Evidence Informed Practice Is A Critical Part Of Nursing Care

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.

Scholars have been critical of the medical establishment’s and state’s involvement in constructing and policing of transgender identity. These kinds of pressing issues have occupied the small existing literature. There is not much information and studying what is being done on transgender in traditional areas, family studies research, such as their dating behavior and formation of intimate relationships in adulthood. There is little research on the issues around being parents, their children’s experiences with having transgendered parents, as well as relationships in the family as a whole, and relationships in work and school.

Perhaps the most significant contributing cause of the poor quality of healthcare afforded to transgender patients is the fact that the majority of healthcare providers do not know how to treat trans patients. According to a study done by the Royal College of Nursing, it was discovered that “78% [of surveyed nursing staff] had not had training on how to care for transgender people, and only 13% of those surveyed said they had felt prepared to meet the needs of trans patients they had cared for” (Duffy, 2016). Additionally, around four out of five staff had “no training

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.

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

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.

Briefly describe the problem or issue that you have decided to be the topic for your project proposal in order to orient your classmates and faculty

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.

The healthcare delivery system and the care for patients has brought new dimension which necessitated the need for competencies, perfection and accountability into the healthcare system. This has brought about a change in nursing education to now pay more attention to practical nursing. To affect better client’s outcome, knowledge must be applied clinically in a holistic way to the benefit of the patient we serve. Steven, K., (2013) in his article “The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas”, suggests that, the recommendation that nurses lead delivery system and care bring to the fore that necessitate for new competencies, beyond evidence-based practice, that are requisite as nurses transform healthcare. Directions

There are five levels of strength of the evidence on the Johns Hopkins tool, and I gave the article “Sleep in the Hospitalized Patient: Nurse and Patient Perceptions” a ranking of level III. I used the Johns Hopkins nursing evidence based practice research evidence appraisal scale tool to decide on my ranking level which breaks it down step by step to find the strength of the research. The description of level III is “nonexperimental study, qualitative study, or meta synthesis” (cite JHNEBP). Non-experimental studies consist of no manipulation of variables and randomization is not controlled, qualitative studies are made up of interviews or focus groups and have small sample sizes, and

The focal point of this discussion is to create an organized method to bring evidence base practice (EBP) awareness to the forefront, increase knowledge to health care nursing in prevention and management as they are confronted daily with clinical problems, lack of up-to- date EBP research. Nurses will develop the skills for early detection by exploiting the four-stage framework model in their organization and validating the need for implementation of accessible current evidence base research to bring about optimal patient care and safety.

CONCEPT 1 CONCEPT OF EVIDENCE BASED NURSING 1.0 INTRODUCTION/IDENTIFICATION OF CONCEPT Nursing as a profession has changed so much to compare with what is use to be decades ago. Technology, nursing procedures, teaching and nursing research have contributed much in high quality delivery of nursing care. It was on this note that evidence based practice was adopted. Evidence-Based Practice is regarded by the Academy of Medical-Surgical Nurses as a way to affect best available patient care. It focuses on the integration of the best available evidence to direct nursing care and improving patient outcomes thus helping health practitioners address

There are some limitations in all research studies and the use of them in the practice. Evidence shows that there are different situations for different individuals, and every single individual needs a specific treatment based on his/her situation.

This class has been an eye-opener for me, especially in many area nurses can participate in evidence-based practice and implement change in clinical settings. Improving patient outcomes, saving cost, and the management of chronic illnesses has made evidence-based practice the focus in healthcare today. For instance, the institute of medicine focuses on improving health care quality for greater outcomes through the use of research studies. Evidence-based practice has been proven to decrease mortality, mobility, and medical errors in healthcare. Healthcare provider, such as doctors, nurses, and even hospitals can be held financially and legally responsible for policies and standard in healthcare today is not based on evidence-based practice. Evidenced based practice also enables nurses to provide safe and effective care to patients with information that are reliable and clinically proven to work (Brower, 2017). Without research and evidence-based practice, there would be many unanswered questions in healthcare, and clinical practice would not be valid if it were not proven scientifically to be true