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Evidence based practice in the clinical setting
Evidence-based practice in the clinical setting
Evidence-based practice in the clinical setting
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Essential III: Scholarship for Evidence-Based Practice
Evidence-based nursing practice is essential in delivering a high quality care to the patients compare to the traditional practice. Studies show improved patient outcomes when the best evidence is used in delivery patient care. This essential mentions the steps of evidence-based practice process such as identification of the issue, acquire the best evidence regarding the issue, integration of the evidence, and the evaluation of the outcomes. The first step on this process is identification of the problem, and nurses are more than anyone else in medical field to identify problems or issues that arise in their clinical practice. Nurses are in often contact with the patients, are the ones that collect data, document and analyze this data. The second step of EBP is the conducting reliable research from different
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sources: Internet, scholarly articles, books, and magazines.
Collaborate with other health care provider to synthesize the research that was conducted. Another step is the integration of the evidences that can be done by using different models such as Stetler Model, Ottowa Model of Research and IOWA model of evidence-based practice. Then the last step is the evaluation of the outcomes. The baccalaureate program offers the basic understanding of evidence-based nursing practice such as the steps of evidence based practice, different models that are used to apply evidence to clinical practice. It teaches the students that the main goal of the evidence-based practice is to conduct research and apply the most recent research into the nursing practice and improve patient outcomes. However, as nurses we always have to advocate for the patients. The essential emphasizes that the basic information acquired in baccalaureate programs
it will prepare the students for the real world of nursing. The second part of this journal will discuss how the contest of this essential will impact my future. Baccalaureate education provides a basic understanding of how evidence-based practice is developed, including the research process, clinical judgement, interprofessional perspectives, and patient preference as applied to practice. New nurses are expected to implement evidence-based practice in patient care. I will stress the fact that the BSN program offered at Davenport University it prepared me with the basic knowledge on evidence-based practice. In the evidence-based practice class we actually had the opportunity to apply all five steps of the evidence-based practice and present our work to the staff and students of DU Warren campus. The experience that I have gained during the school it will definitely help me as a nurse in the future since evidence-based practice is an important approach to provide the best quality care to patients and their families. I will be able to identify issues and problems. Evidence-based practice will prepare me to collaborate and work together as a team to identify an evidence-base practice issue in the clinical setting. I will give me basic knowledge on how to conduct research that is valid, appropriate, and reputable; synthesize the research and then apply it.
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).
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.
The Iowa model, developed by Titler in 1994, focuses on organization and collaboration incorporating conduct and use of research, along with other types of evidence (Titler et al, 2001). Since its origin in 1994, it has been continually referenced in nursing journal articles and extensively used in clinical research programs (LoBiondo-Wood and Haber, 2006). This model allows us to focus on knowledge and problem-focused triggers, leading staff to question current nursing practices and whether care can be improved through the use of current research findings (Titler, 2006). In using the Iowa model, there are seven steps to follow: (1) selection of a topic or problem for evidence-based practice, (2) forming a team, (3) Evidence retrieval, (4) Grading the Evidence, (5) Developing an EBP Standard, (6) Implementing the EBP, and (7) Evaluation (Titler et al, 2001). The Iowa Model of Evidence-Based Practice has been extensively used in nursing, focusing on assessing, developing, implementing, and evaluating evidence based practice protocols or guidelines; however, there are many sources of knowledge rather than evidence based knowledge e.g. clinical experience, patient experience, and local data or information.
Evidence-Based Practice Preparation in Nursing Education: Recent BSN Graduates and Their Experience With Applying Evidence-Based Practice. Doctoral Dissertation (Doctoral Dissertation). Capella University. Retrieved from ProQuest Digital Dissertations. (3502734) http://search.proquest.com.ezp-02.lirn.net/pagepdf/993006005/Record/3CA1ED1ED991402DPQ/1?accountid=158614
Counselors are very dependent on the research of others. Counselors are among many who are responsible for producing evidence based practice. Counselors have a responsibility to be eager and capable of locating and using evidence based interventions. Research reports are used to help summarize the findings of different types of research in the counseling profession. The results of a research report should summarize the findings of the research. According to Sheperis, Young, and Daniels 2010, “it should be easy for the reader to connect the findings with the stated research questions and to determine whether the finding support or refute your hypothesis” (p.239). The following are two challenges that the counseling profession is faced with when it comes to outcome research: (1) producing sufficient volumes of evidence and (2) being able to find, interpret, and use the evidence from previous research. These challenges place a limit on the variety of interventions that are available to the counseling profession. One intervention that works for one child, might not produce the same results for another child. So it is very important that research provides information that is useful and effective. The lack of studies makes it more challenging to determine whether or not an intervention is an effective solution that will improve a student’s behavior or academics. “Ultimately, regardless of how effective a counselor may be, if the problems are not properly measured and assessed, intervention is disadvantaged and treatment is comprised” (Sheperis, Young, & Daniels, 2010, p. 3). In order to best serve clients we have to complete comprehensive research and use the results to the advantage of the client.
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
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.
This writer will apply the JHNEP Evidence-Based Practice model to the practice question. Literature has been reviewed, and recommended changes have been developed and presented to the College nursing chair and council. The intent is to implement this practice change at the start of a new semester. Semesters are 12 weeks in duration which allows this project to fall within the 16 week guidelines.
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
The latest culture of nursing includes evidence-based practice. Without proven rationales, nursing interventions would not be substantiated with facts, and the credibility of nursing practice would suffer. Using descriptive and inferential statistics, evidence can be revealed, and the practice of nursing can be improved with better patient outcomes (Kim & Mallory, 2014). Within each specialty one can find evidence-based practice, such as the setting of critical care nursing, where many critically ill patients require mechanical ventilation due to acute respiratory failure secondary to the primary critical illness. Nutrition is a key component within the total care nursing practice that is typically observed in the critical care setting (Ramprasad & Kapoor, 2012).
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
Initiating and implementing an evidence-based practice (EBP) in a large health care organization requires much more than a clinical observation. Which method of knowledge translation of research findings are used, organizations are duty bound to facilitate best practices that influence patient outcome (Grimshaw, et al., 2012). Archie Cochrane, the front runner of the EBP gave the “wooden spoon” award the poorest rating to the field of obstetrics as far as not using EBP to provide patient care. This award brought forth “The Cochrane Pregnancy and Childbirth database (Ting, 2014).
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...