Evidence Based Clinical Practice

In this essay, I am going to consider how evidence-based practice can be used to support, justify, legitimate and/or improve clinical practice. I am also going to explore and discuss primary and secondary research evidences about how nursing interventions can potentially improve the quality of life of patients in the community suffering from heart failure. I will gather these evidences using a literature search which I will include an account of. Using a critiquing framework for support, I will appraise both primary and secondary evidences that I have chosen. I will also look at potential non-evidential factors that can influence evidence utilisation in practice. Finally, a conclusion will be drawn.

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).

The incorporation of evidenced-based practice (EBP) into nursing practice is supported by research to positively improve the quality of care and improve patient outcomes. EBP is important to the nursing profession because it also leads to increased job satisfaction, teamwork, and levels of engagement in clinicians (Melnyk, et al., 2017). Miniature research projects such as quality improvement projects, surveys, and clinical research studies are frameworks used to get feedback and data from patients during their time spent in health care systems. EBP is not the standard of care in many health care systems (Melnyk, et al., 2017). This due to many factors, including lack of EBP mentors, nursing programs that do not incorporate EBP into the curriculum,

Unfortunately, “VTE comprised of DVT and/or PE represent a serious public health challenge, affecting up to 600,000 Americans annually. The consequences can be deadly; VTE has been identified as the most common cause of preventable mortality in hospitalized patients, accounting for up to 10% of hospital deaths” (Shermock et al., 2013, p. 1) It is imperative that all patients admitted to the ICU should be assessed for VTE. The assessment should be done frequently. It is important to assess both subjective and objective data. Past medical history is very important. It is essential to find out if the patient has any predisposition to a VTE including any trauma to veins, any varicosities, obesity, COPD, HF. Certain medications can also put a patient at risk for VTE such as oral contraceptives, hormone therapy, tamoxifen, or raloxifene. Also, any recent surgeries such as orthopedic, gynecologic, gastric, or urologic and past surgeries involving veins or a central venous catheter can put a patient at risk. Objective data includes fear, anxiety, and pain. Monitor vital signs frequently. Check the integumentary system for symmetry; taut, shiny, warm skin, erythematous, tender to palpation. Not every patient

It synthesizes the results of various primary studies by using strategies that reduces biases and random errors. These reviews follow a strict scientific design and provide consistent estimates about the effects of interventions, therefore, conclusions are defensible. Systematic reviews shows where knowledge is lacking and can be used to guide future research. These reviews are usually carried out in the areas of clinical tests such as diagnostic, screening and prognostic; public health interventions; economic evaluations; adverse effects and how and why interventions work. Cochrane reviews are systematic reviews undertaken by Cochrane Collaboration members, aims to help people to make well-informed decisions about healthcare by preparing, maintaining, and promoting the accessibility of systematic reviews of the effects of healthcare

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.

In healthcare, evidence based practice (EBP) has grown and become important in providing the best quality care possible to patients. There are numerous ways to collect and use the research in the nursing profession. Studies are constantly being done to help better nursing and all of the healthcare field in order to help patients live better and maintain their health. There are different types of research such as qualitative and quantitative. Qualitative uses the human experience or something that has been lived by someone and quantitative examines for meaning and goes more in depth to research things and strives to test a hypothesis or makes use of statistical data to answer research questions (LoBiondo-Wood

Evidence Based Practice is a principle that is centered on the improvement of patient care and outcomes, by introducing and researching current based evidence when making decisions for that patient. According to Johnston (2016), “Health-care practitioners are increasingly being encouraged to implement research evidence into practice in order to ensure optimal patient outcomes and provide safe, high-quality care”. Throughout the course of this class, whether it be from researching about Evidence Based Practice, or the implementation of nursing care delivery models, patient care and the way we treat our patients is at the forefront of change. We know that change is necessary, now it is just a matter of how to implement that change into the healthcare

The purpose of this essay will be to discuss evidence based practise and its use in nursing, I will be discussing, the types of research and various forms of data, including the principles of evidence based practise and research. Evidence Based practice is finding the most effective, research proven, evidence to make decisions regarding the service users individual needs and the best decisions for them. As David Sackett quotes, "evidence based practise is the integration of best research evidence with clinical expertise and patient values." (Sackett D, et al 1996, p.71) Evidence based practice is good practice, assist practitioners, avoiding information overload and applying the most useful information.

Goodwin, V., Richards, S., Henley, W., Ewings, P., Taylor, A., Campbell, J., & ... Campbell, J. L.

Social media (digital technology) platforms are defined as any form of digital communication through which users create online communities to share information, ideas, personal messages, and other content (such as videos). Over the last several years, the use of social media platforms such as blogs, text messaging, games, and Twitter, have had significant growth. Social media tools have become an effective way to expand reach, foster engagement and increase access to credible, evidence-based health information.

The purpose of Chapter two is to establish the theoretical foundations of the Evidence-Based Practice (EBP) project, discuss the connection between the EBP model and the PICOT question, discuss the literature search and appraisal of evidence that supports the project, synthesize the findings into recommendations for best practice to form a model for the EBP Project. The PICOT question at the core of the project’s purpose asks: For elementary school staff does the use of a specific anti-bullying program training reduce the risk of bullying in the school compared with current anti-bullying practices? This chapter details the search strategy including databases, keywords, limiters, inclusion and exclusion criteria, and describes the method of

Special education practitioners appear to have produced the majority of the research on the prevalence of evidence-based practice in education. Studies of the prevalence of evidence-based practice in general education do exist, but in at least one instance, the research was published in a special education journal (Kretlow and Helf, 2013). Kretlow and Helf (2013) published a study of kindergarten, 1st and 2nd grade teachers that asked these teachers about the reading programs they were implementing. The results indicate that few of these teachers are using reading curricula that is demonstrated to be evidence-based. Studies among special educators have produced similar results. Research by Cook and Cook (2013) suggested that significant misunderstanding exists about what evidence-based practices are and this has led some special education teachers to ignore evidence-based practices. Similar results were obtained by Carter, Stephenson, and Strnadova (2011) regarding the prevalence of

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,

Preventing errors relating to commonly used anticoagulants. (2008). Joint Commission perspectives. Joint Commission on Accreditation of Healthcare Organizations, 28(11), 13-15.