Evidence Based Practice: The Most Important Competency To Use In Nursing Practice

In order to develop nursing knowledge and establish evidence-based practice (EBP) in nursing, there needs to be a "concept model, one or more theories and one or more empirical indicators" (Fawcett & DeSanto-Madeya, 2013, p. 26). The theoretical framework can be advantageous in guiding and supporting the design and execution of an EBP change. Using a conceptual model (C) theory (T) and empirical research (E) provides the foundation for an intervention to an identified clinical problem. Known as C-T-E structure, the application of this system in nursing practice involves an elevated level of critical reasoning, which assists in knowing what data is important and how it relates to practice change (Chinn & Kramer, 2011; Fawcett & DeSanto-Madeya, 2013; Mazurek Melnyk & Fineout-Overholt, 2015). The doctoral level of nursing necessitates the need to combine the understanding and knowledge gained from using the C-T-E structure, and then integrate the concepts and theories into daily practice.

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.

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

Provided nursing care in accordance with established policy, physician’s orders, the resident plan of care

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

Standard 1.1 outlines that the registered nurse should access and analyse the best available evidence which includes research to ensure they provides safe and quality practice (Nursing and Midwifery Board of Australia, 2016). This was absent in scenario one as a result of a fast verbal medical handover Mary to Nicole. There was no guidance as to which patient was being discussed, and no time to write down all the important medical information required about her patients (Edith Cowan University, 2016). In scenario two Mary provides more guidance to Nicole about which patient she is talking about ensuring all the necessary information is received by Nicole (Edith Cowan University, 2016). Research has proven that handover is often difficult in the health care process, and often results in information being lost, distorted or misinterpreted. Verbal handover has also been described as an incomplete process when compared to information available in patient notes and records (Drach-Zahavy & Hadid, 2015). This is demonstrated in both scenarios with Nicole being given a fast handover with no guidance about where the information she is being given is relevant to. Whilst in scenario two Mary provides prompts and gives Nicole time to write down all the necessary information she requires (Edith Cowan University, 2016).

The clinical nurse practitioner has numerous areas of core competencies that vary greatly from the five categories listed for the nursing administrator. Nurse practitioner competencies are: scientific foundation, leadership, quality, practice inquiry, technology and information, policy, health delivery system, ethics, and independent practice (NONPF, 2012). The nurse practitioner needs to have a solid foundation in the nursing science field (NONPF, 2012). Quality competencies are another area in which clinical nurse practitioners need to hold as they are dealing directly with patients and their needs (NONPF, 2012). Relationships between access, cost, quality, and safety and how they influence health care are what are needed for nurse practitioners (NONPF, 2012). Also, interpreting knowledge into practice interacts with the quality of the practice. Generating knowledge about the practice and constantly improving the practice through evidence based best practices furthers the area of nursing (NONPF,

The first competency area is scientific foundation competency. This competency critically analyzes data and evidence for improving advanced nursing practice. Nurse practitioners rely on scientific competency to integrate research, theory and knowledge into practice. Research of their practice will allow NPs to influence public policy through participation in professional organizations and in health policy activities at the local, state, national and international levels (Sherwood, Brown, Fay, & Wardell, 2012, para. 6).

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

How do you rely on family traditions and personal experience when you become ill and/or when you care for an ill family member?

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.

As the healthcare industry changes, challenges arise for the healthcare administrators of acute-care organizations. One of these challenges includes the need to ensure that every member of the nursing staff is competent within this continuously changing environment. Competence is not an achievement; it is a habit of lifelong learning. The Joint Commission defines competencies as the knowledge, skills, aptitude and behaviors that an individual possesses in order to perform tasks correctly and skillfully.

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.

Thomas & Timminis et al study reveals, in this day and age, the working environment has been inevitable in relation of shortage of staff, accompanying as a consequence of workload commitments, the governing body may not consent sufficient time for mental health nurse to perform such necessary EBP processes (Alzayyat, 2014).

Evidence base practice is essential in nursing practice. It incorporates 3 key components which are clinical expertise, patient values, and best research evidence in order to provide the most effective and safe decision making for patient care. Neglecting a key component can affect the accuracy and efficiency of a research. Clinical expertise is based on a clinician’s experience, skill, education level and understanding in a certain area of nursing practice. Patient values can impact evidence base practice depending on their needs, preferences, expectations, values, understanding, and concerns. Best research evidence can be obtained from clinical research with supporting evidence base literature and sound methodologies. Each component will be discussed in further detail and how it links to clinical decision making by registered nurses in order to achieve the best evidence-based practice available.