In this essay, I am going to consider how evidence-based practice can be used to support, justify, legitimate and/or improve clinical practice. I am also going to explore and discuss primary and secondary research evidences about how nursing interventions can potentially improve the quality of life of patients in the community suffering from heart failure. I will gather these evidences using a literature search which I will include an account of. Using a critiquing framework for support, I will appraise both primary and secondary evidences that I have chosen. I will also look at potential non-evidential factors that can influence evidence utilisation in practice. Finally, a conclusion will be drawn.
Evidence-based Practice (EBP) is about utilising the finest scientific evidence available, incorporating it with clinical experience, patient value and preferences to change or improve targeted healthcare practice (Houser & Oman, 2011). Consequently, it provides professionals a way to address queries to provide best quality care (Fawcett et al, 2001). EBP is also one of the professionals’ responsibilities under the Nursing and Midwifery Council (NMC) code of conduct in which they stated that professionals must deliver care based on current and best evidence attainable (NMC, 2008). However, problems may arise with this method that can affect certain nursing interventions. For example, referencing the aspect of care that I have chosen, there might be new evidences for or against specific nursing actions to help heart failure patients. There may be new research to improve current practice in helping heart failure patients more effectively and efficiently. This shows that professionals should always be aware of new information within their area of care. There are a lot of evidences available to professionals but it may be quite difficult for them to determine which ones provide good quality information. Due to this, hierarchies of evidence have been developed. Hierarchy of evidence is about grading primary sources on which one provides better evidence based on their design (Evans, 2003). This reflects different types of research designs to distinguish ones that are susceptible to bias to ones that have sound results [National Health Service (NHS) Centre for Reviews and Dissemination, 1996]. Mulhall (2002) and Hanberg & Brown (2006) cite the gap between research and practice and how it can be implemented. In order for EBP to work, adjustments to attitudes, values and work behaviour have to be made (McCluskey & Cusick, 2002). These are factors that deter EBP as some staff may be reluctant in changing their practice. This may be because they lack trust to evidence (Spallek et al, 2010) or they cannot see the reason behind the changes being made. For example, a nurse that had been working in dealing with heart failure patients for a long time might not want to change her way of carrying things out. EBP obviously can help in assisting to try and provide best quality care but clearly there are still areas that need to be considered and further explored to exploit the benefits of it.
In order to ensure I get all possible articles, I have used a variety of resources such as the library to look for hard-copy of journals and books. As well as this, I used electronic databases to search for the primary and secondary sources that I require. Books and hard-copy journals provided me with possible articles to use. However, as I have chosen a specific subject and a few more criteria to search for articles in this essay, those articles were quickly disregarded. Afterwards, I decided to perform an electronic literature search. Firstly, I went to the subject area of Health and Social Care as this perfectly fits my criteria. Secondly, went onto Databases to see what available databases there are. I have chosen the British Nursing Index (BNI) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus to look for...
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