Evidence-Based Nursing

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.

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

Nursing education is constantly evolving as new techniques are introduced within the medical profession. Thus, it is imperative nurses are kept updated, and continuously learning new methods to enhance and improve patient care. Over the last 150 years there has been a drastic change in nursing`s participation in research. Nursing research advanced initially from the investigations made by Nightingale in the nineteenth century of nursing education during the 1930`s. This further progressed to the research of nursing roles in 1950s following on to the 1990s where nurses began to focus on clinical problems and finding solutions to these problems which had a major impact within the nursing profession. As of today many health professionals are focusing on clinical research which in turn has helped to establish an evidence informed practice for nurses. (Burns and Grove 2003)

Findings of evidenced based practice have to be disseminated to ensure that innovations for practice are replicated or applied in other settings by stakeholders in the health fraternity and healthcare professionals (Forsyth, Wright, Scherb & Gaspar, 2010). One of the objectives of dissemination should be to improve the practice. Dissemination of evidenced based practice findings in nursing is very critical in knowledge synthesis, translation, and translation. It is imperative in strengthening healthcare, informing policy, and improving practice decisions based on clinical evidence (Rycroft-Malone & Bucknall, 2010). This is realized by transforming clinical changes into practice. It actually involves two stage processes namely: translation of evidence into practice and integration of research recommendations into actual practice. Effective dissemination of evidence based practice findings enable staff to share information about developments in healthcare practice and implement innovation (Freemantle & Watt, 1994).

The background information and review of literature showed a definite opportunity to improve healthcare practices which would also improve patient safety. The methodology was clear and unbiased. It should have provided credible information. The data analysis done gave accurate results according to the information

According to Lewis, Dirksen, Heitkemper & Bucher (2014), “Evidence-based practice is a problem-solving approach to clinical decision making. It involves the use of the best available evidence in combination with clinical expertise and patient preferences and values to achieve desired patient outcomes.” Using evidence based practice in nursing is extremely important, because evidence-based practice is the result of others trying a practice one way but needing to change some of the guidelines to make the practice safer and over all better for patients.

Evidence based practice is an important priority in nursing because it ensures that the best quality and most effective care is being used. Restraint use is an intervention that is being minimized more and more. It can be an important intervention when necessary but there are specific circumstances and guidelines that must be followed. Evidence based practice is proving that restraint use may be eliminated due to safety concerns and more beneficial interventions being used.

Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored in the implementation of Evidence Based Practice.

According to The American Nurses Association (ANA) Evidenced-based practice is a "scholarly and systematic problem-solving paradigm that results in the delivery of high quality healthcare" (American Nurses Association, 2010, p. 65). Through the use of evidence-based practice nurse and other health care professional have the ability to create clinical decisions, which allows clinical questions to be answered and aid in quality improvement. Furthermore creating a safe, efficient, productive environment for patients and staff that may result in improving patient outcomes and reduce expenses. Nursing research helps health care providers provide evidence-based practice, which may result in quality improvement (Rebar & Gersch, 2015).

Personally, I have never experience any type of research that can relate to nursing, however; I have experienced evidence based practice at work. The institutions I’m at has changed the foley policy nevertheless, like countless nurses pulling a foley and given a patient lasix made no sense. This is where EBP came into play because, what is effective for nurses might not be healthier for the patients. The struggle to understand the different between EBP and primary research although, several nurses might feel they are the same entity and that the names remain interchangeable myself included.

Evidence based practice is more likely to take hold in an environment that is supportive and understanding that change although may be necessary is typically difficult to implement without some resistance. Evidence based practices are crucial in improving patient outcomes and having healthier patients at discharge. This in turn can reduce re-hospitalizations, allow for better participation in rehab if needed and promote better disease self management along with cost savings at the hospital. In order to provide this, the floor nurses need to be educated on the new process and fully understand why it is better then how it was previously being done. Resources should be readily available be it extra staff, supplies or constant and continuous education

Evidence based practice in nursing research has changed the era of nursing. Every nursing intervention is evidence based. I have not served on a research/EBP council at work but I have written a nursing research paper based on evidence based practice. The title of my paper was hand washing with soap and water vs. hand sanitizer. I found out that using hand sanitizer is efficient to kill germs but hand washing with soap and water in between after 4-5 application of hand sensitizer will improve results. Hand sensitizer will kill 99.99% germs but the residue stays in the hand. Hand washing with soap and water will flushes the residue away. So, practicing both technique will help prevent infection and cross

Although the American Association of Colleges of Nursing clearly defined the role of Doctor of Nursing Practice (DNP) degree in 2004, some confusion about the academic programs still exist. The role of both the DNP and PhD-prepared individuals is to improve the quality of health care and the health of population through the use of the best evidence when assisting them in making decisions about treatment options. Melnyk, B. M. (2013). According to the national leaders in major healthcare fields, mentioned a gap between research and practice and the importance to apply research findings and engage in evidence-based practice. In order to translate this knowledge, the clinician must understand the healthcare delivery in order to help narrow the research-to-practice gap and transform health care. DNP-prepared nurses are trained to reduce the research-to-practice gap. Because most nurse lack knowledge to critically appraise research studies and the skills to effectively implement evidence-based practice (EBP) in their clinical settings.

Evidence-based practice is important to the nursing field today. Nurses need to be able to understand and use the research to help them in the work field. Evidenced-based practice helps nurses to use the best evidence in making decisions with patient care decisions. Nurses and other health care professionals usually conduct the evidence that is found (Pilot & Beck, 2014).

Pressure injury is both financial and quality burden to the healthcare system in particularly when hospitals could potentially lose their reimbursement from the government for hospital acquired stage 3 and 4 pressure injuries. My workplace has commenced a series of campaigns to target and reduce the incidence of pressure injuries since 2014. This review shows that nutritional support and in particular high protein with arginine-enriched supplement have the tendency to be associated with a significant healing rate in pressure injury compared to routine care, which includes usual diet and standard pressure injury care. With these promising results, standardised pressure injury care policy to include