Evidence Based Practise - Essay Example

Evidence Based Practice Introduction: Evidence based practice has become the buzz word in the health care system in the recent past, after nearly three decades of development of the concept. Practically any activity connected with the delivery of health care services have been impacted by the concept of evidence based practice. This growing percolation of evidence based practice into all levels of the healthcare delivery system brings about the necessity for any professional involved in the field of healthcare. The requirement for an appropriate understanding of evidence practice for the nursing professional is even more, as the nursing professional is essentially involved in enhancing the successful outcomes of patients, which is central to evidence based practice. Evidence Based Practice: There are several definitions for evidence based practice, and the passage of time has seen the definition and scope of evidence based practice enlarge. A definition that provides clarity to the concept of evidence based practice have been provided by Dawes at al, 2005, which reads “Evidence-Based Practice (EBP) requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources”. The evidence based concept requires any professional in the health care system to have the capability to gain, assess apply, and integrate evolving knowledge, and also be able to adapt to the changes in the healthcare environment throughout their professional career (Dawes, Summerskill, Glaziou, Cartabellotta, Martin, Hopayian, Porzolt, Burls & Osborne, 2005). Thus evidence based practice requires the best evidence that is currently available, taking into consideration the circumstances of the patient and patient preferences to enhance the quality of clinical judgements that result in successful outcomes that are cost effective (Mootz, 2004). Benefits of Evidence Based Practice: Evidence based practice evolved from the need to address four factors that were the cause for concern in the healthcare system. The first was the geographic variation that was observed in the frequency in which medical and surgical procedures occurred, the manner in which patients with a particular disease were managed, patient outcomes, and the cost of the care provided, which were not explainable by differences in patients’ demographic or clinical characteristics, The second was the emerging evidence that a lot of the care provided was inappropriate. The third factor was the indication that a quite a few of the patients were not receiving the benefits of the health care delivery system. The final factor was the ever increasing cost of heath care (Steinberg & Luce, 2005). Thus the benefits that accrue from the evidence based practice is the appropriate medical and surgical that has universal possibilities, a more equitable distribution of the delivery of health care to all the communities, and sensitivity to the costs involved in the delivery of health care ( Fleming, 2007). An additional benefit that evidence based practice provides is that it upholds the ethic of upholding the dignity of the patient, through its requirement that those providing health care service ensure that decisions on the health care service be taken after providing appropriate information to the patient and involving the patient in the decision making process (Hattab, 2004). Barriers to Evidence Based Practice: The numerous benefits that ensue from evidence based practice should have caused evidence based practice to spread to all aspects of health care delivery. This has not occurred because of the existence of impediments to evidence based practice. The impediments that are mostly seen are time constraints, lack of priority and lack of approval of authorities (Bhandari, Montori, Devereaux, Dosanjh, Sprague & Guyatt, 2003). Hockenberry, Wilson & Berrera, 2006 provide a full list of the barriers to effective implementation if evidence based practice as “limited access to the literature, lack of confidence in the staffs ability to critically evaluate empirical research, limited interest in scientific inquiry, a work environment that does not support or value EBP, inadequate research resources, and limited authority or power to change practice based on research findings”. Banning, 2005, suggests that a major impediment to evidence based practice among nursing professionals is the lack of adequate knowledge of the concept and canons of evidence based practice, which makes them diffident in practicing it. Implications of Evidence Based Practice for Nursing: Nursing is known to be grounded in seeking ways in which care of patients can be enhanced. Evidence based practice provides the empiric means of acquiring knowledge, focuses on the methods of critically appraising and applying data and research that is available to provide insight and understanding for better clinical decision making. Evidence based practice is not the only manner in which nursing professionals can acquire knowledge, but it has the benefit of providing the means to framing and addressing questions about the manner in which the best patient care can be provided (Pipe, Wellik, Buchda, Hansen & Martyn, 2005). Sumner, 2005, suggests that evidence based practice combined with critical thinking enables the nursing profession to provide answers to the queries it is frequently confronted with like, what is caring? What do we do as a caring profession? Why do we care? How do we care? Nursing however, is confronted with several challenges in translating the best evidence into clinical practice. The more critical of these challenges are the lack of comprehensive and relevant databases in many areas of nursing activity; the current explosion in the amount and type of information being generated; the inherent time constraint issues. All of these challenges are exacerbated by the increased demands for nursing care in the present times. There also exists the issue of the need for accurate and systematic ways to obtain inferences from the research, as applied to particular patient populations. In spite of these challenges nursing as a profession will need to bridge the gap between research and clinical practice and meet the demands of evidence based practice, for otherwise it will be left behind by the other professional and activities in the health care system (Pipe, Wellik, Buchda, Hansen & Martyn, 2005). Conclusion: Evidence based practice has become a reality in all the spheres of activity of the health care system, as it is seen as the best means for enhanced and efficient delivery of health care. The nursing profession steeped in the care of patients have been swept into the path of evidence based practice. There are challenges that the nursing profession faces in adapting its clinical practice to the needs of evidence based practice, but it necessarily has to adapt to keep up with the changes in the occurring health care system Literary References Banning, M. 2005. ‘Conceptions of evidence, evidence-based medicine, evidence-based practice and their use in nursing: independent nurse prescribers views’, Journal of clinical nursing, vol. 14, no. 4, pp. 411-417. Bhandari, M., Montori, V., Devereaux, P.J., Dosanjh, S., Sprague, S., & Guyatt, G. H. 2003. Challenges to the practice of evidence-based medicine during residents surgical training: a qualitative study using grounded theory’, Academic medicine : journal of the Association of American Medical Colleges, vol. 78, no. 11, pp. 1183-1190. Dawes, M., Summerskill, W., Glasziou, P., Cartabellotta, A., Martin, J., Hopayian, K., Porzsolt, F., Burls, A. & Osborne, J. 2005. ‘Sicily statement on evidence-based practice’, BMC medical education, vol. 5, no. 1, pp. 1-3. Hockenberry, M., Wilson, D. & Barrera, P. 2006. “Implementing Evidence-Based Nursing Practice in a Pediatric Hospital”, Pediatric Nursing, vol. 32, no. 4, pp. 371-377. Fleming, K. 2007.’ The knowledge base for evidence-based nursing: a role for mixed methods research?’ ANS. Advances in nursing science, vol. 30, no. 1, pp. 41-51. Hattab, A. S. 2004, ‘Current trends in teaching ethics of healthcare practices’, Developing world bioethics, vol. 4, no. 2, pp. 160-172. Mootz, K. 2004. ‘Evidence-based nursing--a comprehensive term’, Pflege, vol. 17, no. 3, pp. 196-207. Pipe, T.B., Wellik, K.E., Buchda, V.L., Hansen, C.M. & Martyn, D.R. 2005. ‘Implementing Evidence-Based Nursing Practice’, Urologic Nursing, vol. 25, no. 5, pp. 365-370. Steinberg, E. P. & Luce, B. R. 2005. ‘Evidence Based? Caveat Emptor!’ Health Affairs, vol. 16, no. 7, pp. 134-139. Sumner, F.J. 2005, ‘Caring – The Foundation of Advanced Nursing Practice’, Medscape Today [Online] Available at:http://www.medscape.com/viewarticle/496360.(accessed on April 11, 2007). Read More