Thank you for your contribution to this week’s discussion and enjoyed reading your post. I agree in your research that "an integrative review involves literature compilation, analysis, and synthesis of multiple findings so that a targeted clinical question is being answered." According to Mannix, Wilkes, and Daly (2013), an integrative review was chosen as the frame- work for the examination of the published literature. The rationale for choice of this approach primarily included a desire to capture empirical research that had as its focus, the characteristics of clinical leaders or leadership, irrespective of the research methods utilized. Furthermore, you may benefit from reading Ganong's Stages of an Integrative Research Review (1987),
Melnyk’s Hierarchy of Evidence is a system often use for assigning levels of evidence in nursing by integrates clinical expertise and patient choices with the best available research. It is represented by a pyramid that enumerates the levels of strength of the evidence from 1 to 7, of which level 1 is the higher level. The higher level on the pyramid, the more likelihood that the research is valid; therefore, answering a clinical or practice question. “The systematic review or meta-analysis of randomized controlled trials are at the top of the evidence pyramid and are typically assigned the highest level of evidence, due to the fact that the study design reduces the probability of bias” (Melnyk, 2011). The weakness of the system is that when
Avolio, B. J. (2007, Jan 1). Promoting more Integrative Strategies for Leadership Theory Building. American Psychologist, pp. 25-33.
Simpson, M., & Patton, N. (2012). Leadership in Health Practice. In J. Higgs, R. Ajjawi, L.
According to Sackett, (1996) evidence–based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about patient care. Straus, Richardson, Glasziou, & Haynes (2005, p. 1) described evidence-based practice (EBP) as “the integration of the best research evidence with clinical expertise and unique patient values and circumstances.” According to Straus et al, (2005, p.3) those practicing evidence based medicine must follow five specific steps: a) Include the need for data into an answerable question, b) Track down the best evidence, c) Critically appraise the evidence for validity, impact, and application, d) Integrate the critical appraisal into clinical practice, and e) Evaluate the effectiveness and efficiency of implementing steps a-e-and seek ways to improve them. Subsequently, without current best evidence, clinical practice cam become out-dated to the detriment of patients, this is an untenable circumstance and one which should never be allowed to happen.
Burns, N. & Groves, S. K. (2009). The practice of nursing research: Appraisal, synthesis, and
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
Research is a systematic process that ultimately leads to the development of new knowledge and solutions to problems or questions (Adams, 2012). Evidence-based practice is the use of the best scientific evidence available to support clinical decisions when caring for individuals or groups of patients (Santos, Pimenta, & Nobre, 2007). The connection between research and evidence-based practice is derived from the fact that nurses use solutions found in research to validate and refine existing nursing knowledge. As a result, nursing practice is impacted. (Adams, 2012). In addition, the goal for conducting nursing research is not only to improve patient outcomes, but also to provide credibility to the nursing profession through evidence-based practice (Adams, 2012). Therefore, research provides the foundation for the develo...
230) in EBP. Clinical opinion, together with the best relevant research evidence, provides the framework to for the best patient outcome. The nurse’s clinical opinion is acquired through knowledge and skills developed from undergraduate, graduate, or continuing education, clinical experience, and clinical practice (Melnyk & Fineout-Overholt, 2010). Clinical opinion also includes internal evidence, which is generated within a clinical setting from quality improvement outcomes, management initiatives or EBP implementation projects (Melnyk & Fineout-Overholt, 2010). Nurses use their clinical opinion when they identify each patient’s condition, individual risks, personal values and expectations, benefits of possible interventions, and gather evidence for EBP. When searching for the best available evidence, there is a hierarchy in the strength of evidence. The highest level of evidence usually comes from a systematic review or an evidence-based clinical practice guideline based on a systematic review. Systematic reviews provide the strongest evidence through a summary combining the results from many relevant, unbiased studies, to answer a particular clinical question. Nurses critically assess the individual studies, to gather the best evidence available for patient care. Systematic
Although, many a times, the biggest barrier to deliver the best treatments are the senior health care professionals and the nursing leaders who do not entertain the implementation of the interventions planned based on the evidences obtained from research studies (Eizenberg, 2011). This is because most of the leaders were educated when either evidence based on research practices did not exist or were not well integrated into the educational programs and are thus strict followers of ritual or opinion based practices (Newton & McKenna, 2009). Thus, when the new generation nursing professionals who have learnt to utilize evidence based on research practices enter the nursing world, they are posed with challenges of whether to follow their seniors or to follow what is ethical according to them (Newton & McKenna, 2009). Even the political and organizational cultures that are resistant to changes form the biggest barrier. Such barriers act as a huge problem that prevents the best outcomes for patients (Melynk,
Polit and Beck (2010 p. 4) describe the research process as “a systematic inquiry designed to develop trustworthy evidence about issues of importance to the nursing profession, including nursing, practice, education, administration and informatics”. With the use of research, nurses can update themselves with the knowledge and analytical skills necessary to facilitate the use of appropriate evidence in clinical decision making for effective health service delivery (Greenhalgn 2010). Clinical decisions should be supported by current, appropriate and robust evidence rather than invalid primary training or the interpretation of personal experiences (Thompson and Dowding 2002). Baker (2010 p. 6) defines EBP as “the conscientious, explicit and judicious use of theory-derived, research-based information to make decisions about care delivery to individuals or groups of patient, taking into consideration individual’s needs and preferences”. It offers the nurse with the skills and knowledge to assess best update health care literature and practice (Donald and Greenhalgh
The Qualitative Critical Appraisal Checklist found on the Critical Appraisal Skills Programme (CASP) (2013) was used to assess the quality of the studies. It is a popular choice for evaluating the trustworthiness and reliability of qualitative research (Holloway and Wheeler, 2010). The aims of studies were clearly stated and the justification for the need of the research was clearly explained in the study background (Burn and Grove, 2011). As the qualitative study is interested in individual’s perceptions and experiences the researchers have chosen an appropriate methodology for the study addressing the research goals (Parahoo, 2014). All five articles used a similar research design phenomenological approach that seeks to explore the lived
Segregation in educational institutions taking place in the United States is not often talked about. People may consider apartheid schooling taking place presently to a nation that does not respect basic human rights. Thus, the injustices taking place in public schools are not easily classified because it is commonplace to many. It can be argued that apartheid schooling was never completely dismantled in the United States. Jonathan Kozol’s book The Shame of the Nation (2005) provides evidence and insight to apartheid within the educational system that children are currently experiencing. The structure in children’s curriculum, the way they are spoken to as well as the funding public schools are funded are examples to the inequalities that children face. Conceptually, structural violence is what keeps educational injustices to recur.
When we seek out interprofessional evidence-based practices, we find successful studies that take into consideration the three concepts
“At its core evidence based ‘anything’ is concerned with using valid and relevant information in decision making” “high quality research is the most important source of valid information”. Psychological Association (2006, p. 273) defines EBP as "the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences. " When caring for patients it is fundamentally important to have a good selection of up to date evidence Based Practice clinical articles to support research strategies, this allows professionals to assemble the most recent and accurate information known which enables them to make decisions tailored to the individual’s plan of care. It is essential to have clinical expertise and have the involvement of the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.... ... middle of paper ...
The idea behind conforming to evidenced based practices is that research is the most likely tool to improve patient