Evidence Based Practice (EBP)

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.

The Evidence-Based Practice (EBP)is the systematic decision-making process to improve the work environment and clinical practices to get better quality patient outcomes. The EBP is the process where data collection, organizing, processing and implementing of the research findings are the critical points for the right results. One of the essential aspects of interest of using EBP research for nursing practice is that it gives the highest conceivable quality care and cost-effective treatment possible. It helps to fill the gaps and weaknesses in patient care so that patients will get better outcomes. It also blends the evidence and clinical experience to provide better patients experiences. It is essential as it helps to increase patient safety and improve quality of life. It also helps to reduce various medical complications and keeps the healthcare costs low.

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).

Evidence-Based Practice (EBP) was initially a movement in medicine, dating back to early 20th century (Spring, 2007). It was described as a careful decision making process about the care of individual patients using best available evidence by Sackett, Rosenberg, Gary, Haynes, and Richardson (1996). Greenhalgh (2010) gave a similar definition but with more emphasis on the mathematical assessment of the potential benefit and harm. By now, EBP has been widely adopted by many health disciplines, including psychology. In 2005, the American

Using the knowledge of EBP I am able to review current research on practice issues or problems in my organization by evaluating the problem or issue and determining the PICO components to establish the EBP question. This information can help provide some of the search terms used to gather the information. I would evaluate the relevance and believability of the data by assessing the strength and quality of the data. This is achieved by looking at evidence provided in the last five years to assure the research is current. High quality evidence can often be found in well-known professional journals or on government agency websites. The type of evidence is defined as research (level 1-3) or non-research (level 4-5). For example, level one research is a randomized control trial. To measure quality you would look at the sample size and the adequacy of control used for the study and if it was a larger study this would be a higher quality. The strength and the quality as noted in these features help to define the relevance and believability and thus the ability to draw conclusions form the evidence.

Research, quality improvement (QI), and evidence-based practice (EBP) all play an important role in the field of healthcare and are essential for the delivery of quality patient care. While each involves teamwork, critical thinking, and creativity there are distinct differences between them.

The impact of evidence based practice has been brought into nursing through education, practice, and science over the last decade. Evidence based practice provides quality care to patients that is effective, safe, and efficient. Evidence based practice promises moving care to a high level of producing the intended health outcome for the patients. “EBP is aimed at hardwiring current knowledge into common care decisions to improve care processes and patient outcomes” (Stevens, 2013). EBP empowers nurses and expands their skills by using the best available evidence to guide nursing care and patient outcomes.

As every patient is unique and has his/her own condition, nurses and other health care providers need a source to follow as a guideline. Evidence based practice can be used as good guideline for health care provider, and it also can show different ways of care and their results. Evidence based practice has a huge role in the world of nursing profession. One of the biggest goals of nurses is to apply the evidence into their practice in a right way, even though a lot of nurses could not apply the evidence into their practice in the right way. ((Schmidt & Brown, 2015). Role of a professional nurse is to implement the evidence into practice in a right way, and create the right result from it. There are a lot aspects involved in evidence based practice

Evidence-Base practice (EBP) is defined as based on problems identified from nursing practice; using best evidence and professional expertise and merging them into current practice to ensure patients receive quality care (French, 1999). Evidence-based practice is a part of quality improvement process; it is made of evidence, clinical expertise, patient preference and the context of care (Barker, 2013). In brief, evidence-based practice is the guideline in the nursing practice that requires nurses gather and use clinical evidence to help diagnose or assess patients correctly by using their knowledge and experience in order they can deliver the quality of care to the patients (Ellis, 2013). In the other words, in the nursing practice the clinical evidence supports all the nursing procedures performed.

Evidence-based practice is one of the strategies that has been applied in various aspects of social studies and social work. Researchers have associated this approach of social work with various benefits as well as challenges. However, there are various facets of evidence-based practice ranging from published case studies and the use of empirical studies. The process of selecting a particular evidence-based practice in social work depends on availability of resources, scope of the study and the goals of the study. This discussion will focus on a case study of a social worker Ajia Meux, who narrates her story on how she uses evidence-based practice to perform her duties as a social worker. It will also provide a case study on how the evidence-based practice indicated by Ajia could be used to solve certain social problems of an anonymous client. Consequently, this paper provides the benefits of applying evidence-based studies on social work.

Nursing organizations, particular the American Nursing Association coupled with the Institute of Medicine (IOM) are two of the chief driving forces, to push for EBP. According to (Houser, 2015, p. 12.), “evidence-based practice is quickly becoming the norm for effective nursing practice”. For gone are the days where nurses make decision or judgement based on intuition. We all know that numerous lives had been saved with this method, but we tend to ask ourselves when the outcome was unfavorable, what could we have done differently? Or why things did not work out the way we had expected. This is one of the reasons why the National Institute of Nursing Research (NINR) came into existence. (Houser, 2015, p.7) states that the mission is to “improve the health of individuals, families, communities and populations through evidence-based nursing

There are many different definitions of Evidence-Based Practice (EBP). According to EBP book, most EBP definitions contain three components “research-based information, clinical expertise, and patient preferences” (In Schmidt & In Brown, 2019, p. 4). These three words explain what is EBP in a simple way for me to understand. It means EBP research includes collecting information, reviewing, evaluating, and implementing evidence into the practice to improve patient outcomes. EBP is unique concept because it doesn’t only take consideration of the evidence, but it does give preference to individual patient’s values and needs to advocate for improved patient experiences. EBP is a holistic approach to improve patient care outcomes and nursing practices. By utilizing EBP into my practice is not an extra task but it helps to cover the difference in patient care to improve patient

To address the problem of CRF, the Rosswurm & Larraee model will be used in implementing guideline (Rosswurm & Larraee, 1999). The key component of Rosswurm & Larraee model includes 6 steps;

Evidence-based practice (EBP) in nursing means making decisions about patient care on the basis of best, current, standardized practice and guidelines. According to an article, written by Dr. Kathleen Stevens, the development of evidence-based practice (EBP) is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care (Stevens, 2013). The author also mentioned in her article that the intended effect of EBP is to standardize healthcare practices to science and best evidence and to reduce illogical variation in care,