Developing and Evaluating New Practice Approaches

Developing and Evaluating New Practice Approaches

One of the exciting aspects of participating in the health care field is the discovery of new techniques, treatments, and technologies that improve the quality of care and improve health outcomes. As someone engaged in advanced nursing practice, you have the opportunity to search for new solutions to issues in your specialty area. What tools can you use to guide the discovery process? What needs to be considered as you determine new practice approaches to address issues in health care? This week, you consider new ways to address the EBP Project issue you identified in Week 2 see attached file). Developing and Evaluating New Practice Approaches

To prepare:

  • Reflect on your analysis of the evidence base that addresses your selected issue from the EBP Project (identified during      Week 2 [see attached file]).
  • Using methods articulated in the Learning Resources, formulate new evidence-based practice strategies to address the issue and improve health care quality.
  • What are the theoretical bases for your proposed strategies?
  • What might be the economic impact of implementing your proposed strategies? Developing and Evaluating New Practice Approaches

By tomorrow  Wednesday day 10/03/18 10:00 am, write an essay of a minimum of 550 words in APA format, and at least 3 scholarly references from the list of required readings below. Include all level one headers as numbered below:

Post a cohesive response that addresses the following:

1) Briefly summarize your selected issue (see my PICOT question below & attached file) and propose new evidence-based practice strategies. Describe the theoretical basis for your strategies.

2) Discuss the potential economic impact of your suggested strategies.

3) How could the new practice strategies improve health care quality? Developing and Evaluating New Practice Approaches

Required Readings

White, K. M., Dudley-Brown, S., & Terharr, M. F. (2016). Translation of evidence into nursing and health care practice (2nd ed.). New York, NY: Springer.

  • Chapter 6, “Translation of Evidence for Leadership”

Balakas, K., Sparks, L., Steurer, L., & Bryant, T. (2013). An outcome of evidence-based practiced education: Sustained clinical decision-making among bedside nurses. Journal of Pediatric Nursing, 28, 479-485.

Brown, D.S. (2012). Interview with quality leaders: Dr. Donna E. Shalala and Dr. Linda Burnes Bolton on the committee on the Robert Wood Johnson Foundation initiative on the future of nursing at the Institute of Medicine. Journal for Healthcare Quality, 24(4), 40-44. Developing and Evaluating New Practice Approaches

Brandt, B., Lutfiyya, M.N., King, J.A., & Chioresco, C. ( 2014). A scoping review of interprofessional collaborative practice and education using the lens of the Triple Aim. Journal of Interprofessional Care, 28(5), 393-399.

Grindel, C.G. (2016). Clinical leadership: A call to action. Med-Surg Nursing, 25(1), 9-16.

Mannix, J., Wilkes, L, & Daly, J. (2015). Grace under fire: Aesthetic leadership in clinical nursing, Journal of Clinical Nursing, 24, 2649-2658.

Stetler, C.B., Ritchie, J.A., Rycroft-Malone, J., & Charns, M.P. (2014). Leadership for evidence-based practice: Strategic and functional behaviors for institutionalizing EBP. Worldviews on Evidence-Based Nursing, 11(4), 219-226.  Developing and Evaluating New Practice Approaches

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 (see attached file).

PICOT Question

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months


Clinical reasoning is a process used by nurses and other clinical professionals to collect data, process information, understand a patient’s situation or problem, develop treatments and interventions, and develop outcomes. This concept is often used synonymously with decision making or problem-solving. Even though they are related concepts, there is a difference in the process of clinical reasoning and the conventional decision-making process. The main difference between clinical reasoning and these other concepts is that the former focuses on the strategies that clinicians use to make their judgment and solve a problem (Simmons, 2010). Clinical reasoning is often applied in practice to enhance patient outcomes. Developing and Evaluating New Practice Approaches

How Reasoning Strategies are Applied in my Specialty Area.

           In developing interventions for improving the experiences and outcomes for intensive care unit (ICU) patients, various clinical reasoning strategies are often applied. One of the strategies most commonly used in this specialty area is the hypothetic-deductive model of reasoning. This reasoning strategy begins with the identification of initial cues about the patient or patient group, and then relevant information is developed to determine the causes of the cues and develop interventions. An example of the use of this strategy is Holdsworth et al. (2015). This study begins by hypothesizing that the mobilization of ICU patients is important, but there are attitude and belief barriers that prevent nurses from mobilizing patients. The researcher’s go-ahead to conduct a study of the nurses’ attitudes and beliefs with the help of a survey study and with the results they recommend interventions to help nurses improve the way they deal with patients. Needham (2008) also uses the same inquisitive strategy to determine how the mobilization of ICU patients can help to improve their physical functioning. In this case, the researcher performs an analysis of existing evidence to conclude that patients in ICU can enhance their physical activity for quicker recovery. Developing and Evaluating New Practice Approaches

Applying Reasoning Strategies to the Refinement of my EBP Project Question

My EBP question seeks to understand how the early mobilization of patients in intensive care can help them to recover quicker for early discharge to be possible. There are various reasoning strategies that I have used so far to develop the question and will be used to develop the appropriate answers to enhance patient outcomes. The basic strategy applied to refine the EBP project question is considering the patients’ situation. I made an observation that patients in intensive care take too long to be discharged, which led to the inquisitiveness of the situation to determine some of the reasons for the long hospital stays. To answer the develop question, I can apply the strategies of gathering and reviewing information from various research studies on the issue. There is a multitude of evidence on ICU patients’ hospital stay on online databases like Medline, CINAHL, and ProQuest. The information presented on these sites can help to evaluate the various strategies that are likely to be effective in improving the recovery of the ICU patients. Later, information processing, which involves an analysis, making of inferences, and prediction of outcomes, can be helpful in developing the best intervention for the ICU patients to recover quickly. After these strategies have been applied, then I can move ahead to take action for the improvement of ICU patients’ experiences and outcomes. Developing and Evaluating New Practice Approaches


Holdsworth, C., Haines, K. J., Francis, J. J., Marshall, A., O’connor, D., & Skinner, E. H. (2015). Mobilization of ventilated patients in the intensive care unit: An elicitation study using the theory of planned behavior. Journal of critical care30(6), 1243-1250.

Needham, D. M. (2008). Mobilizing patients in the intensive care unit: improving neuromuscular weakness and physical function. Jama300(14), 1685-1690.

Simmons, B. (2010). Clinical reasoning: Concept analysis. Journal of Advanced Nursing, 66(5), 1151-1158 Developing and Evaluating New Practice Approaches.