The Experience of Implementing Evidence-Based Practice Change

Subject: Medicine

1025 words

3 pages

September 2nd, 2022

When delivering care to patients, nurses must use the current best practice derived from evidence-based research. They need to ascertain the quality of evidence before applying it in clinical practice. This is typically done through the critiquing process – the systematic procedure of appraising a research piece’s limitations and strengths to ascertain its credibility and applicability or feasibility in nursing practice. This paper provides a comprehensive critique of the article titled “The Experience of Implementing Evidence-Based Practice Change: A Qualitative Analysis.” It suggests the phenomena under study and highlights the research design or method adopted by the investigators. However, it does not mention the community or group being surveyed. Moreover, the abstract included in the research report provides a concise overview of the study. It provides information about the survey’s purpose, the adopted methodology, the selection procedure, and the sample size. The authors also summarized the research’s main findings, conclusion, and pertinent recommendations.

The authors distinguished the research problem being investigated, unambiguously and explicitly stating it in an easily identifiable manner. The research problem distinguished by the investigators is significant to the nursing profession. The problem statement also presents a persuasive argument for the new survey. A strong correlation exists between the research problem and the method used: the selected research method was appropriate for evaluating this issue comprehensively.

The authors did not delineate the relevant research questions in the report. Moreover, they did not also include a justification for not incorporating the research question in the report. Appropriate procedures for safeguarding study participants were fully enforced. Study participants were informed of voluntary participation in the survey. Regarding IRB approval, Irwan et al. (2013) five groups were mandated to acquire IRB approval from their institutions before embarking on EBP projects. Appropriate measures were implemented to minimize risks and increase participants’ benefits.

The qualitative research design adopted by the investigators was congruent with the procedures used to gather and analyze data. There were significant variations in the time participants spent on their respective projects. The selected design provided investigators with the opportunity to capitalize on the timely understanding of the measured concepts. Moreover, it did not limit the number of contacts with the research participants. Furthermore, the study population was adequately identified: the authors also provided a comprehensive description of the study sample. The study sample comprised verbatim reflection log entries from nineteen teams who took part in the IEBPC during 2009 and 2010 (Irwin et al., 2013). The approach utilized to enrol study participants was appropriate and productive. The researchers used the direct sampling approach; this method enhanced information richness and helped the investigators address the survey’s needs.

The procedures used to collect data in the survey were appropriate. The qualitative researchers cross-checked the data; this approach helped them achieve triangulation. The researchers asked appropriate questions whose responses were recorded in a proper fashion using a secure virtual office website: the collected data was also sufficient. The researchers also provided a detailed description of the data gathering and recording procedure, which were appropriate for the selected study design. The adopted data collection procedure was effective in minimizing potential research bias. The study’s data collection staff received adequate training and experience in EBP procedures before the survey’s commencement.

The researchers used adequate strategies to enhance the rigor or trustworthiness, and integrity of their survey. The authors documented the survey methods and decision procedures adequately to ensure the confirmability and suitability of findings. Irwin et al. (2013) also provided an adequate description of the data management and analysis procedures. The analysis generated an appropriate thematic pattern that helped elucidate the barriers and facilitators of EBP implementation in clinical practice. A content analysis was done to minimize the possibility of bias.

The researchers provided comprehensive summaries of the study findings; they used supporting arguments and excerpts to enhance readers’ understanding of the survey’s outcomes. The themes developed in this study sufficiently captured the data’s meaning. Furthermore, the analytical process provided an insightful, authentic, provocative, and meaningful overview of the experiences encountered during EBP implementation. A logical correlation existed between the themes developed by the investigators, which in turn helped them develop an integrated and convincing general theme. Figures were the primary visual aid used in the survey; they provided comprehensive summaries of the study findings.

The study findings were interpreted within the appropriate cultural/social context. Moreover, the significant outcomes’ interpretations and elucidations were based on the findings of previous studies conducted on the topic. The content included in the discussion section was congruent with the identified research limitations. The investigators provided a comprehensive discussion of the study’s implications for clinical practice. The researchers recommended that nurses adopt the critical success factors distinguished in the article to plan efficient EBP implementation. Other implications include the EBP project’s implementation for meaningful interdisciplinary collaboration and team building and the integration of small milestones, deadlines, and clear activity descriptions into the EBP plan’s creation. These recommendations are reasonable, feasible, practicable, and complete; they did not include implications for prospective studies.

The report is well-written, organized, and adequately comprehensive for critical analysis. Moreover, the elucidations of the adopted procedures, outcomes, and findings’ interpretations were vivid and thorough. The investigators’ clinical experience and qualifications enhance confidence in the study findings and subsequent interpretations. Moreover, the study findings can be trusted; this is due to the strategies adopted by the researchers to ensure the rigor and trustworthiness of the adopted methodology. The survey contributes meaningful evidence that could be utilized in nursing practice to promote quality care delivery. Given that EBP is the foundation of nursing practice, nurses can integrate the critical success factors distinguished in the survey into the EBP implementation process to foster interdisciplinary collaboration, team building, and quality care provision.

Nurses are required to utilize valid, reliable, and high-quality findings from various studies to improve patient outcomes and provide appropriate care. To execute this role effectively, they typically perform critical evaluations of available literature. Although the researchers did not include a literature review and theoretical framework in the article, they adhered to the recommended guidelines for conducting qualitative research. Therefore, the outcomes can be generalized and adopted by nurses during EBP implementation.

References

Irwin, M. M., Bergman, R. M., & Richards, R. (2013). The experience of implementing evidence-based practice change: A qualitative analysis. Clinical Journal of Oncology Nursing, 17(5), 544–549. Web.

Appendix

Research Critique Framework: Qualitative

Aspect of the Report	Critiquing Questions	Answer Yes/No	Comment(s)
Title	Is the title a good one, suggesting the phenomena and the group or community understudy?	Yes	The research article’s title is appropriate It suggests the phenomena under study and highlights the research design adopted by the investigators. It does not mention the community or group being surveyed
Abstract	Did the abstract clearly and concisely summarize the main features of the report (problem, methods, results, conclusion)?	Yes	It clearly and concisely summarized the research’s main findings, conclusion, and pertinent recommendations.
Introduction Statement of the Problem	Was the problem stated unambiguously, and was it easy to identify? Is the problem significant for nursing? Did the problem statement build a persuasive argument for the new study? Was there a good match between the research problem and the methods used – that is, was a qualitative approach appropriate?	Yes	It delineates the problem unambiguously. It easy to identify the problem. The problem significant for nursing. The problem statement built a persuasive argument for the new study. The qualitative approach was appropriate.
Research Questions	Were research questions explicitly stated? If not, was their absence justified? Were questions consistent with the study’s philosophical basis, underlying tradition, or ideological orientation?	No	The research questions were not explicitly stated. No justifications were provided for its omission.
Literature Review	Did the report adequately summarize the existing body of knowledge related to the problem? Did the literature review provide a strong basis for the new study?	No	The authors did not include a literature review analysis in the research report.
Conceptual/Theoretical Underpinnings	Were key concepts adequately defined conceptually? Was the philosophical basis, underlying tradition, conceptual framework, r ideological orientation made explicit and was it appropriate for the problem?	No	The authors did not include a conceptual framework in the research report.
Method Protection of Human Rights	Were appropriate procedures used to safeguard the rights of study participants? Was the study externally reviewed by an IRB/ethics review board? Was the study designed to minimize risks and maximize benefits to participants?	Yes	Appropriate procedures for safeguarding study participants were fully enforced. Study participants were informed of voluntary participation in the survey. Irwan et al. (2013) indicate that indicate that IRB approval requirements were inconsistent across organizations; however, five groups were mandated to acquire IRB approval from their institutions before embarking on EBP projects. Appropriate measures were implemented to minimize risks and increase participants’ benefits.
Research Design	Was the identified research tradition congruent with the methods used to collect and analyze data? Was an adequate amount of time spent with study participants? Did the design unfold during the data collection, giving researchers opportunities to capitalize on early understandings? Was there an adequate number of contacts with study participants? minimized?	Yes	The research design adopted by the investigators was congruent with the procedures used to gather and analyze data. There were significant variations in the time participants spent in their respective projects. The selected design provided investigators with the opportunity to capitalize on the timely understanding of the measured concepts. It did not limit the number of contacts with the research participants.
Sample and Setting	Was the population adequately identified? Was the sample described in sufficient detail? Was the approach used to recruit participants or gain access to the site productive and appropriate? Was the best possible method of sampling used to enhance information richness and address the needs of the study?	Yes	The study population was adequately identified. The authors also provided a comprehensive description of the study sample. The study sample comprised verbatim reflection log entries from nineteen teams who took part in the IEBPC during 2009 and 2010 (Irwin & Richards, 2013). The approach utilized to enroll study participants was appropriate and productive. The researchers used the direct sampling approach; this method enhanced information richness and helped the investigators address the survey’s needs.
Data Collection	Were the methods of data gathering appropriate? Were data collected through two or more methods to achieve triangulation? Did the researcher ask the right questions or make the right observations, and were they recorded in the appropriate fashion? Was a sufficient amount of data gathered?	Yes	The procedures used to collect data in the survey were appropriate. It allowed the researchers to create a verbatim record for evaluation. The qualitative researchers cross-checked the data; this approach helped the investigators to achieve triangulation. The researchers asked appropriate questions whose responses were recorded in a proper fashion using a secure virtual office website. The collected data was sufficient – the authors contrasted, arranged, and merged conceptualizations and themes until a consensus was attained.
Procedures	Were data collection and recording procedures adequately described and do they appear appropriate? Were data collected in a manner that minimized bias? Were the staff who collected data appropriated trained?	Yes	The researchers provided a detailed description of the data gathering and recording procedure, which were appropriate for the selected study design. The adopted data collection procedure was effective in minimizing potential research bias. The study’s data collection staff received adequate training and experience in EBP procedures before the survey’s commencement.
Enhancement of trustworthiness	Did the researchers use effective strategies to enhance the trustworthiness and integrity of the study? Were the methods for trustworthiness adequate? Did the researcher document research procedures and decision processes sufficiently that findings are auditable and confirmable?	Yes	The researchers used adequate strategies to enhance the rigor or trustworthiness, and integrity of their survey. All entries were reviewed by two qualitative investigators using content analysis to distinguish concepts and themes. Documenting all evaluations on verbatim documents allowed the investigators to maintain an audit trail. These personalities then contrasted, arranged, and merged conceptualizations and themes until a consensus was attained. The authors documented the survey methods and decision procedures adequately to ensure the confirmability and auditability of findings.
Results Data Analysis	Were the data management and data analysis methods adequately described? Did the analysis yield an appropriate “product” (a theory, taxonomy, thematic pattern)? Did the analytic procedures suggest the possibility of bias?	Yes	The researchers provided an adequate description of the data management and analysis procedures. The analysis generated an appropriate thematic pattern that helped elucidate the barriers and facilitators of EBP implementation in clinical practice. A content analysis was done to minimize the possibility of bias.
Findings	Were the findings effectively summarized, with good use of excerpts and supporting arguments? Did the themes adequately capture the meaning of the data? Did the analysis yield an insightful, provocative, authentic, and meaningful picture of the phenomenon under investigation?	Yes	The researchers provided comprehensive summaries of the study findings; they used supporting arguments and excerpts to enhance readers’ understanding of the survey’s outcomes. The themes developed in this study sufficiently captured the data’s meaning. Furthermore, the analytical process provided an insightful, authentic, provocative, and meaningful overview of the experiences encountered during EBP implementation.
Theoretical integration	Were the themes or patterns logically connected to each other to form a convincing and integrated whole? Were figures, maps, or models used effectively to summarize conceptualizations? If a conceptual framework or ideological orientation guided the study, were the themes or patterns linked to it in a cogent manner?	Yes	A logical correlation existed between the themes developed by the investigators, which in turn helped develop an integrated and convincing overall theme. Figures were the primary visual aid used in the survey; they provided comprehensive summaries of the study findings. As indicated earlier, a conceptual framework was not developed for this survey.
Discussion Interpretation of the findings	Were the findings interpreted within an appropriate social or cultural context? Were major findings interpreted and discussed within the context of prior studies? Were the interpretations consistent with the study’s limitations?	Yes	The interpretation of findings was performed within the appropriate cultural/social context. The significant outcomes’ interpretations and elucidations were based on the findings of previous studies conducted on the topic. The content included in the discussion section was congruent with the identified research limitations.
Implications/recommendations	Did the researchers discuss the implications of the study for clinical practice or further research-and were those implications reasonable and complete?	Yes	The investigators provided a comprehensive discussion of the study’s implications for clinical practice. The researchers recommended that nurses adopt the critical success factors distinguished in the article to plan efficient EBP implementation. Other implications include the EBP project’s implementation for meaningful interdisciplinary collaboration and team building and the integration of small milestones, deadlines, and clear activity descriptions into the EBP plan’s creation. These recommendations are reasonable, feasible, practicable, and complete; they did not include implications for prospective studies.
General Issues Presentation	Was the report well-written, organized, and sufficiently detailed for critical analysis? Was the description of the methods, findings, and interpretations sufficiently rich and vivid?	Yes	The report is well-written, organized, and adequately comprehensive for critical analysis. The elucidations of the adopted procedures, outcomes, and findings’ interpretations were vivid and thorough.
Researcher credibility	Do the researchers’ clinical, substantive, or methodologic qualifications and experience enhance confidence in the findings and their interpretation?	Yes	The investigators’ clinical experience and qualifications enhance confidence in the study findings and subsequent interpretations. They are certified nurses in the field of oncology with advanced educational qualifications.
Summary Assessment	Do the study findings appear to be trustworthy-do you confidence in the truth value of the results? Does the study contribute any meaningful evidence that can be used in nursing practice or that is useful to the nursing discipline?	Yes	The study findings can be trusted; this is due to the strategies adopted by the researchers to ensure the rigor and trustworthiness of the adopted methodology. The survey contributes meaningful evidence that could be utilized in nursing practice to promote quality care delivery. Given that EBP is the foundation of nursing practice, nurses can integrate the critical success factors distinguished in the survey into the EBP implementation process to foster interdisciplinary collaboration, team building, and quality care provision.

Note. Adapted from “Guide to an Overall Critique of a Qualitative Research Report,” by D. F. Polit and C. T. Beck, 2017, Nursing Research: Generating and Assessing Evidence for Nursing Practice (10th ed.), pp. 106-109.