Evidence Based Nursing Practice

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)

In almost every case of a terminal disease, pain is intolerable and seeing someone in such agony is heartbreaking. For example, Brittany Maynard, a 29 year old brain cancer patient who had to move to Oregon so she can avail of the Death with Dignity act. “Maynard knew that her form of brain cancer would be excruciating. She would endure swelling of the brain that would very likely cause seizures, painful headaches and the gradual loss of bodily function. Doctors know that for about 5 percent of the population, no amount of morphine can block the agonizing pain the terminally ill endure” (EDITORIAL: Dying with dignity). Palliative care can often be provided for the dying patients and alleviating pain to provide comfort for the dying has always been the priority. “Palliative care focuses on relieving the symptoms, particularly the pain, of incurable illness.” (Palliative Care) But, in relieving pain through the prescribed medications there are also side effects that are caused by the prescribed pain suppressors and two examples will be lethargy and it compromises breathing. In most cases the effectivity of the pain medication may no longer alleviate the pain. If a patient will be in such agony for the remaining days or weeks the quality of life is no longer present. The agony of pain prevents a patient from performing even just the bodily functions.

Pain is one of the most common and feared complications of cancer. It is exacerbated by stress, anxiety, fatigue, and malaise which accompany advanced cancer. Pain is generally absent in the early stages of cancer, but it is a significant factor as the illness progresses to advanced stages. Cancer-associated pain can arise from a variety of direct and indirect mechanisms including direct pressure, obstruction, and invasion of a sensitive structure, stretching of visceral surfaces, tissue destruction, infection, and inflammation (McCance 2010). Pain is generally accepted as whatever the patient says it is, wherever the patient says it is. Treatment of pain and its associated symptoms is a primary responsibility of the healthcare team. Treatment modalities for pain include the use of opioid analgesics, patient-controlled analgesia, psychological interventions, and preventing recurrence of pain. Reinforcing the reporting of pain by the patient is important, as is a respect for the social and cultural differences with respect to pain perception.

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).

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.

It was pretty difficult to choose to the most important competency to use in nursing practice since all of them play a vital role in our nursing practice, however I do see why evidence based practice is the most important competency to you. Evidence based practice is designed as a clinical- decision making process based on theory-derived information necessary to provide patients with care that is effective, safe and efficient. In order to have effective patient outcomes, it is necessary for new researched-based knowledge to be transformed into the clinical setting and implemented effectively within the health care system. As the healthcare system evolves, so do our nursing practices and the same polices that once use to be in place, may no

Evidence-based practice is the process of searching research to gain knowledge in the quest to improve nursing intervention. It requires time, resources, teamwork, collaboration, and dedication, but it’s our calling and duty as nurses to ensure that patients receive the highest quality of care. For this paper, I will identify a new best practice to initiate, describe steps required to implement it, and give examples from literature that support the change in patient care.

A1 Quantitative Article: Friedl, A., Aegerter, C., Saner, E., Meier, D., & Beer, J. (2012). An intensive 5-year-long influenza vaccination campaign is effective among doctors but not nurses. Infection, 40(1), 57-62. doi:10.1007/s15010-011-0193-6

Nursing research is a systemic analysis in response to the question or problems encountered in the clinical practice, education and administration. Research studies have a great influence in nursing because provided strong evidence that support nurses to make the right clinical decision in the clinical setting, cost effective and as a consequence a positive outcome in the patient recovery. Qualitative and Quantitative are the two main research methods used in nursing studies.

Nursing research is a fundamental component to the health care field. Nursing research helps implement new changes in the lifelong care of individuals and is used to develop treatments that provide the most optimum level of care in health care system.