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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
EBP is defined by Sacket et al as 'the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.' (Duncan, 2006) The best evidence in this context could therefore be argued to come from information that has been researched using quantitative methods that is numerical data that tests a hypothesis such as randomized control trials (RCT)(Duncan, 2006).
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
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
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...
Health Care Changes Rapidly, Over the next few years, the transformation from volume-based to value - based health care will be significant. Nurses use many forms of evidence to guide clinical practice , Including Nursing research. Over the past two decades , nurses have made great progress in increasing
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
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)
EBP is now accepted as the gold standard for professional nursing practice because patient outcome has improved (Flynn, 2015). A report from the Institute of Medicine (IOM) in 2003 states that EBP is considered a core competency and in 2010 confirms EBP is a basic competency. The American Nurses Association (ANA) Standard of Practice along with the American Association of Colleges of Nursing has included the competency, as recommended by the IOM, for professional nurses as well (Long, 2003). There has never been a better time for nurses to further their education to meet the challenge of being competent is research and
“At its core evidence based ‘anything’ is concerned with using valid and relevant information in decision making” “high quality research is the most important source of valid information”. 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 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 recent 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 of the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.... ... middle of paper ...
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
The NHS Outcomes Framework (NHSOF) has identified five key domains in order to deliver Evidence-Based Practice (EPB) to the patient. These five domains of the Department of Health (2014-15)
Ubbink, DT, et al. Implementation of evidence-based practice: outside the box, throughout the hospital. Netherlands Journal of Medicine [serial online]. 2011;69(2):87-89
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.
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).