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Ethical principles in nursing autonomy
Reflection on evidence based practice
Chapter 5 evidence based practice
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Evidenced Based Practice (EBP) is essential to enable all nurses to provide the most current up to date practises for their patients. This process involves research, systematic review of current practises, critical thinking skills, evaluation and application to the clinical setting. In addition to this, the nurse must take into account the patients’ preferences. For nurses to have professional autonomy they must be able to justify their actions and demonstrate an understanding of why they perform the tasks they do. This defines them as unique professionals judged by their knowledge and not simply by their hands on skills.
As stated by McSherry, Simmons & Pearce (2002);
“Nurses are responsible for the care they provide for their patient. They have to be active, competent and autonomous in providing this care and be able to justify what they do. It is no longer acceptable for nurses to base care on ritual and tradition- they must be able to justify the decision they have made about appropriate care and treatment on the basis of a professional expertise which includes using research evidence to inform practice.” (p.1).
One of the best known definitions of evidence based practice is; “The conscientious, explicit and judicious use of current best evidence about the care of individual patients.” (Sackett et al. 1997, as cited in Holland & Rees, 2010, p. 7). Individualised care and research is by no means a new concept. Florence Nightingale first demonstrated EBP through her note taking and analysis of data, this resulted in reduced mortality rates for medical and surgical patients as hygiene practises were improved. (Schmidt & Brown, 2009). For today’s nurse this transcribes into using the best research knowledge to make clinical d...
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...(Eds.). The evidenced- based practice manual for nurses. (pp.273-291).Sydney, NSW: Churchill Livingstone.
Polit, D.F., & Beck, C.T. (2010). Essentials of nursing research: Appraising evidence for nursing practice. (7th ed.). Philadelphia, USA: Lippincott Williams & Wilkins.
Rees, C. (2010). Understanding evidence and its utilization in nursing practice. In Holland, K., & Rees, C. (Eds.). Nursing: Evidence-based practise skills. (pp.20-39). New York: Oxford University Press.
Schmidt, N.A., & Brown, J.M. (2009). Evidence-based practice for nurses: Appraisal and application of research: Sudbury, Mass: Jones and Bartlett Publishers.
Stillwell, S.B., Fineout-Overholt, E., Melnyk, B.M. & Williamson, K. M. (2010). Evidence- Based Practice Step by Step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3),58-61.
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.
Burns, N., & Grove, S. K. (2011). Understanding nursing research: building an evidence-based practice (5th ed.). Maryland Heights, MO: Elsevier/Saunders
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.
According to ASHA Evidence Based Practice is the combination of clinical expertise opinion, data, and patient’s perspectives, with the goal of providing high-quality services (2013). The process of evidence-based practice consists of formulating a research question, collecting evidence, including views, and then evaluating the entire process. This project introduces the research topic I’ve chosen, which identifies a researchable problem, and formulates an answerable question that is relevant to nursing and evidence-based practice.
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
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
LoBiondo-Wood, G., & Haber, J. (2014). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice (8th ed.). St. Louis, MO: Elsevier, Inc.
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
Research based practice is arguably the hallmark of professional nursing and is essential for high quality clinical and cost effective nursing care (ICN 2009)
What are the best ways of achieving this in the reality of the modern NHS? 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 vitally important that the nurse is given the time to research and the trust to start off the process of change for better care. References Cullum, N., Ciliska, D. and R. Haynes, Marks (2008).
Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The establishment of Evidence‐Based practice competencies for practicing registered nurses and advanced practice nurses in Real‐World clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15. doi:10.1111/wvn.12021
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,
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
Evidence based practice (EBP) is a key component in delivering cost-effective, high quality health care. [1] However, only around half of the care providers in the United States utilized EBPs. Additionally, nearly a quarter of services delivered to American consumers are unnecessary and potentially harmful. Today, educators are teaching and promoting evidenced based health care to future nursing professionals. The Institute of Medicine (IOM) supports this action as a means to achieve the objective that 90 percent of all medical treatments have a foundation in evidence based practices by the year 2020.
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...