Evidence Based Practice

Topics: Nursing, Evidence-based medicine, Systematic review Pages: 6 (2227 words) Published: August 13, 2013
Historically nurses’ decision making has relied on tradition, authority, trial and error and research (Lee 2003, p. 618). However, more recently the appreciation and application of evidence based practice (EBP) has caused a shift in clinical nursing decision making (Lee 2003, p. 618). EBP is defined as ‘integrating individual clinical expertise with the best available external clinical evidence from systematic research’ (Sackett et al. 1996, cited in Rolfe, Segrott & Jordan 2008, p. 448). EBP must take into account patient values and be tailored to individual patient needs (Foo et al. 2011, p. 522) and requires a commitment to lifelong learning (Johnson 2008, p. 169). This paper will explore the importance of EBP in clinical practice, outline the barriers faced by nurses’ in utilising research in their practice, describe the strategies in clinical settings to enhance the use of research in practice and the personal strategies I will employ to ensure that my future practice as a nurse will be based upon evidence and research. The overarching aim of EBP is to arm nurses’ and patients with care options based on the best available evidence (Glasziou & Haynes 2005, p. 36), by using a systematic approach to clinical problem solving (Akobeng 2005, p. 837). There are numerous reasons as to why EBP is essential in clinical practice. First and foremost, EBP leads to quality health care and better patient outcomes (Parker 2005, p. 4). This is reinforced by the revision and inclusion of EBP standards in the Australian national competency standards for registered nurses’ (Waters et al. 2009, p. 510). Standard 3.1 states that the nurse will ‘practice within an evidence-based framework; identifies the relevance of research in individual/group health outcomes’ (ANMC 2006, p. 6). EBP is an expected competency for graduating nurses (Miller, Ward & Young 2010, p. 76). Nursing care has previously heavily relied on ritualistic practices. McCutcheon and Zeitz (2005, p. 303) describe ritualistic action as undertaking activities that are without thought or understanding as to their purpose. The individuality and complexity of different patients’ therefore negates this approach and requires nurses’ to utilise EBP (McCutcheon & Zeitz 2005, p. 303). Additionally, use of EBP is also important for the nurse as it is essential in ongoing professional development (McDonnell 1998, p. 259). From an organisational perspective, EBP plays an important role in providing a quality health care system and promotes continuous improvement (Holland 2008, p. 33). McDonnell (1998, p. 259) identifies other organisational benefits of EBP, including cost-effectiveness and increased health gains. Another important factor of implementing EBP is consumer expectation that EBP is utilised in the clinical setting (Glasziou & Haynes 2005, p. 36). Numerous studies report that most nurses’ have a positive attitude toward EBP (Foo et al. 2011, p. 523), however they reported that nurses’ did not have the skills or support to utilise EBP in daily practice (Foo et al. 2011, p. 523; Lee 2003, p. 619). There are various reasons as to why health professionals do not utilise research in their practice. Lee (2003, p. 618) acknowledges that research utilisation and EBP are not the same. However, many of the barriers to research utilisation are similar to EBP, therefore these will be explored. Chau, Lopez and Thompson (2008, p. 641) categorise barriers to utilising research in practice into four groups. These include health-care professional-related, organisational-related, research-related and presentation-related barriers. A systematic review conducted by Estabrooks et al. (cited in Chau, Lopez & Thompson 2008) identified health-care professional-related barriers as personal beliefs, involvement in research, drive to learn, professional characteristics and demographic characteristics. Lack of knowledge and skills related to research appraisal, particularly of...
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