Introduction
In this assignment as detailed in the module eleven handbook (South Trent School of Operating Department Practice, 2012) the author will aim to explore and describe the principles and methods of scientific enquiry that underpin Evidence Based Practice (EBP). Research and evaluate the choice of the various methods that can be used within the healthcare and theatre based setting and relate these practices to the Operating Department Practitioners (ODP’s) Standards of Proficiency (Health Professions Council. 2008).
The author will also look at an existing piece of research that is related to operating department practice and will critically analyse and evaluate it using the Critical Appraisal Skills Programme (CASP) appraisal tool and reflect on the critical skills that have been developed whilst writing and researching this assignment and the time that has been spent within theatre.
Evidence Based Practice
Evidence-Based Practice (EBP) can be defined in two ways. Sackett (1996) explains about evidence based medicine (EBM) and that by using the best clinical expertise alongside the best available external clinical evidence from systematic research then the patient would receive the best treatment available. Although one issue with this approach is that the only point that the patient is involved is when the decision has already been reached. The author feels that on occasions the final decision may not be the best one. An alternative approach comes from Gray (2001) who discusses that using the best evidence available, in consultation with the patient would aid both parties in deciding the best option which will suit the patient. As a patient in the past the author knows which approach has been taken when discus...
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...on: Health Professions Council.
Kelley, K et al. (2003). Good practice in the conduct and reporting of survey research. Oxford Journal. 15 (3): 261-266.
Morton and Morton. (2003). What is Evidence Based Practice? http://www.ebnp.co.uk/What%20is%20EBP.htm, (07/01/14).
National Research Ethics Service. (2014). Welcome to the National Research Ethics Service. http://www.nres.nhs.uk. (10/01/14).
National Institute for Clinical Excellence. (2002). Principles for Best Practice in Clinical Audit. National Institute for Clinical Excellence. Oxford: Radcliffe Medical Press.
Sackett, D.L et al. (1996). Evidence based medicine: what it is and what it isn't. British Medical Journal, 312: 71.
South Trent School of Operating Department Practice. (2012). Critical Analysis and Evidenced Based Practice. (Module 11 Handbook). South Trent School of Operating Department Practice.
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).
It is essential that when using evidence-based practice guidelines to choose a treatment, that variety of research methods are applied so that the best relevant data can be produced. Such methods include qualitative/quantitative research, randomised controlled trials and systematic reviews. Both qualitative and quantative methods produce valuable data. Quantative research produces numeric evidence that is necessary for practice and can be measured and qualitative research produces descriptive data about the subject by using patients views etc. which can also be applied to clinical practice (Broeder et al, 2010)
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
Reflection and analysis of critical incidents is widely regarded as a valuable learning tool for nurses. Practice requires us to explore our actions and feelings and examine evidence-based literature, thus bridging the gap between theory and practice (Bailey 1995). It also affords us the opportunity to change our way of thinking or practicing, for when we reflect on an incident we can learn valuable lessons from what did and did not work. In this way, we develop self-awareness and skills in critical thinking and problem solving (Rich & Parker 2001). Critical incidents? ?
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 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.
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.
It is within this stage that I would review the group level structure within the operating room department. It will be very important to look at the group structure between the nurses and doctors and to gauge team effectiveness along with goal clarity. The current environment is very hostile and understanding the root cause will help facilitate a solution. Another environmental issue in this case is that another local hospital is in need of a highly trained OR Director for which no one has been hired. It is important to look at the recent separations of skilled nurses and to understand why there has been such a quick turnaround.
Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144
Evidence-based practice is giving apt and effective care to patient based on integration of best evidence supporting the practice, clinical experience and patient’s preference (8). Studies has shown that health care workers are aware of the benefits of evidence bases practice such as ensuring quality and providing consistent care, practicing updated interventions or techniques and giving effective services but there is a mismatch in actual practice. This part of the paper will looked at barriers anticipated in adopting evidence based parctise among healthcare workers and will end with recommendations that could manage this problems.
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 resent 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 from the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.
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.
Thus, it is imperative that evidence-based practice is conducted to provide the best current, valid and reliable evidence in an aim to close the gap between non-conformity and coincide with the professional obligation of providing the patient with the best possible care (Liamputtong, 2013).... ... middle of paper ... ... Patient safety and quality of care. Rockville, MD: Agency For Healthcare Research And Quality, U.S. Dept. of Health.
Walshe,K. & Rundall,T. 2001, Evidence based management:From theory to practice in health care ,Milbank Quarterly, Vol.79, PP.429-457
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...