Evidence-based practice (EBP) aims to help healthcare organizations meet the Quadruple Aim of improving patient experience, population health, costs, and provider work life. EBP integrates research evidence, clinical expertise, and patient values into decision-making. It can help enhance patient experience through better care, improve population health by generating insight into health characteristics, reduce costs by improving value and seamless data tracking, and improve provider work life by identifying stressors and easing burdens. Overall, EBP provides an approach for organizations to consider when aiming to achieve the balanced objectives of the Quadruple Aim.

1. Evidence-Based Practice and the Quadruple Aim.
Evidence-Based Practice and the Quadruple Aim. Assignment: Evidence-Based Practice and
the Quadruple Aim Healthcare organizations continually seek to optimize healthcare
performance. For years, this approach was a three-pronged one known as the Triple Aim,
with efforts focused on improved population health, enhanced patient experience, and
lower healthcare costs. More recently, this approach has evolved to a Quadruple Aim by
including a focus on improving the work life of healthcare providers.Evidence-Based
Practice and the Quadruple Aim.ORDER A PLAGIARISM-FREE PAPER HEREEach of these
measures are impacted by decisions made at the organizational level, and organizations
have increasingly turned to EBP to inform and justify these decisions. To Prepare: Read the
articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and
Kim et al. (2016) provided in the Resources. Reflect on how EBP might impact (or not
impact) the Quadruple Aim in healthcare. Consider the impact that EBP may have on factors
impacting these quadruple aim elements, such as preventable medical errors or healthcare
delivery. To Complete: Write a brief analysis (no longer than 2 pages) of the connection
between EBP and the Quadruple Aim. Your analysis should address how EBP might (or
might not) help reach the Quadruple Aim, including each of the four measures of: Patient
experience Population health Costs Work life of healthcare providers By Day 7 of Week 1
Submit your anaylsis. Submission and Grading Information To submit your completed
Assignment for review and grading, do the following: Please save your Assignment using the
naming convention “WK1Assgn+last name+first initial.(extension)” as the name. Click the
Week 1 Assignment Rubric to review the Grading Criteria for the Assignment. Click the
Week 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this
area. Next, from the Attach File area, click on the Browse My Computer button. Find the
document you saved as “WK1Assgn+last name+first initial.Evidence-Based Practice and the
Quadruple Aim.(extension)” and click Open. If applicable: From the Plagiarism Tools area,
click the checkbox for I agree to submit my paper(s) to the Global Reference Database. Click
on the Submit button to complete your submission. ALL WORK MUST BE IN APA FORMAT
Learning Resources Note: To access this week’s required library resources, please click on
the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in
nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 1, “Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry”
(pp. 7–32) Boller, J. (2017). Nurse educators: Leading health care to the quadruple aim

2. sweet spot. Journal of Nursing Education, 56(12), 707–708. doi:10.3928/01484834-
20171120-01 Note: You will access this article from the Walden Library databases.
Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving patient care through
nursing engagement in evidence-based practice. Worldviews on Evidence-Based Nursing,
13(2), 172–175. doi:10.1111/wvn.12126 Note: You will access this article from the Walden
Library databases. Kim, S. C., 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. doi:10.1111/wvn.12171 Note: You will access this article from the
Walden Library databases. Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson,
K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based
practice. American Journal of Nursing, 110(1), 51–53.
doi:10.1097/01.NAJ.0000366056.06605.d2 Note: You will access this article from the
Walden Library databases. Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt,
E. (2014). The establishment of evidence-based practice competencies for practicing
registered nurses and advanced practice nurses in real-world clinical settings:Evidence-
Based Practice and the Quadruple Aim. Proficiencies to improve healthcare quality,
reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(1), 5–
15. doi:10.1111/wvn.12021 Note: You will access this article from the Walden Library
databases. Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost
and meaning in work. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160
Note: You will access this article from the Walden Library databases. Walden University
Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019, from
https://academicguides.waldenu.edu/az.php?s=19981 Required Media Laureate Education
(Producer). (2018). Introduction to Evidence-Based Practice and Research [Video file].
Baltimore, MD: Author. Introduction to Evidence-Based Practice and Research Program
Transcript NARRATOR: Research evidence and nursing practice. MARIANNE
SHAUGHNESSY: Well, nursing is an art and a science. And research really relates to the
science component, because looking at clinical issues through the lens of strong scientific
research allows us to provide the best care possible for our patients. At the end of the day,
it's incumbent upon all of us to stay current with what's being published. NARRATOR:
Creating new knowledge to improve patient care at the bedside. JANET BROWN: Well,
research is the creation of new knowledge. And evidencebased practice is finding a way to
address a clinical problem. There are commonalities, but evidence-based practice is looking
at outcomes directly related to that clinical question that one is grappling with in practice.
NARRATOR: Using evidence-based practice to inform clinical decisions. NOLA SCHMIDT:
Imagine if you had an ill family member, would you want the healthcare providers, the
physicians, the nurses to say, well, let me consult the eight ball and take a guess about how
we should treat your loved one? Or should we actually base our decisions for care on what
we know is best practice, or what the evidence tells us will get us the best outcomes? So I
think evidence-based practice is critical for providing patients the care they deserve.
MARIANNE SHAUGHNESSY: Nursing research takes a closer look at the phenomena that
surround the human experience of health and illness and takes a rigorous scientific

3. approach to looking at that experience, to either describe it or define and identify ways to
influence the outcome of that experience.Evidence-Based Practice and the Quadruple Aim.
And as the questions arise from clinical practice, theoretical frameworks give us a way to
contextualize or look at the problem. And research is the systematic process that we use to
identify solutions to the problem or generate conclusions. There's constant knowledge
coming out every day. And you don't have to look any farther than the multitude of medical
and nursing journals published every month to the health section of the New York Times.
And it's very important for all of us to stay current on what the best practices are. As new
research is published and new knowledge is identified, it's important that we all apply that
to our clinical practices, because it's what we as nurses do. Well, all of nursing practice
should be built on evidence. But our evidence comes from a lot of different sources.
Sometimes it's tradition, sometimes it's authority, and sometimes it's a journal article.
But it's incumbent upon us to stay current with what's coming out, because once new
information is published and new Introduction to Evidence-Based Practice and Research ©
2018 Laureate Education, Inc. 2 knowledge is generated, as nurses, we have to stay on top
and let our practice be guided by the evidence. In many facilities, they've begun to develop
evidence-based practice committees that work hand in hand with policy and procedure
committees, which makes perfect sense when you think about the fact that policies and
procedures do need to be updated periodically. And it provides a wonderful opportunity for
those nurses who are working on policies and procedures to combine efforts with nurses
who want to bring their practice up to the current state of the science, so that the nurses
who are working on the evidence-based practice committee can collect the information,
summarize it, and then design a policy or procedure for the facility that is defined by the
evidence. There are many, many different ways nursing research has changed nursing
practice.Evidence-Based Practice and the Quadruple Aim. I can pull an example for you from
my discipline in gerontology. Nurses used to be taught that for patients who were unsafe
ambulating on their own, that it was wise to use vest restraints to restrain them in bed. And
particularly, we used that strategy often with older adults, who might have been unsafe
ambulating independently around their hospital rooms or to the bathroom. So for years, we
tied patients into beds with the belief that we were keeping them safe. And there were two
nurse researchers at the University of Pennsylvania School of Nursing, Doctors Neville
Strumpf and Lois Evans, who took on this nursing research question and published some
very, very significant evidence in the 1980s that showed that once these patients were
restrained in the beds, they were not only at just as much risk for injury because of trying to
release themselves from restraints, but they were also then subjected to all of the hazards of
immobility, such as pressure ulcers, pneumonia, urinary tract infection, and other problems
that we know result from keeping patients mobile in bed. So when that piece of literature
came out, the result of that has been the fact that most nursing homes and many hospitals
are now either restraint free or have very distinct and time-limited procedures for using
restraints. So that's one obvious example. There are multitudes of others, because nursing
research has really guided best practices in doing everything from IV dressing changes to
trach care. A lot of the tasks that nurses do every day have been addressed through nursing
research. JANET BROWN: Evidence-based practice is essentially important because finally,

4. we have a model in nursing that will move research to the bedside. And the process of
evidence-based practice is a process that practicing nurses can get their arms around and
embrace and bring forward, finally.Evidence-Based Practice and the Quadruple Aim. For
years, we tried to talk about research utilization, and the process was just too complex to be
able to move into any sort of change. And the evidence-based practice movement has really
propelled the use of research at the bedside for practicing nurses, and that's why it's so
important. Introduction to Evidence-Based Practice and Research © 2018 Laureate
Education, Inc. 3 It is essential that patient care be based on evidence. For as long as nursing
has been around, we have based our practice on many different models of knowledge--
tradition, authority, trial and error, and we can't do that anymore. There is no way that we
will have all of practice be based on evidence immediately, but we have to move toward that
model. And having practicing nurses engaged in implementation of best practice is the only
way that this change will happen. And as we look at practice and best practice, we must rely
on a pyramid of evidence in making decisions about what research is ready to be
implemented. So we have to have good research in order to have evidence-based practice.
Students get confused, because as we go through the evidence-based practice model, they
see that when we're doing an evidence-based practice project, there will be steps that are
recognized, the same steps as in the research model. And so those processes are very much
the same. And students get confused when they're doing evidence-based practice, thinking
that they're essentially doing research. Practicing nurses have to keep clear what their
objectives are. Practicing nurses, staff nurses are charged with answering clinical questions
and making certain that they are doing practice that is yielding good outcome. And that's
what evidence-based practice is. Research is one of the scariest words in the English
language for a baccalaureate student and certainly a new graduate. NOLA SCHMIDT: Well, I
think the key to evidence-based practice is remembering that it involves three components.
It involves what is best evidence, what is the clinician's judgment, and what is the patient
preference. So we have to look at what's worked for us in the past as a clinician, what has
been our practice. And we also have to inquire about what the patient perceives would be
best for them. Just because it works for everyone doesn't mean that it will work for the
patient that you're taking care of. I think these decisions aren't made in a vacuum.
Evidence-Based Practice and the Quadruple Aim.You consult with your team, other nurses,
other physicians, the pharmacist, other healthcare providers, in making decisions about
what should be the plan of care. When I was a clinical nurse specialist, we were working on
an adult med-surg and pediatric unit. And at that time, the peds and adult unit had merged.
And so the nurses were using patient-controlled analgesia, PCA pumps, on the adults, but
we weren't using them on the kids. And so the nurses wanted to start using the PCA pumps
on the children. So one of the nurses sort of spearheaded this, and she went out and she got
some articles. She shared them with the physicians and with the pharmacist, and we came
up with a protocol that allowed us to begin allowing children to use the Introduction to
Evidence-Based Practice and Research © 2018 Laureate Education, Inc.Evidence-Based
Practice and the Quadruple Aim.Evidence Based PracticeEvidence-based practice (EBP)
refers to the integration of best evidence from research, patient values and clinical expertise
into decision-making processes within the health care environment. EBP is intended to

5. enable health care providers (such as nurses) translate findings from research into clinical
practice (Melnyk&Fineout-Overholt, 2018). EBP is recognized as a key factor for meeting
the Quadruple Aim in health care, defined as: improving patient experience of care
(including satisfaction and quality); improving the health of populations; reducing per
capita cost for health care; and improving the work life of health care providers and reduce
burnout (Sikka, Morath&Leape, 2015). In this respect, EBP helps to reach the Quadruple
Aim as determined by the four measures of patient experience, population health, costs, and
work life of health care providers.Meeting the objective of achieving the Quadruple Aim is a
difficult exercise. With no perfect solution for achieving the four objectives in the health
care system, EBP serves as a good starting point through presenting guidelines for
organization. Firstly, EBP helps to enhance the patient experience through better care. The
core of EBP is improving provider-patient conversation with a focus on effectiveness and
efficiency. In presenting research evidence on what works best for patients, EBP augments
expertise with experience from clinicians and patients to build a comprehensive model of
real life provider-patient interactions. Clinicians who use EBP get to understand the
common pitfalls of health care delivery and formulate strategies for how best to navigate
challenging patient conversations to achieve the best outcomes (Sikka et al., 2015).
Secondly, EBP helps to improve population health. EBP includes survey data collections that
generate insight into population health characteristics. This information helps in
understanding past and current population health events, and predicting future events. The
information can then be used to design intervention that target specific aspects of the
population (Melnyk&Fineout-Overholt, 2018; Sikka et al., 2015).Evidence-Based Practice
and the Quadruple Aim.Thirdly, EBP helps to reduce per capita cost of health care through
improving value. The tools presented by EBP helps with seamless data tracking. This
function is useful for allowing providers to instantly assess their performance even as they
track data across the health care system. This enables cost-effective implementations
(Melnyk&Fineout-Overholt, 2018). Finally, EBP helps to improve the work life of health care
providers. Changes with the health care system have typically been met with much
skepticism since they increase stress, burnout and feelings of not providing quality care to
patients, instead of easing provider burden as initially intended. EBP helps in identifying the
right way to implement changes so that provider satisfaction is improved. EBP does this by
engaging them differently with evidence that offers an effective and delightful change
approach. For all medical personnel, EBP helps to shrink the gaps between building a
knowledge base and testing that knowledge base in practice. Rather than practically testing
new care concepts and approaches, medical personnel can now rely on EBP to eliminate the
need for tests (Kim et al., 2016; Melnyk&Fineout-Overholt, 2018).Evidence-Based Practice
and the Quadruple Aim.EBP is all about using the best available evidence to make clinical
decisions that ensure the best outcomes. EBP helps to focus on patient engagement by
building the required skills such as motivational interviewing so that providers can engage
in better interactions with patients thus contributing to this objective of the Quadruple Aim
(Crabtree et al., 2016). In this respect, EBP helps to reach the Quadruple Aim as determined
by the four measures of patient experience, population health, costs, and work life of health
care providers. As such, EBP should be the standard of care in health care systems to enable

6. them achieve the Quadruple Aim objectives.Evidence-Based Practice and the Quadruple
Aim.