Tiffany Dennis RE: Discussion 
Nurs 6052 Week 1 Main Post
Evidence-based practice (EBP) helps to take the guesswork out of nursing science. EBP can be defined as the meticulous use of research evidence compiled to improve patient outcomes, provoke quality, cost-effective, and efficient care (Bernadette Melnyk & Ellen Fineout-Overholt, 2018).
Organization website
            The Joint Commission (TJC) accredits and certifies over 22,000 health care organizations and programs in the United States. Health care facilities that desire to be accredited by TJC must endure an in-depth on-site survey every three years except laboratories; they require surveys to be conducted every two years. TJC surveys are meant to guide and assess the organizations performance in the areas of patient safety, treatment, and quality of care (The Joint Commission, n.d.).
            Where Evidenced-Based Practice (EBP) appears
             The mission of The Joint Commission is to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. Its vision is that all people always experience the safest, highest quality, best-value health care across all settings (TJC, n.d., para. 1). Every year TJC releases one of their most well none Evidenced-Based Practice (EBP) initiatives known as the National Patient Safety Goals. The goals are created by researching and gathering information about emerging patient safety issues from a plethora of experts and stakeholders. Once the information is gathered, then more EBP must occur to provide individualized goals for various healthcare settings such as ambulatory care, behavioral health, critical access hospitals, and many more(The Joint Commission, n.d.).
Is the organizations work grounded in EBP?
The Joint Commissions work is grounded in EBP because it is responsible for providing evidenced-based standards that focus on patient safety and quality care. These standards are not published until the completion of the seven steps of EBP has been completed. Once TJC compiles its annual list of standards, they are submitted for public feedback before actual publication, which is step four of the EBP process Integrate the evidence with clinical expertise and patient preferences and values. Research studies prove that EBP leads to higher quality care, improved patient outcomes, a reduction in cost for both the patient and facility and greater nurse satisfaction when compared to traditional approaches (Melnyk et al., 2010).
Perception
Usually, during a Joint Commission survey, the entire hospital is frantic and in an uproar. To endure these surveys has proved to be very stressful for all involved. From a leadership perspective, I have found reading these articles and researching TJC to be very insightful and informational. As a nurse at the bedside, we are given directives without adequately knowing the reasoning behind the interventions and objectives. Providing proper education, training and allowing input from nurses and other healthcare workers have proven to enhance nurses appreciation, knowledge competencies, and practice of EBP (Kim et al., 2016).
EBP is essential to our everyday lives both inside and outside healthcare facilities. Grocery stores, outlets, car dealerships all use EBP to promote sales and improve customer satisfaction because a return customer, patient, or volunteer are all essential to the survival of any business industry.
References
Bernadette Melnyk & Ellen Fineout-Overholt. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Lww.
Kim, S., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340“348. https://doi.org/10.1111/wvn.12171
Melnyk, B., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step: The seven steps of evidence-based practice. AJN, American Journal of Nursing, 110(1), 51“53. https://doi.org/10.1097/01.naj.0000366056.06605.d2
National patient safety goals. (n.d.). https://www.jointcommission.org/standards/national-patient-safety-goals/
The Joint Commission. (n.d.). About The Joint Commission. The Joint Commission. https://www.jointcommission.org/about-us/#:~:text=The%20mission%20of%20The%20Joint,the%20highest%20quality%20and%20value.
The Joint Commission. (n.d.). About The Joint Commission. The Joint Commission. https://www.jointcommission.org/about-us/#:~:text=The%20mission%20of%20The%20Joint,the%20highest%20quality%20and%20value.
TJC. (n.d.). Mission and Vision. https://www.jointcommission.org/about-us/#:~:text=The%20mission%20of%20The%20Joint,the%20highest%20quality%20and%20value.

Jennifer Drumm 
            As nursing continues to grow and evolve, it is vital to improving integrity with the assistance of evidence-based practice. EBP allows nursing to provide essential care to patients while reducing errors and utilize best practices.  Nurses can develop relationships with patients, capture professionalism daily, and decrease harm with new knowledge and research provided by EBP. Anytime EBP is used, it creates a stable foundation for nursing practice to grow as healthcare advances in precision and complexity. Nurse and health organizations benefit from the implementation of EVP research. Nurses who have the expertise of EBP are better guided in their decision-making when caring for the patient; therefore, quality of care is improved (Melnyk and Fineout-Overholt, 2018, p. 9). EBP validates they are providing care that is relevant and is best practice, thus increasing integrity.
           The U.S. Department of Veterans Affairs Healthcare exemplifies an organization that creates “evidence-based recommendations for care throughout the VA intending to ensure Veterans and Servicemembers receive high-quality health care. According to their mission, they “Honor America’s Veterans by providing exceptional health care that improves their health and well-being.” This mission blends well with their vision to continue benchmark of excellence in value in healthcare and benefits by providing exemplary services that are both patient-centered and evidence-based (Administration, 2020).  Their mission is similar to other private healthcare organizations and is commendable. They encompass EBP for all Veterans that can be challenging for a large governmental organization.
           My original thought was the Veterans Health Care system is a large government organization that has an outdated practice as a means to maintain low cost, with consistent care throughout all its facilities that doesn’t deviate. It isn’t easy to update effective practice, improve, and spread the evidence base for healthcare practices. The gap between research evidence on effective practices and practice itself is well known per Augustsson  et al., (2019) in a study on how to bridge this gap (Augustsson et al., 2019). A barrier to implementing change in large organizations is the sheer volume of people that need to change, priorities of stakeholders, and reimbursement for training.  I was also surprised that they had adopted EBP because my perception of organizations with this vision includes research and education-based institutions, such as John Hopkins or Mayo Clinic. My understanding of EBP has changed because it can be applied to reduce healthcare costs and improve care in all types of health care organizations regardless of size or type of institution.
Administration, V. H. (2020). About VHA – Veterans Health Administration [General Information]. Retrieved June 5, 2020, from https://www.va.gov/health/aboutVHA.asp
Augustsson, H., Churruca, K., & Braithwaite, J. (2019). Re-energising the way we manage change    in healthcare: The case for soft systems methodology and its application to evidence-based practice. BMC Health Services Research, 19(1), 666. https://doi.org/10.1186/s12913-019-4508-0
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

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