Practicing Evidence-Based Medicine: A Case Study

In this essay, I am going to consider how evidence-based practice can be used to support, justify, legitimate and/or improve clinical practice. I am also going to explore and discuss primary and secondary research evidences about how nursing interventions can potentially improve the quality of life of patients in the community suffering from heart failure. I will gather these evidences using a literature search which I will include an account of. Using a critiquing framework for support, I will appraise both primary and secondary evidences that I have chosen. I will also look at potential non-evidential factors that can influence evidence utilisation in practice. Finally, a conclusion will be drawn.

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).

Pressure ulcers occur over bony prominences when skin is compressed for long periods of time, affecting the blood supply to certain areas, leading to ischaemia development (Waugh and Grant, 2001). Compression of skin is caused by pressure, shearing and friction, but can also occur due to pressure exerted by medical equipment (Randle, Coffey and Bradbury, 2009). NICE (2014) states that the prevalence of pressure ulcers in different healthcare settings in December 2013 was 4.7%, taken from data available for 186,000 patients. The cost of treating ulcers can vary depending on severity from £43 up to £374 (NICE, 2014). Evidence based practice skills are essential in nursing as it allows the best available evidence to be used to improve practice and patient care, while improving decision-making (Holland and Rees, 2010). I will be critiquing two research papers; qualitative and quantitative, using a framework set out by Holland and Rees (2010), and will explore the impact on practice. Using a framework provides a standardised method of assessing quality and reduces subjectivity.

Briefly describe the problem or issue that you have decided to be the topic for your project proposal in order to orient your classmates and faculty

Evidence Based Practice Nursing is the utilization by nurses of Evidence Based Research findings that, according to Houser (2012), steer the nurse toward integration of clinical expert opinion and experience with an unbiased exhaustive review of the best scientific evidence professional nursing care literature can provide while incorporating patient values and preferences. Evidence Based Practice Nursing entails adopting a systematic critical thinking decision making process guided by a deliberate and defined chosen Evidence Based Nursing model path that involves searching,

The incorporation of evidenced-based practice (EBP) into nursing practice is supported by research to positively improve the quality of care and improve patient outcomes. EBP is important to the nursing profession because it also leads to increased job satisfaction, teamwork, and levels of engagement in clinicians (Melnyk, et al., 2017). Miniature research projects such as quality improvement projects, surveys, and clinical research studies are frameworks used to get feedback and data from patients during their time spent in health care systems. EBP is not the standard of care in many health care systems (Melnyk, et al., 2017). This due to many factors, including lack of EBP mentors, nursing programs that do not incorporate EBP into the curriculum,

Evidence Based Practice is beyond the Advanced Nurse Practitioners and the patients, it is more and part of an organizational culture. Advanced Nurse Practitioners have to understand how literature findings can be reviewed in order to determine if they are relevant and clinically significant to the population they serve as your focus on lesbian, gay, bisexual, and transgender (LGBT) community. It is a good idea to use the evidence-based policy to implement and provide education and training. In addition to education and training, the clinical environments need to be change which can change some behaviors towards this

Applying evidenced-based practice has three steps. Step one is making sure the research is creditable. Going into detail about step one should model a social work practice. In a social work practice, you always want to make sure you are looking for clarity and in some cases it helps to paraphrase it or reword it differently. As a social worker you have to be non-judgmental and try to understand every perspective. You have to be unbiased when it comes to wording and how it affects the meaning of the conversation. Also, making sure the research on the surveys or interviews are fair and represent the entire population. The second step is when you match your outcome of the research in your own “practice wisdom." As a social worker you want to compare the research you made with prior experience. You want to have different perspective and information that help you understand the client better. Lastly, the last step is to ask questions to the clients about their significance of what they have accomplished by working with you. Just asking what the client has learned can help

An evidence based practice, in my opinion, is the care provided to the patients based on the best evidences derived from the research. According to Hickson et.el (2013) an evidence based practice (EBP) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients”. This definition recognizes three foundations of EBP such as the research evidence, expertness of the clinician and the client’s preferences and goals (Hickson, Laplante-Lévesque, & Wong, 2013).

The purpose of Chapter two is to establish the theoretical foundations of the Evidence-Based Practice (EBP) project, discuss the connection between the EBP model and the PICOT question, discuss the literature search and appraisal of evidence that supports the project, synthesize the findings into recommendations for best practice to form a model for the EBP Project. The PICOT question at the core of the project’s purpose asks: For elementary school staff does the use of a specific anti-bullying program training reduce the risk of bullying in the school compared with current anti-bullying practices? This chapter details the search strategy including databases, keywords, limiters, inclusion and exclusion criteria, and describes the method of

Special education practitioners appear to have produced the majority of the research on the prevalence of evidence-based practice in education. Studies of the prevalence of evidence-based practice in general education do exist, but in at least one instance, the research was published in a special education journal (Kretlow and Helf, 2013). Kretlow and Helf (2013) published a study of kindergarten, 1st and 2nd grade teachers that asked these teachers about the reading programs they were implementing. The results indicate that few of these teachers are using reading curricula that is demonstrated to be evidence-based. Studies among special educators have produced similar results. Research by Cook and Cook (2013) suggested that significant misunderstanding exists about what evidence-based practices are and this has led some special education teachers to ignore evidence-based practices. Similar results were obtained by Carter, Stephenson, and Strnadova (2011) regarding the prevalence of

Evidence based practice (EBP) is an important part of social work. Every social policy and interaction with individuals is based on experience and careful selection of research. Moreover it aims to empower individuals and reduce discrimination. Therefore it promotes productive interactions, which is crucial in this economic climate. Therefore. Social workers have to be competent and confident in analysing the latest research and being able to judge whether it is suitable in practice. Moreover this is supported by Standards of proficiency (SOP) section 14 “Be able to draw on appropriate knowledge and skills to inform practice”.

Healthcare continues to evolve at an extremely rapid pace. It is vital that patients are given the highest quality of care throughout the duration of care received. Melnyk & Fineout-Overholt (2015) states that evidenced based practice is the key to delivering a higher quality of care that facilitates the most favorable outcomes. In order to remain abreast in the face of change, healthcare providers must research and employ initiatives that forwards the healthcare entity as a whole. Unfortunately healthcare providers and healthcare organizations fail to utilize evidenced based practice as often as they should. Often time this is a result of unfamiliarity with research, inability to appropriately incorporate research into active daily practice,

Evidence Based Practice is primarily describing as a process that integrates available research with a practitioner that will relate to the clients’ needs. (Parrish, 2011) The process entitles five steps that explains how the single system works. Begin by coming with practice questions that can be answered. Then find something research for the practice questions. After your finding, next review any research that you have found. Then take the research that you found and collaborate it with your practitioner to relate to your client’s needs. Lastly, keep a record of outcomes to study if the treatment working. (Parrish,

There is constant change in health care and the amount of new evidence related to improved patient outcomes is so abundant it is difficult to keep up with new recommendations. Adoption of evidence-based practice and care by an interprofessional team requires good communication skills and reinforcement of the reasons for change. Efforts to communicate change effectively must create a sense of urgency and generates a vision and motivates staff to accept change. Williams, Rycroft-Malone, & Burton (2016), discuss the importance of change agents or intermediaries that serve as educator and role-models to adopt evidence-based practice. They concluded that an active and constant presence at the bedside by intermediaries develops trust, influence,