Evidence Based Practice

Topics: Randomized controlled trial, Evidence-based medicine, Clinical trial Pages: 10 (2317 words) Published: May 8, 2014
This assignment will be set around evidence based practice (EBP) and the nursing part of EBP will be discussed throughout this essay. There will be two parts to this discussion, part 1 will be a clinical question chosen personally, and being researched through the internet using a variety of databases. The end result will then be discussed on how the question performed, and whether it was either easy to research or changes had to be made gain greater or less results. Below is the clinical research question that was chosen personally. The clinical research question: “Do silver dressings work on healing ulcer wounds or is there other dressings that show greater results”? Researching this question, Ovid was used. 687 results appeared, this was too high of a result. So the research question was reworded “Are Silver dressings more effective than other dressings on open wounds”? Again using Ovid, on an advanced search, this yielded 0 results. The question was then rephrased to, “Is there supporting evidence that silver dressings work on the healing of ulcer wounds?” 350 results appeared which was just over half the results I obtained from the first research question. However, this was okay but still a little too much. After this a different database was tried, the CINAHL database, on this research the question had been broken down into words; silver dressings supporting evidence, healing open wounds, this yielded 0 results. Ovid was the best site to ask this research question as even though the results were too much, I still had a good amount of hits, as for the CINAHL database this did not show any results. Therefore, Ovid does show to be a good research database. When researching this question, it was not clear enough, the question needed to be a bit more thorough when written, the results reflected off this by achieving 687 results and 350 on Ovid. Ovid was used first as it is a well-known website, which is also a database used widely for nursing and medical journals. Regardless of how popular both databases are the research questioned failed as either too much or zero results appeared, and could not be met in the middle. On reflection receiving 687 hits and then 350 is far too much and no matter how much the question was rephrased and broken down no results were satisfying. This question had too much academic material and could not be lessened in any way for the chosen topic. I think that next time the MeSH database could be used to research the chosen question, this would increase more of a chance of a wider and more in depth result and maybe reworded using medical terms. Part 2 – The Critical Analysis of a Randomised Control Setting using the Casp Tool It has been 10 years since evidence based practice (EBP) appeared. It was the early 1990’s when EBP was first introduced and since then it has made a significant impact on health services (Reynolds, 2000). Evidence based nursing is about making right choices towards a patient and towards client care. This may involve different decisions being made for treatment choices, provisions of services and competence. The one meaning of evidence based practice is that it uses the “best of evidence in making decisions about patient care” (Sackett et al, 2000). When the decision is being made about a patient and their care, the best available evidence should be used in their practice. The nurse should reflect on the requirements, values, circumstances and preferences together with their own professional experience, skills and when making choices for the patient (Moule et al, 2009).

The paper that has been chosen is a randomised control trial (RCT). Nelson, (2011) describes a RCT as being used to answer questions on two or more interventions and the difference it would have made on a trial (Nelson, 2011). Nurses who are applying clinical decisions, evidence based research must be used. It is also important that all clinicians have the admittance to clinical trials and...

References: CASP (2010) Critical Appraisal Skills Programme: making sense of evidence about clinical effectiveness: 11 questions to help you make sense of a trial: http://www.casp-uk.net/wp-content/uploads/2011/11/CASP_RCT_Appraisal_Checklist_14oct10.pdf
How to Cite. Evans, D. (2003), Hierarchy of evidence: a framework for ranking evidence evaluating healthcare interventions. Journal of Clinical Nursing, 12: 77–84
Hierarchy of evidence: a framework for ranking evidence
Nelson, A. (2011), what is a Randomised Controlled Trial? Evidence Based Nursing 2011; 14:4 97-98
Nixon, J., Cranny, G., Iglesias, C., Nelson, E.A., Hawkins, K., Philips, A., Torgerson, D., Mason, S. and Cullum, N. (2006), Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial. British Medical Journal; 332:1413
Sackett, D. Rosenberg, W. Muir Gray, J. Haynes, R. Richardson, W. (1996) Evidence Based Medicine: what it is and what it isn’t. British Medical Journal; 312:7023, 71-72
Sibbald, B. Roland, M. (1998) Understanding Controlled Trials: Why are randomised controlled trials important, British Medical Journal 1998:316:201
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