Leading and Managing Change in Clinical Practice

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.

According to Dr. David Sackett (1996) Evidence Based Practice (EBP) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”

Evidence based practice is the basis for needed change in practice and function. It is a sound method for scientific, fact-based change. Changes which have no evidence to support them are fragile, unscientific, and subjective. These changes don’t effect real change over time, as they aren’t able to be proven to a more general population.

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

According to Dr. David Sackett, Evidence Based Practice (EBP) is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It is a clinical decision-making process in which clinicians use theory-derived, research-based knowledge to inform their decisions about care delivery. Most importantly, consideration of individual needs, preference and resources must be included.

Define evidence based practice and discuss the possible facilitators and barriers for Sam to utilise the best research evidence in clinical practice.

Evidence-Based Practice (EBP) was initially a movement in medicine, dating back to early 20th century (Spring, 2007). It was described as a careful decision making process about the care of individual patients using best available evidence by Sackett, Rosenberg, Gary, Haynes, and Richardson (1996). Greenhalgh (2010) gave a similar definition but with more emphasis on the mathematical assessment of the potential benefit and harm. By now, EBP has been widely adopted by many health disciplines, including psychology. In 2005, the American

a. The current thought about evidenced based practice is that it can be useful if the evidence is good and been proven to work. Just like any other new thing in the medical field it has many criticisms but they have been debunked on the basis of underlying misinformation or misunderstandings. One of the problems with evidence based practice is human judgement, when picking out which evidence to use it can be influenced by a decision maker 's biases and political interests. Another problem with evidenced based practice is that some of the EBP out there does not meet the requirements of scientific evidence.

Evidence based practice and practice based evidence are a big part of a treatment process. These two can provide appropriate treatment that is needed to make advances in health care practices. Having enough evidence helps people determine whether to do something or not. To provide the best possible treatment for each patient you have to take information and see what will work best for each of your patients. Some will work and some will not work. Methodological issues can arise with in any type of research and some are more controversial than others. In the article “Practice Based Evidence: Back to the Future” (2011) the point of view was that research comes from evidence and that

Evidence- based practice is a trend both within the occupational therapy field and in the medical profession as a whole. It was first introduced in 1971 when Archibald Cochrane published “Effectiveness and Efficiency” where he suggested that because resources are limited clinical evaluation and treatment should be made based on sound evidence (Katsikis, 2014; Shah & Chung, 2009). The definition of EBP written by Sacket (1996) is still frequently quoted today; he defined EBP as "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research."

Evidence Based practice was established to enhance the quality of patient care. An EBP has been considered as a series of mechanisms to improve the patient care as well as preventing the medical errors by clinicians. In order to optimize the patient wellbeing, today clinicians are expected to use their clinical knowledge along with use of research evidence in to the practice. Practicing EBP can enhance the clinician’s excellence in the practice (Manske & Lehecka, 2012). A quality care which is based on evidence

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.

for buy-in, enabling action, creating short-term wins, don’t let up, and making it stick). Bridges

1990). On the other hand, resistance is any conduct that tries to keep the status quo, i.e.,

Evidence-based practice (EBP) offers a framework utilization of systematic high-quality research, an analysis which consistently enhances measurable client outcome and clinical decision-making grounded in rationality; EBP depends on data collected through experimental research and accounts for individual client characteristics and clinician expertise. The potential benefits of EBP comprise of increased service delivery and quality of care, heightened accountability, and a bridging of the research-practice gap (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000). It is imperative that research scholars are cognizant of research outcome dependability and validity prior to implementing results