Introduction This assignment will identify a specific issue of practice, within the clinical area, through the process of reflection and critical evaluation. It will identify the influence Evidence Based Practice (EBP) has had on Neonatal care and how that has affected current working practices. Following the five step evidence based medicine (EBM) model outlined by Akobeng (2005), 3 papers will be identified for review. Findings from the search and critical analysis will be used to examine any recommendations for potential future practice. The introduction of EBP has provided clinicians with the tools to use the best available evidence when making decisions (Leach, 2006). Fineout-Overholt et al. (2005) defines evidence based practice (EBP) …show more content…
Every day, medical and nursing staff rely on their experience, knowledge of current practice and research available, to provide the best possible care. Greenhalgh et al. (2014) argues that real EBP is not based on rules, but on tactic knowledge, experience and what is right for that individual. As neonates are unable to make autonomous decisions, parents will make them on their behalf (Sundean and McGrath, 2013). The British Association of Perinatal Medicine (BAPM, 2017) and the National Institute of Clinical Excellence (NICE, 2010) supports parental involvement in the decision making process. As a nursing practitioner it is frustrating and upsetting to see complications develop, especially if there are things practitioners can do to avoid this. It is not acceptable to see poor care provided when staff are not updating their knowledge. However one of the challenges for staff is the lack of protected time given to update their knowledge or for …show more content…
Several acronyms have been developed to help provide the framework for developing the question depending on the speciality or source of issue. Cooke et al (2012) discusses these different acronyms and their uses which are explained in appendix 3. Table 1 shows Akobeng (2005) 5 step EBM model which was used to provide a systematic approach, together with the PICO formula (Sackett et al., 1997, cited in Holland and Rees, 2010, pg. 151), to define and focus the question. PICO or PICOT are frequently used for intervention type questions and work well for Quantitative research, but may not be ideal for Qualitative searches. As this was an intervention based question and timing was not a factor, the acronym PICO has been applied in Table
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.
Nurses also refer to vital signs when assessing for deterioration but findings showed omissions were apparent in observation charts, lacking empirical evidence preferred by doctors to assess and advice further action. The review also highlighted ineffective communication between nursing and medical staff with problems experienced communicating complex information between different disciplines (NPSA
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.
EBP is a method of finding evidence and using it in practice: as Blaney (1986) states, it is used to assess health, plan, implement, and evaluate individualized care (p.182). Finotto et al. (2013) breaks EBP down into steps as follows: Formulate a research question; find the most relevant evidence; appraise evidence; integrate evidence with clinical experience and patient values to make practical decisions; and evaluate the outcome (p.460). Carrazzone (2009) and Moch et al. (2010) argue that didactic components with EBP integrated into the education are believed to be beneficial to studen...
Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored in the implementation of Evidence Based Practice.
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
Determining which components are most critical is accomplished by conducting a current literature search. Formulation of a “PICO [question] can make it easier to identify search concepts and appraise the results retrieved from database searches” (Polly Beam, n.d., para. 1). The PICO frameworks defines the population, intervention...
Peto, R. (2008). Why did you do it like that? Examining clinical decisions. Paediatric Nursing,
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.
Neonatal resuscitation is intervention after a baby is born to strengthen it’s breathe or to boost its heartbeat. Approximately 10% of neonates require some assistance to begin breathing at birth, but only 1% require serious resuscitative measures. Informed consent regarding neonatal resuscitation is a constant ethical debate. This discourse ordinarily occurs between doctors and parents; parents often feel that the decision has been made for them, believing that they were not fully informed of any consequences that may occur before making their final action plan, or thinking that their opinion was not taken seriously; however, doctors see the procedure in a different light, that the parents can’t choose the best option for the child regardless of counseling, or performing as the parents wished but believing that the result could have differed if the parents had known all the effects that it will have further down the line, or convinced that they would have made a better
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.
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...
The key area of decision-making on direct patient care is intervention effectiveness, picking an intervention