APA REFRENCES NOT OLDER THEN 5 YEARS OLD. ONLY AND ONLY JOURNALS AND ARTICLES, NO WEBSITES ACCEPTED.
NMBA STANDARDS MUST BE FOLLOWED, FILE WILL WE ATTCHED IN THE ORDER. PLEASE READ THROUGH AND KINDLY FOLLOW IT.
Evidence based practice (EBP) is the clinical decision making process which is based upon the best available evidence, new research findings, clinical experience and patient preferences. Nurses are expected to implement research findings into their practice, but many are not trained on how to do this. Therefore, it should not be expected that nurses are at the forefront of EBP implementation in the clinical setting.
How does evidence based practice improve patient outcomes? ?How is evidence based practice applied theoretically and clinically? ?Is it feasible to expect RNs to implement EBP in the clinical setting without training / support?
Evidenced Based Nursing Practice
Over the years, evidence based practice has become commonplace in as far as nursing profession is concerned. In Australia, Nursing and Midwifery board of Australia provides standards which advocate for utilisation of evidence based practice by nurses in provision of care (NMBA, 2013). Researchers believe that utilisation of evidenced based nursing goes a long way in improving patient’s outcomes. Moreover, nurses have come to a realisation that collaboration of research findings in clinical practice has led to major improvement in the field of nursing. Nurses have been able to identify the significance of evidence based practice in growth of the nursing profession as well as increased credibility of nursing practice (Pooler, 2014).
Implementation of the best evidence requires that nurses should have relevant skills and resources to enable them carry out proper appraisal and evidence synthesis. It is important to note that implementation of evidence based research has proven to be a challenge since most often than not, the evidence based practice are either partially successful or not successful at all (Polit & Beck, 2013). However, it has become a challenge for the healthcare sector to implement new findings in day to day practice due to limited funds. Therefore, it calls for the healthcare sectors to have funds which will help in endorsement of these research findings.
Impact of Evidence based practice on patient outcomes
Nurses who play part in research, utilise the NMBA standard 7 which calls for utilisation of research findings in evidence based practice (NMBA 2013). Evidence based practice has contributed to achieving significant changes in healthcare profession. Through utilisation of this practice which calls for respect of patient’s culture, patients tend to recover quickly when their culture and beliefs are recognised. Research has it that, recognition of a patient’s cultural beliefs in provision of care has a great impact on the treatment outcome (Godshall, 2016). In addition, research indicates that proper documentation of the assessments, diagnosis and interventions on patient help in continuity of care provided to patients (Melnyk & Fineout-Overholt , 2011). Nurses ensures proper documentation of any activity carried out on a patient and this ensures positive outcomes from the patient through continued care.
Through this practice, relevant strategies including effective health programs, quality services and efficient interventions have been put in place (Burns & Grove, 2011). All these result into positive patient outcome and cuts on cost. Nursing practice based on research evidence goes a long way in optimizing patient outcome and providing safe and cost effective healthcare (Burns & Grove, 2011).
EBP has led to improved information in the health sector. This is so because, in its utilization, health organisations are forced to source out new information and synthesise it properly. Health providers are there able to keep abreast with current trends by utilizing new research information and embracing new changes with efficiency (Burns & Grove, 2011). Health organisations therefore continue to evolve without stagnation. Moreover there has been increased funding in the health sector. Governmental agencies have been funding to heath organisations based on how these organisations have implemented evidence based practice (Stevens, 2013). When the health sector is funded, more resources including the human resources, pharmaceuticals and non-pharmaceuticals are made available for the utilization by the patient, hence better outcomes.
Evidence based approach has also promoted technological development in the health sector. Through technological advancements, patients are in a position to acquire better services (Godshall, 2016). For instance, through technological advancements, there has been invention of a 3D CT scan machine which helps in better diagnosis of some conditions. Furthermore, new radio therapy machines have been brought in to enhance management of cancer, therefore producing better patient outcomes. Organisations have made significant upgrades as well as substantial improvements (Godshall, 2016). Health providers should seek to apply the modern technologies in the broadest way possible in order to improve the quality of their services. Re-evaluation which is basically essential for EBP makes organisations retain relevance in a time when changes are encountered every other day.
Theoretical and clinical application of Evidence based practice
Evidence based practice is based on the premise that healthcare professionals should not base their practices on traditions, belief or myths but on information based on research. The practice involves three entities, identification of a clinical problem, literature, evaluation of research evidence and determination of appropriate interventions (Sandström, Borglin, Nilsson & Willman, 2011). Thus, EBP integrates research findings, theory and practice. Through creation of awareness on EBP, it has renewed appreciation of linkages among research, theory and practice. Research findings and clinical data provide evidence for EBP hence generation of practice guidelines and situation specific theories (Sandström et al., 2011). Many evidenced based practice models have been put in place with the major goal being establishment of EBP protocols, procedures or guidelines with other models focusing on implementation in the healthcare setting or institution.
According to Melnyk & Fineout-Overholt 2011, Implementation of evidence based practice has contributed too many benefits in the clinical setting. The practice has provided interventions for diagnosis and management of diseases through implementation of scientific evidence. For instance, there has been an improvement in the management of conditions such as, tuberculosis, HIV/Aids as well as cancer. Drug regimen for treatment of tuberculosis has been changing from time to time based on clinical trials conducted (Burns & Grove, 2011). In addition, new methods of cancer treatment are innovated leading to better outcomes in management of cancer patients, therefore, the lager part of the world tend to adjust to management of cancer as well as change of medications for HIV and patients with tuberculosis.
It is also important to note that, through implementation of evidenced based nursing, nurses have in a position to use the most current research evidence to provide rationales for the quality of nursing interventions (Godshall, 2016). In addition, nurses are able to pass this to the students in the clinical area when guiding them. As a result, these students are able to develop knowledge and skills required to enhance quality of care provided for improved patient outcome through provision of rationales or reason why a care is provided in a certain way. This is in accordance with the NMBA standard 7.1 which calls for the evaluation, monitoring of patient care to help in achievement of expected goals and outcomes.
How Registered Nurses implement Evidence Based practice
In the nursing profession, nurses have a responsibility in making sure as well as providing evidenced based practice (Pooler, 2014). Furthermore, nurses should question practices currently being implemented and utilize care which is evidenced so as to make the care more effective. In order to provide quality care, nurses should base their care on research and knowledge rather than care that is out-dated or care based on traditions or myths ( Mackey & Bassendowski, 2016). Research has shown that through implementation of evidenced based nursing practice, there has been an improvement in the quality of care provided leading to improved life of the recipients of this care. In modern nursing, there are some models which have proven to be effective in nursing practice. For instance, there is the utilization of nursing care plans ensures provision of quality care through evaluation and documentation. In addition, nurses are educating students on research based practice as form of preparing the in the nursing profession in future. This is in accordance with NMBA 2013 standard 3.3 which calls for use of long life learning process for continuing professional development of self and others.
Many a time, nurses are faced with ethical issues during their practice. Utilisation of NMBA 1.5 which requires nurses to utilise the ethical framework in making decisions will go a long way in solving various ethical issues encountered during practice. For instance, there may be a conflict between two ethical principles when dealing with a patient who has given a do not resuscitate order. Through utilisation of the ethical framework which entails ethical decision making, theories and principles, the nurse is in a position to make a decision which is not based on emotions or intuitions (Polit & Beck, 2013). This therefore shows how evidence based practice is crucial in nursing practice. Furthermore, nurses contribute to evidence based practice through participation in carrying out research. During nursing practice, nurses encounter gaps existing between the reality and already existing theories. Thus, they are prompted to do research so as to bridge the gap that exists as well as provide solutions to existing health problems.
In conclusion, it is clear that nurses are significant in implementation of evidence based practice. It therefore calls for training of these nurses to add on their knowledge and skills. Furthermore, there should be adequate provision of resources in the health care setting to help successful implementation of these research findings in research. In addition, implementation of evidence based practice requires relevant changes to be made in the healthcare systems rather than changing the healthcare workers working in these settings. The world is evolving day in day out and therefore, the healthcare sector should as well embrace change through Implementation of evidenced based practice which will be significant in provision of high quality care. Therefore, all health care workers should embrace the evidence based practice to ensure an improvement in the health care sector more so, in improving patient outcomes.
Boltz, M., Capezuti, L., Fulmer, T. T., & Zwicker, D. (2016). Evidence-Based Geriatric Nursing Protocols for Best Practice, Fifth Edition. New York, NY: Springer Publishing Company.
Burns, N., & Grove, S. K. (2011). The practice of nursing research. Conduct, critique & utilization, 4.
DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-based nursing: A guide to clinical practice. Elsevier Health Sciences.
Godshall, M. (2016). Fast Facts for Evidence-Based Practice in Nursing, Second Edition: Implementing EBP in a Nutshell. New York: Springer Publishing Company.
Grove, S. K., Burns, N., & Gray, J. R. (2014). Understanding nursing research: Building an evidence-based practice. Elsevier Health Sciences.
Hoffmann, T., Bennett, S., & Del Mar, C. (2013). Evidence-based practice across the health professions. Elsevier Health Sciences.
Levin, R. F., & Feldman, H. R. (2012). Teaching evidence-based practice in nursing. Springer Publishing Company.
Lipscomb, M. (2016). Exploring Evidence-based Practice : Debates and Challenges in Nursing. London: Routledge.
Mackey, A., & Bassendowski, S. (2016). Original article: The History of Evidence-Based Practice in Nursing Education and Practice.Journal Of Professional Nursing,.
Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410-417. .
Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The establishment of evidence‐based practice competencies for practicing registered nurses and advanced practice nurses in real‐world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15.
Polit, D. F., & Beck, C. T. (2013). Essentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams & Wilkins.
Pooler, A. (2014). An Introduction to Evidence Based Practice in Nursing & Healthcare. London: Routledge.
Pravikoff, D. S., Tanner, A. B., & Pierce, S. T. (2015). Readiness of US Nurses for Evidence-Based Practice: Many don’t understand or value research and have had little or no training to help them find evidence on which to base their practice. AJN The American Journal of Nursing, 105(9), 40-51.
Sandström, B., Borglin, G., Nilsson, R., & Willman, A. (2011). Promoting the implementation of evidence‐based practice: A literature review focusing on the role of nursing leadership. Worldviews on Evidence‐Based Nursing, 8(4), 212-223.
Schneider, Z., & Whitehead, D. (2013). Nursing and midwifery research: methods and appraisal for evidence-based practice. Elsevier Australia.
Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing, 18(2).