Review Of The Impact Of Evidence-Based Practice In Nursing And The Next Big Ideas

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.

The following literature will define the term, “evidence informed practice”. It will discuss the benefits and limitations of integrating evidence informed practice in nursing. It will include information about how nurses can overcome these barriers. It will also illustrate the importance of utilising evidence informed practice to enhance the quality of service delivered within the healthcare profession.

In the article “What Do Nurses Really Do?”, Suzanne Gordon explores what nurses truly do. She concludes that nurses “save lives, prevent complications, prevent suffering, and save money” (Gordon 2006). Nurses provide care for their patients in the physical and emotional sense. Emotionally caring for a patient and being sensitive to his or her needs result from interacting with patients while performing the skills and using the knowledge that nurses learned in school. Nurses grow in their skills, knowledge, and attitudes through practice. Quality and safety education for nursing incorporates competencies that all nurses must use in their practice. These nursing competencies include evidence-based nursing practice, quality improvement, safety, teamwork and collaboration, patient-centered care, and informatics.

Evidence base practice is essential in nursing practice. It incorporates 3 key components which are clinical expertise, patient values, and best research evidence in order to provide the most effective and safe decision making for patient care. Neglecting a key component can affect the accuracy and efficiency of a research. Clinical expertise is based on a clinician’s experience, skill, education level and understanding in a certain area of nursing practice. Patient values can impact evidence base practice depending on their needs, preferences, expectations, values, understanding, and concerns. Best research evidence can be obtained from clinical research with supporting evidence base literature and sound methodologies. Each component will be discussed in further detail and how it links to clinical decision making by registered nurses in order to achieve the best evidence-based practice available.

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-informed practice is a critical part of nursing care. To be able to have evidence-informed practice, nurses need to be able to conduct research to find the most up-to-date and relevant information related to patient- and family centered care. When caring for patients, it is paramount to recognize the importance of family and the role they play in care. When one comes out as transgender, it is something that is not only going to affect the said person, but also their friends and family. Family members are key support systems so when you are caring for one person, you are in turn caring for the family as well. This is known as patient- and family-centered care. As there has been an increase in literature pertaining to family-centered care, the question of interest is “What is the impact on a spouse when a partner is transgendered?” To find the answer to this clinical question, the database Medline was utilized. The keywords LGBTQ, transgender, family-centered, spouse, nurse, sexuality and health care were used and combined with Boolean operators. Through this research, knowledge can be gained on how to properly care for the spouse of a transgendered person. This paper will discuss the key impacts of having a transgender spouse, nursing approaches that we can integrate into our care, and resources available for the non-transgender spouse.

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.

Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored in the implementation of Evidence Based Practice.

According to The American Nurses Association (ANA) Evidenced-based practice is a "scholarly and systematic problem-solving paradigm that results in the delivery of high quality healthcare" (American Nurses Association, 2010, p. 65). Through the use of evidence-based practice nurse and other health care professional have the ability to create clinical decisions, which allows clinical questions to be answered and aid in quality improvement. Furthermore creating a safe, efficient, productive environment for patients and staff that may result in improving patient outcomes and reduce expenses. Nursing research helps health care providers provide evidence-based practice, which may result in quality improvement (Rebar & Gersch, 2015).

It was pretty difficult to choose to the most important competency to use in nursing practice since all of them play a vital role in our nursing practice, however I do see why evidence based practice is the most important competency to you. Evidence based practice is designed as a clinical- decision making process based on theory-derived information necessary to provide patients with care that is effective, safe and efficient. In order to have effective patient outcomes, it is necessary for new researched-based knowledge to be transformed into the clinical setting and implemented effectively within the health care system. As the healthcare system evolves, so do our nursing practices and the same polices that once use to be in place, may no

As you observed the professional/registered nurse’s role in this setting, what evidence of a professional level of nursing practice? During my labor and delivery rotation, there were many different situations that showed evidence towards a professional level of nursing. One of them being the control of medicine. The patient that I was working with was put on Pitocin to induce labor.

Historical research is established on documentation of resources that are used to retrospectively examine events or people. According to the book Evidenced Based Practice For Nurses “Historical methods are concerned with uncovering and generating evidence and with interpreting that evidence in the historical context in which it was created” (Schmidt & Brown, 2015). The questions that are being asked are “Who are we?” “Where did we come from?” “Why did we do this?” And “How did we get to this point?” (Schmidt & Brown, 2015) .The objective of this type of research is to describe and understand the past, with the hope of guiding the present future. One type of sampling used in this method is called strategic sampling. This is when a researcher

There are five levels of strength of the evidence on the Johns Hopkins tool, and I gave the article “Sleep in the Hospitalized Patient: Nurse and Patient Perceptions” a ranking of level III. I used the Johns Hopkins nursing evidence based practice research evidence appraisal scale tool to decide on my ranking level which breaks it down step by step to find the strength of the research. The description of level III is “nonexperimental study, qualitative study, or meta synthesis” (cite JHNEBP). Non-experimental studies consist of no manipulation of variables and randomization is not controlled, qualitative studies are made up of interviews or focus groups and have small sample sizes, and

Changes in the Health Care System and the Practice of Nursing have become complex. Technological changes, complicated client needs, short hospital length of stay, and departure from acute care to community based care, all these changes have underscore the need for professional nurses to think critically in order to provide safe and effective client care. A better educated nursing workforce can provide good health education to patients and their families. The affordable care of 2010 has required the need for nurses to expand their role of practice to meet complicated patient demands. This has prompted the Institute Of Medicine to review the “Future of Nursing, Leading change and Advancing Health”. {Creasia & Fribery,2011}