Assignment : Evidence Based Practice, Research, And Quality Improvement

Evidence-Base practice (EBP) is defined as: “based on problem identified from the practitioner’s area of practice; a combining of best evidence and professional expertise and an integration of this into current practice; about ensuring patients receive quality care, being part of quality improvement processes; about collaboration and requiring a team approach” (French, 1999). Scott and Mcsherry (2008) supported the French’s assertion, proposing the key elements of EBP are that it is a theory-driven process, which involves the use, evaluation and application of research; identification of best evidence; evaluation of care; problem solving; decision-making; clinical expertise; and requires patient involvement. Evidence-based practice is made of evidence, clinical expertise, patient preference, the context of care (Barker, 2013). In brief, evidence-based practice is the parameter in the nursing practice that it requires that the nurses gather and use clinical evidence to make decision for the patients so that in the nursing process they can deliver the quality of care for the patients (Ellis, 2013). In the other words, in the nursing practice all the nursing procedures performed by the clinical evidence supported.

NICE (2014) defines its clinical guidelines as recommendations, which are systematically-developed, on how healthcare professionals should care for a condition or conditions of patient. On the best available evidence, these recommendations are based (NICE 2014). Grol (2010) emphasizes the fact that to improve patient care, efforts are being made on evidence-based guidance, which is one way to do this. NICE guidelines are developed with methodological rigour using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument (Rapu & Matthews 2014). This instrument was designed as to assess, across the spectrum of health, the quality of practice guidelines (Brouwers et al. 2010). Furthermore, it provides guideline development directions and gives information that should be contained in guidelines (Brouwers et al. 2010). Established above, it provides a structure

Evidence-based practice is extremely important in health care. It is not only important to know how to perform a certain skill, but why it should be done. There needs to be a standard of care and providers need to know the best way of doing things based on evidence. The article mentions that in the 20th century, many medial decisions were made on doctor assessment and preference (Brower, 2017). Many physicians were practicing dramatically different when compared with one another, which led to the realization that changes needed to be made and Evidence-based practice began to develop. Even though Evidence-based practices have been in play for a while, there is a gap between understanding and applying evidence-based

Gerrish, K. Lathlean, J. (2015). The research process in nursing. West Sussex: John Wiley & Sons. p263.

Evidence-based practice is the practice of making clinical decisions based off the best available research evidence coupled with the nurse’s own expertise, while also taking into account, the patient’s assessments and own personal preferences. This use of research has proven effective at providing better outcomes and lower healthcare costs, yet there are several barriers, such as time, education, and support, which prevent nurses from consistently using evidence-based practice (AJN, 2012). The top three barriers to the use of evidence-based practice are lack of time, education, and support in implementing new practices and using them consistently.

Once an area of evidence-based practice has been chosen for investigation, the reviewer must locate current evidence sources and, using a structured approach, assess each for applicability to the issue being investigated. The aim of this paper is to use a Rapid Critical Appraisal Checklist (Melnyk and Fineout-Overholt, 2011) to support these sources of evidence into a review that discusses the importance of daily, high-level, multidisciplinary communication and patient safety. The summaries of these evaluations will be provided as an appraisal of each study.

Bradley, S., & Mott, S. (September 2012). Handover: Faster and safer? Australian Journal of Advanced Nursing, 30(1), 23-32.

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

The panel of health care experts tasked with formulating these guidelines included masters and Ph.D. prepared nurses, public health physicians, along with family practice physicians and public health researchers. The guidelines were created after the panel reviewed published research and evidence-based studies on the topic using rigorous evaluation, standardization, and inclusion criteria. Tables provided easily understood visuals on how recommendations were ranked and corresponded with the quality of the evidence reviewed. These easy to read tables allowed the reader to identify the strength of the recommendations as well as the level of evidence supporting each recommendation. Considerations as stated previously included not only the efficacy of the treatment but the cost and ease of implementation across the identified

Evidence base practice is essential in nursing practice. It incorporates 3 key components which are clinical expertise, patient values, and best research evidence in order to provide the most effective and safe decision making for patient care. Neglecting a key component can affect the accuracy and efficiency of a research. Clinical expertise is based on a clinician’s experience, skill, education level and understanding in a certain area of nursing practice. Patient values can impact evidence base practice depending on their needs, preferences, expectations, values, understanding, and concerns. Best research evidence can be obtained from clinical research with supporting evidence base literature and sound methodologies. Each component will be discussed in further detail and how it links to clinical decision making by registered nurses in order to achieve the best evidence-based practice available.

According to Stevens (2013), the call to develop and implement evidence-based practice (EBP) within all healthcare disciplines is fueled by legislative demands for improvement in standard medical metrics such as mortality and morbidity. However, increasing demands by the public for evidence related to the metrics and outcomes of such concepts as quality of life illustrate what may be more important to the client (Stevens, 2013). This client-directed focus has resulted in patient-centered outcomes research (PCOR) (Stevens, 2013). "The Patient-Centered Outcomes Research Institute (PCORI) helps people make informed health care decisions, and improves health care delivery and outcomes, by producing and promoting high integrity, evidence-based information

This essay will be a critical review on the study conducted by Majid et al (2011). The article which is titled ‘Adopting evidence-based practice in clinical decision making:

CSI is a severity scoring system that uses disease-specific measurements to categorize different levels of a patient’s severity. [51-53] These measurements include patient historical factors, physiologic parameters, and laboratory results. CSI covers a wide spectrum of diseases; more than 3,500 disease-specific severity matrices have been developed. It has been applied to predict patients’ prognosis[46], length of stay, re-hospitalization[54] and service cost[55, 56] and so on. Additionally, it has been used as a control factor in both retrospective [56, 57] and prospective clinical studies [58], which is hallmark of the Practice-Based Evidence (PBE) Research [59, 60]. Compared with traditional randomized control trial (RCT) studies[59], PBE studies simplify inclusion of a larger sample size, promote conducting long term follow-up, and are closer to real practice as opposed to the restrictions placed recruitment in RCTs. Compared with traditional observational studies[59], PBE standardizes confounding factors and makes the study design easier, more reliable, and more reproducible.

This piece of work will be exploring the different forms of research and their significance in the evidence-based practice.

Evidence based practices are important to explore for various diseases so that their efficacy level can be determined and medical staff can be trained accordingly. Particularly speaking in the context of chronic diseases, evidence based practices are to be evaluated with the joint efforts of multiple healthcare institutions so that it can bring benefits to the overall healthcare industry.