Discussion: Nursing Research and Evidence-Based Practice

In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care. 

Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).

                                                          To prepare:

Consider a recent clinical experience in which you were providing care for a patient.

Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?

What questions have you thought about in a particular area of care such as a procedure or policy?

Review Chapter 2, pages 31–34 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.

Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.

Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier. 

Post an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.

                                                           Required Readings

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 1, “Introduction to Nursing Research in an Evidence-Based Practice Environment” 

This chapter provides an introduction to nursing research, its history, and the evolution of evidence-based practice. It includes an overview of credible sources of evidences and a description of the different paradigms used in nursing research.

Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice”

The focus of this chapter includes an overview of the key aspects of evidence-based practice, a review of how to identify credible research and appraise its value, and, finally, a discussion on how to take the identified evidence and convert it into a practice.

Chapter 3, “Key Concepts and Steps in Qualitative and Quantitative Research” 

In this chapter, quantitative and qualitative research models are compared and the major steps in each approach are described. Information is also presented on the different sections of a research journal article and how you can identify the research model that was utilized.

Adams, J. S. (2010). Utilizing evidence-based research and practice to support the infusion alliance. Journal of Infusion Nursing, 33(5), 273–277.

Retrieved from the Walden Library databases.

This article examines how evidence-based research and practice supports infusion alliances. The text also specifies the increasing challenges that infusion nurses face.

Mallory, G. A. (2010). Professional nursing societies and evidence-based practice: Strategies to cross the quality chasm. Nursing Outlook, 58(6), 279–286.

Retrieved from the Walden Library databases.

This article describes strategies for reducing the gap between research knowledge and practice. The article also details how nursing societies could use these strategies to improve the quality of care.

Newhouse, R. P., & Spring, B. (2010). Interdisciplinary evidence-based practice: Moving from silos to synergy. Nursing Outlook, 58(6), 309–317.

Retrieved from the Walden Library databases.

In this article, the authors examine the state of interdisciplinary evidence-based practice (EBP). The authors detail efforts to promote interdisciplinary EBP, academic and clinical training regarding interdisciplinary EBP, and strategies that may facilitate EBP translation across disciplines.

Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y-L., Chang, Y-K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: Nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229–236.

Retrieved from the Walden Library databases.

This article reviews a study that sought to determine nurses’ awareness of, knowledge of, and attitude toward EBP. The article also describes factors likely to promote barriers to EBP adoption.

Shivnan, J. C. (2011). How do you support your staff? Promote EBP. Nursing Management, 42(2), 12–14.

Retrieved from the Walden Library databases.

This article explores the role of the nurse manager in supporting evidence-based practice. The article also explains barriers and strategies to promote EBP for a nurse manager.

Walden Student Center for Success. (2012). Clinical Question Anatomy. Retrieved July 9, 2014, from http://academicguides.waldenu.edu/content.php?pid=183871&sid=2950360 

Media

Laureate Education (Producer). (2012). Timeline of nursing research. Baltimore, MD: Author.

This multimedia piece features a timeline of major events in nursing research. The timeline highlights how historical events and seminal research have contributed to nursing practice.

Please cite at least 3 references

My specialty: Mental Health Nurse

To complete the discussion question you have to access to the resources in Walden library, you can access to my student portal:

Walden University

My walden

 username:

                         Password: Piloto05

Let me know if you need anything else, thanks

PROMPT:Choose an existing essay, and then write a “cover version” of it. ELABORATION:The main idea here is to do the same thing with an existing essay that a musician does when she covers an original song. That is, make it relevant for a new situation. First, be careful which essay you choose. In selecting, be conscious of who made the argument, when they made it, whom they made it to, and what their purpose was. DON’T just choose by an argument’s title. Also, be careful how you identify what the actual argument of the essay is (this can be trickier than you think.) Second, be thoughtful in re-imagining what the argument should look like, given that, now, you’re the author, the times are possibly different, and you have a different audience and purpose from the original argument. Take these things into consideration as you write, and make choices in the writing that reflect that awareness. Here’s an example: imagine you’ve chosen Judy Brady’s “I Want a Wife,” written in 1971 for the first issue of Ms. magazine, read by American women, in a time when women’s issues did not get covered by mainstream media. You’re not married as Brady was, so maybe it doesn’t make sense to rail against marriage inequality with the same personal passion she does. If you’re not a woman, your way of discussing women’s issues needs to account for that fact. Your audience is different (you’re not writing for Ms.), so there are different expectations readers would have for you. The times are different, so this might need to factor into how you make the claim now, versus how it was made then (i.e., what would’ve been shocking to people in 1971 wouldn’t be shocking now). Maybe you don’t fancy yourself a journalist like Brady, and so you choose not to deliver the writing as magazine article, but rather in some other form (an editorial on a webpage, perhaps? A rant on a YouTube post? A personal blogpost?). Hopefully, this gives you an idea of the kinds of decisions you’ll make. Essentially, you’ll need to do these things: (1) take an essay from another time, made by another person, for a different audience; (2) identify the central argument; (3) write something, from your own POV, in 2018, to an audience you choose, in a format you choose, that speaks to this time and place in a way that’s both true to the original argument, and also true to your personality as a writer.

ETHC445 Exam1. (TCOs 2, 4, 5, 6) The idea that the assisted suicide of terminally ill patients should be allowed simply at the patient’s direction reflects what type of ethics? (Points : 5) Hobbes’ State of NatureRand’s ObjectivismAristotle’s concept of VirtueThomas Aquinas’ concept of conscienceSocrates’ concept of excellence 2. (TCOs 1, 2, 7) What is the moral ideal of temperance? (Points : 5) Exercising control over one’s own desires and inclinationsKeeping one’s temper under controlMinimizing the impact of one’s decisionsSeeking the good of others before one’s ownOvercoming one’s passions 3. (TCOs 1, 2) One of the common errors in Ethics is that of the hasty conclusions. Hasty conclusions consist of what? (Points : 5) Rushed work under pressureComparing unknown cases to known ones to find precedentsEmbracing conclusions before examining cases fullyJudging cases by the source of their originBelief that first impressions are valid until challenged 4. (TCO 2) Prescriptive language is commonly used in ethics for what reason? (Points : 5) To indicate what is prohibited or impossibleTo indicate that one choice is better than othersTo show what actions are legalTo convey requirements and obligationsTo indicate that there are really no choices available 5. (TCOs 7, 8) Ethical Egoism proposes that all decisions should be made to promote what? (Points : 5) Our fiduciary responsibilitiesThe good will of othersOur self-interestsThe welfare of the communityStronger relationships 6. (TCOs 2, 4, 9) Free people are motivated toward forming social structures according to a social contract in order to overcome what problem identified by Thomas Hobbes? (Points : 5) The need to overcome disagreementsA perpetual state of warfareThe establishment of a monarchyTaxation to support the costs of governmentOrganized ways to select leaders 7. (TCOs 3, 6) Agricultural biofuels are not properly a renewable source of energy in the environmental ethics debate. Which of the following also is not a renewable source of energy? (Points : 5) Windmill turbinesHydroelectric powerTidal flow generatorsBiomass waste systemsSolar cells 8. (TCOs 3, 6, 7) The notion that the only thing good without qualification is a good will is attributed to whom? (Points : 5) St. Thomas AquinasSocratesJohn LockeImmanuel KantOliver Cromwell 9. (TCOs 8, 9) Which ethical concept is organized and directed toward following the greatest happiness principle? (Points : 5) Natural ethics and lawJustice and mercyRights and responsibilitiesVirtue-ethics of excellencePrinciple of utility 10. (TCOs 3, 6, 7) Syllogisms in formal deductive logic are called “valid” when: (Points : 5) the correct form of the syllogism style is used.the premise statements are true.the syllogism is first determined to be “sound.”the verbs are written in present tense.the conclusion proceeds from the premises. 11. (TCOs 1, 2) When choosing one course of action while working with a dilemma, the other courses of action are lost and become unavailable. This makes ethical choices in dilemma situations particularly what? (Points : 5) IncoherentComplicatedIllogicalPainfulCruel 12. (TCOs 1, 2, 7) What is the role of conscience as Thomas Aquinas sees it? (Points : 5) To teach ethical principlesTo disclose and build religious faithTo enable rational thought about consequencesTo align personal ethics with those of othersTo guide actions through a view of right and wrong 13. (TCOs 2, 8) The rule or principle to be applied in making decisions is an example of which kind of ethical discovery process? (Points : 5) Principle of utilityA posteriori rationalityA priori rationalityEmpirical rationalityScientific method 14. (TCOs 1, 2, 5) The Social Contract theorist whose troubled childhood was most clearly reflected in his theories was who? (Points : 5) Thomas AquinasThomas JeffersonJean-Jacques RousseauThomas HobbesJohn Locke 15. (TCOs 3, 6, 7) Kant’s concern that people choose to observe universal laws as their duty is expressed through what actions? (Points : 5) Their habitsTheir maximsTheir desiresTheir lovesTheir loyalties 16. (TCOs 2, 7, 8) Aristotle’s Ethics of Virtue have found modern application for business and industry through what practice? (Points : 5) Resolution models applicationsGoals and objectivesCore values of organizationsBusiness modelsProfessional codes of discipline 17. (TCOs 2, 8) Professional codes of conduct serve what function for business and industry? (Points : 5) Allow businesses to avoid training professional staffersEnable transfer of valued employees across state linesEnable contracting of temporary employeesSpecify continuing education needs and requirementsProviding assurance of the professional qualifications of members 18. (TCOs 2, 7) Aristotle’s Ethical Doctrine of the Mean measured personal virtues on a scale that included the virtue itself, the excess of it, and the deficiency of it. If the virtue is COURAGE and the deficiency is COWARDICE, what is the excess? (Points : 5) WisdomModerationThere is no excessRecklessnessLove 19. (TCOs 8, 9) In personal or organizational conflict, what benefits accrue to all parties when a leader or consultant employees one of the ethical conflict resolution models of Week 6? (Points : 5) Objectives of what winning the conflict means get refined and better understoodConflict management gets slowed down and settled.Conflict can be handled in a sequential, step-by-step mannerParties can be reconciled without solving the issuesPersonal relationships can be separated from issues 20. (TCOs 1, 2) The Latin term a priori describes the origin of knowledge developed rationally, and the term a posteriori describes knowledge developed through observation and experience. What is an example of ethics is best described as discovered in an a postiori manner? (Points : 5) Social ethicsCare-based ethicsConsequentialist ethicsTheological ethicsOperational ethics 21 The Environmental Protection Agency (EPA) was created through a congressional enabling act as a governmental agency to act on the concerns voiced by environmental ethicists. Their actions include all of the following except for which one?Subpoena regulation offendersMonitor situations of environmental concernFine offendersSponsor new legislation on environmental issuesconfiscate property of offenders(TCOs 1, 2, 7) 22 What is the moral ideal of prudence? (Points : 5)Taking a traditional approach to problematic situationschoosing behavior judiciously by consulting experienceTaking care to slow down decision makingAvoiding risksResisting impulsiveness23 One of the common errors in Ethics is that of the double standard. Double standard consists of what? (Points : 5)Discriminating in the application of ethical criteria based on our own preferencesSetting aside ethical criteria in special casesTaking steps to avoid condemnation of othersUsing one set of criteria for judging cases concerning ourselves and another for all othersSuspending judgment when concerned that the consequences would be too severe24 Prescriptive language in ethics is often characterized by what common word? (Points : 5)RightProperBestPossibleShould25 Each person ought to do whatever will best promote his or her own interests. (Points : 5)UtilitarianismKant’s Categorical ImperativeSocial Contract TheoryEthical EgoismGilligan26 John Locke, as a Social Contract theorist, is said to have been the most influential person who was not actually present at the table when what document was written? (Points : 5)The Articles of ConfederationThe Declaration of IndependenceThe Magna CartaThe ConstitutionThe Treaty of Westphalia27 Animal sentience is demonstrated by all the following except which one? (Points : 5)ConsciousnessAwarenessResponse to external painful stimuliAnimatednessEmotive response28 (TCOs 3, 6, 7) Kant said that the only thing “good without qualification” is what? (Points : 5)The best interests of all concernedActs of mercyThe amount of happiness producedPersonal virtuesA good will29 (TCOs 8, 9) “We ought to do whatever will promote the greatest happiness for the greatest number.” This is an example of what? (Points : 5)Ethical EgoismUtilitarianismKant’s Categorical ImperativeSocial Contract TheoryGilligan30 (TCOs 3, 6, 7) Syllogisms in formal deductive logic are called “sound” when the syllogism is determined to be “valid” and: (Points : 5)the premises share common terminology.there are three or more premises.the premises are true statements.all of the premises are written in present tense.the premises have been independently cited.31. (TCOs 1, 2) Different from normal problem solving, dilemmas are different in what aspect? (Points : 5)Problems are much more complicatedWhen one choice is chosen, the opportunity for the others is lostProblems are much more urgentProblems are so much more real and less theoreticalProblems usually involve not honoring our own virtues32 (TCOs 1, 2, 7) According to Thomas Aquinas, what ethical capacity do people of every culture naturally possess? (Points : 5)Logical thinkingPersonal virtuesSelf-interestAbility to learn lessonsConscience33. (TCOs 1, 2, 5) The world view of ruthless and unending competition for property and wealth was spelled out in which of these concepts? (Points : 5)Locke’s notion of the natural state of manRawls’ notion of the veil of ignoranceAristotle’s notion of the doctrine of the meanHammurabi’s code of lawHobbes’ state of nature34 (TCOs 3, 6, 7) Which school of ethics is primarily applied as a practical matter through rights and duties? (Points : 5)ObjectivismNormative ethicsConsequentialist ethicsDeontological ethicsInterdisciplinary ethics35 (TCOs 2, 7, 8) Personal development and discovery through the repetition of good acts and study of virtue characterizes what ethicist? (Points : 5)PlatoAristotleLutherAugustineSocrates36 (TCOs 2, 7) Aristotle’s Ethical Doctrine of the Mean measured personal virtues on a scale that included the virtue itself, the excess of it, and the deficiency of it. If the virtue is BEING FRIENDLY, and the excess is BEING INGRATIATING, what is the deficiency?(Points : 5)UnconcernThere is no deficiencyAngerAnnoyingBeing surly37. (TCOs 8, 9) Processes and systems designed to slow down disagreeing behavior and think situations through more deliberately are called (Points : 5)value clarification processes.conflict resolution systems.objectivist tactics.primary schools of ethics.care-based ethics.38. What is the moral ideal of justice? (Points : 5) Acts of mercy beyond what is required Making decisions in order to build friendships Meeting legal requirements Evaluation of situations according to their merits Meeting the terms of the Social Contract39. One of the common errors in Ethics is unwarranted assumptions. Unwarranted assumptions consist of what? (Points : 5) Preconceptions before ethical dilemmas are confronted Failing to read carefully and with attention to detail Taking too much for granted Speculating apart from information Treating case studies carelessly40. Ethics that teaches us what we should do in our own self-interest is taught through which style of ethics? (Points : 5) Rousseaus social constructionism Rands objectivism Aristotles politics Contemporary care-based ethics Platos Ring of Gyges example41. The Environmental Protection Agency (EPA) was created through a congressional enabling act as a governmental agency to act on the concerns voiced by environmental ethicists. Their actions include all of the following except for which one? (Points : 5) Subpoena regulation offenders Monitor situations of environmental concern Fine offenders Sponsor new legislation on environmental issues Confiscate property of offenders42. (TCOs 8, 9) John Stuart Mill’s theory of Utilitarianism is the most common form of ethics in use today. It is used so commonly because it belongs to which of the Primary Schools of Ethics? (Points : 5) Care-based Ends-based Economy-based Law-based Efficiency-based43. TCOs 3, 6, 7) Syllogisms in formal deductive logic are called “sound” when the syllogism is determined to be “valid” and: (Points : 5) the premises share common terminology. there are three or more premises. the premises are true statements. all of the premises are written in present tense. the premises have been independently cited. 44. Different from normal problem solving, dilemmas are different in what aspect? (Points : 5) Problems are much more complicated When one choice is chosen, the opportunity for the others is lost Problems are much more urgent Problems are so much more real and less theoretical Problems usually involve not honoring our own virtues45. (TCOs 1, 2, 7) Where did Thomas Aquinas say that conscience originates? (Points : 5) Through the hard work of reasoning Direct gift from God in all cultures through natural law An a priori source By observing the objects and actions of the world An empirical response of guilt for past actions Page 2 – Essays 1. (TCOs 1, 2, 3, 7) In support of TCO #7 and in the Week 7 discussions, you developed and placed into the threaded discussions your personalized ethics statement of what has become important to you in the practice of ethics as you have practiced ethics during the course. Your first task in this question is to briefly present that personalized statement in just a few sentences before continuing with the question. Much of the rest of the exam will involve your working with that personalized statement through brief applications and cases. Use your ethical philosophy to solve the following ethical situation. Explain how your philosophy helped you make your decision. Should citizens have an ethical obligation to serve their country when it is at war? Under what circumstances, if any, is it ethical for a person to refuse to serve? A significant number of people believe war is always wrong, and that no circumstances justify one nation’s taking up arms against another. Is this view ethically sound? How about realistically? Please state which side you agree with, and why. Explain and defend your position using your ethical position statement. In answering, be sure to look at both sides of war: that is, a country defending itself against aggression and of a strong country coming to the aid of a weaker country that has been attacked unjustly. Then, explain how your ethical philosophy affected how you answered this problem. (Points : 30) 2. (TCOs 1, 2, 7) Analyze the following ethical situation using YOUR ethical philosophy. Read the situation and then in your answer, explain why this is an ethical situation, what the “issues” are, and how an “ethical” person would resolve them. Explain how YOUR ethical philosophy has helped you read a conclusion about how to resolve or analyze this situation. Employees’ worth to their employers may diminish before they are eligible for retirement. In such cases, the employer is faced with the dilemma of choosing between retaining an old and trusted yet unproductive worker for 5 or 10 more years, or firing that worker and jeopardizing his or her retirement benefits. 1. Should an employer have an ethical obligation to keep such unproductive, but loyal employees? What if the employee had been a problem his or her entire career? Are there certain circumstances where your answer to these questions would be different? 2. What is the duty of an unproductive employee to his or her employer? Is there an ethical obligation to retire when productivity begins to wane? If a person is simply “coasting” for his or her last few years, is that person “unethical?” Be sure to explain your answer. (Points : 30) 3. (TCOs 1, 7, 9) How do you feel St. Thomas Aquinas would have solved the above ethical situation differently or the same as you did using your philosophy? Please explain the reasons for the similarities or differences. (Points : 40) 4. (TCOs 1, 2, 4, 9) A first-term junior senator has placed a bill before the Senate that promises to correct tax inequities that affect thousands of workers. However, the bill is being held up in committee. The senior senator who serves as Sub-Committee Chairperson is responsible. The senator, however, has learned of a secret scandal in the Chairperson’s personal life. The junior senator visits the Chairperson and tells him that unless the bill is released from committee, he will divulge the scandal to the press. The Chairperson then releases the bill from committee and it is passedand becomes law. Identify and tell what ethical philosophy the senior and junior senators are using, if any. Now, use your ethical philosophy to analyze the situation. Explain how, using your philosophy, you would have solved this situation either the same way as the characters in the situation did, or differently. Why? (Points : 30) 5. (TCOs 5, 6) You work for a grocery store and a new manager is hired to oversee your department. He comes into your department (the butcher shop) and explains to you that for the past 6 months, your department has been losing money for the store because of the waste and spoilage going on from having to discard unsold meat and poultry. He tells you that from now on, he wants you to package ground meat in smaller, more compact packages, with older meat on the bottom of the package (so it is not visible to the customer) and the fresher meat on the top, where it is visible to the customers. In this way, you can move more of the older meat and still receive the top dollar for it. As he leaves the department where you were having the discussion, he turns and says, “And by the way, one more month of losses like we had last month from this department, and you can kiss your job goodbye.” Will you repackage the meat in the way he requested? Why or why not? Explain what ethical analysis you used to come to this conclusion. (Points : 30) 6. (TCOs 6, 8) Analyze your answer above using the Front Page of the Newspaper ethical dilemma resolution model. Show your steps. (Points : 40)

Can you PLEASE HELP ME with this assignment!? for Microsoft corp



Based on the external factors, internal factors, Strategic Analysis and TOWS analysis below,

Provide the four functions of management (P.L.O.C) down below for Microsoft Corp:

Operations: 2 for Planning, 2 for leading, 2 for organizing, 2 for control

Marketing: 2 for Planning, 2 for leading, 2 for organizing, 2 for control

Finance: 2 for Planning, 2 for leading, 2 for organizing, 2 for control

HR: 2 for Planning, 2 for leading, 2 for organizing, 2 for control

IT: 2 for Planning, 2 for leading, 2 for organizing, 2 for control

R&D: 2 for Planning, 2 for leading, 2 for organizing, 2 for control

The point of the PLOC is to dig into the management foundation of the firm. THANK YOU VERY MUCH!

• Attachment 1
• Attachment 2
• Attachment 3
• Attachment 4
• Attachment 5
• Attachment 6
• Attachment 7

Exhibit 6 : P. L. O. C Functional AssessmentFunctionalATEDPLANNINGLEADINGORGANIZINGCONTROLOperationsMarketingFinanceHRITR&D]