Is Nursing an Art or Science

Evidence-based practice is the practice of making clinical decisions based off the best available research evidence coupled with the nurse’s own expertise, while also taking into account, the patient’s assessments and own personal preferences. This use of research has proven effective at providing better outcomes and lower healthcare costs, yet there are several barriers, such as time, education, and support, which prevent nurses from consistently using evidence-based practice (AJN, 2012). The top three barriers to the use of evidence-based practice are lack of time, education, and support in implementing new practices and using them consistently.

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.

As a provider of care, professional nurses depend on research, theories, and evidence based practice to guide the care they provide to patients. Nurses deliver care to their patients based on information they have learned through many years of school and training. Training for nurses and other providers of care is founded on theories, research, and evidence based practice in the healthcare field. Theories, research, and evidence based practice are all important for providing care to patients and each can be used in a different manner depending on the situation. Clinicians often use research based evidence to design and implement care that is high-quality and cost effective for patients. Evidence based practice can be used to provide care to patients in a steadily changing clinical environment. (PDF page 8-9). Nursing theories are frequently used as frameworks for establishing nursing care interventions and assessing

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.

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).

Introduction 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.

Focused Clinical Research Questions Discovering new information applicable to the field of nursing begins by asking a focused clinical research question. According to Stone (2002), asking the appropriate question is essential for the research process that follows. Although there are countless nursing problems that are worth investigating, it is imperative to

Introduction Evidence based practice, “involves integrating the best available research evidence with professional expertise while also taking account of patient preferences the patients state setting and circumstance and health care resources” (Gerrish, K. Lathlean, J, 2015). As the health care profession constantly changes, then it is vital that all evidence based practice is kept up to date with current information and research, relating to nursing practice. Always assuring that the patients need are taken into consideration (Sackett et al, 1996).

Nursing Evidence-Based Practice 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 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.

According to Sackett, et. al. (1996), nurses do have the potential to contribute to an evidence based practice. Nurses today are believed to understand and conduct research studies based on their own professional practice. Nursing research is a process that validates and refines existing knowledge and creates new knowledge that directly and indirectly influences nursing practice scientifically (Burns & Grove, 2001). EBP is defined as the use of the best clinical evidenced and such evidence characteristically comes from research conducted by nurses and other healthcare providers (Newhouse, et. al.

There currently exists a struggle to bridge the theoretical with the real. This is struggle exists in healthcare as much as in any other aspect of the working world and in healthcare can be related directly to Evidence-Based Practice (EBP) and clinical nursing. The summarized definition of EBP for healthcare

Evidence-based practice is “the use of the best scientific evidence integrated with clinical experience and incorporating patient values and preferences in the practice of professional nursing care” (Houser, 2015, page 12). Evidence-based practice is important to nursing care for many different reasons. One of the main reasons is that using evidence-based nursing care provides better patient outcomes verses using the traditional trial and error method. Evidence-based practice is based on scientific studies and desirable patient outcomes. Healthcare professionals who provide patient care using evidence-based nursing practice are acting in the best interests of their patients. Errors in clinical decision making have greatly been reduced by using evidence-based practice for providing nursing care to patients. Patients are often placed at a higher risk for harm or injury when using the traditional trial and error method of nursing care. Therefore, the trial and error method should be avoided at all costs because it is unethical and unacceptable from a nursing standpoint (Houser, 2015).

Importance of Evidence Based Practice Evidence-based practice (EBP) in nursing means making decisions about patient care on the basis of best, current, standardized practice and guidelines. According to an article, written by Dr. Kathleen Stevens, the development of evidence-based practice (EBP) is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care (Stevens, 2013). The author also mentioned in her article that the intended effect of EBP is to standardize healthcare practices to science and best evidence and to reduce illogical variation in care,

Introduction Staffing shortages coupled with the high competing mental and physical demands involved in patient care, breed loopholes of distraction and, inevitably, draw nurses away from the most important aspect of our profession; therapeutic connection. New patient satisfaction requirements from the Affordable Care Act, tied to reimbursement, further challenge nurses to