On a daily basis health care professionals are confronted with difficult questions and situations while caring for patients. They want to know how to interpret diagnostic test accurately, how to predict the prognosis of a patient, and how to compare the effectiveness of therapeutic intervention. As health care professional we are challenged to stay familiar with any new information regarding health. This allows us to give our patients the highest quality health care available. This is where Evidence-Based Practice is important. It is defined as the integration of the best systematic research evidence with clinical expertise and patient values.
The intent of this presentation is to look at the pros and cons of Evidenced-Based Practice, how nursing schools need to teach it to their students, how nursing management can incorporate it to their employees and how it can work for patients with pressure ulcers.
PROS AND CONS OF EVIDENCE-BASED PRACTICE
Evidence-Based Practice is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of patients, (1) It involves integrating the individual clinical expertise of the physician or nurse with the best available external clinical evidence for systematic research and individual patient preferences, (2) Research shows that patients’ outcomes are at least 28% better when clinical care is based on evidence rather than the tradition common sense (Bryan-Brown, 2006).
Opponents of Evidence-Based practice argue that the use of it can potentially nurses to be less autonomous and it is “responsible for the suppression of the innovation and creativity” (Walsh, 2010 p.27)
There have been barriers to Evidence-Based Practice implementation identified as the time it takes to research evidence, limited team cooperation, and staffing levels. Also, for nurses in rural areas, they are less likely to hear about new research for evidence based practice. Often it is the nurses in the larger medical centers that participate in the research or have the information easily obtainable.
Fortunately, the research on the benefits of Evidence-Based Practice are abound. Data is collected over a period of time targeting a particular audience. Quantitative and qualitative research is gathered by research groups. There are two mnemonics to remember when conduction quantitative and qualitative research: For quantitative research, PICO stands for: 1. Patient population, 2. Intervention, 3. Comparison group and 4.Outcome.
Alternatively, the mnemonic SPICE stands for: 1. Setting, 2. Perspective, 3. Intervention. 4. Comparison group and 5.Evaluation.
Ideally, once qualitative and quantitative integration occurs, qualitative metasynthesis takes place and more definitive interpretations of the study can be incorporated (Broeder & Donze, 2010 p.199).
TEACHING EVIDENCE-BASED PRACTICE
Ferguson and Day (2005) emphasized that nursing faculty are incorporating Evidence-Based Practice by helping students increase their skills in accessing and analyzing the most relevant evidence to support their beginning nursing practice. Nursing faculty can help students recognize the importance of current research evidence.
Erikson-Owes and Kennedy (2001) emphasized that an evidence based nursing approach is a learned skill for both the student and the clinical educators that requires intellectual curiosity to explore beyond “the way it has always been done” (p.137).
Students need to be able to enhance their evidence-based knowledge through guided research questions, systematic searches, reading and critiquing the strength of the evidence, synthesizing the evidence and preparing the evidence based on recommendations.
The phrase, “Knowledge of Power” applies to the responsibility nursing leaders have to empower their staff. Leaders need to have their staff, “think outside the box”....
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Erickson-Owens D.A., & Kennedy, H.P. (2001) Fostering evidence-based care in clinical teaching.
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