Introduction According to Houser (2012), evidence Based Practice Nursing is the application of evidence based findings by nurses to steer the nurse toward integration of clinical expert opinion and experience with an unbiased comprehensive analysis of the best scientific evidence professional nursing care literature can provide while integrating patient principles and preferences. When planning for sustaining evidenced based practice, it is vital to adopt a methodical critical thinking decision making method, directed by deliberately adopting Evidence Based Nursing model pathway that encompasses searching, appraising, synthesizing, adapting, implementing, with a continuous evaluation of outcomes (Houser, 2012). Consequently, in an attempt to create or sustain an evidence-based practice, the plan must be well thought out, assessed, implemented and evaluated for desired outcome. My current area of nursing practice is in a Med-Surge/Orthopedic unit of an acute health care setting. We are specialized in Total Joint replacements, with an occasional spillover of Medsurg cases, who are admitted to the floor due to lack room at the specific units. My plan to create and sustain an evidence-based practice, will be in regards to creating and instituting a required pre-surgical class for patients who have elected to undergo a joint replacement. Model and Approach Consequently, I intend to adopt the Advancing Research and Clinical Practice Through Close Collaboration (ARCC) model
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.
Evidence - Based Nursing, An introduction (2008, p. 285 ) “ The rapidity of change and the reorganization of nursing services within the health care sector presents challenges for the advancement of EBP. Managers and administrators should facilitate the uptake of practice based on current, high-quality research by formalizing the expectation that nurses care be Evidence Based”.
Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.
Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model reaffirm that evidence based, is a reality concept in the clinical and educational setting. This model help the nurses at all levels will find clear explanations of the differences between quality improvement, research and evidence-based practice and, as long as they can establish good multidisciplinary team working, this model will be able to apply in the home health care agency to achieve the goal of my project. Also useful strategies for defining evidence-based practices problems and how to develop and implement a correct care plan. This model helps to develop research evidence, and find the correct
Professionalism in nursing has advanced greatly over the years. A cornerstone for change includes that of evidence based practice (EBP) as the drive of nursing intervention and patient care. According to the Quality and Safety Education for Nurses (QSEN), Evidence-based practice is described as the combination of the most recent evidence with clinical knowledge that includes the patient’s best interests in mind for greater patient outcomes (QSEN, 2017). The QSEN’s goal is to prepare nurses for improvement in quality and safety of patients (2017). Because of this goal, six competencies, including evidence-based practice, are listed for criteria of improvement in nursing practice (2017). I have been fortunate to have experience with implementing this practice and providing education in certain EBP protocols in my career. One EBP protocol in particular that our unit has been involved in since May of this year includes Enhanced Recovery After Surgery (ERAS) now referred to as Improving Surgical Care and Recovery (ISCR).
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.
Evidence-based practice is the practice of making clinical decisions based off the best available research evidence coupled with the nurse’s own expertise, while also taking into account, the patient’s assessments and own personal preferences. This use of research has proven effective at providing better outcomes and lower healthcare costs, yet there are several barriers, such as time, education, and support, which prevent nurses from consistently using evidence-based practice (AJN, 2012). The top three barriers to the use of evidence-based practice are lack of time, education, and support in implementing new practices and using them consistently.
The John Hopkins Nursing Evidence-Based Practice Model is a powerful problem-solving approach to clinical decision making and is used in research. The model is designed to meet the needs of the practicing bedside nurses and used a three step process called a PET, facilitating nurses in translating evidence to clinical, administrative and education based on evidence. According to Melnyk and Overholt (2015), there are three steps to the JHNEBP model. The first phrase is practice questions: Identification of an EBP question and defines its scope. The second phrase is evidence of internal and external evidence team determine if its feasibility to implement. The final phase is a translation which includes recommended practice for changes and dissemination of findings.
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 when recent research is integrated into the clinical setting for maximum delivery of health care. A lot of evidence based practice was developed from research studies conducted by nurses such as decubitis ulcer prevention. Knowing and demonstrating the scientific methods and processes will help to advance nursing care by providing better interventions for patient care. Patient care plans should be developed based on evidence (Dycus, 2009). With monitoring outcomes from evidence based practice it can be determined if the care caused improvement in the healthcare setting. Using quality measures such as charts and diagrams to understand performance.
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 will be extremely helpful among the hospital setting because it will allow for me to learn from reliable resources. Using evidence-based practice thus far has helped for me to learn about different cultures and become more prepared when meeting with patients. I will continue to work within the hospital setting and need to be sensitive of how different cultures feel about the medical system as well as treatment options. At times, I have found myself wondering why my patient does not want to go a certain treatment route and many times I can use evidence-based practice to get a better understanding. Many times evidence-based practice has allowed for me to share articles with coworkers and have dependable evidence to fall back on when advocating for my patient within team meetings.
Evidence-Base practice (EBP) is defined as based on problems identified from nursing practice; using best evidence and professional expertise and merging them into current practice to ensure patients receive quality care (French, 1999). Evidence-based practice is a part of quality improvement process; it is made of evidence, clinical expertise, patient preference and the context of care (Barker, 2013). In brief, evidence-based practice is the guideline in the nursing practice that requires nurses gather and use clinical evidence to help diagnose or assess patients correctly by using their knowledge and experience in order they can deliver the quality of care to the patients (Ellis, 2013). In the other words, in the nursing practice the clinical evidence supports all the nursing procedures performed.
Evidence-based practice (EBP) in nursing means making decisions about patient care on the basis of best, current, standardized practice and guidelines. According to an article, written by Dr. Kathleen Stevens, the development of evidence-based practice (EBP) is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care (Stevens, 2013). The author also mentioned in her article that the intended effect of EBP is to standardize healthcare practices to science and best evidence and to reduce illogical variation in care,