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. As stated by McSherry, Simmons & Pearce (2002); “Nurses are responsible for the care they provide for their patient. …show more content…
(Polit & Beck, 2010). As nursing is person-centred and relies on a multidisciplinary team approach it has to take into account the care setting, patient predilections, clinical judgement and best available evidence. (Holland & Rees, 2010). The key steps involved in evidence based practice come from a thirst for knowledge that once ignited makes the next step to asking a well worded clinical question easier. A well formulated question improves patient outcomes and supports the implementation of change. One such method looks at foreground and background questions. A background question is usually a basic knowledge question and is usually answered by a textbook. Foreground questions are usually specific and once answered can help in clinical changes. An acronym useful for formulating a well worded question is PICOT. ( Stillwell, Fineout-Overholt, Melnyk, Williamson, 2010). “PICOT is an acronym for the elements of the clinical question: patient population (P), intervention or issue of interest (I), comparison intervention or issue of interest (C), outcome(s) of interest (O), time it takes for the intervention to achieve the outcome(s) (T).” (Stillwell et al., 2010, p. 59). When a question has been identified the best study design can be chosen. For a prognosis question, a good quality cohort study would be used. For a non-compliance question, a qualitative study would be appropriate and for the effectiveness of treatment a systematic
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
A PICOT question is formulated in order to assist the researcher in obtaining answers to a specific question, decreases the uncertainty surrounding the issue, and provides a systematic approach to achieve an answer (Melnyk, & Fineout-Overhold, 2013). The authors find that each component of the PICOT question drives the next step of the evidence based practice process. First, a specific population must be determined by controlling the group to a certain age range or special sub-group. By compiling a specific group the clinician is more likely to formulate better evidence to support the issue. Next, an intervention is introduced and can be a therapy, test, disease process, etc. The authors conclude that, “the more specifically the intervention or issue of interest is defined, the more focused the search will be” (p.29). Then, a comparison group is added, but only necessary if completing a quantitative study. Lastly, an outcome is determined of which the study will reveal by a given time period.
This question format model, helps in optimization of applied research specifics, medical style questions, updated peer review of research, and even allows assessing students to support evidence based practice in defining appropriate questions (Holloway et al. 2004).
The tools include “a question development tool, an evidence rating scale, and appraisal criteria for research and non-research evidence” (Schaffer et al., 2013, p.1204). The question development tool provides specific steps for formulating the clinical practice question. The rating scale allows users to rate the “strength of evidence and quality for both research and non-research evidence” (Schaffer et al., p. 1204). The rating scale also allows users to rate practitioner expertise and patient experience.
Findings of evidenced based practice have to be disseminated to ensure that innovations for practice are replicated or applied in other settings by stakeholders in the health fraternity and healthcare professionals (Forsyth, Wright, Scherb & Gaspar, 2010). One of the objectives of dissemination should be to improve the practice. Dissemination of evidenced based practice findings in nursing is very critical in knowledge synthesis, translation, and translation. It is imperative in strengthening healthcare, informing policy, and improving practice decisions based on clinical evidence (Rycroft-Malone & Bucknall, 2010). This is realized by transforming clinical changes into practice. It actually involves two stage processes namely: translation of evidence into practice and integration of research recommendations into actual practice. Effective dissemination of evidence based practice findings enable staff to share information about developments in healthcare practice and implement innovation (Freemantle & Watt, 1994).
Using evidence-based practice in daily patient care may seem like a time-consuming process, but in reality it is not. It should come as a natural process once incorporated into your daily routine. The process (as cited in Houser, 2013) involves six elements: (1) Ask a relevant clinical question, (2) search for the best evidence in the literature, (3) critically appraise the evidence, (4) integrate the evidence with clinical experience and client preferences, (5) evaluate the outcome of the practice change, and (6) disseminate the
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.
When considering a change in practice we need to firstly understand why we need to make a change? Secondly when making a change, we need to justify a decision. This can be achieved by exploring the components which encompass decision making within nursing practice. Cullum et al (2007) identifies four requirements:-Clinical experience, valid researched evidence, available resources and lastly but no less important the patient
Evidence-Base practice (EBP) is defined as based on problems identified from nursing practice; using best evidence and professional expertise and merging them into current practice to ensure patients receive quality care (French, 1999). Evidence-based practice is a part of quality improvement process; it is made of evidence, clinical expertise, patient preference and the context of care (Barker, 2013). In brief, evidence-based practice is the guideline in the nursing practice that requires nurses gather and use clinical evidence to help diagnose or assess patients correctly by using their knowledge and experience in order they can deliver the quality of care to the patients (Ellis, 2013). In the other words, in the nursing practice the clinical evidence supports all the nursing procedures performed.
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.
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.
The process of using Evidence Based Practice in a patients care plan consists of five key stages. Asses the patient and formulate the problems from this you will then need to access the relevant clinical articles. Using this information you should then be able to assess which is the best method of treatment discarding any misleading or ambiguous articles. You then need to incorporate this knowledge into the patients care plan. Finally you need to evaluate and assess the patient during treatment to ensure effectiveness.
patient history, system reviews, physical examination, evaluation, diagnosis, prognosis, psychosocial aspects, intervention, follow-up and the patient’s progress). It is a part of the paper where in first explains why the patient was selected for the case report, provides it’s relevant history including demographic characteristics and pertinent psychological, social and environmental factors, and includes relevant medical diagnoses . It also explains the examination procedures clearly, addresses the reliability and validity of the measurements i.e. cites published reliability studies, provides the results of your own mini-reliability study, or makes a presumptive argument, explains all examination data as well as decision making process that led from examination through the evaluation, diagnosis, clinical impression and prognosis to the plan of care and the selection of intervention. In intervention it explains the chronology and amount of interventions as well as changes in treatment and rationale for changes made in interventions over
The Evidence-Based Practice (EBP)is the systematic decision-making process to improve the work environment and clinical practices to get better quality patient outcomes. The EBP is the process where data collection, organizing, processing and implementing of the research findings are the critical points for the right results. One of the essential aspects of interest of using EBP research for nursing practice is that it gives the highest conceivable quality care and cost-effective treatment possible. It helps to fill the gaps and weaknesses in patient care so that patients will get better outcomes. It also blends the evidence and clinical experience to provide better patients experiences. It is essential as it helps to increase patient safety and improve quality of life. It also helps to reduce various medical complications and keeps the healthcare costs low.
Most studies (n=25; 64%) were conducted in the US; 14 studies were randomized controlled trials (RCT; 36%), 10 studies were quasi-experimental studies with control but no random allocation (29%) and 15 studies were pre-post designs with no control (38%). Intervention length ranged from 1 to 12 weeks. Table S2 provides information on each study design, sample, intervention, outcomes,