Evidence Based Practice In 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.

The following literature will define the term, “evidence informed practice”. It will discuss the benefits and limitations of integrating evidence informed practice in nursing. It will include information about how nurses can overcome these barriers. It will also illustrate the importance of utilising evidence informed practice to enhance the quality of service delivered within the healthcare profession.

The key steps involved in evidence based practice come from a thirst for knowledge that once ignited makes the next step to asking a well worded clinical question easier. A well formulated question improves patient outcomes and supports the implementation of change. One such method looks at foreground and background questions. A background question is usually a basic knowledge question and is usually answered by a textbook. Foreground questions are usually specific and once answered can help in clinical changes. An acronym useful for formulating a well worded question is PICOT. ( Stillwell, Fineout-Overholt, Melnyk, Williamson, 2010).

However, this is not the recommended protocol shown in the literature. The current unit practice and evidenced based practice will be compared. The barriers to performing evidenced based practice will also be assessed.

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

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).

Nurses always want what works best for their patients rather than having to struggle to find what works. The nurse plays a key role in implementing evidence-based practice because it is the nurse who is the advocate and care giver to their patients. Because of evidence-based practice different aspects of nursing care are always changing. It is crucial for nursing practice to evolve because through research other health care professionals have found things that work best and is resulting in less patient deaths and furthering complications in a patient’s illness. Some of the examples that will be discussed here as result of evidence base practice are: better pain assessments in pediatric patients, preventing pressure ulcers, kangaroo care, music therapy to help distract, better hand hygiene, and teaching parents about life saving techniques.

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.

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

In Nursing, one must provide the best patient care possible. Using evidence-based care when practicing is one way to ensure that a patient is receiving the best care. Research is often performed to find up to date evidence based care techniques in different articles. Processes have been developed to nurture the knowledge and guide nurses with research reviews, such as the PICO model. The first step to any type of research, is to develop a focused clinical question or hypothesis to reflect on throughout the evaluation of the information. This will help organize the research to provide better analysis and utilization of the PICO model. PICO stands for population, intervention, comparison, and outcomes. The purpose of this paper is to discuss the use of the PICO model in the article, A Systematic Review of the Interventions for Nipple Trauma in Breastfeeding Mothers.

The tools include “a question development tool, an evidence rating scale, and appraisal criteria for research and non-research evidence” (Schaffer et al., 2013, p.1204). The question development tool provides specific steps for formulating the clinical practice question. The rating scale allows users to rate the “strength of evidence and quality for both research and non-research evidence” (Schaffer et al., p. 1204). The rating scale also allows users to rate practitioner expertise and patient experience.

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.

Critical Appraisal skills program (CASP) will be defined and will be later use to critically appraise the research mentioned above. The importance of evidence based (EBP) in healthcare settings would be briefly explained. Lastly validity, strength and weakness of the study would be looked into and to conclude if it’s or not fair enough to be used or modified services to patients and service users in care settings.

There is the expectation for nurses to work effectively and efficiently, which can be achieved using evidence based research. The argument for medical personnel to use their own knowledge to create personalize care and treat patients is what is used in evidence based research (Hunker, 2014). The researches focus on the personalized treatments that have worked for a certain population. Moreover, the alternative to using evidenced based research, sounds like try and error which does not sound professional considering it is not supported by any evidence.