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Evidence-based practice is defined as “making decisions through the conscientious, explicit and judicious use of the best available evidence from multiple sources by asking, acquiring, appraising, aggregating, applying and assessing to increase the likelihood of a favorable outcome.” (CEBMA.) The definition implies the use of critical thinking and best available information, facts or data supporting a claim, assumption or hypothesis.
The use of evidence in medicine is based on the decision that the treatment of a patient should be founded on the latest and best knowledge of what actually works at that point in time. This was however not what it used to be. While research and studies are conducted every year, the vast wealth of knowledge
Melnyk’s Hierarchy of Evidence is a system often use for assigning levels of evidence in nursing by integrates clinical expertise and patient choices with the best available research. It is represented by a pyramid that enumerates the levels of strength of the evidence from 1 to 7, of which level 1 is the higher level. The higher level on the pyramid, the more likelihood that the research is valid; therefore, answering a clinical or practice question. “The systematic review or meta-analysis of randomized controlled trials are at the top of the evidence pyramid and are typically assigned the highest level of evidence, due to the fact that the study design reduces the probability of bias” (Melnyk, 2011). The weakness of the system is that when
Evidence Based Practice emerged in the late 20th century, becoming widespread in the 21st century. According to Research and Practice: The Role of Evidence-Based Program Practices in the Youth Mentoring Field ( 2009) “The concept of Evidence Based Practice (EBP) actually has its roots in the medical field, where the work of Archie Cochrane (1972) and others examined the key role that the substantial body of medical research and literature could play in how doctors make decisions in patient care” (para 6); Thus, a doctor’s decision would be an “educated” decision, based on evidence gathered (patient symptoms), history of cases they have overseen, or research of previous case diagnosed by another doctor, with a related case. Evidence Based Practices are defined as “ integration of: (a) clinical expertise/expert opinion, (b) external scientific evidence, and (c) client/patient/caregiver perspectives to provide high-quality services reflecting the interests, values, needs, and choices of the individuals we serve” (“Evidence Based Practice (EBP),” 1997-2014); often described as the “Best Practices”. The evidence itself is not the basis of decisions made, but it does help support the process of care given to our clients.
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).
Evidence based practice is the basis for needed change in practice and function. It is a sound method for scientific, fact-based change. Changes which have no evidence to support them are fragile, unscientific, and subjective. These changes don’t effect real change over time, as they aren’t able to be proven to a more general population.
Evidence-Based Practice is a methodology, framework, gathering of ideas or concepts, adopted principles and strategies supported by research (Fixsen et al.,
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
To conclude Evidence Based Practice is a process of building up accurate information from medical research which has been correlated and assessed. From this the nurse is capable of advising the best plan of care. For nursing standards to improve it is vitality important that the nurse is given the time to research and the trust to start off the process of change for better care.
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
In health care, evidence-based research is crucial. Nurses revolve their practice on evidence so that they may provide the best health care. Without research, there would be no evidence to prove health care related findings (Shmidt & Brown, 2012). With appropriate
Polly Beam, J. S. (n.d.). Levy Library. Evidence Based Medicine Tutorial. 1.3 What’s Best: The Evidence Hierarchy. Retrieved April 9, 2014, from http://libguides.mssm.edu/hierarchy
The concept of evidence based practice is an ongoing guide to the bettering of practice that also contains the dreaded word change. Even though change is not always looked at as a positive thing, it is a way in which professionals continue to grow. The reality is that EBP is a life long learning process in which managers, innovators, and leaders ensure their staff are continually aiming towards professional
Walshe,K. & Rundall,T. 2001, Evidence based management:From theory to practice in health care ,Milbank Quarterly, Vol.79, PP.429-457
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.
Evidence Based Practice (EBP) builds from critical thinking as it is a concept that utilizes the best available ideas with experience. Raines (2004, p. 71-85) and the University of Minnesota (cited in http://hsl.lib.umn.edu/learn/ebp/mod01/index.html) further states EBP can be broken down into five steps;
The importance of Evidence-Based Practice is to ensure the best possible care is provided for patients. Evidence-Based Practice functions by measuring the effectiveness of a treatment and differentiating findings between high-quality and low-quality. It also helps with health development and improves the reliability and facilitates students to become reflecti...