Reflection On Evidence Based Practice

Gerrish, K. Lathlean, J. (2015). The research process in nursing. West Sussex: John Wiley & Sons. p263.

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.

Evidence-based practice is an approach in the decision making of using the best evidence about the care of a patient.it is an integration of clinical expertise, patient values and the available evidence from ongoing research .taking into consideration internal and external influences, it promotes critical thinking in the application of the evidence in patient care. The impact of EBP has been echoed in the optimal health care, quality of life and clinical outcomes (Mabbott, 2011). Application of EBP in the plan of care has resulted in benefits such as reduced costs, decreased variation in care and nurse satisfaction. The EBP movement is one component essential aimed at transforming the current knowledge into a plan of care decisions to improve

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.

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,

The impact of evidence based practice has been brought into nursing through education, practice, and science over the last decade. Evidence based practice provides quality care to patients that is effective, safe, and efficient. Evidence based practice promises moving care to a high level of producing the intended health outcome for the patients. “EBP is aimed at hardwiring current knowledge into common care decisions to improve care processes and patient outcomes” (Stevens, 2013). EBP empowers nurses and expands their skills by using the best available evidence to guide nursing care and patient outcomes.

Evidenced-based practice (EBP) originated in Canada from a new form of medical school which was launched during the 1970s at an institution called McMaster University (Hoffmann, Bennett, & Del Mar, 2010). This new medical program was uncommon in a variety of its methods. The primary variation was the abbreviated three year medical program which is very brief in comparison to other medical school framework (Hoffmann, Bennett, & Del Mar, 2010). Instructors conceded that the ideal concept of teaching medical students everything they would possibly need to know in regards to practicing medicine with in this program was an unattainable undertaking (Hoffmann, Bennett, & Del Mar, 2010). In response to this epiphany, instructors at this institution transformed their educational approach and focused on instruction that would provide students with the skills and tools they would need to effectively locate health information while practicing as healthcare professionals (Hoffmann, Bennett, & Del Mar, 2010). This scientific approach to healthcare is now known as evidence-based practice (Hoffmann, Bennett, & Del Mar, 2010). In the past, healthcare practitioners made decisions for patients based on personal and professional experience, hearsay, and lack of scientific evidence (White, 2004). An evidence-based practice links the

Jeremy, nice posting about continuing to advance evidence-based practice (EBP). Stevens (2013) wrote that clinical leaders have the chance to advance ahead and change healthcare from a systems view, thus directing their efforts on evidence-based practice (EBP) for proven effectiveness, patient commitment, and patient safety. I see that through this program that this is only the beginning, I have the sturdy foundation from which I can build from the bottom up. Now that my eyes are open more and I challenge the organization or leaders more with the data to support my claims, I am now the squeaky wheel that grates on your nerves.

As mentioned before, my chosen policy priority is childhood obesity, an epidemic with many health issues associated with it. According to Burns, Grove, and Gray (2011), research used as evidence- based practice (EBP) has been implemented in the clinical practice to achieve quality care, efficiency, and positive outcome for patients and healthcare organizations. Furthermore, when EBP is applied to clinical practice it provides description, explanation, prediction and the control of phenomena. To this, Saviñon, Taylor, Canty-Mitchell, and Blood-Siegfried (2012) suggested that nurses can advocate for the children by encouraging parents to provide children with a variety of foods in adequate amounts to support growth and energy play. Furthermore,

In healthcare, evidence based practice (EBP) has grown and become important in providing the best quality care possible to patients. There are numerous ways to collect and use the research in the nursing profession. Studies are constantly being done to help better nursing and all of the healthcare field in order to help patients live better and maintain their health. There are different types of research such as qualitative and quantitative. Qualitative uses the human experience or something that has been lived by someone and quantitative examines for meaning and goes more in depth to research things and strives to test a hypothesis or makes use of statistical data to answer research questions (LoBiondo-Wood

Goodwin, V., Richards, S., Henley, W., Ewings, P., Taylor, A., Campbell, J., & ... Campbell, J. L.

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

The purpose of faculty training in the nursing profession is to provide program evaluation to examine evidence-based practice in a simulation of care and provide safe nursing practice. Patients with a tracheostomy are high risk and have numerous problems for nurses to find because of respiratory problems. In addition, understanding the facility policy regarding tracheostomy care, the faculty must possess specific knowledge and skills to provide satisfactory care. Evidence-based research has provided the organization for nurses to improve nursing care standards and practice regarding tracheostomy care (Schreiber, 2015). On the other hand, the patient simulation laboratory (SIM lab) coincides with this setting because it uses state-of-the-art

Each clinical day, I am constantly thinking about what is evidence based; what have I learned for lecture. To be honest, I never thought I would be thinking so much about evidence based practice, but I feel it’s essential that each and every single one of my patients gets the best possible care that they deserve. Some ways that I’ve incorporated EVP into my clinical is having discussions with employees about the correct needle length size, observing employees do certain procedure and reflect back, as well as, if I see something that doesn’t seem right, I’ll ask the nurse a question. For example, the nurse and I were doing a postpartum assessment and I noticed when the nurse was assessing the patient’s lochia, that she didn’t have the patient turn to see if any blood was pooled under her.