1. jwilde 
Evidence-based practice requires the healthcare worker to be open to change.  They must avoid doing things a certain way because that’s how it’s always been done, and transition to utilizing research and studies to guide their actions.  However, our text discusses that organizational factors are often the most significant barriers to developing evidence-based models.  Lack of interest, motivation, leadership, vision, strategy, and direction among leadership were all cited as barriers frontline staff members face (Melnyk & Fineout-Overholt, 2019).  In my practice, I have worked for university hospitals that conduct research showing the best way to do something or a new treatment, the organization would drag its feet implementing these changes at a policy level.  These facilities would be policy-driven and speak against implementing the new research until the policies would be updated.  Policy reviews were not conducted regularly and some policies are these facilities were a decade or more since the last revision.  These policies are necessary, but regular reviews to follow evidence-based practice models are a daunting task, within Banner Health we have thousands of policies that require regular updates.  But with the ease of access to new information, the speed of new studies being produced, and the rapid change within healthcare, we must become active participants in our health systems to ensure these policies are updated regularly.
As we learn about evidence-based practice, EBP, and its importance, we should be mindful ensure we utilize it.  We don’t want to be like the ones that were warned of in Revelation “I know your works; you are neither cold nor hot. I wish that you were either cold or hot.  So, because you are lukewarm and neither cold nor hot, I am about to spit you out of my mouth” (NRSVUE Bible, 2021, Revelation 3:15-16).  As we learn of its importance, we should ensure we incorporate EBP into our practice and into our workplaces.
In a study of nurse practitioners and their use of EBP, the authors found the nurse practitioners reported EBP as very important but they did not utilize it. The authors cited several reasons, such as lack of EBP competence, lack of support, inadequate resources.  But they also cited physician-driven practice and the need to maintain professional/political boundaries (Clarke et al., 2021).
In a separate study the authors found that a stronger emphasis on evidence-based implementation must be utilized.  The authors discuss the success or failure of EBP initiatives depend on the leadership, with nurses in the unique position of both frontline staff and leaders.  Nursing formal and informal leaders are key stakeholders in the implementation efforts.  As nurses become active leaders in the implementation of EBP these initiatives will the authors suggest more initiatives will be successful (McNett et al., 2021).
Within my own practice, I manage several procedural areas, an hybrid Cardiac Cath and Interventional Radiology Lab, Endoscopy department, and the Medical Imaging nurses that perform procedures in MRI, Nuclear Medicine, CT, and Ultrasound.  There are several opportunities to identify new research and developing procedures.  As we expand our services and bring new procedures onboard, the staff have opportunities for training, as well as new approaches, e.g., cardiac baths through ulnar arteries instead of traditional femoral or radial approaches.  On several occasions new procedures have required I become an expert before the staff begin so that they can rely on me as a resource.  We recently launched our structural heart program performing transcatheter aortic valve replacement, TAVR, in the lab instead of a hybrid OR suite.  This was an effort that required collaboration with myself and my boss maintaining the progress forward and overall vision.  As OR would meet with us and discuss the research of best practices, I was required to be able to speak to our procedures and policies at a high level and bring other leaders onboard ensuring proper context of the research.  When procedures began, I have to be able to give answers to not only my direct reports but the staff of other leaders and ensure we followed EBP that many were not familiar with.
References
Bible Gateway. (2021). Bible gateway passage: Revelation 3 – new revised standard version updated edition https://www.biblegateway.com/passage/?search=Revel…
Clarke, V., Lehane, E., Mulcahy, H., & Cotter, P. (2021). Nurse practitioners’ implementation of evidence?based practice into routine care: A scoping review. Worldviews on Evidence-Based Nursing, 18(3), 180–189. https://doi.org/10.1111/wvn.12510Links to an external site.
McNett, M., Tucker, S., & Melnyk, B. M. (2021). Evidence?based practice requires evidence?based implementation. Worldviews on Evidence-Based Nursing, 18(2), 74–75. https://doi.org/10.1111/wvn.12494Links to an external site.
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in Nursing & Healthcare: A guide to best practice (4th edition). Wolters Kluwer Health. 
2. tayc 
I hope you are all having a great week so far! Before we begin, we must remember what exactly is meant by evidence based practice or EBP. According to a recent article, evidence based practice is “a holistic, individualized approach to health care delivery. Health care professionals who use this approach apply patient values, relevant and proven evidence, and clinical expertise to every aspect of care delivery, with the goal of providing optimal care and improving patient outcomes” (Duquesne University, 2022). This type of care is important as it works to provide patients with the best care based on scientific findings. EBP works to improve quality care for patients while working to help a facility efficiently run. As an office manager of a Gastroenterology practice, evidence based practice is important in working to improve our patient outcomes and help our facility improve our care. The GI field is always improving and finding new ways to diagnose and treat conditions related to the GI tract. For instance, a lot of our patients suffer from a condition known as celiac disease. Years ago, it would of been hard to treat this condition and detect it, but now we have the ability to utilize lab serum testing and ways of diagnosing through endoscopes. With my profession, I plan to maintain my relevance by continuing to work to provide treatment options for patients and finding ways to make testing measures affordable. One thing I have mentioned in the past is how our practice has opened affordable plan services for procedure options to locate GI conditions. One article found evidence based practice “prevents unsafe/inefficient practices and improves healthcare quality, but its implementation is challenging due to research and practice gaps” (Cardoso et al, 2021). 
In the next three years I hope to still be in the Gastroenterology field. I really enjoy the management position I am in with being an office manager, but I want to do more. My practice is a small practice with one doctor. While sometimes this feels like a good thing, I feel as though I am limited on the amount of patients we can help. I hope int he next three years to move into a management position for a GI surgical facility or even at a hospital setting. My plan is to continue to implement ways to make screenings and care affordable. But also having access to treatment options that we can provide to patients for further protection. Scientific findings are so important to me, especially in the GI field. Years ago, the recommended age for colonoscopy screenings was over 50. My grandfather died at 51 due to having colon cancer that went undetected. Now the recommended age is 45 and there are so many patients that we have found it much much sooner and the outcome is not just to remain comfortable. We are able to treat it in many different ways. The Bible verse I have selected for this week is Proverbs 3:5-6, “Trust in the Lord with all your heart and lean not on your own understanding; in all your ways submit to him, and he will make your paths straight” (Bible Gateway Passage, n.d). To me this relates to the topic as I do not know where my mind will be in the next three years, but the Lord will get me to where I am going. He will ensure my path leads me to hopefully continue to improve the field and help those around me. I wish you all the best this week !