patient satisfaction scores are very important to the corporation. I have

seen on several patient satisfaction surveys that a common complaint is patients are unaware of

whom is coming and going in their rooms during their care. All staff do wear name badges, but

they seem to always be turned around making them unidentifiable. A quality improvement

project could be to find a way to fix this; such as double-sided name badges or if that would even

increase patient satisfaction scores.

Alternatively, a more patient centered quality improvement project could be utilizing

distraction methods between medication administration in the chronic pain patients. By first

recognizing an area of concern or a simple question of “how do we fix this” a quality

improvement topic can be formed. In order to do a quality improvement study, one must conduct

evidence-based research and read studies and evidence about their topic of QI.

Implementing

Once a QI topic is found and it is deemed that a clinical question has been brought up in

which further evidence may answer, the next step is to gather that evidence. It is important to

validate also that the evidence found is credible and reliable. There are different types of
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evidence or studies and data that are important to understand before a QI project or EBP can be

pursued as a result of the data.

Systematic reviews are a good place to start on the evidence gathering step. Polit and

Beck (2017) state, “Systematic reviews are a pivotal component of EBP” (p. 72). They continue

to describe them as inquiries that follow similar steps as those of primary studies. In order to

implement quality improvement into EBP it is important to review appropriate data on the topic.

Furthermore, Polit and Beck (2017) state that if your initial data collection and review

proves to include promising data, the next step would be to integrate the evidence found with

your own data collected or your own experiences in order to further the aspect of practice in EBP

(p.90).

Lastly when all other steps are completed it is still equally important to assess the

integration of the information in your practice. Was the implementation successful or not? What

could have made it better? And other questions that might assess or conclude the project (p.91).

Topic Search

In the table below I have shown two different database search results in order to

demonstrate how different databases can yield different results. The topic I chose to research is

distraction method as a form of pain control.

Database Search terms Hits-Results MeSH, Boolean New Results

operators, filters and
limits
CINHAL Pain management & 252 Limits: Full text 32
distraction Age: Adult
Year: 2012-2019
Scopus Pain management & 680 Limits: Open access 2
distraction Subject: Nursing
Age: 2012-2019
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From the table you can see the drastic difference in search results based on the number of

filters or limits used. I found the more you filter out unwanted documents the easier it will be to

find relevant research based on your topic. By limiting the age of the documents, I was able to

make sure the research was recent and up to date, in some cases that would be very important.

By limiting to full text, I was able to weed out documents that I wouldn’t be able to utilize fully

due to the inability to view the entirety of them.

EBP model comparison

There are many different EBP models. Additionally, different models seem to be more

appealing given the area of study and can also have different focuses such as process oriented or

mentor oriented (Polit & Beck, 2017). Depending on your field of study one model such as the

ARCC might be good for nurse educators and another such as the Iowa Model, might be good

EBP model for family practice area. Given a topic such as pain control one model might result in

better practice and outcomes than the other.

The ARCC model’s key focus and concepts are mentor based or unit based whereas the

Iowa model’s emphasis is on organizational process and utilizes a trigger or problem aspect

which might prove useful in some instances. Using the pain control topic, the ARCC model

would be less helpful in problem solving pain control methods or other areas of discussion on

pain control. The Iowa model would prove helpful on this topic as pain would be the trigger and

it would better model pain in a clinical atmosphere (Gawlinski & Rutledge, 2008).

By first understanding what EBP project outcome you have in mind, you can better select

a model to assist. Polit and Beck (2017) state, “Although each model offers different

perspectives on how to translate research findings into practice, several of the steps and
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procedures are similar across the models” (p.79). It seems that spending a lot of time selecting a

specific model is not as important as the utilization of the model you have chose.

Conclusion

To adequately and safely provide patient care as an APN, it is pivotal to understand and

be able to utilize EBP in every-day practice. Understanding the differences of concepts and by

doing proper research using the best most up to date evidence, evidence-based practice can have

much better outcomes and lead to better quality improvement. Furthermore, understanding

quality improvement topics, projects, and implementation techniques, will provide better

outcomes as well. In order to be an efficient, well rounded advanced practice nurse, it is pivotal

to understand the importance of evidence-based practice and its role in APN.

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References

Gawlinski, A., & Rutledge, D. (2008). Selecting a Model for Evidence-Based Practice Changes

A Practical Approach. AACN Advanced Critical Care, 19(3), 291-300.

Hall, H. R., & Roussel, L. A. (2017). Evidence-based practice an integrative approach to

research, administration, and practice (2nd ed.). Burlington, MA: Jones & Bartlett

Learning.

Polit, D. F., & Beck, C. T. (2017). Nursing research generating and assessing evidence for

nursing practice (3rd ed.). Philadelphia: Wolters Kluwer.

Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence‐based practice models for

organizational change: overview and practical applications. Journal of Advanced

Nursing, 69(5), 1197-1209.

Tracy, M. F., & O'Grady, E. T. (2019). Advanced practice nursing: An integrative approach (6th

ed.). St. Louis Missouri: Elsevier Saunders.