Running head: GLOBAL HEALTH 1

Global Health: QI, EBP, and Original Research Evidence

NUR3666

Florida International University

May 31, 2019

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Abstract

The purpose of this study is to discuss the differences between Quality Improvement (QI),

Evidence-Based Practice (EPB), and Original Research Evidence (ORE). Through this study, we

will determine how practice based on these three concepts, and their variances advance the

patient’s overall healthcare experience and outcome. We will also learn why nurses must know

and understand the differences between these vital concepts. It is known that patients are

frequently unutilized in the development, and enhancement of their care delivery. To improve a

patient’s interaction with healthcare professionals, the goal should be consistency and

consideration. By means of collaboration and contribution from healthcare professionals, and

direct patient feedback, improvement can occur throughout the care continuum. On a global

scale, technology, artificial intelligence (AI), and integrated systems effectively advance

healthcare approaches. Understanding the healthcare service delivery system in terms of the

conclusion of a patient’s involvement, the quality of care, practices and treatment that nurses

give will impact the patient’s overall experience.

Keywords: Global health, standard practices, quality improvement, systems, evidence-

based practice, original research evidence, and methods.

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Global Health: QI, EBP, and Original Research Evidence

Significance and Background

The significance and background in today’s healthcare system is vital. According to

Wiley, “Nursing education plays a vital role in the acquisition of EBP competence in nursing

students” (Labrague, DM, RN, CHSER, et al., 2019). Nurses can distinguish what is minimally

anticipated to progress our healthcare system on a global scale by sustaining any improvements

through acquired knowledge, skill and testing. Utilizing QI, EBP, and ORE, through a series of

interventions, data collection, evaluation and measuring outcomes, nurses help to improve value

in healthcare. As individuals interrelate across the globe, our health can be compromised in

numerous ways. Global health has gained consideration through study, research, and practice to

improve healthcare interactions for everyone worldwide. According to Global Health Now,

“Global health is an area for study, research, and practice that places a priority on improving

health and achieving equity in health for all people worldwide (Cemma, 2017). Nurses aid

healthcare goals as they gain insight on QI, EBP, and ORE, and their differences validate their

importance and how they are unified with healthcare delivery.

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Quality Improvement (QI)

Quality improvement, and improvement of effectiveness heavily relies on applying

discipline to our health practices. Quality improvement also requires the development and

enhancement of practical plans. When the practicality is adhered to it is conceivable to

incorporate the principles into our work as professionals. As healthcare professionals, we can

extend beyond the boundaries of the workplace to ensure patients get quality care. The aim of

quality improvement in global health is to overcome societal disparities while allowing all the

chance to improve their overall health. When individuals become sick, no matter where they are

in the world, they expect a certain level of treatment. When under a doctor’s care, sometimes a

patient may not know what level of care to expect, or if they are even getting the best care

possible. Therefore, it is up to us as champions to ensure that each patient receives the proper

care that they deserve and should expect.

According to the U.S. Department of Health and Human Services, “Improvement work

invariably involves work across multiple systems and disciplines within a practice. The quality

improvement (QI) team or committee (QIC) is the group of individuals within a practice charged

with carrying out improvement efforts” (Quality, 2019). The QI team may include individuals

such as, physicians, nursing staff, health educators, and even patients. In global health, QI is used

to make care better using systems that focus on the scope of service, along with the standards of

practice. We must know that we are expected to meet standards by increasing awareness and

realizing how we conduct ourselves throughout all interactions with patients. Nurses must

perform optimally while demonstrating proficiency. Nurses must possess competence to reach

reasonable decisions, actions, and outcomes. This includes having the ability to recognize how

quality improvement is beneficial, and how it can be utilized for a better patient care outcome.
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Evidence Based Practice (EBP)

Evidence-based practice is based on several factors such as patient input, internal

evidence, and external evidence. These factors may require analysis, evaluation, testing and

recording. According to Nurse.com, “Evidence-based practice is a conscientious, problem-

solving approach to clinical practice that incorporates the best evidence from well-designed

studies, patient values and preferences, and a clinician's expertise in making decisions about a

patient's care. Unfortunately, no standard formula exists for how much these factors should be

weighed in the clinical decision-making process. However, there are a variety of rating systems

and hierarchies of evidence that grade the strength or quality of evidence generated from a

research study or report” (Nurse.com, 2019). The various types of evidence-based practice

include: quantitative research, qualitative research, systematic reviews, and analysis.

Nurse.com further states, “Qualitative study/quantitative study: descriptive, word-based

phenomena, such as symptoms, behaviors, culture and group dynamics. Quantitative studies use

statistical methods to establish numerical relationships that are correlational or cause and effect”

(Nurse.com, 2019). Our textbook teaches that nurses must consider client uniqueness, i.e.,

financial, cultural, and other characteristics. According to our text, “The process of EBP includes

assisting in delineating a problem through communication of an identifiable problem, pursuing

and appraising the obtainable details, implementing a practice intervention as a product of the

evidence, and evaluating the accomplish process for effectiveness” (Boswell, EdD, RN, CNE,

ANEF, FAAN & Cannon, EdD, RN, ANEF, 2019). After initial contact with nurses, patients

should be confident that the nurse is competent to work with the patient using current, up-to-date

health information and practices. Then applying proper individualized patient care, that is

delivered with the expectations of the patient.

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Original Research Evidence (ORE)

Research has its responsibilities because there will be roadblocks along the way to

discovery and delivery. Nurses must always have knowledge of new evidence along with the

ability to scientifically incorporate any of that evidence into their daily practice. According to

our text, “Nursing has the responsibility to generate scientific data and to use that data to achieve

optimal outcomes. EBP uses the best clinical data available in making decisions about nursing

care. Thus, the profession demands that nurses not only be responsible for the use of research but

also participate in research to add to the body of nursing knowledge through EBP” (Boswell,

EdD, RN, CNE, ANEF, FAAN & Cannon, EdD, RN, ANEF, 2019). This type of practice also

improves the chances of delivering the highest quality of care, while simultaneously reducing

costs. Thorough research gives nurses opportunities to increase their knowledge and undergo

scientific processes which validate what they currently know and understand.

According to PubMed, “There is a tremendous need to enhance nurses' skills so that they

achieve competency in EBP in order to ensure the highest quality of care and best population

health outcomes. Academic programs should ensure competency in EBP in students by the time

of graduation and healthcare systems should set it as an expectation and standard for all

clinicians” (Melnyk, et al., 2018). Nurses are responsible for what they know and do not know

and must use their critical thinking skills when conducting research. They are also expected to

use data analysis through publications and properly evaluate their findings. They must also

appraise the evidence and use their decision-making skills to apply that evidence and research

data into their patient care. When nurses face barriers to research, they must find ways to utilize

their time, and place importance on the purpose of the research. They must improve their

attitudes and most of all, avoid resisting any changes that may occur as a result of their research.
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Discussion

Knowing what nursing is and understanding the various levels of nursing is important

prior to deciding to become one. What inspires an individual to become a nurse depends on that

person because we are all unique and capable of compassion. Being an agent of change is one of

the priorities that is placed upon one who decides to become a nurse. Nurses must have the

ability to validate and confirm the effectiveness of their practice by consuming the knowledge

and skill obtained through working directly with both patients and physicians. Providing

evidence-based quality care can be challenging; however, it is necessary to give patients the

quality care they need. In order to help people with their individual needs, nurses must always be

focused on changing and improving. Going with the flow, the service and information they

provide will ensure improvement. Nurses must also bear in mind the procedures or practices that

they use to ensure the client has a practical plan of care in place, and ready for application. Once

nurses have evaluated their strategies, they will know what further steps to take based on their

expertise, planning, and improving systems across their organization. Steps must be followed

and identified to assess the areas that need improvement.

Nurses wear many hats, such as advocates, counselors, and teachers which puts them in a

position to deal with serious issues such as the end of life. Nurses must deal with families of

patients and must possess the ability to implement their many roles during the call of duty.

Nurses require strong service orientation, and possessing a vision for improvement will cause

questioning, contemplation, and consideration of the desired outcomes. The more detailed

information nurses have about their goals will help them to be involved in achieving the common

goal or objective. With clarity, the execution of plans or goal setting is successfully

accomplished.
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Conclusion

Nurses work closely with physicians and patients; therefore, nurses must know the

differences between quality improvement, evidence-based practice, and original research

evidence. Nurses are on the forefront in the healthcare industry and are expected to be up-to-date

and competent. Nurses will have many opportunities to serve in many areas, and the important

discipline of patient care will impact the healthcare system. Many healthcare practitioners value

evidence-based practice because they want to provide the best care for the patient. In evidence-

based practice there are levels of evidence and the method requires detailed skill to solve

problems and incorporate the findings of evidence from studies and conclusions. For example,

patients rely on their nurse to give them the absolute best care that they can receive. The main

goal for nurses is to make the best decision using the best research and evidence.

Nurses are allowed to be up close and personal with patients to the point where patients

will tell them things that they will not tell anyone else. Nurses are trusted because they are in a

setting where people come to them for service sometimes at a time of uncertainty. This fact alone

can weigh heavily on the outcome of the patient experience. Moreover, hazards and risks should

be considered. For example, there are factors such as safety and whether or not the treatment

provided helps or endangers the patient. Knowing the differences between quality improvement,

evidence-based practice, and original research evidence will prepare nurses for their career. They

will be prepared and equipped to deal with just about any type of situation they may find

themselves in, whether it is in an inpatient or outpatient setting. The nurse will be able to

perform in a clear, concise, competent, and responsible way. As health professionals render

service, they also have the responsibility, and are expected to protect the ones they serve.
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References

Boswell, EdD, RN, CNE, ANEF, FAAN, C., & Cannon, EdD, RN, ANEF, S. (2019).

Introduction to Nursing Research Incorporating Evidence-Based Practice. In E. R.

Boswell, & E. R. Cannon, Introduction to Nursing Research Incorporating Evidence-

Based Practice (pp. 2-3). Odessa, Texas: Jones & Bartlett Publishing.

Cemma, M. (2017, September 26). What’s the Difference? Global Health Defined. Retrieved

from Global Health NOW: https://www.globalhealthnow.org/2017-09/whats-difference-

global-health-defined

Labrague, DM, RN, CHSER, L. J., McEnroe‐Pettite PhD, RN, D., Konstantinos, T., D’Souza

PhD, RN, M. S., Fronda MAN, RN, D. C., Mirafuentes MAN, RN, E. C., . . . Graham

MSN, RN, M. M. (2019, May 28). Predictors of Evidence‐Based Practice, Knowledge,

Skills. Miami, Florida, USA.

Melnyk, B. M., Gallagher-Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., & Tan,

A. (2018, february 15). The First U.S. Study on Nurses' Evidence-Based Practice

Competencies Indicates Major Deficits That Threaten Healthcare Quality, Safety, and

Patient Outcomes. Worldviews Evidence Based Nursing, pp. 16-25.

Nurse.com. (2019, May 26). Evidence-Based Practice. Retrieved from Levels of Eviedence:

https://www.nurse.com/evidence-based-practice

Quality, A. f. (2019, May 23). Practice Facilitation Handbook. Retrieved from Agency for

Healthcare Research and Quality: https://www.ahrq.gov/professionals/prevention-

chronic-care/improve/system/pfhandbook/mod14.html