Evidence Based Practice

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" The institute of Medicine has set a goal that by 2020, 90% of all health care decisions will be evidence based" (Mazurek et al., 2009). On entering the words "Evidence Based Practice" into the Cumulative Index for Nursing and Allied Health Literature( CINAHL) database in December 2012, the amount of articles to be found by the author of this assignment was 5694. It could be said that this shows the importance of evidence based practice in today's world of nursing. In 2012, the words accreditation, in private health care settings, Health Information and Quality Authority ( H.I.Q.A) standards, in the public sector and indeed Clinical Governance are spoken every day! Cranston (2002) stated that for the organisation, clinical governance lies at the heart of quality assurance and that clinical governance is linked to clinical effectiveness which is the goal of evidence based practice. Inevitably as a result of this all health care professionals are required to use evidence based practice in their every day working lives. Thus promoting accountability and quality patient care. However we must ask ourselves is there a down side to all this evidence based practice? What is wrong with the way we always did things? As already stated above it is a necessity for all health care professionals to use evidence based practice, however for the purpose of this assignment the author will concentrate on the nursing profession, looking at how the use of evidence based practice is important for the patient, the nurse and finally the organisation. On the other hand the author will also look at the barriers of evidence based practice for nurses. The methodology used is that of a literature review on evidence based practice in nursing. In addition a S.W.O.T. analysis was undertaken by the author looking at the strengths, weaknesses, opportunities and also the threats to evidence based practice. At the outset it is important to firstly look at what evidence based practice is. It has been defined as " the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients" (Sackett D.L, 1996) In addition it is further described as the "integration of best research evidence with clinical expertise and patient values" (Sackett, 2000). On speaking about Professor Archie Cochrane, Barker ( 2010) stated that "he argued there was a need to ensure treatment was delivered in the most effective way and to ensure that available evidence was used" (p. 5). The dictionary definition of evidence is a “grounds for belief or disbelief; data on which to base proof or establish truth or falsehood” (Collins 1998) So where you may ask do we obtain this evidence? Well " the range of different sources of evidence that can inform practice includes personal reflection, journal articles, policies, guidelines, reports and professional consensus, as well as research and audit. However, the literature generally implies research is the strongest form of evidence" (Dale, 2005). So why is it important to use evidence based practice to the nursing profession? For this section the author has divided it into three; the patient, the nurse and finally the organisation. Improvement in the quality of care received by the patient.

The Department of Health and Children (2001) stated that improving quality in the Irish Healthcare system requires the implementation of internationally recognised evidence based guidelines and protocols. Furthermore Craig and Smyth (2007) stated that " the main aim of evidence based practice is to obtain the best outcomes for patients by selecting interventions that have the greatest chance of success" cited by Leufer and Cleary-Holdforth (2009). Every working day a nurse carries out daily duties; a bed bath, medication administration, mobilising patients post joint replacement, and many more, the list is endless; but how does the nurse know that what he or she is doing is the best way...
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