Evidence-Based Practice in Nursing Report

Evidence-Based Practice in Nursing Report


In module 1, the identified clinical question was, “In adults aged 65 y/o and above with Alzheimer’s disease (P), how does nonpharmacological therapy (I) compared with no form of therapy (C) lower behavioral and psychiatric symptoms of dementia (O) for four (4) weeks?” In relation to this topic, this essay will describe the eight (8) steps to integrating EBP into treating Alzheimer’s disease patients using nonpharmacological therapies to lower their behavioral and psychiatric symptoms of dementia. The essay will explore the potential barriers a clinician might face in implementing new interventions to address AD. Also, the essay will describe the sources of internal evidence that can provide data to improve patient outcomes.

Part 1

There are eight steps to integrating EBP into the health environment. These steps include (1) establishing formal implementation teams, (2) building excitement, (3) disseminating the project, (4) developing clinical tools, (5) piloting test the evidence-based practice change, (6) preserving energy sources, (7) timeline for success, and (8) celebration of success.

Establishing formal implementation teams: This project seeks to implement new nonpharmacological practices to lower behavioral and psychiatric symptoms of dementia in Alzheimer’s disease patients. T implementation team will comprise nurse leader, registered nurse (RN) staff, patients, patient caregiver, and accreditation board members (Schaefer & Welton, 2018). These stakeholders will actively collaborate to achieve improved patient care and outcomes.

Building excitement: To get the implementation teams on board to embrace the proposed change, embracing a collaborative effort and fostering effective communication will be motivating. Also, fostering a team culture whereby opinions by team members are considered in decision-making will motivate the team (Buccheri & Sharifi, 2017). Besides, identifying and empowering champions will ignite positive change. Further, providing feedback and positive reinforcement will boost the team’s morale towards the change implementation and success. Using quality and performance improvement data will strengthen the team’s passion and encourage creativity.

Disseminate evidence: In this step, multifaceted strategies like education will help overcome skepticism to change, skills deficits, and knowledge deficits. Also, experience sharing will be encouraged to emphasize the need for positive change outcomes, including internal and external evidence such as quality improvement data and actual patient values and experiences (Schaefer & Welton, 2018). Besides, evidence dissemination will involve the provision and assimilation of new interventions. Shared knowledge of the clinical issue and identified gaps in patient outcomes will be foundational to embracing change in clinical practice. Evidence summaries will be shared with providers and other key stakeholders.

Developing clinical tools: To implement the new practice into care, nurses must fill out checklists, document patient care records, integrate reminders and alerts into workflow processes at the point of care, and expose the providers to EBP information relating to the clinical question. Other clinical tools will include documentation templates, condition-specific order sets, clinical guidelines, contextually valid reference data, and diagnostic support embedded into EMRs (Oner, et al., 2021). Developing these tools will enhance the consistency and appropriateness of the new practice.

Piloting test the evidence-based change: Prior to EBP change implementation, testing it on smaller scale should be completed first. In this context, the EBP change piloting test will be done on a sampled number of Alzheimer’s disease patients with dementia before implementing the selected nonpharmacological interventions into the entire population (Buccheri & Sharifi, 2017). This will help identify clinical issues surrounding the feasibility and applicability of the new interventions on the future of AD treatment and EBP implementation efforts.

Preserving energy sources: Most people are resistant to change. To avoid change resistance in this EBP implementation, the appropriate strategies include active engagement of support staff, implementation of manageable projects, motivating and encouraging persistence, encouraging patience and tolerance, and anticipating setbacks while integrating EBP into the health environment (Duncombe, 2018).

Timeline for success: In reference to the PICOT question, the timeline for success will be four (4) weeks. As explained in step one, the new change to implement is nonpharmacological interventions to lower behavioral and psychiatric symptoms of dementia among AD patients. These interventions include music therapy, physical exercises, touch therapy, combined activities, and occupational activities.

Celebration of success: The success of this EBP implementation in the successful treatment of AD patients with dementia will depend on the collaboration of the implementation team. Upon success, the involved implementation team members will be recognized in the hospital newsletter, recognize the personnel in presentations, encourage administrators and supervisors to recognize them, promote their job position, and award them with gift cards.

In implementing a new practice to help AD patients’ lower behavioral and psychiatric symptoms of dementia, clinicians face various challenges. The main barriers for clinicians in implementing EBP in this clinical question include burnout, high demand for quality patient care, inadequate training, limits on time and other resources, lack of motivation, negative attitude, and the gap between clinical and educational practice (Duncombe, 2018). To overcome these barriers and improve patient outcomes, nurses should establish patient-centered goals, understand patient data, allocate sufficient resources, and establish a positive nurse-patient relationship. Also, nurses should perceive EBP as a consistent and effective approach to offering patient care. Besides, stakeholder engagement helps in EBP implementation with barriers of time, training, knowledge gap, and resistance is easily overcome.

Part 2: Sources of Internal Evidence

The six sources of internal evidence include quality management, clinical systems, finance, administration, human resource departments, and electronic medical records (EMR).

Quality management department: This is the first source of internal evidence. Information to improve patient outcomes includes patient satisfaction scores, incident reports, data published by accredited bodies, and data for regulatory bodies (Gomez-Benito et al., 2018).

Finance department information: This is the second source of internal evidence helpful in providing data to demonstrate patient outcomes improvement (Oner, et al., 2021). This source includes information like charges of medications, tests, supplies, medical equipment, readmission rates, and patient days.

Human resource department information: Human resource department deals with the recruitment and training healthcare professionals. As a source of internal evidence, HR information includes nurses’ education levels, nurse staff turnover, nurse-patient ratios, practitioner skills mix, contract labor use, labor category hours, and staffing ratios.

Clinical systems information: A clinical information system (CIS) is designed for critical care settings, such as the intensive care units (ICU). As a source of internal evidence for improving patient outcomes, CIS seeks to reduce medication errors, provide quality care to AD patients with dementia in real-time, and improve clinical decision-making (Coleman, et al., 2016). In this context, CIS varies with the system, e.g., pharmacy data and diagnostic test results.

Administration information: This source of internal evidence includes information such as patient preferences, patient values, patient concerns, patient complaints, and consequences of the treatment model (Gomez-Benito et al., 2018).

EMR information: Electronic medical information helps practitioners effectively diagnose AD patients, provide safe and quality care, and lower medication errors. Also, EMR information helps improve provider and patient communication and interaction (Coleman, et al., 2016). Besides, EMRs improve care convenience. Examples of EMR information include patient-level information gathered via clinical care documentation.


The essay has discussed the eight steps of integrating evidence-based practice into the health environment. In reference to module 1, the proposed change is to implement nonpharmacological practices to lower behavioral and psychiatric symptoms of dementia in Alzheimer’s disease patients. The barriers that nurse leaders face in implementing this change include burnout, high demand for quality patient care, inadequate training, limits on time and other resources, lack of motivation, negative attitude, and the gap between clinical and educational practice. Nurse training and education, creating patient-centered goals, and sufficient resources allocation can help overcome these barriers. In providing data to demonstrate improvement in patient outcomes, the sources of internal evidence include quality management, clinical systems, finance, administration, human resource departments, and electronic medical records. 


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