Evidence Based Practice For Nurses: Historical Research

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.

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

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 healthcare delivery system and the care for patients has brought new dimension which necessitated the need for competencies, perfection and accountability into the healthcare system. This has brought about a change in nursing education to now pay more attention to practical nursing. To affect better client’s outcome, knowledge must be applied clinically in a holistic way to the benefit of the patient we serve. Steven, K., (2013) in his article “The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas”, suggests that, the recommendation that nurses lead delivery system and care bring to the fore that necessitate for new competencies, beyond evidence-based practice, that are requisite as nurses transform healthcare. Directions

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).

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 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).

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

The importance of evidence based practice ( EBP ) is to enable nurses to provide high quality care, improve outcomes for patient and families and to run a more efficient health service. Therefore other agencies within the health service will benefit when interventions and care is based on research (Burns & Grove 2007). According to the (Nursing and Midwifery Council 2004)(NMC) nurses are accountable to society to provide a high quality of care so therefore it is important that nurses reflect, evaluate the care and keep abreast of new knowledge and evidence that is available (Burns & Grove 2007). Providing a streamlined service, which is cost effective and based on current evidence based practice has shown to reduce cost but also to enhances

The ultimate goal of nursing practice is to deliver high-quality nursing care and to improve health outcomes. As a nurse, I should be able to exercise my clinical judgment as I plan and provide care to my patient. Evidenced-based practices are the foundation of quality patient care which I must always support and rely on.

Over the years nurses have relied on utilizing nursing interventions founded only on tradition. By following this trend nurses aren’t giving the best care, but the most popular care to patients. By choosing to care for patients using evidence based practice, nurses are giving the interventions they use credibility.

The Ganz et al. (2009) research was performed in order to evaluate the ICU nurses oral care routines and if they were using appropriate, up-to-date evidenced based techniques and lastly if evidence-based practices (EBP) was associated with personal demographics and professional characteristics. Ganz et al. (2009) had found that previous research and studies has shown that poor oral hygiene may contribute to greater risks for pneumonia which results in an increase in mortality and morbidity (Ganz et al., p 133). In fact some of the research studies had stated that there was no documentation of the nurses oral care practices and these practices were not even up-to-date with recent evidence (Ganz et al., p 133). In addition to that, ventilator-associated

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.

Theoretical knowledge is the knowledge that nurse researchers established by gathering valuable ideas from books or other resources. These ideas applied through theoretical only.

There are five levels of strength of the evidence on the Johns Hopkins tool, and I gave the article “Sleep in the Hospitalized Patient: Nurse and Patient Perceptions” a ranking of level III. I used the Johns Hopkins nursing evidence based practice research evidence appraisal scale tool to decide on my ranking level which breaks it down step by step to find the strength of the research. The description of level III is “nonexperimental study, qualitative study, or meta synthesis” (cite JHNEBP). Non-experimental studies consist of no manipulation of variables and randomization is not controlled, qualitative studies are made up of interviews or focus groups and have small sample sizes, and