Nursing Management

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.

Evidence based practice is when recent research is integrated into the clinical setting for maximum delivery of health care. A lot of evidence based practice was developed from research studies conducted by nurses such as decubitis ulcer prevention. Knowing and demonstrating the scientific methods and processes will help to advance nursing care by providing better interventions for patient care. Patient care plans should be developed based on evidence (Dycus, 2009). With monitoring outcomes from evidence based practice it can be determined if the care caused improvement in the healthcare setting. Using quality measures such as charts and diagrams to understand performance.

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.

The John Hopkins Nursing Evidence-Based Practice Model is a powerful problem-solving approach to clinical decision making and is used in research. The model is designed to meet the needs of the practicing bedside nurses and used a three step process called a PET, facilitating nurses in translating evidence to clinical, administrative and education based on evidence. According to Melnyk and Overholt (2015), there are three steps to the JHNEBP model. The first phrase is practice questions: Identification of an EBP question and defines its scope. The second phrase is evidence of internal and external evidence team determine if its feasibility to implement. The final phase is a translation which includes recommended practice for changes and dissemination of findings.

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.

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).

This paper will discuss how evidence based practice effects nursing practice and how nurses can apply what they learn to their practice. Evidence based practice is a great way to improve the quality of care we provide. “Evidence based practice means using the best available research findings to make clinical decisions that are most effective and beneficial for patients” (Chitty & Black, 2011, p.258). By allowing nurses to participate in research and development, we are able to see firsthand how effective our intervention can be. Nurses run into all kinds of problems on a daily basis and they are able to share their experience and expertise to help develop a better way to solve a problem.

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).

The way we practice healthcare and healthcare organizations are changing due to the pressure to reduce costs, improve the quality of care and to meet rigorous guidelines. This change has forced health care professionals to examine we evaluate our overall performance. Paradise Hospital, Inc. has not had any service improvements since 1995. A physician named Avedis Donabedian (2005) proposed a model for assessing health care quality based on structures, processes, and outcomes. He defined structure as the environment in which health care is provided. This is known as the organizational characteristics such as the measurement of staffing ratios and the number of hospital beds. The process is described as the method by which health care is provided. This represents the communication and interaction seen between doctor and patient. The necessity for the tests and procedures performed. The outcome is defined as the consequence of the health care provided, was there a desirable or undesirable effect.

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

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.

Nurses are encouraged to integrate and apply evidence based practice in their daily practice. Evidence based practice is utilizing scientific knowledge/theory while making clinical decisions to provide quality care to their patients.EBP is very important and applicable in today’s clinical and nursing practice and it is used to provide best quality care to their patients and has to be monitored closely. Nurses should apply EBP in all day to activities like nursing intervention,

something is done in a specific way. It also takes into consideration the preferences of

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,