...Evidence Based Practice Nursing Implications Evidence Based Practice Nursing Implications Evidence based practice has been changing the direction of care and clinical research with regards safety, patient centered, and cost efficient care delivered to patients. The purpose of this paper will show the importance of Evidence Based Research by defining this form of research and the importance of using the research to improve on nursing practice. It will also show research examples of qualitative and quantitative studies and how it would improve patient outcomes and nursing practice within the Neonatal Intensive Care Unit. Barriers will be discussed that prevent nursing from using and embracing the current research. Finally, the conclusions will summarize the main points of this paper. Importance of Evidence Based Research The importance of evidence based research is, and should, be the driving force on nursing practice to patients. It should go hand in hand with the critical thinking skills that nurses already have and use with regards to care. Evidence Based Research is important because it is an accumulation of information that forms clinical practice. Evidence based research incorporates the patient/family, cost, and safety of care to be delivered. It changes the care from; the way it was always done to the way research proves it should be done, which may still be the way it was always done. The difference is that the now the processes are backed by highly reviewed...
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...Implementation of Evidence-Based Practice Sheila Wright Submitted to Sharon Mooney, RN, MSN in partial fulfillment of NR 460R Evidence-Based Practice in Nursing Regis University April 9, 2010 Implementation of Evidence-Based Practice Throughout history, nursing practice has experienced change. Florence Nightingale initiated the greatest change in nursing in the mid-1800’s when she gathered data regarding the morbidity and mortality of soldiers (Chitty & Black, 2007). Nightingale recognized there was a need for change to improve patient outcomes. Her determination to provide the best possible care, based on the evidence she gathered, has inspired a profession. Today, the process of using research to care for patients is referred to as evidence-based practice. The purpose of this paper is to define and explain the importance of evidence-based practice, discuss qualitative and quantitative research studies which affect medical-surgical areas, and barriers preventing research utilization and how they may be overcome. Definition of Evidence-Based Practice There are numerous definitions of evidence-based practice (EBP). EBP is defined by Boswell and Cannon (2007) as, “A research-based, decision-making process used to guide the delivery of holistic patient care by nurses” (p. 340). Cope (as cited in Chitty & Black, 2007), defines EBP as “using the best available research findings to make clinical decisions that are most effective and beneficial for patients”...
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...Teachers and school leaders: making a difference through evidence-based practice A research paper for ACT Government schools ISBN 978-0-9757487-4-9 © Australian Capital Territory, Canberra 2007 Apart from any use as permitted under the Copyright ACT 1968, no part may be reproduced by any process without written permission from the ACT Department of Education and Training, ACT Government, PO Box 1584, Tuggeranong ACT 2901. Produced for the ACT Department of Education and Training by the Measurement, Monitoring and Reporting Directorate. Telephone: Canberra 6205 9214 Fax: Canberra 6205 8353 ACT Government Homepage address 2 Introduction The purpose of this paper is to provide a research base for the ACT Department of Education and Training’s discussion paper for ACT government school teachers: Teachers and school leaders: making a difference through evidence-based practice. Evidence-based practice is defined as the collection and analysis of relevant data and research and the application of this evidence to teaching and learning and to whole school improvement. The conceptual framework of the School Excellence Initiative underpins the paper. This places student achievement and learning at the centre of any discussion. In the research literature, there are many, often contradictory definitions of data, information and knowledge. This paper will use ‘data’ as a collective (singular) noun and define terms as follows: • data: a collection...
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...EVIDENCE BASED PRACTICE BENCY GNANASIGHAMANI AMERICAN SENTINEL UNIVERSITY Introduction Medical and health care is one of the most dynamic human disciplines, and large amounts of money are spent annually on high-quality and sophisticated research, resulting in an exponential growth in health care literature. Regularly, new and more effective medicines, medical devices, and procedures are invented. One major objective behind all these efforts is to help doctors, nurses, and medical technicians provide the best possible care and treatment to patients. In addition to using traditional and well-established procedures and practices, health care practitioners are adopting innovative interventions that are based on best practices as well as solid research-based evidence. Evidence-based practice is one such technique and is quickly gaining popularity due to its potential to effectively handle clinical issues and provide better patient care (ANA 2003). Implementation of Evidence Based Practice places additional demands on nurses to apply credible evidence to individual client situations through searching related evidence, using clinical judgments, and considering client values and system resources. To effectively apply the Evidence Based Practice process, in addition to the basic skills required to undertake nursing work, a nurse must have the ability to: identify knowledge gaps, formulate relevant questions, conduct an efficient...
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...thoroughly examine the importance of evidence-based practice within the health care setting. The use of evidence-based practice as a practical framework to locate, appraise and apply the best research will further discussed throughout this essay. In addition this essay will explore how health care professionals can use the five steps of evidence based practice (EBP) as a practical framework to overcoming barriers to locating, appraising and applying the best research evidence in relation to Occupational Health and Safety (OHS). The use of hand washing in relation to infection control will be the OHS area explored. Evidence based practice is a framework that involves an expert finding experimental evidence concerning the value of or effectiveness of altered treatment options, the significance of this evidence is then established in relation to the patients situation (Liamputtong, 2010).Evidence Based Practice generates the need for clinically vital information regarding clinical and health care issues (Liamputtong, 2010). This clinically vital information is gathered by altering evidence into answerable questions, once this information is gathered the appraised information will be put into clinical practice and evaluated based on performance (Liamputtong, 2010). The importance of the five steps of Evidence Based Practice is consistent and conclusive. Before EBP, clinical knowledge was primarily relied on in areas where minimal research was undertaken (Youngblut & Brooten...
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...his time at university has been taught about evidence based practice (EBP). His first experience of implementing the five steps of EBP, asking an answerable question, acquiring the evidence, appraising the evidence, applying the evidence and assessing the process Liamputtong (2010), will be critically analysed in this essay. An encounter of qualitative and quantitative approaches to research, and how Sam can apply the evidence generated from a quantitative approach to evidence based clinical practice will be detailed below. Evidence based practice can be defined as clinical decisions for individual patients derived from the most appropriate evidence available (Facchiano & Snyder, 2012). It is a nurse’s care of duty to use appropriate clinical practice that will best suit the needs of the patient. Implementation of EBP based on an understanding of research findings is a requirement of competency standards for Australian and New Zealand nurses and midwifes (Borbasi & Jackson, 2012). Sam noticed conflicting practices while watching a routine wound clean; tap water was used instead of saline solution by one of his fellow nurses. This made Sam begin to think about what evidence there was to support using water, or if the nurse should have used saline instead. Sam decided to research this topic further, which comprised of him asking a targeted question that he could then translate into research. The clinical question was defined using PICO(T) which Borbasi & Jackson (2012) define...
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...Overcoming Barriers In Evidence-Based Practice University of Louisiana at Lafayette Overcoming Barriers in Evidence-Based Practice All healthcare organizations will experience some kind of change over time. When it comes to using evidence- based practice within a healthcare system, deciding on what to implement is the easy part. The hard part is implementing the practice and making it stick. There are many barriers for why implementing EBP is not easily attainable by nurses. Some of these barriers include, "lack of time, lack of value placed on research in practice, lack of knowledge about EBP, lack of technical skills to find evidence, lack of resource to access evidence, lack of ability to read research, resistance to change, and lack of organizational support for EBP” (Schmidt & Brown, 2015, p. 10-11). Personal Barriers A barrier that I can personally relate to is the resistance to change barrier. While orienting to a new job in labor and delivery, I was paired with a preceptor who was a far more experienced nurse than I was. She taught me the ins and outs of labor and delivery, as well as, explained to me why things are done the way they are done. Since she started as a labor and delivery nurse, there has been more research and more evidence-based practice strategies that have come out. My preceptor was resistant to these practices. She felt like there was no reason she should change the way she did certain things. Because she was resistant to change, I felt like I was also...
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...Core Competency in Evidence Based Practice Daniel O’Brien University of Louisiana Lafayette Evidence-Based Practice (EBP) Evidence based practice in the health care setting is the use of research, clinical presentation, clinical expertise, and the use of patient preference when delivering said healthcare (Institute of Medicine, 2003). This means using the latest research available, paired with what the nurse has learned on the job, in order to deliver care that the patient desires related to the current medical condition at present. The evidence-based practice should follow the PICOT model (Finkelman & Kenner, 2016). The PICOT model aims to locate research that can identify a population and interventions and then match the outcomes and time required to...
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...HPNA Position Statement Evidence-Based Practice Background Increased attention is being directed toward the development of methods that can provide valid and reliable information about what works best in healthcare. The careful scientific evaluation of clinical practice became a prominent focus during the second half of the 20th century.1 More recently, attention has been paid to methods of determining which of multiple proven approaches to a healthcare problem works best for which patients.2 Evidence-based practice encompasses implementing the best-known practices into the clinical setting using a scientific approach. It evolved from evidence-based medicine, which was developed in Canada to teach medical students. “Evidence-based medicine has been defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”3, p. 3 The National Quality Forum’s report A National Framework and Preferred Practices for Palliative and Hospice Care Quality is a consensus report that is a first step toward introducing evidence-based measures into palliative practice on a formal, national level.4 The Agency for Healthcare Research and Quality (AHRQ) supports organizations in their efforts to improve the quality and efficiency of healthcare by facilitating the use of evidence-based research findings in clinical practice.5 The nursing discipline has also embraced evidence-based practice over the past 25 years, initially through...
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...The Effect of Telemonitoring in CHF patients Evidence Based Practice Project Sacred Heart University The Effect of Telemonitoring in CHF Patients Evidence Based Practice Project Question (PICOT) Question: In elderly individuals over the age of 65, does the use of a mobile phone-based medication adherence application, compared to a mobile phone texting reminder, increase medication compliance by 25%, within 12 weeks of implementing the program? Evidence Appraisal Matrix Source (APA) | Type of Study design (RCT, phenomenology, etc.)/Purpose | Level of Evidence(According toMelnyk & Fineout-Overholt) | Sample, settingInclusion/ExclusionCriteria | Methods, instruments, data analysis | Findings/Implications | Inglis, S. C. (2011). Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Cochrane Database Of Systematic Reviews, (6), doi:10.1002/14651858.CD007228.pub2 | Systematic Review | Level I | Twenty-five studies and five published abstracts were included. 16 evaluated structured telephone support, 11 evaluated telemonitoring, and two tested both interventions. Inclusion criteria:only peer reviewed, published RCTs comparing structured telephone support or telemonitoring to usual care of CHF patients were included. | Various search engines such as: MEDLINE, EMBASE, CINAHL, and AMED were searched from 2006 to November 2008.Relevant studies and systematic reviews and abstract conference proceedings were hand searched. No...
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...A. Identify a current nursing practice within your healthcare setting that requires change. DEVELOPING OR CREATING AN INDEX TO MINIMIZE RISKS OFPRESSURE SORE 1. Describe the current nursing practice. An instrument specifically designed to aid health care workers evaluate the dangers of pressure sores that a patient faces is called the Braden Scale. After assessment, the victim is categorized depending on six aspects: capability of physical activity, hydration and nutrition status, capacity to alter position, the ability to respond after sensing discomfort related to pressure, shearing or exposure of the skin to friction during locomotion, and skin exposure to moisture. If the overall score is lower it means the risk of pressure sore is higher (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d). Prior to this Change, Skin assessment was based on non- formalized risk assessment which varies with each clinical practice. 2. Discuss why the current nursing practice needs to be changed Using non-formalized risk assessment in Predicting pressure ulcer resulted in non-uniformity and personal clinical judgement which varies from one person to another. Using Clinical judgement is more effective where the staffs are experienced and their experience assist in appropriate predictability, but with novice staff, the use of clinical judgment is inappropriate. In a multisite trial, Braden scale was tested by clinics bringing together skilled nursing facilities...
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...Implications of Evidence Based Practice-Research Patricia Davis Immaculata University The Importance and Implications of Evidence Based Practice-Research Evidence based practice is a way of providing health care that is guided by incorporating current knowledge and clinical expertise. This research and resource information corrects clinical problems, application of quality interventions, and evaluates the outcomes for further improvements in the future. Evidence based practice is an approach that improves the impact of nursing, psychology and social work. It gives research the cause and effect that gives validity to the information. The purpose of evidence based practice is ensuring that patients receive the best quality care and keep nurses, nursing care, and knowledge up to date. The American Nurses Association (ANA) recognizes the importance of evidence based practice (EBP), and that it incorporates the registered nurse to integrate, participate in the formulation, and contribute to the knowledge of research to improve healthcare outcomes (ANA, 2010). Evidence based research results in favorable patient outcomes across various geographic locations. The impetus for evidence-based practice comes from decisions of efficacy, and healthcare facility pressures for cost containment. Evidence practice stresses changes in the education of students, more practice-relevant research, and closer working relationships between clinicians and researchers. The evidence based practice...
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...The author’s intention is to identify an aspect of clinical practice which lends itself to change at a micro level. The definition of a micro-change is an intervention of change aimed at the individual or the way small teams work. The micro-level change is not to be confused with a service change (Walsh, 2009). 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 preferences and experiences. The area of clinical practice to be studied is within a community district nursing team consisting of 7 qualified nurses and 3 health care assistants. The location is situated within a seaside town with a large population of over 65 year olds. Through clinical experience, the author has found a flaw in quality of care when nursing staff are using the overview assessment document which has been adapted from the single assessment process produced by the Department of Health (DOH, 2002). When assessing nutrition there is a series of six questions and an asterisk to consider the “Malnutrition Universal Screening Tool” (MUST, 2003) however experience in practice would suggest the tool (MUST, 2003) isn't used and a local...
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...catheters (CVCs) are used on a routine basis to gain vascular access during procedures in dialysis, infusion of chemotherapy and Apheresis. While CVCs can be lifesaving they also have significant risks of surgical-site infection (SSIs). Providone-iodine (Betadine) has been the primary cleanser for central line placement for the last decade, but surgical- site infections (SSI) continue to increase raising the question if betadine is a sufficient agent for surgical insertion of a CVC or is there an alternative proven through evidence- based practice to be a more effective anti-microbial. A2a. Basis for Practice Procedures and protocols are researched by the safety committee who release their findings to the clinical practice committee for review and evaluation. In a culture that use to accept betadine as the primary anti-microbial agent to cleanse the skin prior to CVC insertion has been questioned and through evidence based practice is in favor of using chlorhexidine gluconate (CHG) as the primary agent by identifying and concluding that it is superior to betadine by reducing the risk of SSIs by approximately 50% (Chaiyakunapruk, Veenstra, Saint, and Lipsky (2009). If the clinical practice committee approves the use of CHG for CVC insertion it is communicated to the department of nursing followed by the nurse managers, educators and staff nurses. A2b. Rationale CHG and betadine are anti-microbial agents that reduce the incidence of primary SSIs. Cleansing the surgical...
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...ty As we have learned, evidence-based practice is the gold standard for guiding nursing policies that result in quality care and best patient outcomes. Unfortunately, despite significant evidence supporting the need for practice change, many barriers exist that prevent integrating evidence into practice. According to Schmidt and Brown (2012), using research, nurses have a direct role in contributing to evidence-based practice changes. When a discrepancy is identified between a care standard and nursing practice, resulting in negative patient outcomes, nurses have a responsibility to take actions to change the practice. When investigating a discrepancy, nurses utilize existing evidence and research to shape new policies supported by scientific evidence. Schmidt and Brown explain that Roger’s model of diffusion mirrors the process in which evidence-based practice originates in small institutions and eventually diffuses into standards of care. According to these authors, evidence-based practice is cultivated and supported at five levels: by the individual nurse, the healthcare institution, and at the regional, national, and international levels. By involving participation at all five levels, evidence-based practice changes can be implemented and supported. The change process involved in creating policies supported by evidence is often time consuming and complex. After compiling evidence supporting the practice change, incorporating this evidence into practice and implementing...
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