Integration of Evidence-Based Practice into Professional Nursing Practice
In this paper we will discuss the integration of evidence based practice into professional nursing practice. Scott & McSherry (2008) define evidence based practice as the combination of individual, clinical, or professional expertise with the best available external evidence to produce practice that is most likely to lead to positive outcomes for a patient. Despite literature surrounding what evidence based nursing is and isn’t, nurses struggle to get evidence into practice. Many reasons have been reported including a lack of understanding about evidence based nursing means. Scott & McSherry (2008) also define evidence based nursing is a process by which nurses make clinical decisions using the best available research evidence, their clinical expertise and patient outcomes. We will also discuss nursing’s simultaneous reliance on and critique of EBP in the context of critical reasoning. There will also be discussion of a study done that examined the effects of integrating evidence based practice into clinical practicum among RN-BSN students and the limitations of evidence based practice and an alternate view of decision making. Lastly we will discuss evidence that challenges the traditional practice regarding injection sites (Cocoman & Murray 2010).
According to Guem et al. (2010) evidenced based practice is a problem solving approach to clinical care that incorporates the conscious us of the current best available evidence, a clinician’s expertise, and the patient values. Evidence for evidence based practice does not always rely on research findings. Sources used can include research findings, clinical experience, quality improvement data, logical reasoning, recognized authority, and client satisfaction, situation, experience, and value (Leddy & Pepper 2008 p. 266). On the contrary evidence based nursing is essential because of its potential to save time and money and improve patient outcomes by decreasing costs, through standardizing and streamlining costs (Scott & McSherry 2008). It is important o understand the difference between evidence based practice and evidence based nursing because at times they are used interchangeably. Scott & McSherry (2008) state that the nursing practice has welcomed EBP but when it comes to EBN, it is still yet to come reality because the concept is much unsophisticated and can lead to problems associated with its use and misuse. EBN is merely a construct and has yet to be successfully implemented (Scott & McSherry 2008). In essence the dilemma with EBN is that we don’t really know the definition of nursing. Although there are problems with the definition we know that clinical judgment is one of the major concepts used in nursing thus it reinforces the notion of EBP and ultimately EBP.
To advance the profession and ensure solid standards of practice, we should look beyond evidence based practice, while useful in implementation it is just one of many other component parts (Jutel 2008). Evidence based practice is like the new black in nursing practice and already occupies a prominent position, several international nursing organizations support its use as a strategic action in the advancement of the profession. Despite the emphasis on EBP, there is also a strong opposition to it, not with the actual use of EBP being a problem but with the fundamentals on which it stands. These arguments complain of the veracity of the criteria used in EBP which simultaneously undermines and cannot support EBP (Jutel 2008). If it had not been for the cultural turn which recognized that things are not always as they seem or that power, society, and culture contribute as much as science to generating knowledge, the debate about EBP would have never surfaced (Jutel 2008). Although nurses argue against EBP, they lack important tools necessary to replace EBP. “Nursing education places high value on authority...
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