Evidence Based Practice Essays
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Understanding Research in Evidence Based Practice Essay Sample
Evidence-based practice in adult nursing.
Evidence-based practice is a requirement of the Nursing and Midwifery Council (NMC) (2018) Code, so incorporating these activities into practice is vital for nurses. This essay critiques a research study carried out by Sawer et al. (2020) with the title, Is shame a barrier to sobriety? A narrative analysis of those in recovery. Subsequent to critiquing the research, two of the findings will be analysed critically to consider these in the light of the broader evidence base. Finally, the discussion will evaluate how evidence-based research can enhance or affect practice before arriving at conclusions on this topic.
The study of Sawer et al. (2020) was critiqued utilising a critical review form for qualitative studies developed by Letts et al. (2007). The findings for each of the sections of this form can be seen in the Appendix. It should be noted at the outset that the type of research undertaken was in this case, qualitative. According to Grove and Gray (2022, p. 21) “Qualitative research is a systematic subjective approach used to describe life experiences and situations and give them meaning.” This helps to understand the perspectives, perceptions and worldviews of participants (De Chesnay, 2016). It differs very significantly from quantitative research paradigms which are typically based on gathering numbers and testing theory. Given that the authors wished to understand experiences in depth, the approach of Sawer et al. (2020) may be considered suitable for this study. The research design itself was a narrative inquiry – also suitable because this seeks to understand participants’ own stories in their own words and comprehending lived experience (Blessinger and Carfora, 2015). Sawer et al. (2020, p. 79) clearly articulate their research questions which were: “In what ways do participants tell their stories of shame? And how is shame experienced and/or understood by those in recovery from alcohol dependence?” This helps demonstrate study reliability as the research questions are suited to the research design and type of research.
Sawer et al. (2020) gathered their sample of participants from Alcoholics Anonymous, including five males and three females within the study, and using a snowball sampling-based approach. Sampling is the process of selecting participants from the total population to take part in the study, aiming to include representative individuals from the wider group (Cernat et al, 2022). Snowball sampling is a technique that is usually used to access difficult to access populations, through asking participants for referrals to other potential participants (Terry, 2017). While it is very useful for this purpose, it also has the risk of sampling bias creeping into the process because people may potentially refer others that have similar experiences or worldviews, meaning that the research may narrow in its findings (Fain, 2017). This ultimately can lead to issues of reliability, trustworthiness and validity in research. Typically, in quantitative research, researchers seek to achieve saturation of data (Boswell and Cannon, 2022) which occurs when researchers are gathering data, and no new information is being found. Another key problem with the study of Sawer et al. (2020) is that the researchers do not refer to this within their study. This leads to further questions about reliability and trustworthiness of the findings, and the extent of academic rigour applied overall.
On data collection, the authors used interviews with a view to encourage the telling of stories in some detail, with one initial question used asking about the participant’s story of recovery, followed up by further prompts to gain more data from participants (Sawer et al., 2020). Though the authors did not use the word “shame” in the interview, they did in the participant information sheet (Sawer et al., 2020). The use of semi structured interviews in this way is well-aligned to a qualitative research approach (Holloway and Galvin, 2016). It is not clear from the research why other techniques such as focus groups were not considered, since these can gather a greater depth of information when used at the right times (Dingwall and Staniland, 2020), however, this may be due to the nature of the topic and a possible reluctance to discuss shame in front of others. From the perspective of academic robustness, discussion of why not focus groups could have been helpful. On data analysis, Sawer et al. (2020, p. 80) carefully detail out their five step approach adopted from Crossley, which included reading and familiarising, identifying narrative tone, identifying imagery and themes, weaving a coherent story and cross analysis to synthesise themes. From a trustworthiness and validity perspective, noticeably missing from the Sawer et al. (2020) study is any reference as to how their own worldviews and beliefs may have shaped the data collected, its analysis and findings, since as Dewing et al. (2021) point out, this could have a significant influence. Holloway and Galvin (2016) argue that it could also draw in the potential for bias, leading to validity and reliability concerns.
Finally, the study was conducted according to ethical principles, and this is seen throughout the documentation of the research of Sawer et al. (2020). Sawer et al. (2020) describe how they sought ethical approval at the outset, and the use of informed consent forms to help ensure that harm did not come to participants (Llahana et al., 2019). They also anonymised names to ensure that participants could not be identified (Williamson and Whittaker, 2019) which might be considered particularly important on the topic of shame relating to alcohol misuse. One possible area for improvement might have been to signpost participants to extra counselling services, or having a counsellor present, since it is possible to imagine that the content may have been distressing for some, potentially.
One of the main findings of the Sawer et al. (2020) research was that participants had a deep seated negative view of self, present well before they were dependent on alcohol. Critiquing this finding, a few other studies were identified on undertaking a search, which support this point. In particular, the study of Kougiali et al. (2021) on mechanisms and processes involved in women’s pathways into alcohol dependence and towards recovery also highlights this point. The research of Kougiali et al. (2021) was a qualitative meta-synthesis of other studies undertaken in this field, identifying 23 research papers of relevance. Kougiali et al. (2021, p. 437) showed that there was a link between difficult situations in childhood and how this impacted on the person’s sense of self. Shame and stigma was seen to be present long before alcohol dependence, and sometimes it was found to delay seeking recovery, however, once recovery began, the authors showed that this helped revise the concept of self (Kougiali et al., 2021). This mirrors the findings of Sawer et al. (2020, p. 83) which showed that participants felt they had faults and that they had a “fault with self” which alcohol could relieve. Sawer et al. (2020) also pinpointed the concept that shame was likely to delay going to start the recovery process. Furthermore, while on the subject of offending and prison rather than alcohol dependence, Flood (2018) found that being able to recover and transform self-required shedding underlying feelings of shame. While the subject is somewhat different, the same overall process of deep seated shame can be seen to impact on change for a person (Flood, 2018) further adding some weight to the findings of Sawer et al. (2020).
Importantly, the research of Kougiali et al. (2021) might be considered higher up on the hierarchy of evidence than the research of Sawer et al. (2020). This is because the work of Kougiali et al. (2021) can be seen to be a robust and comprehensive review of other qualitative studies already existing in this specific area of research (Greenhalgh, 2019). Meanwhile, the study of Sawer et al. (2020) is lower down on the hierarchy of evidence because it represents just one small scale study into this topic. While there are various different hierarchies of evidence that have been proposed, as can be seen from the analysis of Melnyk and Fineout-Overholt (2018) in all cases, meta synthesis of qualitative studies are always considered more academically robust than a single qualitative study. Of course, this does depend on how the meta synthesis was conducted, since if the methodology was not academically robust this might affect validity of the Kougiali et al. (2021) findings, a point which does also challenge the hierarchy of evidence as a concept overall (Houser et al., 2016). Nonetheless, the study of Kougiali et al. (2021) does appear to be reliable, trustworthy and valid, so this is not the case in this scenario.
A second key finding of the Sawer et al. (2020) study was that participants’ recovery was enabled through being able to discuss and make sense of personal shame arising from experiences. On searching the literature, no one study was identified that outlined this exact finding, though there were some similar and related findings within the literature base. For example, research undertaken by Romo and Obiol (2021) that carried out interviews of 22 adults in alcohol recovery found that the way in which participants handled stigma and associated shame influenced their recovery. This lead Romo and Obiol (2021) to outline the importance of Alcoholics Anonymous and other treatment centres to use communication to break down stigma to lower barriers to recovery. Moreover, other research undertaken showed that one key stage in recovery was discussing shame with others and developing accountability which helped as a commitment to overcome drinking (Chambers et al., 2017).
However, the Chambers et al. (2017) study was based on the use of an online help group/network rather than in-person AA-style recovery, which means that the findings could diverge from those of Sawer et al. (2020) as a result of this. This is particularly pertinent given the point of Chambers et al. (2017) that online networks give people control over how they choose to present themselves – which may not necessarily align with the reality.
When considering this second finding of Sawer et al. (2020) it is helpful to consider analysis undertaken by Lund (2017) in a study which examined qualitative data drawn from interviews with 21 former substance abusers, examining their recovery process. Importantly, Lund (2017) links guilt and shame in recovery to the Christian faith, and highlights that these types of self-conscious emotions are partially socially constructed through this religion. While this highlights the importance of shame in recovery when considering those that identify as Christian or who have been brought up within Christian mindsets/worldviews, it does question the transferability of the findings to other different kinds of cultures. With this in mind, it should be noted that Sawer et al. (2020) gathered their data from participants at Alcoholics Anonymous, itself known to be a group based on Christian tradition (Douglas, 2013). Therefore, it cannot and should not be assumed that the findings of the Sawer et al. (2020) research will necessarily apply to other people who have different worldviews and beliefs based on different religious and spiritual perspectives, necessarily.
According to Abu-Baker et al. (2021) evidence-based practice is an approach that utilises both the best and latest available research, working alongside clinical expertise and drawing in the patient’s situation and values to determine the course of action for care/practice. Evidence-based research has benefits to bring to nurses in their practice (Linsley et al., 2019). Linsley et al. (2019) argue that this is more the case than ever before, as nursing roles are increasingly being expanded, requiring that they have greater knowledge. As Linsley et al. (2019) point out, this means that nurses need to be able to question their practice and interrogate the research to continually improve care. This is supported within the NMC (2018) Code, which requires that nurses offer care on the basis of the best available evidence relating to this. As argued by Ellis (2018) the drawing in evidence can help update practice and the provision of care so that it improves outcomes for service users.
As Abu-Baker et al. (2021) outline, incorporating evidence-based practice into nursing has a number of advantages for practice, which have been evidenced to show lower cost, improved quality of care, improving patient outcomes and enhancing safety. These are all good reasons for incorporating evidence into practice for nurses.
As Pooler (2014) outlines, evidence based practice is not something that is done once and then assumed to be complete. Rather, it is a continual process of working to improve practice and care (Pooler, 2014). This is important, given that a nurse’s career could conceivably span 40 or more years, and the evidence on best practice may very well change during that timeframe. Questioning what is being done and why is therefore something that needs to be done with regularity, which Pooler (2014) specifies must include identifying evidence, appraising it, acting on it and reflecting on the outcome, for the best results. However, this is not straightforward to do due to barriers that can exist hampering the use of evidence-based practice. For example, research by Li et al. (2019) on community nurses showed that while practitioners may have a positive attitude to adopting evidence-based practice, they may not necessarily have good knowledge of how to go about it. Furthermore, a lack of time and resources can make it to actually implement evidence-based practice into care, and these are further barriers that can be experienced (Li et al., 2019). Fry and Attawet (2018) also identified evidence that obstacles to evidence-based practice for nurses and midwives include a lack of time and a need for organisational and management support of this process. However, as has been demonstrated, evidence-based practice has a multitude of important benefits to bring, particularly in terms of positives for patient outcomes. Therefore, arguably nurses need to follow the NMC (2018) Code and ensure that time is made available for evidence-based practice so that these benefits can be realised for service users. Nurses should also reflect on their own knowledge and capabilities and work on personal development in this area as highlighted by Pooler (2014) to ensure that the best outcomes do indeed result from taking an evidence-based practice approach to care.
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This critical analysis of a qualitative study by Sawer et al. (2020) has shown that the research undertaken does have some flaws in terms of reliability, trustworthiness and validity. These issues arise out of the recruitment, sampling and data collection processes as well as a lack of reflection on how the authors’ own beliefs might have influenced the findings overall. Nonetheless, some support can be pinpointed for the findings elsewhere in the body of literature, meaning that the work of Sawer et al. (2020) may still be considered of use in building the evidence in this area. This is important given that evidence based practice can improve the quality and safety of care provided by nurses. Nurses may need to work to ensure that barriers to implementing evidence-based practice are overcome to ensure that these benefits can be realised in providing care to service users.
Abu-Baker, N.N., AbuAlrub, S., Obeidat, R.F. and Assmairan, K. (2021) Evidence-based practice beliefs and implementations: a cross-sectional study among undergraduate nursing students, BMC Nursing , 20 (13) https://doi.org/10.1186/s12912-020-00522-x
Blessinger, P. and Carfora, J.M. (2015) Inquiry-Based Learning for Science, Technology, Engineering and Math (STEM) Programs , Bingley: Emerald Publishing Group
Boswell, C. and Cannon, S. (2022) Introduction to Nursing Research , 6 th edition, London: Jones & Bartlett Learning
Cernat, A., Sakshaug, J., Atkinson, P., Williams, R.A., and Delamont, S. (2022) SAGE Research Methods Foundations, London: SAGE Publications
Chambers, S.E., Canvin, K., Baldwin, D.S. and Sinclair, J.M.A. (2017) Identity in recovery from problematic alcohol use: A qualitative study of online mutual aid, Drug and Alcohol Dependence , 174 (1) 17-22
De Chesnay, M. (2016) Nursing Research Using Case Studies , New York: Springer
Dewing, J., McCormack, B. and McCance, T. (2021) Person-Centred Nursing Research , New York: Springer International
Dingwall, R. and Staniland, K. (2020) Qualitative Research Methods for Nurses, London: SAGE Publications
Douglas, M. (2013) Constructive Drinking , London: Taylor & Francis
Ellis, P. (2016) Evidence-Based Practice in Nursing , 3 rd edition, London: SAGE Publications
Fain, J.A. (2017) Reading, Understanding and Applying Nursing Research , 5 th edition, Philadelphia: F.A. Davis
Flood, F. (2018) Reframing Trauma: The Transformative Power of Meaning in Life, Work, and Community, Journal of Psychiatry and Psychiatric Disorders , 2 (1) 145-166
Fry, M. and Attawet, J. (2018) Nursing and midwifery use, perceptions and barriers to evidence-based practice: a cross-sectional survey, International Journal of Evidence-Based Healthcare, 16 (1) 47-54
Greenhalgh, T. (2019) How to Read a Paper , 6 th edition, London: Wiley
Grove, S. and Gray, J.R. (2022) Understanding Nursing Research: Building an Evidence Based Practice, 8 th edition, London: Elsevier Health Sciences
Holloway, I. and Galvin, K. (2016) Qualitative Research in Nursing and Healthcare , London: Wiley Publications
Houser, J. (2016) Nursing Research , 4 th edition, London: Jones & Bartlett Learning
Kougiali, Z.G., Pytlik, A. and Soar, K. (2021) Mechanisms and processes involved in women's pathways into alcohol dependence and towards recovery: a qualitative meta-synthesis, Drugs: Education, Prevention and Policy , 28 (5) 437-453
Letts, L., Wilkins, S., Law, M., Stewart, D., Bosch, J., & Wes-Morland, M. (2007) Critical Review Form – Qualitative Studies , Hamilton: McMaster University
Li, S., Cao, M. and Zhu, X. (2019) Evidence Based Practice, Medicine , 98 (39) e17209
Linsley, P., Kane, R. and Barker, J.H. (2019) Evidence-Based Practice for Nurses and Healthcare Professionals, 4 th Edition, London: Sage Publications
Llahana, S., Yedinak, C., Follin, C. and Crossman, A. (2019) Advanced Practice in Endocrinology Nursing, New York: Springer International
Lund, P. (2017) Christian faith and recovery from substance abuse, guilt, and shame, Journal of Religion and Spirituality in Social Work, 36 (3) 346-366
Melnyk, B. and Fineout-Overholt, E. (2018) Evidence Based Practice in Nursing and Healthcare, Philadelphia: Wolters Kluwer Health
NMC (2018) The Code, London: NMC
Pooler, A. (2014) An Introduction to Evidence-Based Practice in Nursing and Healthcare, London: Taylor & Francis
Romo, L.K. and Obiol, M.E. (2021) How People in Recovery Manage the Stigma of Being an Alcoholic, Health Communication , https://doi.org/10.1080/10410236.2021.1983339
Sawer, F., Davis, P. and Gleeson, K. (2020) Is shame a barrier to sobriety? A narrative analysis of those in recovery. Drugs: Education, Prevention and Policy , 27 (1) 79-85
Terry, A.J. (2017) Clinical Research, 3 rd edition, London: Jones & Bartlett Learning
Williamson, G.R. and Whittaker, A. (2019) Succeeding in Literature Reviews and Research Project Plans for Nursing Students, 4 th edition, London: Sage Publications
Appendix: Critical Review Form
Critical Review Form-Qualitative Studies (Letts et al., 2007)
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Importance of Evidence Based Practice in Nursing
Compared to other professions, nursing practitioners spend a significant portion of their time caring for patients through administration of treatment, catering for patients’ needs and making major decisions concerning the care process. Most nursing practitioners are also involved in the formulation and design of policies to enhance the wellbeing of patients, carrying out research and enlightening patients and their communities. To stay relevant, nursing practice must evolve into a profession that is more focused on continuous research and knowledge, hence the significance of evidence based practice (Youngblut and Brooten 467).
Evidence based nursing refers to the practical use of best research in the clinical care of patients. Best evidence entails best nursing research, knowledge, management, policy, and practice. Evidence based nursing advocates for utilization of the best, up-to-date available evidence to address patient needs. Traditionally, nursing practice was based on the opinions and experiences of the practitioners, and less often incorporated input from non-practitioners. The emergence of evidence based nursing practices shifted treatment approaches to become evidence oriented, resulting into establishment of treatment standards that are more rational and consistent (Youngblut and Brooten 470).
Evidence based practice focuses more on the needs of the patient, thus it encompasses processes of lifelong learning through regular assessment of issues that have direct practical implications to the patients, then critically and efficiently evaluating the existing best evidence for the particular issue in order to implement it. The process of evidence based practice, therefore, involves the identification of a practice issue, formulation of the possible hypotheses to the question, followed by search for best evidence from credible resources.
The evidence obtained is then critically evaluated and the clinical relevance assessed in order to generate recommendations. The approved evidence is then utilized in clinical practice and evaluated to determine its effectiveness and outcomes. Evidence based practice is, thus, a life-long, self-directed, issue-based learning that involves assessment of the relationship between clinical reasoning and research evidence.
Importance of Evidence Based Nursing
Evidence based nursing is particularly important because it offers practical clinical standards of practice that have been shown to contribute to positive patient outcomes. Evidence based practice is established on practical guidelines, known as best practice, that have been well acknowledged by practitioners and health care organizations for they have been proved to be integral in the achievement of the health sector’s stringent practice standards.
In nursing, evidence based practice is well accepted for its role in enhancing individualization of nursing care to the needs of the patients, for its effectiveness, and the opportunity it offers to nurses to utilize the value of clinical judgment. Evidence based nursing ensures that patients receive care that is relevant to their problem, promotes sound decision making process that is more explicit, reduces risks to the patient, thus, ensuring maximization of benefits, and provides the practitioners with the knowledge that empowers them to evaluate healthcare research and practice. This makes nurses to keep pace with advances in nursing practice (Youngblut and Brooten 472).
Evidence Based Practice in Addressing Gaps in Nursing Knowledge
The nursing practice is a profession of continuous learning and development. Evidence based practice empowers nurses to be adept in obtaining relevant nursing knowledge rapidly, thus facilitating making of critical decisions based on an informed process. Evidence based nursing has been shown to equip the practitioner with the ability to evaluate data before applying the data in the care of patients, thus positively influencing health outcomes.
Evidence based practice also encourages nurses to stay informed on current and innovative care standards in order to remain relevant in the profession. Evidence based practice represents a rational development in the persistent effort to narrow the gap between research and practice, and facilitates the use of research knowledge in real life clinical care settings (Youngblut and Brooten 474).
Patients depend on nurses to perform the best in order to sustain their health. This subsequently compels the nurses to be actively involved in a continuous learning mechanism to evaluate the best approach for care delivery. Evidence based nursing practice, therefore, empowers nurses to fully actualize their professional role and avoid confining themselves to technical knowledge (Mulhall 4).
A number of studies have shown that evidence based practice positively influences nursing practice and is significant to safe nursing practice (Youngblut and Brooten 473; Kania-Lachance et al. 48). It has positively influenced the attitudes of nurses towards the profession, while its effective use is associated with quality care, improved patient outcomes, professional development, satisfaction, and success in professional practice. The provision of high quality care is directly linked to progressive professional advancement and acquisition of relevant nursing knowledge and skills in relation to developments in nursing practice.
Evidence Based Practice in Enhancement of Quality of Patient Care
There is a persistent call for the delivery of nursing care that combines best evidence, critical thinking and new technology in order to improve the quality of care. Studies have demonstrated that nursing practitioners offer health care based on the knowledge they learned in nursing schools, and less often do they base their practice on knowledge from journal articles and reports that are considered up to date.
Considering that the average nurse may be above 40 years in age, this shows that most nursing practitioners may be applying knowledge that is outdated, meaning that quality patient care and desirable health outcomes cannot be achieved (Kania-Lachance et al. 53). The use of evidence based practice enables nurses to deliver high quality patient care established on research and knowledge instead of the old ways, which are based on traditions, myths and outdated literature. Evidence based practice, thus, becomes a significant mechanism through which care that is current and that is based on the latest research evidence is applied (Mulhall 5).
Evidence Based Practice and Improvement of Patient Outcomes
The major role of nurse practitioners is to help their patients achieve improved health outcomes. In contrast to the early practice that was geared towards reduction of morbidity and mortality, current nursing practice extends to other issues such as health care costs, clinical symptoms, functional ability, and quality of life of the patient. The current care, based on evidence based practice critically evaluates nursing practices and outcomes to generate knowledge that is essential in enhancing the quality of care (Kania-Lachance et al. 48).
Studies have shown that patients who are provided with evidence based nursing care experience better health outcomes and increased levels of satisfaction as compared to those who receive care based on traditional practice. Evidence based nursing practice ensures that patients and their families are provided with the best and up-to-date care possible since nurses are empowered to tackle healthcare issues using an evaluative and qualitative approach from the patient’s perspective.
Evidence based nursing practice depends on researched information, patient reports and nursing practitioner experiences in the collection of information that is employed in the provision of care. This helps in the identification of the kind of treatments that are effective on an individual patient and those that are not; hence it ensures that patients receive care that is individualized and most appropriate. Most studies have indicated that the use of best available research knowledge is associated with a lot of benefits than when nurses employ care practices whose mode of action and outcomes has not been established or are poorly understood (Emanuel et al. 22).
A majority of patients entrust nurses with their lives, with the belief that the nursing practitioners will make decisions that would positively impact their health. Evidence based nursing, therefore, provides a mechanism through which nurses regularly base their decisions on the care they deliver to their patients. These decisions have the potential to influence the health outcomes of the patients positively or negatively. It has been shown that patients would experience improved outcomes if the care provided to them is engrained on researched and proven practices (Kitson 460).
Evidence Based Practice and Efficiency of Nursing Practice
Evidence based nursing has also been shown to enhance the efficiency of nursing practice. Nursing care decisions made based on information supported by research makes it convenient for the practitioners to choose the most appropriate care for the patient, instead of adopting untested practices which often carry higher health risks (Emanuel et al. 22).
Evidence based practices, therefore, help in saving time, which is subsequently utilized in caring for other patients in critical conditions. Evidence based practice also ensures that the practitioners apply the available evidence in order to achieve desirable outcome in a cost effective way and minimal time (Kitson 461).
How Evidence Based Practices Enhance Decision Making Processes
Evidence based practice has been shown to be important in supporting and informing decision making at various levels such as clinical, administrative and educational. Through the integration of research, experience, clinical expertise, expert input and client choices, evidence based nursing ensures that clinical decisions reflect the best existing knowledge.
As evidence based practice usually considers risks, costs and benefits of a health care intervention against the preferences of the clients, the nursing practitioners get encouraged to evaluate their practice and decide on the interventions that deliver desirable outcomes. The use of evidence based practice in nursing, in turn, enhances the practitioner’s confidence since all the decisions are made based on proven standards (Kitson 459).
Most people place great value on accountability in the health care sector since it forms the basis for consistent quality care. This challenges the health care providers to regularly evaluate their practice in order to merge research and practice. Evidence based practice, therefore, offers a systematic framework in decision making that reflects best practices and accountability. It provides the nursing practitioners with the opportunity to evaluate the available evidence, thus eliminating the possibility of adopting poor practices that are inefficient and harmful to their clients (Youngblut and Brooten 473).
New clinical evidences arise regularly through completion of research, technological innovations, and from clients who present with unique issues and individual experiences. Basing nursing practice on the knowledge obtained in nursing schools compromises the quality of care due to the redundancy nature of this knowledge.
Evidence based practice is essential in enhancing the safety of the patients since the care they receive reflects the best evidence available. Evidence based practice, therefore, remains an integral component of current nursing practice, hence the need for nursing practitioners to employ it in the enhancement of patient safety and improvement of health care outcomes.
Evidence based practice has emerged as the most efficient, effective and economical method of delivering health care.Additionally, evidence based nursing helps in identifying the gaps in knowledge and conflicts in evidence, thus yielding the potential to narrow the research-practice gap and offering a mechanism for addressing problematic clinical practice issues.
As evidence based practice in nursing is well recognized by many health care stakeholders such as accrediting bodies, professional organizations and third party payers, it is integral in the enhancement of quality and reduction of health care variations. Evidence based practices presents a paradigm that is central to the realization of best possible outcomes at possibly lower costs.
To practice evidence-based nursing, nurses are required to have the extra education that enhances their ability to assist others, in addition to making them more knowledgeable and value their profession. This requires the nursing practitioners to be engaged in continuous learning process so that they can have knowledge relevant to the issues that need to be addressed, and have the competency to appraise the robustness of the evidence.
Emanuel, Vernel, Day Karen, Diegnan Lorraine and Pryce-Miller Maxine. “Developing Evidence-Based Practice among Students.” Nursing Times , 107.49/50 (2011): 21-23. Print.
Kania-Lachance, Donna M., Best Patricia J. M., McDonah Margaret.R., and Ghosh Amit K. “Evidence-Based Practice and the Nurse Practitioner.” The Nurse Practitioner , 31.10 (2006): 46-54. Print.
Kitson, Alison. “Towards Evidence-Based Quality Improvement: Perspectives from Nursing Practice.” International Journal for Quality in Health Care , 12.6 (2000): 459-464. Print.
Mulhall, Anne. “Nursing, Research, and the Evidence.” Evidence Based Nursing, 1(1998): 4-6. Print.
Youngblut, JoAnne M. and Brooten Dorothy. “Evidence-Based Nursing Practice: Why is it Important?” AACN Clin Issues , 12.4 (2001): 468-76. Print.
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Evidence Based Practice Essay
Msn specialty track: family nurse practitioner.
A family nurse practitioner could apply theory, information from research, and knowledge learned in class to formulate patient education strategies as well as to create patient education material. The nursing profession advocates for evidence-based practice. This requires the nurse to know, in order to provide proper care. Therefore, it is important to link research to nursing practice because the data collected through research makes it easier to make clinical decisions (Pipe, Wellik, Buchda, Hansen, & Martyn, 2005). An understanding of nursing theory would also prove important in handling nursing dilemmas by offering a systematic guide for handling nursing issues.
Evidence Based Practice Summary
Evidence based practice is the act of incorporating clinical expertise, best research evidence and patient values and preferences in delivering care. This system, as opposed to previous methods that used the same standard of care for each patient, evaluates treatment plans based on research and the practioners own experiences. The usual workup of this type of practice is to ask a series of “why” questions and meticulously observe patient patterns to paint a better picture of the environmental factors surrounding the patient’s condition. This method advanced treatment modalities as practioners were able to better incorporate external factors in the assessment. Previous styles of care such as defensive medicine, forced providers to aggressively
Importance Of Using Credible And Relevant Evidence
It’s important to use evidence based practices in nursing because it creates solutions to the patient’s needs, it improves the overall care of the patients, reduces harm and helps support nurse’s actions and clinical judgments. Sackett (2000) says that evidence based practice is looking at the best evidence along with using your clinic expertise in helping you to make a decision about the patient’s individuals care. Outline the process undertaken when searching for credible and relevant evidence to support Part 2 of the workbook. (Justify and support answers with credible and relevant evidence whilst adhering to UWS referencing guidance). The first element of finding credible and relevant evidence would be to research journals and articles, as
Introduction Melnyk and Fineout-Overholt (2019) defined Evidence-Based Practice (EBP) as a problem-solving approach to clinical decision-making. It involves using the best available evidence through a systematic search and critical appraisal of relevant evidence, combined with clinical expertise and patient preferences, to improve individual, group, community, and system outcomes. EBP is a lifelong approach to clinical decision-making that combines the best available evidence with clinical expertise and patient values to improve outcomes (Melnyk & Fineout-Overholt, 2019). The University of Missouri Hospital, locally known as MU Health Care, is an organization that emphasizes its mission, vision, and values, all critical elements of evidence-based practice.
A Brief Summary Of The Movie Escape Fire
In the clinical setting, the nurses’ expertise can be used to make clinical assessments and recommendations for routine care at a lower cost than a physician visit. This would increase the number of patients seen and increase the quality of the care provided. The advance practice nurse would be able to hone in on preventative measures and increase patient education. The advance practice nurse can also make recommendations about practice changes needed to facilitate better health outcomes through the use of evidence-based practice. Nursing leaders are aware of how important nursing science is to provide needed evidence to transform practice, even though, finding the time and resources to support any research activity is often challenging (Stone, 2017).
Evidence Based Practice Research
What is Evidence-based practice? Evidence-based practice is an all-around systematic approach to patient care that was built up on research and proven treatment results within nursing in order to increase the patient outcomes. Evidence based practice is define as “the integration of current evidences and practices to make decisions about patient care”. (Medical Surgical Nursing, 2018). Evidence-based practice not only includes the best proven research for practicing patient-centered care, but also merges the patient’s preferences and values into consideration.
Essay On Evidence Based Practice
Evidence-Based Leadership Nola Ward Independence University Evidence-Based Practice Evidence-based practices is the combination of the best research evidence with patients values and clinical expertise which would lead to an improved outcome. According to Annie E. Casey 2010, the evidence-based process interchanges from research to putting into action and finish off with providing information for making treatment decision. Evidence-based practice is found in social policy, social work, educating, child welfare, early childhood and also criminal justice.
Evidence based practice (EBP) is to demonstrate the best practice, which has been supported, with a clear rationale to back it up, while acknowledging the patient/clients best interest. In this professional outline it will be discussed why EBP is so important to start with student nurses career and continuing throughout the nursing career and the second main point will be on the impact it has on patient outcomes regardless of discipline. I believe if this mind set is instilled early in the nurses career the practice will evolve it a more proactive
Importance Of Evidence Based Practice
Cleary-Holdforth and Leufer (2009) explains that evidence based practice is a holistic approach to the delivery of care with the individual at the centre. It involves more than simply using research and is a partnership between inter-professional clinicians, patients and the best available evidence to ensure optimal care for the patient. In terms of evidence based practice this makes it important as it outcome to making patients care better as well as improving the patient exceptions of care. It has been suggested that evidence-based practice is important in health care as it provides the care that meets the individual needs of the patients and helps us identifies gaps in knowledge when we research into subjects.
Disadvantages Of Evidence Based Practice
Evidence based practice (EBP) is a process of integrating high quality evidence into practice or care provided by health professionals and decision makers in health care. This discussion will explore the meaning of the term Evidence Based Practice further and discuss its origins. EBP requires finding the best available evidence to inform practice, its greatest benefit being the best possible care for a client. Other benefits and limitations will be further discussed below. EBP demands the client be seen as an individual and their unique circumstances be considered in the application of evidence
ENSURING EVIDENCE BASED PRACTICE SIGNIFICANCE OF THE CONCEPT Evidence base practice can be defined as the integration of clinical experience and skills, patient values and best research evidence into decision making process for patients’ care (Saclett D, 2002) The integration of the three elements into decision making process enables the practitioner a better opportunity for enhanced clinical outcome and improved quality of life. Evidence alone is not enough in decision making hence the integration of the three elements. In order to ensure effective public health programme the practitioner must ensure that every decision made is evidence based.
Metaparadigm Model Of Nursing
The metaparadigm concept for the discipline of nursing describes the 4 concepts of nursing knowledge, a “global perspective of a discipline” and acts as a framework. It consists of 4 main concepts, person, environment, health and nursing (Masters,2011). The nursing model is a core of nursing which consists of a pattern of living while a person requires nursing. It is also a framework for the process of nursing which organise the process of providing the care and understanding to what care is needed in order to meet the needs of patients that are unable to provide for themselves. Nursing care can be tailored to suit each individual’s requirements and needs.
Pressure Ulcer In Nursing Research
CLINICAL ISSUE AND QUESTION Research is a systematic and scientific way of seeking information on a clearly defined question (Nagy, Mills, Waters & Birks, 2010). Nursing is an evidence based practice profession, therefore, research is an important aspect in nursing profession in order to develop knowledge in clinical practice, and administration. The clinical expertise of a nurse is based on the clinical experience, up to date knowledge of research and clinical literature and educational preparation. Therefore, it is clear that nursing research is an important aspect to develop knowledge about human responses and the best intervention to promote health, prevent and manage illness (Burns & Grove, 2010).
Define Nursing Research And Evidence-Based Practice
Nursing research is providing evidence used to support nursing practices, generate new knowledge, and promote evidenced-based nursing practice, ensure credibility of nursing profession, provide accountability for nursing practice and document effectiveness of nursing care. Nursing research also focuses on the understanding and relieving of the symptoms
Importance Of Knowledge In Nursing
Giving care to a patient is not a straightforward process because a patient is made up of advanced systems. Symptoms and the severity of a disease process are dependent on a particular patient, and it may not always be uniform from patient to patient. Because of this, nurses must be able to use their knowledge appropriately to help a patient. Nurses use techniques, such as Evidence Based Practice, in order to integrate new and advanced knowledge into their patient care (Canada, 2016). By exercising evidence based practice, nurses effectively seek knowledge, take experience from past situations, and apply this intelligence to best give patient care (Canada, 2016).
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The Benefits of Evidence Based Practice in Nursing Essay examples
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Evidence Based Practice For Nursing Practice
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.
This question format model, helps in optimization of applied research specifics, medical style questions, updated peer review of research, and even allows assessing students to support evidence based practice in defining appropriate questions (Holloway et al. 2004).
Evidence Based Practice In Nursing
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.
Therapist Case Report
patient history, system reviews, physical examination, evaluation, diagnosis, prognosis, psychosocial aspects, intervention, follow-up and the patient’s progress). It is a part of the paper where in first explains why the patient was selected for the case report, provides it’s relevant history including demographic characteristics and pertinent psychological, social and environmental factors, and includes relevant medical diagnoses . It also explains the examination procedures clearly, addresses the reliability and validity of the measurements i.e. cites published reliability studies, provides the results of your own mini-reliability study, or makes a presumptive argument, explains all examination data as well as decision making process that led from examination through the evaluation, diagnosis, clinical impression and prognosis to the plan of care and the selection of intervention. In intervention it explains the chronology and amount of interventions as well as changes in treatment and rationale for changes made in interventions over
What Are The Barriers To The Use Of Evidence Based Practice
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.
Evidence Based Practice And Applied Nursing Research Task Essay
Conrad, A., Grotejohann, B., Schmoor, C., Cosic, D., & Dettenkofer, M. (2015). Safety and tolerability of virucidal hand rubs: a randomized, double-blind, cross-over trial with healthy volunteers. Antimicrobial Resistance & Infection Control, 4(1), 1. doi:10.1186/s13756-015-0079-y
Evidence Based Practice And Practice
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 Essay
When considering a change in practice we need to firstly understand why we need to make a change? Secondly when making a change, we need to justify a decision. This can be achieved by exploring the components which encompass decision making within nursing practice. Cullum et al (2007) identifies four requirements:-Clinical experience, valid researched evidence, available resources and lastly but no less important the patient
Clinical Inquiry : Picot Question
A PICOT question is formulated in order to assist the researcher in obtaining answers to a specific question, decreases the uncertainty surrounding the issue, and provides a systematic approach to achieve an answer (Melnyk, & Fineout-Overhold, 2013). The authors find that each component of the PICOT question drives the next step of the evidence based practice process. First, a specific population must be determined by controlling the group to a certain age range or special sub-group. By compiling a specific group the clinician is more likely to formulate better evidence to support the issue. Next, an intervention is introduced and can be a therapy, test, disease process, etc. The authors conclude that, “the more specifically the intervention or issue of interest is defined, the more focused the search will be” (p.29). Then, a comparison group is added, but only necessary if completing a quantitative study. Lastly, an outcome is determined of which the study will reveal by a given time period.
Evidence-Based Practice in Nursing
Findings of evidenced based practice have to be disseminated to ensure that innovations for practice are replicated or applied in other settings by stakeholders in the health fraternity and healthcare professionals (Forsyth, Wright, Scherb & Gaspar, 2010). One of the objectives of dissemination should be to improve the practice. Dissemination of evidenced based practice findings in nursing is very critical in knowledge synthesis, translation, and translation. It is imperative in strengthening healthcare, informing policy, and improving practice decisions based on clinical evidence (Rycroft-Malone & Bucknall, 2010). This is realized by transforming clinical changes into practice. It actually involves two stage processes namely: translation of evidence into practice and integration of research recommendations into actual practice. Effective dissemination of evidence based practice findings enable staff to share information about developments in healthcare practice and implement innovation (Freemantle & Watt, 1994).
Essay on Evidence Based Practice in Nursing
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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 For After Stroke Care
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.
Johns Hopkins Nursing Evidence-Based Practice Model
The tools include “a question development tool, an evidence rating scale, and appraisal criteria for research and non-research evidence” (Schaffer et al., 2013, p.1204). The question development tool provides specific steps for formulating the clinical practice question. The rating scale allows users to rate the “strength of evidence and quality for both research and non-research evidence” (Schaffer et al., p. 1204). The rating scale also allows users to rate practitioner expertise and patient experience.
The Evidence-Based Practice In Nursing Practice
The Evidence-Based Practice (EBP)is the systematic decision-making process to improve the work environment and clinical practices to get better quality patient outcomes. The EBP is the process where data collection, organizing, processing and implementing of the research findings are the critical points for the right results. One of the essential aspects of interest of using EBP research for nursing practice is that it gives the highest conceivable quality care and cost-effective treatment possible. It helps to fill the gaps and weaknesses in patient care so that patients will get better outcomes. It also blends the evidence and clinical experience to provide better patients experiences. It is essential as it helps to increase patient safety and improve quality of life. It also helps to reduce various medical complications and keeps the healthcare costs low.
The Search Process And Study Selection
Most studies (n=25; 64%) were conducted in the US; 14 studies were randomized controlled trials (RCT; 36%), 10 studies were quasi-experimental studies with control but no random allocation (29%) and 15 studies were pre-post designs with no control (38%). Intervention length ranged from 1 to 12 weeks. Table S2 provides information on each study design, sample, intervention, outcomes,
- Evidence-based medicine
- Systematic review