Evidence Based Analysis Medical Clinic

Evaluating EvidenceBefore research should be used in practice, it must be evaluated. There are many complexities and nuances in evaluating the research evidence for clinical practice. Evaluation of research behind evidence-based medicine requires critical thinking

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.

Itroduction: Evidence-based practice is an approach to medicine that uses scientific evidence to determine the best practice (Beyea & Slattery, 2006). As nurses perform their daily tasks they must continually ask themselves, “What is the evidence for this intervention?”. Nurses are well positioned to question current nursing practices and use evidence to make care more effective. In order to improve patients’ outcomes it is the responsibility of the nurse to transition evidence-based practice into the norm, through application of daily practice (Flynn Makic, Rauen, Watson & Will Poteet, 2014). Continual evaluation of current practice must be performed to ensure the use of evidence-based practice opposed to practice based upon tradition. The implementation of evidence-based practice standardizes healthcare practices and diminishes groundless variations within care. These variations lead to the production of uncertain health outcomes (Stevens, 2013).

While this structure provides a starting point for the critique of evidence strength, the prudent evaluation and, subsequent, translation into practice guidelines requires further consideration (Greenhalgh, 2010). Research can be scrutinized into measures of quality. John Hopkins Hospital grades evidence on a high to low scale, A through C, based on criteria including consistency of results, reproducibility of findings, sample size of study, level of study control, organizational design, and expert opinion (Newhouse, Dearholt, Poe, Pugh, & White, 2005). Using this evaluation tool, an A score would result in a recommendation for clinical practice while a score of C should alert the clinician to a low quality of research and should not be incorporated into practice guidelines (Newhouse et al., 2005).

Nurses are responsible in providing holistic, quality care to their clients. In order to effectively provide such care Boswell and Cannon (2009, p. 2 & 7) states that nurses must base their provision of care on the most current, up-to-date health information available and sound nursing knowledge. This is where evidence-based practice (EBP) comes in. Polit and Beck (2010, p. 4) defined EBP as "the use of the best clinical evidence in making patient care desicions". This usually comes from research conducted by nurses and other healthcare professionals. Thus it is pertinent that research reports are critically analyzed.

Today, we are continually striving to improve the quality of care that we deliver and the best method in applying relevant research into clinical practice are through evidence based practice (EBP). We have now come to a time in our careers to shift our direction on how to employ evidence based practice techniques when managing our patient's health care needs. Facilitation is a method that has been investigated as a way to help clinicians accomplish the implementation of evidence into practice. As clinicians, we are encouraged to think outside the box and utilize critical thinking skills as well as express our role as nurses as part of the health care team.

Using evidence-based practice in daily patient care may seem like a time-consuming process, but in reality it is not. It should come as a natural process once incorporated into your daily routine. The process (as cited in Houser, 2013) involves six elements: (1) Ask a relevant clinical question, (2) search for the best evidence in the literature, (3) critically appraise the evidence, (4) integrate the evidence with clinical experience and client preferences, (5) evaluate the outcome of the practice change, and (6) disseminate the

Pain…fever…oozing pus. Who would want to experience that? The answer is no one. Yet, out of the sixty to seventy of women who undergo a cesarean section, twelve percent will experience these symptoms due to a surgical site infection (SSI) ("Adjunctive Azithromycin Prophylaxis for Cesarean Delivery", 2017). SSI are the primary cause of mortality and morbidity amongst cesarean section women. SSI are linked to increased length of stay, hospitalization rate, and healthcare costs. Many cases of SSIs are preventable with appropriate preoperative preparation and surgical technique (McKibben et. al, 2015). One specific prophylactic method is the use of antibiotics preoperatively. Using an EBP model, PICO,

Evidence-based clinical practice or evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” (Sackett et al., 1996). The beginning of Evidence-Based Practice (EBP), formerly known as evidence-based medicine, was initiated by Archie Cochrane in the 1970’s. Cochrane discovered that when many methods of research start developing revealed as main findings that the clinicians were making decisions about patient’s care from practices commonly used for similar illnesses (Mackey and Bassendowski, 2017). Cochrane considered that randomised controlled trials represented a reliable form of evidence that can provide with more valid information that initiated

Evidence based practice is an essential component of the quality health care practice. In a clinical practice setting, it is crucial to provide the best care possible to patients. In order to competently practice evidence based medicine (EBM), it is important to question the current practice, effectiveness of treatment, diagnosis and therapy, and to search for the valid research, appraise the research, and apply the results to the patient population as applicable (Straus, Glasziou, Richardson, & Haynes, 2011).

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.

According to Essential Evidence-Based Medicine, the definition of evidence-based medicine as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients (Mayer 2010). In 1999, several clinicians coined the term evidence-based medicine. At this point, evidence-based medicine assumed a major place in establishing the standard of care (Rubin and Haynes 2012). Most individuals would agree that medicine should be based on evidence and

Evidence- Based Practise is when Researchers used recent clinical information in making choices on the quality of patient care needs and this involves the combination of the best available evidence with clinical expertise, but also not for getting patient’s values, circumstance and consideration of clinical practice context. (Hoffman, Bennet &Del Mar 2013).

Evidence-based practice or EBP is the utilization of the best and up-to-date evidence available in the decision-making process about the patients’ healthcare (as cited by Courtney, Rickard, Vickerstaff, & Court, 2010). It is a combination of patient preferences, expert opinion, clinical expertise, organizational experience, and research (Newhouse, Dearholt, Poe, Pugh, & White, 2007). According to Spruce (2015), it is a combination of patient preference, clinician experience, and the best research available. It assists and informs administrative, educational, and clinical decision making (Newhouse et al., 2007). It ensures effectiveness, efficiency, and efficacy (Newhouse et al., 2007). Moreover, it weights cost, risk, and advantage (Newhouse

All health care providers who utilize evidence-based practice uses research evidence, clinical expertise and patient preferences which make up the components of evidenced based research. It may also be beneficial to use the systematic reviews which are the summary of the research results that will give information helps with the evidence-based practice process (Ahrq.gov, n. d.). The