Instructions Instructions Please respond to all 6 discussion separately/INDIVIDU

Instructions Instructions Please respond to all 6 discussion separately/INDIVIDUALLY. Please divide the words equally between the 6 responses. Discussion #1Two common barriers to Achieving Evidence-Based Nursing Practice:
1. Limited Research Literacy and Skills:
One significant barrier to achieving evidence-based nursing practice is the limited research literacy and skills among nurses. Many nurses may lack the training and knowledge required to critically appraise and apply research findings to their clinical practice. This barrier hinders their ability to implement evidence-based guidelines and protocols effectively.
To address this barrier, two potential solutions can be considered:
a) Enhancing Nursing Education: Nursing education programs should prioritize research literacy and critical appraisal skills within their curricula. By providing comprehensive research courses and fostering an environment that encourages nursing students to engage in evidence-based practice, the foundational knowledge required for research utilization can be established.
b) Continuing Education and Professional Development: Health institutions and organizations should offer ongoing education and training opportunities for practicing nurses to improve their research literacy. Enabling nurses to attend workshops, conferences, and online courses focused on evidence-based practice will enhance their ability to access, appraise, and apply research findings in their clinical practice. (Healthy people.gov, 2021).
2. Organizational Culture and Resistance to Change:
Another significant barrier is the presence of an organizational culture that resists change and fails to prioritize evidence-based nursing practice. In environments where hierarchies and traditional practices prevail, it can be challenging for nurses to implement new evidence-based approaches. This barrier can impede the adoption of evidence-based guidelines and restrict progress towards the IOM’s goal.
Addressing this barrier requires the following approaches:
a) Leadership and Advocacy: Nurse leaders and administrators should act as advocates for evidence-based practice. They can create a supportive culture that recognizes and values nurses’ efforts to integrate research into their practice. Developing strong leadership that champions change and fosters a culture of research utilization is crucial. (Institute of Medicine,2019).
b) Collaborative Decision-Making: Encouraging collaborative decision-making processes within healthcare organizations allows nurses to actively participate in shaping evidence-based practices. By involving frontline nurses in discussions, decision-making, and quality improvement initiatives, organizations can promote a sense of ownership and engagement, ultimately increasing the acceptance and implementation of evidence-based nursing practices. (Estabrooks et al.,2019).

References:
Estabrooks, C. A., Squires, J. E., Cummings, G. G., Birdsell, J. M., & Norton, P. G. (2019). Development and assessment of the Alberta Context Tool. BMC Health Services Research, 18(1), 1-10.

Healthy People.gov. (2021). Clinical Preventive Services. Retrieved from https://health.gov/healthypeople/map/Category.aspx?id=34

Institute of Medicine. (2019). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.
Discussion #2The Institute of Medicine’s ambitious goal of achieving 90% evidence-based practice by 2020 has encountered significant barriers, hindering the progress towards this objective. According to HealthyPeople.gov, the United States has only reached a meager 15% of evidence-based nursing practice. This disparity calls for an exploration of the barriers impeding the achievement of this goal and potential strategies to address them.
Barriers to Evidence-Based Nursing Practice: Lack of Accessible and Relevant Evidence: One of the major barriers to evidence-based nursing practice is the limited availability of accessible and relevant evidence. Nurses often face challenges in accessing up-to-date and credible research materials due to restricted institutional access, overwhelming workloads, and limited time for research (Cha et al ., 2021). This shortage of accessible evidence prevents nurses from making informed decisions, leading to a reliance on traditional practices and personal experiences.
Addressing the Barrier: To overcome this barrier, healthcare institutions can invest in providing nurses with unrestricted access to evidence-based resources through online libraries and databases. Encouraging partnerships with academic institutions and research organizations can ensure the availability of high-quality research materials. Additionally, hospitals can allocate dedicated time for nurses to engage in literature reviews and research activities, enabling them to stay updated with the latest evidence.
Resistance to Change and Lack of Awareness: Resistance to change is another significant obstacle in achieving evidence-based nursing practice. Traditional practices and ingrained beliefs can create reluctance among nursing professionals to adopt new evidence-based approaches. A lack of awareness about the benefits of evidence-based practice and inadequate education on how to critically appraise research studies further contribute to this barrier.
Addressing the Barrier: To address this challenge, nursing leadership and educators must prioritize continuous education and professional development on evidence-based practices. Integrating evidence-based curriculum in nursing education programs and offering workshops can enhance nurses’ skills in critically evaluating research and understanding its practical implications. Creating a culture of openness to innovation and knowledge-sharing within healthcare organizations can also help break down resistance to change.
Strategies to Overcome Barriers
Investment in Technology and Resources: Healthcare institutions should invest in advanced technologies that provide nurses with easy access to evidence-based resources. User-friendly databases, mobile applications, and electronic health record systems can enable quick retrieval of relevant information at the point of care. Collaborations with information technology experts can lead to the development of platforms tailored to nurses’ needs.
Continuing Education and Training: Continuous education is vital to enhancing nurses’ understanding of evidence-based practice. Hospitals can establish mandatory training sessions that focus on critical appraisal skills, research methodologies, and the interpretation of findings (Long et al ., 2020). Online courses and webinars led by experts in the field can provide nurses with flexible learning opportunities.
Mentorship and Peer Support: Implementing mentorship programs where experienced nurses guide their peers in adopting evidence-based practices can foster a supportive learning environment. Peer support networks can encourage the sharing of success stories and practical strategies for integrating evidence into daily practice.
Institutional Policy and Advocacy: Healthcare organizations should develop clear policies that emphasize the importance of evidence-based practice. Leaders can advocate for dedicated time for research, creating research committees, and recognizing nurses who contribute to evidence-based initiatives. Such institutional support can empower nurses to prioritize evidence over tradition.
Conclusion
Achieving the Institute of Medicine’s goal of 90% evidence-based practice in nursing by 2020 remains an unmet challenge. The identified barriers of limited access to evidence and resistance to change are significant hurdles that demand attention. By implementing strategies such as investing in technology, promoting continuous education, fostering mentorship, and advocating for institutional support, nursing practice can overcome these barriers and inch closer to a future where evidence-based care is the norm, ultimately improving patient outcomes and the overall quality of healthcare.

References
Cha, C., & Park, S. (2021). Information flow and nursing care during the early phase of the COVID‐19 pandemic. Journal of clinical nursing.
Long, H. A., French, D. P., & Brooks, J. M. (2020). Optimising the value of the critical appraisal skills programme (CASP) tool for quality appraisal in qualitative evidence synthesis. Research Methods in Medicine & Health Sciences, 1(1), 31-42.

Discussion #3The goal set by the Institute of Medicine to ensure that 90% of practice is evidence-based by 2020 is certainly commendable. However, the current figure of 15% as per HealthyPeople.gov indicates a significant gap. Two primary barriers might hold nursing practice back from achieving this goal.
First, there’s a persistent knowledge-practice gap in the nursing field. Despite the availability of evidence-based research, many nurses may not be aware of the latest findings or may not know how to incorporate them into their practice. This can be attributed to a lack of ongoing education and training. To address this, healthcare institutions could invest in continuous professional development programs. Offering regular workshops, seminars, and training sessions on evidence-based practices can equip nurses with the latest knowledge. Additionally, creating an organizational culture that values and promotes ongoing learning is vital. This can include mentorship programs where experienced nurses guide their younger counterparts in adopting evidence-based practices.
Second, there’s often institutional resistance to change. Implementing new practices can be met with resistance due to a variety of reasons such as the perceived cost of change, fear of the unknown, or a belief that existing practices are sufficient. To overcome this barrier, it is crucial for leadership to be on board in promoting evidence-based practices. Engaging with stakeholders, including nurses, to understand their apprehensions and providing necessary resources can foster a more accepting environment for change. It’s also important to highlight the long-term benefits of evidence-based practice, not just in terms of patient outcomes, but also in cost savings and efficiency, to motivate all staff members to embrace change.
In conclusion, while the goal set by the Institute of Medicine is ambitious, it is achievable if both individual and systemic barriers are recognized and addressed. Continuous learning and a commitment to evolving with the times are crucial for nursing practice to be truly evidence-based.

Institute of Medicine (US) Roundtable on Evidence-Based Medicine. Leadership Commitments to Improve Value in Healthcare: Finding Common Ground: Workshop Summary. Washington (DC): National Academies Press (US); 2019. Institute of Medicine: Roundtable on Evidence-Based Medicine. Available from: https://www.ncbi.nlm.nih.gov/books/NBK52847/

Jacobs JA, Jones E, Gabella BA, Spring B, Brownson RC. Tools for Implementing an Evidence-Based Approach in Public Health Practice. Prev Chronic Dis 2022;9:110324. DOI: http://dx.doi.org/10.5888/pcd9.110324
Discussion #4For any organization striving to promote evidence-based nursing practice, a critical issue often revolves around the integration of research findings into actual clinical care. This issue stems from the challenge of bridging the gap between the wealth of available research and its practical implementation at the bedside. In this context, the primary concern lies in ensuring that the latest and most relevant evidence informs nursing decisions and interventions, ultimately leading to improved patient outcomes.
The disconnect between research and practice in nursing can be attributed to several factors. One major factor is the lack of time and resources available to nurses, who are already stretched thin in their clinical responsibilities. Keeping up with the constant influx of new research findings can be overwhelming, especially when combined with the demanding nature of patient care. Additionally, not all nurses are familiar with the skills needed to critically appraise research studies, making it difficult for them to assess the quality and applicability of the evidence.
Moreover, organizational culture plays a significant role. Some healthcare settings might not prioritize evidence-based practice, either due to a lack of awareness about its benefits or a resistance to change (Smith et al ., 2023). Hierarchical structures can sometimes inhibit open discussions about incorporating new evidence into established practices. All these factors contribute to the persistent challenge of implementing evidence-based nursing care.
Addressing and resolving this issue requires a multi-faceted approach, but a crucial initial step is the establishment of a robust system for evidence dissemination and education. This step involves several key components:
Research Synthesis and Translation: The organization needs to invest in processes that synthesize and translate research findings into understandable, actionable recommendations for bedside nurses. This could involve the creation of dedicated teams responsible for reviewing and summarizing relevant research studies. The summaries should emphasize the practical implications of the findings, making it easier for busy nurses to grasp the significance of the evidence. Education and Training:** Providing ongoing education and training in evidence-based practice is essential. Nurses should be equipped with the skills to critically appraise research studies, allowing them to assess the validity and relevance of the evidence (Immonen et al ., 2019). Workshops, seminars, and online modules can help in enhancing these skills. Training should also include practical strategies for integrating evidence into daily practice.
Accessible Resources: Developing a centralized repository of evidence-based resources can streamline the process of accessing relevant information. This repository could house research summaries, guidelines, protocols, and tools that aid nurses in making informed decisions. Having easy access to reliable resources reduces the time and effort required to search for evidence.
Clinical Champions: Identifying and empowering clinical champions or nurse leaders who are enthusiastic about evidence-based practice can foster a culture of change. These individuals can act as role models, advocating for the integration of evidence into practice and motivating their peers.
Collaboration and Communication: Encouraging open communication and collaboration between researchers, educators, and clinicians is vital. Researchers can learn about the practical challenges faced by nurses, while nurses can gain insights into the research process. Collaborative efforts can lead to studies that directly address clinical issues, making the findings more relevant to bedside care.
By initiating these steps, the organization can lay the foundation for a more seamless integration of evidence-based nursing practice. However, it’s important to recognize that this process is ongoing and requires continuous evaluation and adaptation. Regular feedback loops, outcome measurement, and refinement of the education and dissemination strategies are crucial to ensure that evidence-based practice becomes an integral part of the organization’s culture and, ultimately, leads to improved patient care outcomes.

References
Smith, L., Malinowski, J., Ceulemans, S., Peck, K., Walton, N., Sheidley, B. R., & Lippa, N. (2023). Genetic testing and counseling for the unexplained epilepsies: an evidence‐based practice guideline of the National Society of genetic counselors. Journal of Genetic Counseling, 32(2), 266-280.
Immonen, K., Oikarainen, A., Tomietto, M., Kääriäinen, M., Tuomikoski, A. M., Kaučič, B. M., … & Mikkonen, K. (2019). Assessment of nursing students’ competence in clinical practice: a systematic review of reviews. International journal of nursing studies, 100, 103414.
Discussion #5A primary issue my organizations often face in implementing evidence-based nursing practice is the lack of knowledge, awareness, and understanding of the importance of evidence-based practice among healthcare professionals. Nurses are often accustomed to following traditional routines and established practices, which may not always align with the latest research evidence. This can hinder the adoption of evidence-based nursing practice and lead to suboptimal patient care.
The first step in addressing and resolving this issue is education and promoting a culture of evidence-based practice within the organization. This can be done through various methods, such as workshops, training programs, or conferences, to enhance nurses’ knowledge and understanding of evidence-based practice principles. Providing Nurses with updated resources, guidelines, and tools can also facilitate the integration of new evidence into their practice.(Harvey et al., 2020).
We also need to streamline our organizational structures to encourage collaboration and shared decision-making. Teams should feel empowered to discuss, scrutinize, and implement new research in their practice, and interdisciplinary collaboration should be encouraged for a more holistic approach to patient care (Chou et al., 2021).
Additionally, leadership plays a crucial role in driving change and ensuring the establishment of an evidence-based culture. Nurse leaders should promote and support evidence-based practice by encouraging staff to critically analyze the existing evidence, question routine practices, and seek out new research findings. This can be done through mentorship programs, regular journal clubs, and interprofessional collaborations, fostering an environment that values continuous learning and the integration of new evidence into nursing practice. (Conklin et al., 2019)

References.
Chou, A. F., Duncan, A. R., Hallford, G., Kelley, D. M., & Dean, L. W. (2021). Barriers and strategies to integrate medical genetics and primary care in underserved populations: a scoping review. Journal of Community Genetics, 12, 291-309. https://link.springer.com/article/10.1007/s12687-021-00508-5

Conklin, J., Farrell, B., & Suleman, S. (2019). Implementing deprescribing guidelines into frontline practice: barriers and facilitators. Research in Social and Administrative Pharmacy, 15(6), 796-800. https://www.sciencedirect.com/science/article/pii/S1551741118307526

Harvey, G., Kelly, J., Kitson, A., Thornton, K., & Owen, V. (2020). Leadership for evidence-based practice—Enforcing or enabling implementation? Collegian, 27(1), 57-62. https://www.sciencedirect.com/science/article/pii/S1322769619300125
Discussion #6One of the main issues in my hospital in addressing a solution to evidence-based nursing practice is the challenge of effectively integrating research findings into everyday clinical practice. This integration often involves changing established protocols, investing in training, and ensuring consistent adoption across different departments and among various healthcare professionals. Hospitals operate in complex environments where patient care, safety, financial constraints, staffing challenges, and administrative concerns intertwine, making large-scale shifts like integrating evidence-based practice (EBP) more intricate.
To address and resolve this issue, the first step should be the establishment of a dedicated EBP committee or task force within the hospital. This team would be responsible for continuously reviewing current research, evaluating its relevance to the hospital’s specific patient population, and identifying potential changes in practice. By having a designated team, hospitals can ensure a focused approach to EBP, streamline the process of integrating new findings, and maintain an ongoing dialogue about best practices. This committee should also be interdisciplinary, comprising nurses, physicians, administrators, and possibly patients, to ensure a holistic perspective on care and the practical implications of any changes. With a dedicated EBP committee, hospitals can pave the way for consistent, organization-wide adoption of research-based practices, leading to improved patient outcomes and more efficient care delivery.

Pitsillidou M, Roupa Z, Farmakas A, Noula M. Factors Affecting the Application and Implementation of Evidence-based Practice in Nursing. Acta Inform Med. 2021 Dec;29(4):281-287. doi: 10.5455/aim.2021.29.281-287. PMID: 35197664; PMCID: PMC8800576.

Alqahtani JM, Carsula RP, Alharbi HA, Alyousef SM, Baker OG, Tumala RB. Barriers to Implementing Evidence-Based Practice among Primary Healthcare Nurses in Saudi Arabia: A Cross-Sectional Study. Nurs Rep. 2022 Apr 28;12(2):313-323. doi: 10.3390/nursrep12020031. PMID: 35645357; PMCID: PMC9149906.

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