Nursing Research: Evidence-Based 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.

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.

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.

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.

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.

Evidence - Based Nursing, An introduction (2008, p. 285 ) “ The rapidity of change and the reorganization of nursing services within the health care sector presents challenges for the advancement of EBP. Managers and administrators should facilitate the uptake of practice based on current, high-quality research by formalizing the expectation that nurses care be Evidence Based”.

The Ganz et al. (2009) research was performed in order to evaluate the ICU nurses oral care routines and if they were using appropriate, up-to-date evidenced based techniques and lastly if evidence-based practices (EBP) was associated with personal demographics and professional characteristics. Ganz et al. (2009) had found that previous research and studies has shown that poor oral hygiene may contribute to greater risks for pneumonia which results in an increase in mortality and morbidity (Ganz et al., p 133). In fact some of the research studies had stated that there was no documentation of the nurses oral care practices and these practices were not even up-to-date with recent evidence (Ganz et al., p 133). In addition to that, ventilator-associated

Evidence Base Practice and research is the standard by which health care workers are expected to deliver higher quality care (Carter-Templeton, PhD, RN-BC & Wu, MLIS, AHIP, 2015). There is has been new developments made in terms of the way we gain access to the research and evidence based care resources, mobile electronics have paved way for a quicker more efficient approach to gaining the clinical knowledge for best patient care (Carter-Templeton, PhD, RN-BC & Wu, MLIS, AHIP, 2015). Some electronics that can carry out the task of facilitating this information are “tablet computers, handheld computers, smart phones and personal digital assistants” (Carter-Templeton, PhD, RN-BC & Wu, MLIS, AHIP, 2015) which can be used to download and run applications

Patient care using a common definition of evidence-based practice, professional environment and to determine if the value of the patient to answer the clinical question of integrating their expertise, systematic evaluation research is the determination of the application of the current best evidence. The nurse takes a large portion of hospital and clinical staff in charge of the pivotal role of medical services. If a nurse applies the available evidence-based nursing practice regularly it will make a significant contribution to the quality of care. Since the recognition of the wise nurse organizational impediments in implementing evidence-based practices to increase, interest in developing a model for changing the organizational infrastructure and assess its effectiveness in order to successfully promote evidence-based practice of nurse it is

How do researchers determine reliability in a study? Describe the major types of each. According to our text Understanding Nursing Research: Building an Evidence-Based Practice “reliability testing is a measure of the amount of random error in the measurement technique. It takes into account such characteristics as dependability, precision, stability, consistency, and reproducibility (Grove, Gray, & Burns, 2015, p. 288). It then goes on to describe the different types that, “focuses on the following three aspects of reliability- stability, equivalence and homogeneity” (Grove, Gray, & Burns, 2015, p. 289). The chart on page 289 goes into detail about each term, Test-retest reliability, Alternate forms reliability, Interrater reliability,

The learning process during this course (Advanced Nursing Research: NURS 5301) has been quite a lot. We dealt with the importance of research and evidence-based practice (EBP) in nursing and it has being quite revealing and extensive in contents. The course contents and assignments were in-depth and time-consuming, mostly the literature review paper nevertheless they were informative and educative. The course promotes critical thinking and judgment, more so, the materials and assignments were based on how clinicians will be able to identify a need for change in the current practice and ask the right questions, which in turn generate research that will lead to EBP.

Working in the oncology field can be challenging, yet very rewarding. Chemotherapy is used to destroy cancer cells, however, chemotherapy attacks all cells, good and bad. Because of this, patients going through chemotherapy often experience chemotherapy-induced neutropenia. This leaves the patient extremely susceptible to infection, and often affects the patient’s ability to receive their chemotherapy regimen. In chemotherapy-induced neutropenia, how does the use of granulocyte colony-stimulating factor(s) (G-CSF), compared to not using them, influence the risk of developing severe neutropenia during chemotherapy.

The evidence-based practice should be the force behind changes in medical and nursing practice especially when it is advantageous to patient's health. Moreover, this principle should always be the first requirement despite the financial hurdles we face these days. With that in mind, one of the obstacles which we are trying to overcome in my department is for the leaders to realize that treating diabetic patients with GLP-1 drugs has been proven to be cost-effective while providing greatest HbA1c and weight reductions comparing to other hypoglycemic agents ( ). Besides, those patients would ultimately have higher life expectancy and less microvascular and macrovascular complications leading to considerably improved lifestyle. Although our case

Pressure injury is both financial and quality burden to the healthcare system in particularly when hospitals could potentially lose their reimbursement from the government for hospital acquired stage 3 and 4 pressure injuries. My workplace has commenced a series of campaigns to target and reduce the incidence of pressure injuries since 2014. This review shows that nutritional support and in particular high protein with arginine-enriched supplement have the tendency to be associated with a significant healing rate in pressure injury compared to routine care, which includes usual diet and standard pressure injury care. With these promising results, standardised pressure injury care policy to include

I enjoyed reading your well-put response to this topic. It shows in your writing that you have been a nurse for over 20 years! I agree with your opening sentence that the importance of nursing as a science in with regards to nursing theory, is based on the inclusion of particular “beliefs, behaviors and values” that form a rational group of tested general proposals, commonly regarded as correct, that can be used as principles of explaining and predicting a class of trends (Barrett, 2002). For example, with this we provide research and study such things as to describe evidence-based practice (EBP) beliefs and behaviors of nurses who provide cancer pain management.