Staff Nurses: Application Of Evidence Based Nursing 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.

As a provider of care, professional nurses depend on research, theories, and evidence based practice to guide the care they provide to patients. Nurses deliver care to their patients based on information they have learned through many years of school and training. Training for nurses and other providers of care is founded on theories, research, and evidence based practice in the healthcare field. Theories, research, and evidence based practice are all important for providing care to patients and each can be used in a different manner depending on the situation. Clinicians often use research based evidence to design and implement care that is high-quality and cost effective for patients. Evidence based practice can be used to provide care to patients in a steadily changing clinical environment. (PDF page 8-9). Nursing theories are frequently used as frameworks for establishing nursing care interventions and assessing

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.

Another barrier is that organization does not provide the encouragement and acknowledgment to nurses who implement Evidence Based Practice (Cathy L. O’Nan, 2012). Major factors which prevent nurses from the implementation of Evidence Based Practices (EBP) are a lack of time to read articles, poor coordination with other members of health team and unavailability of nursing research articles. It was also concluded that nurses perceived the lack of managerial and organizational support to implement EBP (Ay, F., 2014).

Evidenced Based Practice (EBP) is essential to enable all nurses to provide the most current up to date practises for their patients. This process involves research, systematic review of current practises, critical thinking skills, evaluation and application to the clinical setting. In addition to this, the nurse must take into account the patients’ preferences. For nurses to have professional autonomy they must be able to justify their actions and demonstrate an understanding of why they perform the tasks they do. This defines them as unique professionals judged by their knowledge and not simply by their hands on skills.

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.

Conrad, A., Grotejohann, B., Schmoor, C., Cosic, D., & Dettenkofer, M. (2015). Safety and tolerability of virucidal hand rubs: a randomized, double-blind, cross-over trial with healthy volunteers. Antimicrobial Resistance & Infection Control, 4(1), 1. doi:10.1186/s13756-015-0079-y

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).

Nurses are responsible in providing holistic, quality care to their clients. In order to effectively provide such care Boswell and Cannon (2009, p. 2 & 7) states that nurses must base their provision of care on the most current, up-to-date health information available and sound nursing knowledge. This is where evidence-based practice (EBP) comes in. Polit and Beck (2010, p. 4) defined EBP as "the use of the best clinical evidence in making patient care desicions". This usually comes from research conducted by nurses and other healthcare professionals. Thus it is pertinent that research reports are critically analyzed.

Sterile technique is required for insertion of an indwelling urinary catheter in the hospital setting, but clean technique can be used for intermittent catheterization in non-acute settings. By itself, sterile technique on insertion doesn't prevent UTI’s. Prevention of UTI’s depends on knowledge of causes, proper care techniques, and early catheter removal. Nurses are taught early on in school that sterile technique helps to reduce infections. It was drilled in our heads the entire time and now to have the evidence tell us that early catheter removal, along with proper technique good hand hygiene is the key to reduce UTI’s.

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”.

Evidence-based practice is important because it lets nurses know what they are doing, why they are doing it and how they can do it better based on scientific research. Then evidence-based practice is a process of professional learning, even in training the nurse must know how to ask the right questions, how to critically appraise evidence, how to make clinical decisions and how to solve the clinical problems. Then the evidence-based practice is not only required for the nurses to have knowledge but also the nurses need to use this knowledge to identify evidence to inform practice and how you might subsequently assimilate this

Why should nurses incorporate research? Nurses should incorporate research in their scope of practice to deliver the highest and safest quality health care. This is based on proven scientific evaluation, peer review, combined with one’s clinical experience, critical thinking, and competency. (Stevens, 2013), “research produces the most reliable knowledge about the likelihood that a given strategy will change a patient's current health status into desired outcomes”. With these analyses, I believe that nurses can achieve great outcomes and patient satisfaction. However in our class lecture, Chamberlain College of Nursing (CCN, 2015), states that “research yields evidence upon which nurses may base their practice, i.e., evidence-based practice”. In a nut-shell, nurses’ combine research to improve their scope of practice, innovate nursing concept, and enlarge nursing knowledge (Hood, 2014, p. 243).

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,