Evidence-Based Practice - Case Study Example

Introduction In order to understand what Evidence-based practice is, it is important to consider best available current research evidence, nurses’ clinical expertise and the needs and preferences of the patient. These are important considerations in evidence-based practice for it is about creating clinical decisions based on the available research evidence, clinical expertise of nurses and the needs of concerned patients. The evidence-based practice therefore is like a design or process to strengthen relationship with patients and it is more than just about improving health care services. In this paper, a critical analysis of Evidence-based practice in nursing is provided by considering its advantages and disadvantages. Furthermore, sme factors that impede the active participation of nurses in evidence-based practice are identified and discussed. What is Evidence-based practice? What exactly is Evidence-based practice? Evidenced-based practice ensures in its application the best scientific evidence available (Peat, 2002). Furthermore, the benefits of patients will be maximised while efficiency of health services is ensured are all considerations of evidence-based practice (Peat, 2002). Evidence-based practice is the use of scientific evidence in the clinical-decision making with respect to the care of patients (Sackett et al., 1996). There is a need to apply current evidence in order for the clinical practice not to be hopelessly outmoded (Murphy & Sharp, 2009). To understand this in detail, it is good to consider some of the common questions of nurses regarding evidence-based practice. In particular, nurses ask questions on what exactly is evidence-based practice, its similarity to nursing research, quality improvement and its relevance to nursing practice. All of these are specific questions that need to be carefully understood by nursing practitioners in order to gain considerable acceptance of the evidence-based practice in their profession. Evidence-based is not about research utilisation, quality improvement and nursing research, however they can be interrelated. Research utilisation is about using available research so as to use them to improve patient outcome or to find what will just fit into clinical practice. Quality improvement on the other hand is about creating best practices in nursing care by focusing on the system, processes, functional, clinical, satisfaction and cost outcomes. In short quality improvement is a management tool and it is not intended to create scientific knowledge. Thus, it is safe to say that quality improvement deals with issues or problems concerning the system, processes, functional, clinical and satisfaction and cost outcomes. Examples of quality improvement can be varied and some of them are the following just to cite a few: 1. Reduction of time interval between the time the prescription is given and the time the patient received it. 2. Evaluation on how effective the programs are in preventing injuries among personnel. 3. Assessment of programs regarding patient’s satisfaction in the emergency department. 4. Improvement on the care of patients using necessary strategy. 5. Improvement of support on education program about smoking prevention. The above stated programs are specific projects under quality improvement. The next consideration is nursing research. Nursing research is about developing, refining and extending the knowledge in nursing. This involves specific areas in nursing such as nursing practice, administration and education. Thus, researches in nursing may involve problems concerning nurses, patients, families and the community. Just like any research, nursing research methods can either be quantitative, qualitative or even both. It is therefore important to consider that evidence-based practice may actually consider research utilisation, quality improvement and nursing research but the entire process requires scientific evidence as the necessary tool for decision-making. This is a higher form of practice since it does not only focus on small detail in the process. In fact, evidence-based nursing for instance tries to cover a wider scope of international clinical applications with specific criteria as far as the validity of research is concerned. In this regard, practicing clinicians are obliged to asses the relevance of whatever intended best studies regarding evidence-based practice on treatment, diagnosis, aetiology and prognosis. Advantages of Evidence-based practice One of the reasons why until this recent time evidence-based practice has been widely heard it is because of its promise and the benefits it brings. To start with, it is important to consider the advantages of evidence-based practice in nursing. It is clear that with evidence-based practice, there is remarkable objectivity which will lead to efficiency. To back this up, it is important to consider that with evidence-based practice, there is a need to create questions regarding specific approach or practice which eventually will lead to a scientific experiment. With scientific experiment everything is expected to create a more concise and objective answer to questions which will eventually lead to sound decision-making process. This is what it means to generate efficient output. It is very important to consider that clinical practitioners must solidly base their decision-making approach on scientific evidence. This creates a domino effect towards the outcome for patients. The result is better outcome for patients. Considering that the decision making process is eventually based on the scientific evidences gathered, there is remarkably higher percentage that patients will be provided with the best care they deserve. Furthermore, provided that there is a need to observe, enumerate and analyse in evidence-based practice, there is a good chance to eradicate subjective case description. This is very important prior to maintaining objective information that can be used in the actual decision-making process. It is good to think that since subjectivity is eradicated, there is a good chance that patients are given with treatment based on confidence and verifiable information. This will also encourage or ensure nurses to continue to increase their stored knowledge in their field. Thus, creating more ways for them to find relevant materials to read or research that talk about objective matters. This eventually will give a more dynamic approach or practice in nursing. With evidence-based practice in nursing there is a guaranteed systematic retrieval of information. This is due to the fact that in evidence-based practice there is recording and cataloguing of evidence. In today’s generation when information is a valuable tool in order to be a cut above any other, it is very important to store important findings or discoveries that are well documented. It is not only enough to properly document them but the most important is to keep them useful whenever the need to make use of them arises. It is the basic principle in evidence-based practice to document findings or any outcomes in order to make use of them whenever there is a need. This is about systematic information retrieval and it is actually one of the most comfortable ways to retrieve information. Since evidence-based practice is a system, what makes it even better is that it contributes not just in systematic retrieval of information but it has a high speed and accuracy. The data are not only guaranteed verifiable but there is also convenience as far as retrieving them is concerned. Disadvantages of Evidence-based practice One of the disadvantages of evidence-based nursing practice is that it can be associated with research utilization, quality improvement and nursing research. In fact, the most common question asked by nurses about evidence-based practice is its definition and how it is really associated with research utilisation, quality improvement and nursing research (Beyea & Slattery, 2006). The bottom line is that it can hardly be implemented in the way as it is due to some common misconception about it. This is a disadvantage side knowing that nurses need to improve their understanding on the concept itself plus the other concepts associated with it. This sounds a very complicated thing to do and thus it requires more time in the process. Evidence-based nursing is very systematic as mentioned earlier. Since there is corresponding system with it, it requires program and with such, everything would turn out mechanical. This is one way of saying that with evidence-based nursing working with other people will probably turn out mechanical as well. Not all nurses have with them critical thinking. For some, it requires further development and it will take time for others to develop. Critical thinking is an essential aspect of evidence-based nursing practice (McGrath, 2005). Following an evidence-based nursing practice is therefore complicated process for those who do not have essential development on their critical thinking ability. There can be so much to understand about the disadvantages of evidence-based nursing practice, but one thing is clear, it can be a very complex process and it requires appropriate knowledge prior to its actual implementation. Factors that impede participation to Evidence-based practice It is important to understand the nature of evidence-based practice, its importance to nursing and the skills needed by the one supporting it since they are necessary and must be required to be part of the education system of nursing students (McGrath, 2005). Education program for nursing career is very important since enough time for schooling is given to learn more about nursing as a career. Education system therefore is a significant problem that can hinder participation to evidence-based practice. Participants lacking the knowledge about evidence-based practice as a process will find a hard time following it. Evidence-based practice must be necessarily introduced at the early stage of student’s learning and career in school. Nursing students are most likely considered independent, self-directed learners as professional nurses. This means that it is effective for them to learn more about evidence-based practice in school at the earliest time possible. That is why it is important to promote that professionalism must start by itself in medical education (Hilton & Southgate, 2007). Primary research done as part of undergraduate program for instance is viewed to encourage evidence-based practice and not only to improve professionalism among health practitioners (Nixon, 1999). Educational system eventually has effective programs that can influence learner’s skills, values, attitudes, and behaviors and they must essentially include features such as longitudinal learning in small groups, group process, reflective learning and experiential learning of skills (Branch, 2010). This means that failure to work socially with all concerned would mean failure of implementing evidence-based practice in the long run. This eventually will discourage participants. It is not only the knowledge and general skills needed in evidence-based practice but as mentioned earlier, specifically critical thinking is a must. It is also important to consider that critical thinking is a specific skill needed by a clinical nursing practitioner in order to successfully participate in evidence-based practice. According to McGrath (2005), critical thinking can be essentially obtained with the right habits of mind, attitudes and traits. Unfortunately, not all clinical practitioners have them. This means that the absence of critical mindedness may also hinder participation to evidence-based practice. In relation to this, the ability and willingness of an individual to try to learn and develop critical thinking can also be a significant factor that can impede participation to evidence-based practice. Afterall, Branch (2010) was able to find out that educational programs employing critical reflections on mastery of skills were able to enhance skills and commitment to professional values among chosen practitioners. Thus, education is a must in developing the required skills. Another important factor is the total integration of evidence-based practice into clinical workflow of nursing practice (Bakken et al., 2008). Failure of integration would mean that the whole system can entirely work as failure over the whole duration of its implementation. Knowledge is still important in the whole process particularly in the integration. The knowledge gap at present in the field of nursing can eventually exist in both education and actual nursing service (Abdellah & Levine, 1965). This means that both educational system and actual or practical nursing service process must be able to unite clear line of understanding in the integration of evidence-base practice and clinical workflow. Conclusion Evidence-based practice has now become part of nursing career since it is the opportunity to serve patients with outmost competence. However, not all participants seem to be competitive in the application process considering that there are some factors that may hinder nurses from participation. With this, it is simply a reminder that evidence-based practice must be first fully integrated in the education system prior to its actual application in the real setting. It is important to consider that nurses before hand must be equipped with knowledge and skills about evidence-based practice prior to giving them chance into actual medical application. References Abdellah, F. G. & Levine, E. (1965). Better Patient Care Through Nursing Research. 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