I need a respose to this discussionSarah Discussion mod 3            According to Tracy and O’Grady

I need a respose to this discussionSarah 

Discussion mod 3
            According to Tracy and O’Grady (2019), one of the core competencies of advanced practice nurses (APN) is evidence-based practice (EBP). It is defined as the conscientious, explicit, and judicious use of the current research-based evidence used to make decisions about the care of individual patients. EDP is the dominant approach used by APNs for clinical decision-making, integrating policies, and seeking evidence for every aspect of practice. There are three levels of core competencies that can be identified; the interpretation of the use of EBP principles in individual clinical decision making, interpretation and use f EBP principles for patient care, and the use of EBP to evaluate clinical practice. There is four steps process to determine if EBP has been defined. They are as follows, formulation of a clinical question, identification and retrieval of pertinent research findings based on literature review, extraction and critical appraisal of data from pertinent studies, and clinical decision making based on this process.
             According to Alatawi et al. (2020), the challenges/barriers encountered by the APN in developing and implement EBP projects can be categorized as individual barriers. Individual barriers can be demonstrated in implementing EBP among nurses, lack of nurse’s knowledge, skills, awareness, lack of professional; characteristics, attitude, experience, language barriers in using EBP. Individual barriers to implementation can demonstrate a lack of professional characteristics. For example, a nurse’s lack of professional autonomy was linked to evidence-based nursing implementation. The lack of awareness, knowledge, and skills can be a barrier for a nurse to trust and implement EBP concepts. A nurse’s attitude and experience can be a barrier to implementing EBP.  A nurse can be unwilling to change or try new ideas, and this would cause them to adhere to evidence-based practice poorly. The language barrier is a big problem in nurse-patient relationships. The language barrier between a nurse and a cognitively impaired or patient who does not speak English can impact the implementation of EBP. Another barrier is the organization, lack of support and supervision, time restriction, lack of training and education, limited resources. A lack of training and education is another barrier. For example, the procedures nurse performed and trusted ten years ago are no longer recommended. Without adequate continued education, nurses and providers would not be aware of or learn how to implement evidence-based practice. Lastly, a lack of time for nurses to study and research evidence can be a barrier.  
            According to Correa-de-Araujo(2016), the recommendation to remove barriers are the increased demands for accountability in safety and health care quality improvement. The (IOM) Institute of Medicine has recommended that training and curriculum development include five core competencies. The competencies are patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and information technology. The AACN (American Association of Colleges of Nursing) also invested in developing a curriculum with new program standards for doctoral, master’s, and undergraduate levels. The education focuses on using evidence for clinical decision-making, systems of care, and the creation of Quality and Safety Education in Nursing Institute (QSEN).
 
Reference
Correa-de-Araujo, R. (2016). Evidence-Based Practice in the United States: Challenges,
            Progress, and Future Directions. 7(1): 2–22. https://www.ncbi.nlm.ni
            h.gov/pmc/articles/PMC4804828/           
Alatawi, M., Aljuhani,E., Alsufiany,F., Aleid,K.,Rawah,R., Aljanabi,S., Banakhar, M. (2020).
            Barriers of Implementing Evidence-Based Practice in Nursing Profession: A Literature
            Review. American Journal of Nursing Science.9(1), 35-42. https://www.researchgate.ne 
            t/publication/342896986_Barriers_of_Implementing_Evidence-Based_Practice_
            in_Nursing_Profession_A_Literature_Review
Tracy, M.F.,