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nursing reflection on using evidence based practice
nursing reflection on using evidence based practice
nursing reflection on using evidence based practice
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Evidence-based practice (EBP) is an interdisciplinary approach to clinical practice that many organizations are being utilized. “The benefits of EBP, including greater cost effectiveness, and better patient safety, clinical outcomes, and patient and staff satisfaction are widely acknowledged” (Embedding a culture of evidence-based practice, page 14). In this paper, I will discuss how evidence-based practice is being utilized in the organization I work for, how nurses at the bedside are encouraged to participate in planning and implement evidence-based changes and what factors are available for nurses to use when implementing evidence-based practice. I will also discuss how nurses can suggest or help improve evidence-based practice and sustain a positive environment for EBP. The organization I work for is Kaiser Permanente. Evidence-based practice is focused on providing the best care to their members based on the highest level of knowledge derived from the systematic inquiry. Kaiser Permanente utilizes evidence-based practice by encouraging the nurses to participate in research to voice their ideas and help shape the future of nursing. The research provides the most objective means of determining how to deliver the best care to the nursing practice and deliver the best service. Since Kaiser encourages the nurses to participate, they developed nursing research program to enhance research and evidence-based nursing practices. I work in the Surgery department in the pre-operative and post-operative phase. One of the EBP that we use is intravenous antibiotic prophylaxis prior to surgeries. Studies have shown absolute decrease of infections and length of hospital stay. The timing of preoperative prophylaxis is crucial. “F... ... middle of paper ... ...s the tools to educate but putting the time to educate the nurses is important. For the workplace resistance, change is hard for some nurses especially the seasoned nurses. Sometimes nurses are intimidated with using technology. I can take the time to teach my peers on how to use and access information to EBP and feel less intimidated. In conclusion, EBP is an approach to clinical practice to help make decision about how to promote health or provide care by combining the best available evidence. Evidence-based practice are being utilized by many institutions and nurses are encouraged to participate in implementing the evidence-based changes. Nurses need to be vocal about implementing EBP because we are the patient advocates. In order to deliver the best patient care and outcomes safely, we need incorporate our nursing process with evidence-based practice.
The Johns Hopkins Nursing Evidence-Based Practice Model provides nurses with a system to formulate a practice question, appraise both research and non-research evidence, and to develop recommendations for practice (Dearholt & Dang, 2012). This model guides nurses through the evidence-based research process with ease and minimal difficulty using a problem solving approach.
According to ASHA Evidence Based Practice is the combination of clinical expertise opinion, data, and patient’s perspectives, with the goal of providing high-quality services (2013). The process of evidence-based practice consists of formulating a research question, collecting evidence, including views, and then evaluating the entire process. This project introduces the research topic I’ve chosen, which identifies a researchable problem, and formulates an answerable question that is relevant to nursing and evidence-based practice.
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.
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
Psychological Association (2006, p. 273) defines EBP as "the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences."
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
“Evidence-based practice is the integration of best research evidence with clinical expertise and patient values” (ASHA). Staff of ASHA embarked upon the new idea of Evidence-Based Practice (EBP) in 2005. The goal of EBP is the integration of: clinical expertise/expert opinion, external scientific evidence, and client/patient/caregiver perspective to provide high-quality services reflecting the interests, values, needs, and choices of the individuals we serve (ASHA). The four steps of EBP include: framing the clinical question, finding the evidence to suppose the question, assessing the evidence, and making the clinical decision. Researchers have studied the status of current implementation of EBP in the field, challenges to implement EBP, the debate of adopting EBP framework in our field, and the use of EBP in SLP practice and EBP knowledge.
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
An evidence based practice committee is a committee within a health care facility that determines the best clinical practices by nurses using current research. These committees determine how policies, protocols, and procedures should be completed, in their specific facility, to have the best possible outcome for the patient.
Evidence-based practice is important to consider when researching for interventions, further knowledge, or help to guide a new idea in the health professions. Evidence-based practice is comprised of three significant concepts: respect and awareness for the targeted population’s values, previous clinical practice or experience with that population, and systematic research to establish a better understanding of what is already known about the study’s focus. These concepts are all taken into consideration when designing and conducting a study because it provides a more valid and credible source for others.
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
In the article, Promoting Evidence-Based Practice Through A Research Training Program For Point Of Care Clinicians, the authors state that evidence based practice is, “a problem-solving approach to clinical care that incorporates the conscious use of current best practice from well-designed studies, clinician’s expertise, and patient values and preferences” (Black, Balneaves, Garossino, Puyat, Qian, 2015, p.14). The nursing student should use evidence-based practice in order to make decisions about the patient's care plan. Using evidence-based practice while deciding how to appropriately care for a patient will ensure that the nursing student is using the most effective and current techniques. The nursing student should also use this standard to guarantee that they are providing the best care possible while still honoring the patient’s values and
A key characteristic of Advanced Practice Nurses (APN) is to develop and refine the ability to generate and synthesize research and use this information to influence positive changes to everyday nursing practice (Burns & Quatrara, 2013). APNs are well placed as clinical leaders to facilitate for frontline nurses the links between practice and research. Stevens (2013) reminds us that evidence-base practice can result in improved care, positive patient outcomes and enhanced nursing satisfaction. Nurses are professionally obligated to ensure that the best evidence supports their nursing work, with the end goal being the delivery of the best care
Evidence based practice (EBP) is a key component in delivering cost-effective, high quality health care. [1] However, only around half of the care providers in the United States utilized EBPs. Additionally, nearly a quarter of services delivered to American consumers are unnecessary and potentially harmful. Today, educators are teaching and promoting evidenced based health care to future nursing professionals. The Institute of Medicine (IOM) supports this action as a means to achieve the objective that 90 percent of all medical treatments have a foundation in evidence based practices by the year 2020.
The Nursing School at Boise State University joined in a partnership with one of the local medical centers to implement an EBP model. The medical center distinguished a need to utilize more EBP in patient care so a project was initiated and successfully completed. Throughout the stages of the project, there was an awakening of what nurses can contribute to their own practice. The staff nurses were the central focus of this project. “Staff nurses “drive the machine” of evidence-based practice, because they observe, assess, ask questions, pass on ideas, and implement new knowledge into clinical practice” (Reavy & Tavernier, 2008, p. 167).