Evidence Based Practice

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).

The incorporation of evidenced-based practice (EBP) into nursing practice is supported by research to positively improve the quality of care and improve patient outcomes. EBP is important to the nursing profession because it also leads to increased job satisfaction, teamwork, and levels of engagement in clinicians (Melnyk, et al., 2017). Miniature research projects such as quality improvement projects, surveys, and clinical research studies are frameworks used to get feedback and data from patients during their time spent in health care systems. EBP is not the standard of care in many health care systems (Melnyk, et al., 2017). This due to many factors, including lack of EBP mentors, nursing programs that do not incorporate EBP into the curriculum,

Emergency department (ED) nurses save lives every day by utilizing their skills and knowledge to assist the physician in providing emergent care to patients who arrive via ambulance or by private auto. Nurses are aware of their responsibilities to respond to the patient's needs quickly and efficiently to provide life-saving interventions and care. However, are ED nurses aware that they contribute directly and indirectly to a large percentage of patient's demise through the insertion of foley catheters, peripheral

Evidence based practice is the incorporation of individual clinical expertise with best research evidence and patient values and expectations. Health care decision of individual patients should be based on best available research evidence. A health decision made from a sound research evidence has the potential to ensure best practice and reduce variations in health care delivery. In health science, an ever increasing plethora of studies being published and is challenging for clinicians to keep up with the literature. Integrating research into practice is time consuming and need methods for easy access to such evidences for busy clinicians. Indeed, clinical decision should be based on the latest research evidence. Systematic reviews and meta-analyses summarize the research evidence, which is generally the best form of evidence, thereby making the available evidence more accessible to decision makers and are positioned

In healthcare, evidence based practice (EBP) has grown and become important in providing the best quality care possible to patients. There are numerous ways to collect and use the research in the nursing profession. Studies are constantly being done to help better nursing and all of the healthcare field in order to help patients live better and maintain their health. There are different types of research such as qualitative and quantitative. Qualitative uses the human experience or something that has been lived by someone and quantitative examines for meaning and goes more in depth to research things and strives to test a hypothesis or makes use of statistical data to answer research questions (LoBiondo-Wood

Choosing a vein for an I.V. is challenging. Berman and Snyder (2016) mention that while caring for a patient that has to have

A patient is indicated for closure if they experience symptoms, irrespective of age, to reduce subsequent morbidity and mortality (21). To reduce this risk, closure should be considered in patients at risk of a paradoxical embolism, such as patients undergoing pacemaker implantation or professional divers (5,

Additionally, as you already might learn from your experience, DVT is a blood clot that develops in deep veins, usually in the lower leg. It could be dangerous because the clot may become large, or it could break in

[3] The nurse’s experience and the emergency medical care provider can explain some difficulties in cannula insertion. Success rate and time to apply intra-venous cannula is mandatory to obtain the best resuscitation of critical patients. Difficult intra-venous cannulation can be challenging even to the most experienced emergency nurse. Central venous catheterization (CVC) is an alternative route for cannulation in patients with difficult intra-venous access. CVC provides a fast effective intra-venous access for flued resuscitation and for Central Venous Pressure monitoring. However, venous thrombosis, catheter associated bloodstream infection, arterial puncture and pneumothorax are most common Central Venous Catheterization (CVC)

According to the Vascular Disease Foundation (2014), six million people suffer from skin alterations associated with chronic venous insufficiency. As clinicians, it is important to understand the pathophysiology of vein disease in order to identify an appropriate course of care and assist patients with prevention of complications. Vein disease has many risk factors that are not modifiable such as age, gender, and family history. There are risk factors that are such as inactivity, obesity, and intravenous drug use that are modifiable behaviors that can be managed to prevent further decline. Prompt identification and intervention to prevent further deterioration is the goal. This paper will review the pathophysiology of chronic venous insufficiency (CVI), deep vein thrombosis (DVT), and arterial thrombosis. Additionally, the influence of patient’s behavior as it relates to the pathogenesis of vein disease will be reviewed.

It is difficult to draw any conclusions regarding risk factors of inadvertent arterial catheterizations due to the lack of a control group. However, four of eleven (36 %) inadvertent arterial catheterizations were made urgently in patients with major trauma in Study III, whereas only 5 % of venous cannulations in Study IV were carried out in emergent situations, indicating that this truly is a risk factor. As indicated by our results, a diagnosis of inadvertent arterial catheterization is often obvious immediately or during initial clinical use due to local symptoms of bleeding or abnormal back-flow of blood through the catheter. Other clinical bedside signs facilitating this diagnosis – in normovolemic patients without central hypoxaemia – include the spout, at systemic pressure, of bright red and/or well oxygenated (confirmed on blood gas analysis) blood by the catheter (Shah 2004).

Pulmonary embolism, synonymous with deep vein thrombosis; are important and is a growing public health problem. Both contribute to the 300,000-600,000 individuals affected by this each year in the US alone. This condition does not discriminate against age, gender, or race and occurs across all boards causing morbidity and mortality. When misdiagnosed, unrecognized, or untreated, PE can cause death quickly; within just an hour. It’s fatal in up to 26% of cases (Andrews, 2010). However, prompt treatment greatly reduces the risk of death. Taking the necessary preventative measures to prevent blood clots is the key to protecting one’s self of these conditions.

Thrombus formation starts in the calf and extends proximally. They mostly begin intraoperatively, but can also start a few days to a month. A thrombus is composed of fibrin and red cells. The development of thrombosis can result from endothelial injury, abnormal blood flow, and/or hypercoagulability. High risks include obesity, prolonged immobility, cancer, smoking, estrogen use, advancing age, varicose veins, dehydration, splenectomy, and orthopedic procedures.

Venous thromboembolism (VTE) has become a major health concern with 300,000-600,000 of cases in the United States annually and contributes to a significant number of avoidable inpatient costs (C. Dooley, 2013). Venous thromboembolism is also cited as the leading cause of preventable in-patient deaths (Dooley, 2013). Research has indicated that post-operative patients on medical surgical units have a 13-31% risk of deep vein thrombosis without interventions using prophylactic antithrombotic therapy (Alhazzani et al., 2013). Deep vein thrombosis (DVT) is a common, yet preventable postoperative