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 …show more content…
There are guidelines that are implemented to support health care practitioners and their patients with making important decisions about health care issues that need special attention (Roddy et al., p 347). These guidelines caused concerns since the present day methods doesn’t allow upgrading the strength of recommendation (SOR) for random selecting participants/subjects in controlled trials that are impractical or unethical (Roddy et al., 2006). Roddy et al (2006) conducted research to develop another technique to determine SOR as well as combining research and expert views (Roddy et al., 2006). The research on developing new recommendations for exercise in managing osteoarthritis (OA) of the hip and knee was explored attention (Roddy et al., p 348). The Delphi technique is a group project and was used in this research study. It is often used and is a recognized method for gathering data from a panel of experts within their area of expertise (Hasson, Keeney, & McKenna, 2000). The Delphi process is built upon the principle that forecasts or decisions from a group of regulated individuals are more accurate than those from unstructured groups (Hasson, Keeney, & McKenna, 2000). Questionnaires are answered by the group of experts than a summary of the information is examined to determine the mean or median scores of the results …show more content…
One reason is that although the participants are expertise in their field of study, they still rely on the other group members to collaborate on the topic which bring about changes on how to resolve the issue (Hasson, Keeney, & McKenna, 2000). This process consist of multiple feedback rounds which tends to result in lower response rates due to the multiple questionnaires received by the participants and can also result in them not continuing or withdrawing from the Delphi process (Hasson, Keeney, & McKenna, 2000). The Delphi process is often time consuming and arduous taking up a large amount of time (several days or weeks) needed to complete the process (Hasson, Keeney, & McKenna, 2000). An experiment done by Scheibe, Skutsch and Schofer has shown that Delphi group participants would change their answers after receiving a biased feedback (Adams, S. J. (2001). When one look at the practice of evidence-based medicine it requires some level of clinical expertise combined with the best available evidence from methodical research (Roddy et al., p 348). Despite my feelings on the Delphi technique, I also think that guidelines can be instituted in a clinical setting to create or improve strength of recommendation. Roddy et al. (2006) however did use more reliable and valid statistical resources such as visual analogue scale (VAS) and one way ANOVA analysis. The VAS is a measurement
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.
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.
Define evidence based practice and discuss the possible facilitators and barriers for Sam to utilise the best research evidence in clinical practice.
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.
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-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).
According to Provision seven the attitudes of Deborah and the other nurses on the unit do not advance the nursing profession. Nursing from the beginning of its existence with Florence Nightingale has fought to be considered not only an art but also a science. Scientific research was one of the governing factors of Nightingale’s principles of nursing. She used statistical data to help her keep records of success and failure rates of her nursing interventions. The use of this scientific research proved to be beneficial because it gave substantial scientific evidence that her nursing interventions significantly decreased mortality rates during the Crimean War. The support of her statistical data enabled nightingale to prove to her colleagues and peers that the art of nursing plays a significant role in patient outcome and mortality. This relates to the nurses in the NICU, because since the beginning of nursing evidence based practice has been implemented and deemed useful. For one to denounce future practice of evidence based practice in contemporary nursing will further remove nursing from its professional status. Nursing is one
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
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.
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).
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.
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.
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.