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Log In or Register to continue With the rise of obesity, the use of the forearm to measure blood pressure is becoming more prevalent. Public health practitioners must be ready to implement an evidence-based approach in their work to meet health goals and sustain necessary resources. The project director relied on the nurse manager for assistance with scheduling meetings, taking minutes, and providing follow-up on issues. The intervention, to develop leaders, was planned using a synthesis of research and theory, along with data from qualitative interviews at two nonparticipating sites and chart audit data (Gifford et al., 2009). (1999). In addition to education, multifaceted interactive interventions are needed to communicate the practice change to clinicians (Greenhalgh et al., 2005; Titler, 2008). • Trying the change Evidence-based practice involves a process similar to research utilization. As Outlined in the Literature* Farrington, M., Lang, S., Cullen, L., & Stewart, S. (2009). The project was accepted for development through an evidence-based practice staff nurse internship program (Cullen & Titler, 2004), thus garnering organizational support and establishing the project as an organizational priority. • State the desire to make the change systematic and with minimal impact on workload (e.g., standing orders to make the process easy for the clinicians) Iowa City: Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics. Education is an essential first step to develop an understanding of why and how the evidence-based practice is done, but education alone does little to change practice (Farmer et al., 2008; Forsetlund et al., 2009; Jablonski & Ersek, 2009; Nicol et al., 2009; Pipe et al., 2009; Prior et al., 2008). Informal leaders who influence peers by evaluating innovations for use in certain settings and promoting clinicians’ use of evidence in clinical decision making are referred to as opinion leaders. Journal of Nursing Management, 19(1), 112-132. This may include feedback on the provider’s performance. Although strong evidence supports the use of some strategies that promote the integration of evidence-based practice in health care, other strategies need further testing. The application of evidence-based practice is the responsibility of every nursing leader, especially in the nurse manager role. • Report the performance gap data demonstrating an opportunity for improvement (e.g., percent of swallow screens completed within 24 hours of admission) • Staff meetings Nurses in leadership positions have responsibility for building and expanding the use of evidence-based practices in care delivery to improve patient and organizational outcomes. Strategies to promote evidence-based practice / evidence-informed decision-making by nurses. • Postings – The increasing use of clinical guidelines, development of health care standards. Nurse educators incorporate evidence-based practice into their curricula and use evidence-based strategies to support their teaching strategies. Melnyk, B.M., & Fineout-Overholt, E. (2011). Localizing or adapting practice recommendations to fit the local setting and culture is an essential step in the process, often using the role of the opinion leader and team of local experts (. (2004). The revised policy was resubmitted and accepted. Academic detailing involves a multifaceted approach to discussions with practitioners. Most researchers report that these readings are not interchangeable (Schell et al., 2007; Schell et al., 2010). Informal leaders who influence peers by evaluating innovations for use in certain settings and promoting clinicians’ use of evidence in clinical decision making are referred to as opinion leaders. Some healthcare organizations choose to add a sixth step, “disseminate,” to the cycle. A literature search revealed a scarcity of research and specific guidelines for selecting the correct equipment to obtain accurate blood pressure readings. • Report to senior leadership The basic procedure for obtaining an accurate blood pressure reading is the following (Pickering et al., 2005; Rushing, 2004; Turner et al., 2008): • Measurements should be taken on the upper arm, • The cuff bladder length should be at least 80% of arm circumference and the width should be at least 40% of upper arm length, • The patient’s arm is supported horizontally at the level of the heart, • If the patient is sitting both feet should be flat on the floor, • The nurse and the patient should not talk during the procedure, • Do not use the arm that has an IV or the side of a mastectomy, • The patient should be sitting 3 to 5 minutes before measurement.

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