Evidence Based 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.

Pressure ulcers occur over bony prominences when skin is compressed for long periods of time, affecting the blood supply to certain areas, leading to ischaemia development (Waugh and Grant, 2001). Compression of skin is caused by pressure, shearing and friction, but can also occur due to pressure exerted by medical equipment (Randle, Coffey and Bradbury, 2009). NICE (2014) states that the prevalence of pressure ulcers in different healthcare settings in December 2013 was 4.7%, taken from data available for 186,000 patients. The cost of treating ulcers can vary depending on severity from £43 up to £374 (NICE, 2014). Evidence based practice skills are essential in nursing as it allows the best available evidence to be used to improve practice and patient care, while improving decision-making (Holland and Rees, 2010). I will be critiquing two research papers; qualitative and quantitative, using a framework set out by Holland and Rees (2010), and will explore the impact on practice. Using a framework provides a standardised method of assessing quality and reduces subjectivity.

Evidence-Base practice (EBP) is defined as: “based on problem identified from the practitioner’s area of practice; a combining of best evidence and professional expertise and an integration of this into current practice; about ensuring patients receive quality care, being part of quality improvement processes; about collaboration and requiring a team approach” (French, 1999). Scott and Mcsherry (2008) supported the French’s assertion, proposing the key elements of EBP are that it is a theory-driven process, which involves the use, evaluation and application of research; identification of best evidence; evaluation of care; problem solving; decision-making; clinical expertise; and requires patient involvement. Evidence-based practice is made of evidence, clinical expertise, patient preference, the context of care (Barker, 2013). In brief, evidence-based practice is the parameter in the nursing practice that it requires that the nurses gather and use clinical evidence to make decision for the patients so that in the nursing process they can deliver the quality of care for the patients (Ellis, 2013). In the other words, in the nursing practice all the nursing procedures performed by the clinical evidence supported.

Today, we are continually striving to improve the quality of care that we deliver and the best method in applying relevant research into clinical practice is through evidence based practice (EBP). We have now come to a time in our careers to shift our direction on how to employ evidence based practice techniques when managing our patient's health care needs. Facilitation is a method that has been investigated as a way to help clinicians accomplish the implementation of evidence into practice. As clinicians, we are encouraged to think outside the box and utilize critical thinking skills as well as express our role as nurse practitioners as part of the health care team.

Using evidenced based practice in nursing care has been found to improve nursing care and patient outcomes for that matter. Though nurses are gradually embracing the use of evidenced based practice, we still have more to do to achieve EBP across the board. Studies have shown increase in responsiveness and attitude to EBP but are still faced by significant barriers in employing it. Therefore what we think and believe is not what is practiced (Stevens, 2013).

Melnyk, B.M. & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Wolters Kluwer.

According to Lewis, Dirksen, Heitkemper & Bucher (2014), “Evidence-based practice is a problem-solving approach to clinical decision making. It involves the use of the best available evidence in combination with clinical expertise and patient preferences and values to achieve desired patient outcomes.” Using evidence based practice in nursing is extremely important, because evidence-based practice is the result of others trying a practice one way but needing to change some of the guidelines to make the practice safer and over all better for patients.

Evidence based practice has a great impact on health care system, nursing practice, teaching, and science. The necessity for evidence based quality enhancement and healthcare alteration underscores the requirement for redesigning and implementing care that is effectual, secure and competent (Stevens, K., Ma., 2013). The movement of evidence based practice commenced with the identification of the problems faced in healthcare system. The unacceptable gap between what we know and what we do in the patients care(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. 2001). The main intend of evidence based practice in health care is to provide the resources by which the most latest relevant evidence from research and studies can be judiciously

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 a provider of care, professional nurses depend on research, theories, and evidence based practice to guide the care they provide to patients. Nurses deliver care to their patients based on information they have learned through many years of school and training. Training for nurses and other providers of care is founded on theories, research, and evidence based practice in the healthcare field. Theories, research, and evidence based practice are all important for providing care to patients and each can be used in a different manner depending on the situation. Clinicians often use research based evidence to design and implement care that is high-quality and cost effective for patients. Evidence based practice can be used to provide care to patients in a steadily changing clinical environment. (PDF page 8-9). Nursing theories are frequently used as frameworks for establishing nursing care interventions and assessing

Evidence based practice is defined as the conscientious use of current best evidence in making decisions about patient care. (Melnyk, 2016) One of its main features is the reliance on the partnership among hard scientific evidence, clinical expertise, and individual patient needs and choices. EBP looks at research findings, quality improvement data and other forms of evaluation data, and expert opinion to identify methods of improvement. Evidence based practice challenges nurses to look at the “why” behind existing methods and processes in the search for improvement. EBP and research based practice have often been confused with one another. Research is generating new knowledge about a phenomenon or validation existing knowledge. “Although evidence-based practice may have opinion-expert opinion, but opinion still-woven in, research is built in such a way avoid bias.” (Melnyk, 2016) Evidence-based practice improves healthcare quality and patient outcomes while reducing costs.

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).

Evidence based practice (EBP) is a concept used in nursing that combines information, such as patient data, from previous research to direct nursing care to evolve, progress and ensure that the highest quality of care is given. Although many nurses have negative misconceptions about EBP, research has shown that the incorporation of EBP into an institution results in improved patient outcomes, greater nursing satisfaction, and reduced costs (Melnyk, 2010). Working through the seven steps of EBP can lead to positive changes in the nursing field that will lead to improved health care.

For nurses today providing the highest level of patient care requires approaches that integrate new expanding research and evidence-based practices (EBP) into their patient care plans. Many nurses may be unaware of their importance to developing these processes and may not be able to differentiate between them. This discussion explains the basic differences and similarities among research and EBP.

Evidence based practice [EBP] is an essential component of the health care system. Combined with both the practice of the APHRA codes of professional conduct and continual support of clinical education there can be little excuse for nurses regardless of practice setting to not uphold a superior level of medical care.