Evidence Based Practice In Nursing

Using evidence-based practice in daily patient care may seem like a time-consuming process, but in reality it is not. It should come as a natural process once incorporated into your daily routine. The process (as cited in Houser, 2013) involves six elements: (1) Ask a relevant clinical question, (2) search for the best evidence in the literature, (3) critically appraise the evidence, (4) integrate the evidence with clinical experience and client preferences, (5) evaluate the outcome of the practice change, and (6) disseminate the

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.

Evidence - Based Nursing, An introduction (2008, p. 285 ) “ The rapidity of change and the reorganization of nursing services within the health care sector presents challenges for the advancement of EBP. Managers and administrators should facilitate the uptake of practice based on current, high-quality research by formalizing the expectation that nurses care be Evidence Based”.

Conrad, A., Grotejohann, B., Schmoor, C., Cosic, D., & Dettenkofer, M. (2015). Safety and tolerability of virucidal hand rubs: a randomized, double-blind, cross-over trial with healthy volunteers. Antimicrobial Resistance & Infection Control, 4(1), 1. doi:10.1186/s13756-015-0079-y

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

The Johns Hopkins Nursing Evidence-Based Practice(JHNEBP) model had been used as a framework for this EBP project. This model focuses on the transfer of knowledge into practice by providing guidelines for nurses and other clinicians based on the best available evidence. There are three main elements in the JHNEBP process are practice, research and education. Each component has prescriptive steps that are a total of 18 subcategories. During the practice stage, five steps need to be done such as identifying an EBP question, defining the scope of practice question, assigning responsibility for leadership, recruiting a multidisciplinary team and also scheduling a team conference. The next component is the evidence/ research stage. Searching

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.

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).

Sterile technique is required for insertion of an indwelling urinary catheter in the hospital setting, but clean technique can be used for intermittent catheterization in non-acute settings. By itself, sterile technique on insertion doesn't prevent UTI’s. Prevention of UTI’s depends on knowledge of causes, proper care techniques, and early catheter removal. Nurses are taught early on in school that sterile technique helps to reduce infections. It was drilled in our heads the entire time and now to have the evidence tell us that early catheter removal, along with proper technique good hand hygiene is the key to reduce UTI’s.

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.

Why should nurses incorporate research? Nurses should incorporate research in their scope of practice to deliver the highest and safest quality health care. This is based on proven scientific evaluation, peer review, combined with one’s clinical experience, critical thinking, and competency. (Stevens, 2013), “research produces the most reliable knowledge about the likelihood that a given strategy will change a patient's current health status into desired outcomes”. With these analyses, I believe that nurses can achieve great outcomes and patient satisfaction. However in our class lecture, Chamberlain College of Nursing (CCN, 2015), states that “research yields evidence upon which nurses may base their practice, i.e., evidence-based practice”. In a nut-shell, nurses’ combine research to improve their scope of practice, innovate nursing concept, and enlarge nursing knowledge (Hood, 2014, p. 243).

Evidenced Based Practice (EBP) is essential to enable all nurses to provide the most current up to date practises for their patients. This process involves research, systematic review of current practises, critical thinking skills, evaluation and application to the clinical setting. In addition to this, the nurse must take into account the patients’ preferences. For nurses to have professional autonomy they must be able to justify their actions and demonstrate an understanding of why they perform the tasks they do. This defines them as unique professionals judged by their knowledge and not simply by their hands on skills.

Nurses face challenges in their day to day practice to find and use reliable, credible evidence to support their clinical decision-making that allows them to meet the expectations of evidence-based practice (EBP) (Fitzpatrick, 2009). EBP refers to making decisions about patient care that are based on the best evidence produced by clinical research combined with nursing expertise and the patient’s desires and views (Barker, Linsley and Kane, 2016). Not only does EBP enhance the quality of care patients receive, it also reduces medical complications and reduces health-care costs (Jeffs et al., 2013). EBP allows nurses to expand their knowledge and skills in order, to deliver high-quality health care based on research and knowledge, rather than supporting possibly outdated nursing traditions.

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 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.