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How evidence based practice is used in nursing field
How evidence based practice is used in nursing field
Application of evidence based practices
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Evidence Based Practice in Nursing Over the last 10 years evidence-based practice (EBP) has grown substantially and is changing the nursing care delivered to patients along with the nursing work environment. Nurses are more involved in the decision making process, and are making clinical decisions with better patient outcomes (Good, Fink, Krugman, Oman, & Traditi, 2011). With technology growing at such a fast pace, new and more effective medicines, medical devices, and procedures are developed daily. Digestible sensors that monitor your bodily systems and 3D printing of embryonic stem cells, blood vessels, and sheets of cardiac tissue that actually beat like a real heart, are significantly impacting the future of healthcare (Honigman, …show more content…
EBP incorporates an organized search for the best up to date empirical research, with clinical expertise, to answer a focused clinical question concerning a patient or a quality improvement issue in the clinical environment. The focused question addresses the patient population, area of interest, comparison intervention or control group, and desired outcome (PICO). Using this question style saves the nurse time and will yield the best available relevant evidence. The process of EBP has several models with common elements that start from uncertainty in the clinical setting, and lead to making an informed decision by assessing and implementing the latest research evidence into practice (Stevens, 2013). Melnyk and Fineout-Overholt (2010) define the seven step process of EBP as: 1. Cultivating the spirit of inquiry, 2. Asking the question in PICO …show more content…
230) in EBP. Clinical opinion, together with the best relevant research evidence, provides the framework to for the best patient outcome. The nurse’s clinical opinion is acquired through knowledge and skills developed from undergraduate, graduate, or continuing education, clinical experience, and clinical practice (Melnyk & Fineout-Overholt, 2010). Clinical opinion also includes internal evidence, which is generated within a clinical setting from quality improvement outcomes, management initiatives or EBP implementation projects (Melnyk & Fineout-Overholt, 2010). Nurses use their clinical opinion when they identify each patient’s condition, individual risks, personal values and expectations, benefits of possible interventions, and gather evidence for EBP. When searching for the best available evidence, there is a hierarchy in the strength of evidence. The highest level of evidence usually comes from a systematic review or an evidence-based clinical practice guideline based on a systematic review. Systematic reviews provide the strongest evidence through a summary combining the results from many relevant, unbiased studies, to answer a particular clinical question. Nurses critically assess the individual studies, to gather the best evidence available for patient care. Systematic
Evidence-based practice (EBP) entails the use of explicit, reliable, and judicious evidence to make effective decisions about the care of patients. This DNP student will introduce EBP with the IOWA model. The IOWA model applies to this DNP proposal. The IOWA model is an EBP applicable in healthcare setting and implemented to show the applicability of evidence in nursing to give the best outcome. Doody and Doody (2011) noted that the IOWA model focuses on problem-focused triggers and knowledge in undertaking quality improvement study. The steps involved include topic selection, team formation, evidence retrieval, grading evidence, developing an EBP evidence, implementation of EBP, and evaluation of the progress. These steps apply to this DNP proposal, showing best practices, guidelines, procedures, and policies
Evidence Based Practice (EBP) is useful to practice because it aids practitioners development and widens their knowledge and insight, therefore enhancing the experience of the practitioner. This ensures that the best quality of care is given to the patient (Duncan, 2006).
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
Evidence - Base Practice has existed for decades , and yet it's routine use in the perioperative setting is lacking . Another reason that practice in the perioperative setting is changing rapidly is the pace at which technologies evolve , and EBP enables perioperative professional to look not at which technologies work . but also at what is most Cost- Effective.
According to Sackett, (1996) evidence–based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about patient care. Straus, Richardson, Glasziou, & Haynes (2005, p. 1) described evidence-based practice (EBP) as “the integration of the best research evidence with clinical expertise and unique patient values and circumstances.” According to Straus et al, (2005, p.3) those practicing evidence based medicine must follow five specific steps: a) Include the need for data into an answerable question, b) Track down the best evidence, c) Critically appraise the evidence for validity, impact, and application, d) Integrate the critical appraisal into clinical practice, and e) Evaluate the effectiveness and efficiency of implementing steps a-e-and seek ways to improve them. Subsequently, without current best evidence, clinical practice cam become out-dated to the detriment of patients, this is an untenable circumstance and one which should never be allowed to happen.
Quality of care and patient outcomes rely heavily on practice based on evidence found in systematic reviews of randomized-control trials. While administration often-times implements core measures that involve EBP in their regulations, it is ultimately the nurse’s responsibility to include EBP into their care of patients. Nurses have an obligation to include EBP into their care because “it leads to the highest quality of care and the best patient outcomes” (Melnyk & Overholt, 2015). The nurse leaders really have a responsibility here because it is their responsibility to stress the importance of EBP as well as reviewing research to determine the best possible findings to implement into their unit’s care. Careful monitoring must be performed to assure compliance because “despite the multitude of positive outcomes associated with EBP and the strong desire of clinicians to be the recipient of evidence-based care, an alarming number of healthcare providers do not consistently implement EBP” (Melnyk & Overholt, 2015). Often times, I find seasoned nurses act putout with anything that changes their methods of care. The important thing to remember is that seasoned nurses, while often-times set in their ways, are great nurses and presenting EBP findings and their success during implementation will keep them involved with EBP because they ultimately want to do what’s best
Polit and Beck (2010 p. 4) describe the research process as “a systematic inquiry designed to develop trustworthy evidence about issues of importance to the nursing profession, including nursing, practice, education, administration and informatics”. With the use of research, nurses can update themselves with the knowledge and analytical skills necessary to facilitate the use of appropriate evidence in clinical decision making for effective health service delivery (Greenhalgn 2010). Clinical decisions should be supported by current, appropriate and robust evidence rather than invalid primary training or the interpretation of personal experiences (Thompson and Dowding 2002). Baker (2010 p. 6) defines EBP as “the conscientious, explicit and judicious use of theory-derived, research-based information to make decisions about care delivery to individuals or groups of patient, taking into consideration individual’s needs and preferences”. It offers the nurse with the skills and knowledge to assess best update health care literature and practice (Donald and Greenhalgh
Nursing research is a systematic enquiry that seeks to add new nursing knowledge to benefit patients, families and communities. It encompasses all aspects of health that are of interest to nursing, including promotion of health, prevention of illness, care of people of all ages during illness and recovery (or) towards a peaceful and dignified death (ICN 2009)
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
There are varying standards of science when it comes to evaluating and judging the efficacy and progress of each branch of science. With the Randomized Control Study being the gold standard for medical care and the estimated 16,000 of these studies being published yearly,2 it is of the utmost importance to all practitioners of medicine to be educated in and be able to use EBM. The physician assistant discipline of medicine is no stranger to the utilization of EBM as it has been a growing par...
When caring for patients it is fundamentally important to have a good selection of up to date evidence Based Practice clinical articles to support research strategies, this allows professionals to assemble the most resent and accurate information known which enables them to make decisions tailored to the individual’s plan of care. It is essential to have clinical expertise and have the involvement from the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.
A nurse is required to be responsible and accountable, updating their knowledge and skills continually by using professional development (NMC, 2008). This requires an understanding and awareness of what Evidence Based Practice (EBP) is. Nurses make decisions about their practice using EBP. Ways in which this can be utilized in the improvement of knowledge and practice is, for example; using established sources of evidence. (Marquis et al, 2012). Nursing practice uses a range of approaches to improve and develop patient care so as a nurse the skill of evaluating sources of evidence is necessary to do this effectively. Evidence is gathered through research. EBP consists of research, data collection and nursing research. When searching for evidence to improve your practice the range of information available is vast. A distinction must be made between evidence that is reliable under scrutiny and evidence which is unreliable. Fitzpatrick (2007) asserts that, to understand evidence based practice is to understand where to look and what credible sources of evidence are. Sources that are credible include information published by a government body or academic institution. Fitzpatrick (2007) recommends identifying key aspects of information of the source to ascertain its credibility, for example; who is the author and where did the research come from? Is the article true or false and how long has it been there? (Fitzpatrick, 2007). A journal article is scrutinised by peers and editors and publishers, whereas in contrast a piece of information on a general website could be published by any person and make any claim and may not pass scrutiny under a peer review. Databases like EBSCO for example have articles that are peer reviewed.
One feature of evidence based practice is a problem-solving approach that draws on nurses’ experience to identify a problem or potential diagnosis. After a problem is identified, evidence based practice can be used to come up with interventions and possible risks involved with each intervention. Next, nurses will use the knowledge and theory to do clinical research and decide on the appropriate intervention. Lastly, evidence base practice allows the patients to have a voice in their own care. Each patient brings their own preferences and ideas on how their care should be handled and the expectations that they have (Fain, 2017, pg.
With the introduction of a hands-on implementation of EBP, the nurses honed in on several different skills. Critical thinking was sharpened, change was implemented without rebuttal, nurses could speak up and be heard, and their self-confidence was bolstered in their area of expertise. Steps (by nursing) to develop & implement EBP: An inpatient oncology unit was chosen for the environment in which this case study was completed. A group of four staff nurses, a unit nurse manager, clinical nurse specialist, nurse researcher, and an infection control nurse were selected to put the project into action....
According to the textbook "EBP is a process for making practice decisions in which practitioners integrate the best research evidence available with their practice expertise and with client attributes, values, preferences, and circumstances."(Rubin & Bellamy, 2012, p. 7).