Submitted to Sharon Mooney, RN, MSN in partial fulfillment of NR 460R Evidence-Based Practice in Nursing
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” (p. 275). It is clear throughout the spectrum of definitions that research is important for making the best possible clinical decisions for patient care. The Importance of Evidence-Based Research
Evidence-based research and EBP are important to nursing for many reasons. The most important reason for evidence-based research is that it provides a scientific basis for nursing care, which is one criteria of a profession. Knowledgeable nurses who use research in practice provide better care and have improved patient outcomes. Research can also help nurses and facilities to provide holistic, efficient, cost-effective care, and better patient teaching. Many nursing studies prompt further research, increasing awareness of a particular subject, and stimulating change (Chitty & Black, 2007). Research Examples Which Affect Medical-Surgical Nursing
Qualitative Research Study
The article, The cultural-ecological orientation of graduate nurses (novice) in medical-surgical nursing, by Mary Oliver, RN, PhD, examines the journey of 10 novice nurses from the start of their careers as they progress into clinical experience regarding psychosocial issues involving patients and how problems were managed. This was an ethnographic interpretive paradigmatic study, using purposeful sampling, which employed the use of observation of the nurses throughout each shift and in-depth interviews following observation. Nurses were observed on the floors on which they worked for more accurate observation. Two themes were drawn from this study: experience is a process and that nurses go through a cultural-ecological orientation. Gaining experience is described as a process in that nurses’ experiences are influenced by the floor on which they work, as well as their personal experience in working with patients. Cultural-ecological orientation is recognition of the importance of how a patient relates to his/her environment and the effects this has on healing. The focus is on therapeutic environment and includes the awareness of the patient’s relationships with his or her family and friends, cultural and spiritual concerns, socioeconomic status and personal beliefs. In conclusion, Oliver found that the novice nurses in this study had concerns about their lack of procedural skill, but were empowered by their increasing cultural-ecological awareness regarding patients (Oliver, 2008). This study is important to medical-surgical nurses in that experienced nurses can nurture...