Evidence Based Practice
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.
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.
References: Brodie, D., Inoue, A. (2005). Motivational interviewing to promote physical activity for people with chronic heart failure. Journal of Advanced Nursing. 50 (5), 518-527. Brodie, D., Inoue, A., Shaw, D. (2008). Motivational interviewing to change quality of life for people with chronic heart failure: A randomised controlled trial. International Journal of Nursing Studies. 45 (1), 489-500. Campbell, S., Hancock, H.C. & Lloyd, H. (2006). Implementing Evidence-Based Practice. In The Research Process in Nursing. Gerrish, K. & Lacey, A. Oxford, UK.: Blackwell Publishing. Cartwright, A. (1986). Health Surveys in Practice and Potential. 2nd ed. London: King Edward’s Hospital Fund for London. CASP (Critical Appraisal Skills Programme). (2011). Appraising the Evidence. Available: http://www.casp-uk.net/index.aspx?o=1203. Last accessed 16 Nov 2011. Davies, E.J., Moxham, T., Rees, K., Singh, S., Coats, A.J.S., Ebrahim, S., Lough, F., Taylor, R.S. (2010). Exercise based rehabilitation for heart failure (Review). The Cochrane Collaboration. Issue 4. Davis, A.J. (1980) Research as an inactional situation: objectivity in the interview. International Journal Nursing Studies. (17) 215-220. DoH (Department of Health). (2006). Best Research for Best Health: A new national health research strategy. Available: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4127153.pdf. Last accessed 18 Nov 2011. Evans, D. (2003). Hierarchy of evidence: a framework for ranking evidence evaluating healthcare interventions. Journal of Clinical Nursing. 12 (1), 77-84. Fawcett, J., Watson, J., Neuman, B., Walker, P.H., & Fitzpatrick, J.J. (2001). On nursing theories and evidence. Journal of Nursing Scholarship, 33(2), 115-119. Glasziou P., Irwig, L., Colditz, C.B.G. (2001). Systematic Reviews in Health Care: a practical guide. Cambridge: Cambridge University Press. Goodacre, S. (2009). Critical appraisal for emergency medicine: 6 systematic reviews. Emergency Medicine Journal. 26: 114–116 Guyatt G.H., Haynes R.B., Jaeschke R.Z., Cook D.J., Green L., Naylor C.D., Wilson M.C Hanberg A. & Brown S.C. (2006). Bridging the theory— practice gap with evidence-based practice. Journal of Continuing Education in Nursing, 37(6), 248–249. Hewitt-Taylor, J. (2006). Clinical Guidelines and Care Protocols. Chichester: Wiley. Higgins, J.P.T., Green S. (2009). Cochrane Handbook for Systematic Review of Interventions. Chichester, UK: Wiley. Houser, J., Oman, K. (2011). Evidence Based Practice: An Implementation Guide for Healthcare Organizations. MA: Jones & Bartlett Publishers. McCluskey, A., Cusick, A. (2002). Strategies for introducing evidence-based practice and changing clinician behaviour: A manager’s toolbox. Australian Occupational Therapy Journal. 49 (1), 63-70. Morrow, B.M. (2008). Randomised controlled trials: fundamental concepts. International Journal of Therapy and Rehabilitation. 15 (7). 290-297. Mulhall A Nazarko, L. (2008). Cardiovascular problems: heart failure. Nursing and Residential Care. 10(5). 233-236. NHS Centre for Reviews and Dissemination. (1996). Undertaking Systematic Reviews of Research on Effectiveness. CRD Guidelines for Those Carrying Out or Commissioning Reviews. University of York, York. NICE. (2005). NICE: Guideline Development Methods. Available: http://www.nice.org.uk/niceMedia/pdf/GDM_Chapter7_0305.pdf. Last accessed 17 Nov 2011. NMC. (2008). The code in full. Available: http://www.nmc-uk.org/Nurses-and-midwives/The-code/The-code-in-full/. Last accessed 10 Nov 2011. O ' Mathuna, D Parahoo K. (2006) Nursing Research: Principles, Process and Issues. 2nd ed. Hampshire: Palgrave Macmillan. Payne, M. (2000). Teamwork in multiprofessional care. Basingstoke: Palgrave. Polit D., Beck C. (2006). Essentials of Nursing Research: Methods, appraisal and utilisation. 6th ed. Philadelphia: Lippincott, Williams & Williams. Polit D., Beck C. (2008). Nursing Research: Generating and Assessing Evidence for Nursing Practice. 9th ed. Philadelphia: Lippincott Williams &Wilkins. Rollnick, S., 1996. Behaviour change in practice: targeting individuals. International Journal of Obesity. 20(1), 22–26. Rycroft-Malone, J., Bucknall, T (2011). Models and Frameworks for Implementing Evidence-Based Practice: Linking Evidence to Action. Oxford: Blackwell Publishing. Sellman, D. (2003). Open-mindedness: a virtue for professional practice. Nursing Philosophy. 4(1). 17-24 SIGN (Scottish Intercollegiate Guidelines Network) Spallek, H., Song, M., Polk, DE, et al. (2010) Barriers to implementing evidence-based clinical guidelines: A survey of early adopters. Journal of Evidence Based Dental Practice 10:195-206. Stillwell, S.B., Fineout-Overholt, E., Melnyk, B.M., Williamson, K.M. Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. The American Journal of Nursing. 2010; 110: 58–61. Thompson, C., Dowding D. (2002). Clinical Decision Making and Judgement in Nursing. Edinburg: Churchill Livingstone. P. 109-129. Tordoff, C. (1998). From research to practice: Nursing Standard. 12(25). 34-37.