Evidence-based practice is a problem-solving approach that integrates systematic search for, and critical appraisal of, relevant evidence to answer a burning clinical, educational or administrative question. In today’s Magnet Monday, I will further explain this approach, why it is important to us at Parkview and how our clinical nurses are making great strides to improve clinical outcomes through evidence-based practice.
What is the difference between quality improvement (QI), evidence-based practice (EBP) and research?
• QI uses existing knowledge to address internal organizational systems and improve performance
• EBP integrates best evidence (often derived from research) into practice to produce desired outcomes
• Research uses a rigorous
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It is a professional obligation that advances the professionalism of nursing and improves patient outcomes. According to the American Nurses Association, “the registered nurse participates, as appropriate to education level and position, in the formulation of evidence-based practice through research…the registered nurse utilizes current evidence-based nursing knowledge, including research findings, to guide practice.”
The Parkview RN Job Description includes many components of EBP, as it:
• Bases individualized care on best current evidence, patient values and clinical experience
• Uses current evidence and clinical experience to decide when to modify clinical practice
• Appreciates importance of accessing relevant clinical evidence by using available resources, including policies and procedures, clinical educators and by independently seeking knowledge
What research/EBP activities do we have at Parkview?
Parkview currently has seven nursing research studies in the development process or pending approval from the Institutional Review Board. Over the past two years, nearly 15 nursing research studies have been completed, including:
• Evaluation of effects of patient hand hygiene on hospital-acquired
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
doi:10.1037/cpb0000021 Melnyk, B.M. & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Wolters
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 a formulation of ideas, research and conclusions to formulate the best possible health care choice (Hood, 2014). In health care the process of utilizing current information begins with a question can something be done better, can the patients benefit as a result and is it cost effective, EBP seeks new information to replace old or outdated information. When there are doubts if something can be done better a research team collects data on the subject using unbiased information they analyze the data, design interventions that are based on the new evidence and makes their final recommendations on their findings (Hood,
Over the last several years, nurses have been facing critical challenges. This is because there is a shortage of qualified individuals inside many facilities. At the same time, they are expected to serve a variety of roles in order to address the needs of stakeholders. To fully understand what is occurring requires focusing on the use of evidence based practices inside a clinical setting and formulating strategies for overcoming barriers to them. Together, these elements will highlight the underlying challenges and how they can be addressed in the long term. (Lundry, 2009)
Nurses are responsible in providing holistic, quality care to their clients. In order to effectively provide such care Boswell and Cannon (2009, p. 2 & 7) states that nurses must base their provision of care on the most current, up-to-date health information available and sound nursing knowledge. This is where evidence-based practice (EBP) comes in. Polit and Beck (2010, p. 4) defined EBP as "the use of the best clinical evidence in making patient care desicions". This usually comes from research conducted by nurses and other healthcare professionals. Thus it is pertinent that research reports are critically analyzed.
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).
Evidence-based practice is defined as the “integration of best current evidence with clinical expertise and patient or family preferences and values for the delivery of optimal health care” (Quality and Safety Education for Nurses, 2012). It is “the use of research in clinical decision making” (Brower, 2017).With the tremendous changes in the healthcare landscape, many processes have to be evaluated for its relevance, reliability,
As every patient is unique and has his/her own condition, nurses and other health care providers need a source to follow as a guideline. Evidence based practice can be used as good guideline for health care provider, and it also can show different ways of care and their results. Evidence based practice has a huge role in the world of nursing profession. One of the biggest goals of nurses is to apply the evidence into their practice in a right way, even though a lot of nurses could not apply the evidence into their practice in the right way. ((Schmidt & Brown, 2015). Role of a professional nurse is to implement the evidence into practice in a right way, and create the right result from it. There are a lot aspects involved in evidence based practice
According to The American Nurses Association (ANA) Evidenced-based practice is a "scholarly and systematic problem-solving paradigm that results in the delivery of high quality healthcare" (American Nurses Association, 2010, p. 65). Through the use of evidence-based practice nurse and other health care professional have the ability to create clinical decisions, which allows clinical questions to be answered and aid in quality improvement. Furthermore creating a safe, efficient, productive environment for patients and staff that may result in improving patient outcomes and reduce expenses. Nursing research helps health care providers provide evidence-based practice, which may result in quality improvement (Rebar & Gersch, 2015).
Melnyk, B.M. & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Wolters Kluwer.
The increasing demand for highest quality of health care, in combination with the requirement for cautious use of available health resources has increased pressure on health care professionals to make certain that clinical practice is based on sound evidence. Changes in treatment methods and with increasing expectations from patients to make available the best possible care, place high demands and responsibility on therapists to conduct a service that is based on current unsurpassed evidence based practice (Bennett, S. & Bennett J.W. 2000). Research evidence will be very helpful for physicians, therapist and all other healthcare planners who require to improve the quality and efficiency of healthcare services. information technology through information services that unite high quality evidence has made this informative evidence easily accessible. However, there are several limitations to the successful application of research evidence to health care. In the below paragraphs, Firstly, I will discuss the benefits for evidence based practice to improve health care. Secondly, I will discuss the limitations that clinicians, planners, and patients may have to overcome to benefit from the current evidence based practice and Lastly, I will critically analyses a case study on should central venous line catheter administration set be changed regularly or left intact.
According to Houser, nursing research is the process that provides us with “unbiased, trustworthy answers to question about nursing practice.” (Houser, 2015). It is the evidence utilized in evaluating and implementing best practice and outcomes. “Research is one of the central tenets that defines a profession” (Houser, 2015). Nurses should incorporate research into their practice for many reasons. It provides the scientific evidence and knowledge that enables the nurse to effectively communicate and collaborate with physicians and members of the health care to provide the best possible outcome for the patients. Nurses are in a unique position to participate in research through data collection, implementation, and evaluation through
Evidence-Base practice (EBP) is defined as based on problems identified from nursing practice; using best evidence and professional expertise and merging them into current practice to ensure patients receive quality care (French, 1999). Evidence-based practice is a part of quality improvement process; it is made of evidence, clinical expertise, patient preference and the context of care (Barker, 2013). In brief, evidence-based practice is the guideline in the nursing practice that requires nurses gather and use clinical evidence to help diagnose or assess patients correctly by using their knowledge and experience in order they can deliver the quality of care to the patients (Ellis, 2013). In the other words, in the nursing practice the clinical evidence supports all the nursing procedures performed.
Evidenced based practice (EBP) defined as “clinical decision making based on the simultaneous use of the best evidence, clinical expertise, and the clients” values (p. 28-29). In nursing practice, following EBP will strengthen influences and guide the nurse’s ability and help them provide the best clinical care practice (ANA, 2013). Nurses follows best practice to improve the quality of care for every patient and will assist them in understanding a study that is not well explained or hard to understand for better patient outcome. My best practices on implementing the project presentation is following and incorporate the evidenced based practice for promoting health for my target audience.