Critical Inquiry And Evidence Based Nursing Practice

In order to develop nursing knowledge and establish evidence-based practice (EBP) in nursing, there needs to be a "concept model, one or more theories and one or more empirical indicators" (Fawcett & DeSanto-Madeya, 2013, p. 26). The theoretical framework can be advantageous in guiding and supporting the design and execution of an EBP change. Using a conceptual model (C) theory (T) and empirical research (E) provides the foundation for an intervention to an identified clinical problem. Known as C-T-E structure, the application of this system in nursing practice involves an elevated level of critical reasoning, which assists in knowing what data is important and how it relates to practice change (Chinn & Kramer, 2011; Fawcett & DeSanto-Madeya, 2013; Mazurek Melnyk & Fineout-Overholt, 2015). The doctoral level of nursing necessitates the need to combine the understanding and knowledge gained from using the C-T-E structure, and then integrate the concepts and theories into daily practice.

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

The knowing addresses how nurses understand the knowledge. The doing of nursing entails the actions of nurses, bringing both knowledge and practice together (Butts and Rich, 2015). The four patterns of knowing, developed by Carper, include empirics. ethics, aesthetics, and personal knowledge. Empirical knowledge is the scientific aspect of knowing. It is based on general knowledge, and usually shared with other disciplines such sociologists and psychologists. Ethical knowledge involves morals and judgement. This is used when determining right or good acts in nursing practice, ensuring that the best decision is made and is right for the patient. Aesthetic knowledge, the art aspect of nursing, involve of the nurse’s understanding and acknowledgment of other’s living experiences. Showing empathy and respect to patients as they experience their life’s journey. Personal knowledge entails self-awareness and others, and interpersonal skills. These four patterns of knowing shows that nursing practice consist of holistic patient care, and not being solely scientific

Barbara Carper’s Fundamental Patterns of Knowing in Nursing explains the several patterns of knowing as they impact nursing theory development. Carper identified four types of knowing in nursing. These four types of patterns of knowing are: empirical knowing, aesthetics, ethical knowing and personal knowing. This author will analyze these four patterns of knowing and how they relate to nursing today.

Recently nurse scientists conduct research that informs evidence-based interventions to promote health and manage illness in various healthcare settings. Therefore, nursing is no longer viewed as a task-oriented discipline, but as a science-oriented discipline which contributes to the research and discovery of new and innovative approaches to improving health outcomes. As stated by the Institute of Medicine: “The impending crisis, which has been foreseen for decades, is now upon us” and the time to act is now. The nursing scientist must continue to conduct researchers to address the challenges associated with providing quality health care through excellence in science and practice and through training the next generation of leaders in healthcare research and

Since its establishment as a profession more than a century ago, Nursing has been a source for numerous debates related to its course, methods and development of nursing knowledge. Many nursing definitions and theories have evolved over time. Furthermore it is in a constant process of being redefined.

At present however, nurses working in clinical practice are now involve in researches. These researches assistance in the emergent of studies that are obligatory to determine the efficiency of nursing interventions and care. Through these activities, there has being tremendous growth in nursing science thus enhancing the development and advancement in the quality of care rendered. Consequently, it is vital that all nurses must constantly be attentive towards identifying nursing hitches and essential issues associated to patient care that can serve as a basis for the identification of researchable

When looking at Nursing as a profession, it is important to identify the body of knowledge which pertains to its profession. According to Carper (1978) the body of knowledge that serves as a rationale for nursing practice has patterns, forms and structure. Understanding these patterns is essential for the teaching and learning of nursing as a profession. Carper (1978) identifies four fundamental patterns of knowing and are known to be empirics, ethical, aesthetics and personal knowledge. Chinn & Kramer (2008) added the fifth pattern to knowing called Emancipatory knowing to address the issues of equality and justice. This essay will explain the five ways of knowing and show how it relates to my nursing practice.

Carper’s ways of knowing provide a fundamental source of information regarding nursing knowledge and practice. Any professional field is built around a variety of knowledge tenets, which help to organize ideas, test those ideas, and then apply them. Carper’s ways of knowing outline fundamental patterns of deriving knowledge and building experience as far as teaching and the practice of nursing are concerned (Zander, 2007). These patterns are used to explain or develop theory in the teaching of nursing, besides helping practitioners to build more knowledge and to enhance their practice. Carper’s ways of knowing identifies four different patterns of knowledge, which are analyzed in this case within their syntactical and conceptual frameworks. They include empirical, personal, ethical, and aesthetic.

For centuries the development of nursing knowledge has been influenced by numerous theorists and their respective theories. These theories have influenced, and continue to influence, nursing education, practice and research. (Johnson & Webber, 2005)

Carper (1978) identified four fundamental patterns of knowing which are (1) empirics, or the science of nursing; (2) personal knowledge; (3) esthetics, or the art of nursing; and (4) ethics, or the moral component of nursing. The purpose of this discussion is to explain how each pattern of knowing affects this author’s practice, and to identify the author’s preferred paradigm and provide justification for choosing this paradigm.

Nursing has been striving to become a research based profession since the Briggs Report (1972) and the lack of apparent integration of research findings into nursing practice has been lamented consistently ever since (Walsh and Ford, 1989). As long ago as 1989 the Department of Health (DoH), in their Strategy for Nursing stated; ‘All clinical practice should be founded on up-to-date information and research findings. Practitioners should be encouraged to identify the needs and opportunities for research presented by their work. Research is fundamental to achieving evidence-based practice in nursing. Evidence-based health care aims to promote clinical and cost-effective care/treatment through the explicit, conscientious, and judicious use of the currently available best evidence from research to guide decisions (Sackett et al, 1996).

Itroduction: Evidence-based practice is an approach to medicine that uses scientific evidence to determine the best practice (Beyea & Slattery, 2006). As nurses perform their daily tasks they must continually ask themselves, “What is the evidence for this intervention?”. Nurses are well positioned to question current nursing practices and use evidence to make care more effective. In order to improve patients’ outcomes it is the responsibility of the nurse to transition evidence-based practice into the norm, through application of daily practice (Flynn Makic, Rauen, Watson & Will Poteet, 2014). Continual evaluation of current practice must be performed to ensure the use of evidence-based practice opposed to practice based upon tradition. The implementation of evidence-based practice standardizes healthcare practices and diminishes groundless variations within care. These variations lead to the production of uncertain health outcomes (Stevens, 2013).

The aim of the nursing profession is to investigate and to assess any issue that may impact patient life. This can be done by the research. The nursing research study has a tremendous influence on current and future professional nursing practice, thus rendering it an essential component of the educational process. The purpose of a nursing research study is to collect the information where the result may identify a solution to a problem. As a result, the research study would play a vital role in the nursing profession. Basically, there are two main types of research studies: quantitative and qualitative, that a research is able to conduct a research study. Each of this type has their own view in

In the nursing profession we are able to use multiple ways of knowing. We may not use them all at the same time and some more than the others, but we do use them. “Four fundamental patterns of knowing have been identified from an analysis of the conceptual and syntactical structure of nursing knowledge” (Reed & Crawford Shearer, 2012, p. 200). The four patterns of knowing include: empirical, esthetics, personal, and ethical.