Understanding Best Methods in Evidence-Based Practices in Healthcare and for Nurses - Research Paper Example

Understanding Best Methods in Evidence-Based Practices in Healthcare and for Nurses Evidence-Based Practice (EBP), in conjunction with professional clinical research, provides continuous quality improvements overall for healthcare, practitioners such as doctors and nurses, and the patients who must make the final decisions, based on those findings. In EBP, deciding what types of treatment a patient will receive, is heavily based on researching records of clinical studies and other patient records which align with what a patient’s symptoms reflect as being similar (Melnyk & Fineout-Overholt, 2011). Recorded evidence from results in research studies and from patient cases, which is coded according to national standards (NANDA, NOC and NIC), provide a rich resource of verified documentation which help other medical staff (doctors and nurses) in providing the best treatment solutions available for the patient and his or her environment (financial and social) (Allred, Smith, & Flowers, 2004). In today’s medical world, electronic clinical information systems (ECIS) are now found in every hospital and clinic setting, allowing for nurses and doctors to quickly access information electronically and apply solutions immediately at the patient’s bedside. When medical staff are able to complete forms and search for information electronically using national standard code terms (or SNLs) on hand-held devices, this eliminates the older practices of having to return to one’s desk to look up information in books and office folders and then notate everything on paper. Eliminating excess time by having portable access to electronic medical information databases on the go, provides the environment in all clinics and hospitals of quickly and accurately providing efficient solutions and operations for all concerned (Allread et al., 2004). The ability for nurses to conduct research also provides the development needed of gaining experience in addressing clinical questions about cases and confronting ethical issues (Webb, 2011). Clinical research also provides opportunities to build a strong foundation of scientific information and knowledge, particularly applicable to clinical settings. Research in evidence-based systems also provide opportunities in developing processes within the nursing management sector as part of delivering better information and infrastructure in hospitals and clinics, between management and staff and between management, staff and patients (Webb, 2011). The main reason for nurses to involve themselves in continual clinical research is to apply the knowledge gained from clinical results into delivering better health care, as well as utilizing various nursing theories towards clinical practice (McEwen & Wills, 2010). 2. Some of the biggest components that ignite and sustain a culture of inquiry for doctors and nurses is that there is always new information coming out from research studies, particularly in medical testing of drugs and process applications, which could be applied to new patients immediately. Even a research study done a year ago can be outdated by this year’s research study that found a new drug that could ease patient pain symptoms if applied under a different set of circumstances (Melnyk & Fineout-Overholt, 2011). Scientific findings may also show that using a certain drug over time is presenting some very unpleasant side effects that are only now just coming into evidence. Therefore, that drug may need to come off the market right away. This would require that any doctors who have prescribed that drug, must contact all their patients currently using it, in order to get them off the drug and on to another one. Another problem that has occurred is that research evidence sometimes take too long in being published thus denying patients better health care practices that could have extended lives a bit longer if implemented sooner. The Institute of Medicine’s Roundtable on Evidence-Based Medicine is a major backer of speeding up the process in implementing positive research findings from medical research that could assist in making better medical decisions about practices and needed solutions to problems. Preventive services are also coming into the forefront as part of continuous review on clinical testing and screening procedures for diseases, such as breast cancer, colon cancer, and other prevalent issues. The United States Preventive Services Task Force (USPSTF) systematically reviews all these processes under the auspices of the Agency for Healthcare Research and Quality (AHRQ), which provides ratings considered the top level guideline for best practices in the medical field (Melnyk & Fineout-Overholt, 2011). A spirit of inquiry should always be in place and encouraged as patients’ lives depend on medical personnel who can make decisions quickly and efficiently with the latest information at hand. Key elements of the spirit of inquiry requires that all practitioners and clinicians constantly question and re-evaluate clinical practices in order to obtain the best results for appropriate functions (McEwen & Wills, 2010). There must also be continuous research on evidence-based practices and also continual reviewing between mentors and practitioners in order to overcome any barriers. Tools should always be made available such as up-to-date computers, maintaining subscriptions to databases, medical journals and libraries, continual educational development, and recognition by peers and administration to reinforcement encouragement of EBP (Melnyk & Fineout-Overholt, 2011). One inquiry tool which has been developed to cut down on wasted time is the ‘Burning Clinical PICOT Question’ (Ch. 1, p. 11), which provides a consolidated focused method of finding information required for a certain patient type and symptoms. The question structure is: P-patient population; I-intervention or issue; C-comparison intervention or a group; O- outcome; and T- time frame. The question is thus, constructed to be strictly focused and eliminates any information in the pull returns which does not fit any of those criteria (Melnyk & Fineout-Overholt, 2011). While the PICOT question is the first in sustaining a spirit of inquiry, the next step is to choose the best evidence, based on where it came from, that relates to the question. This requires a systematic review of the search returns and then, in the third step, a critical appraisal of the evidence, using a number of criteria tools (LoBiondo-Wood & Haber, 2013). The fourth step requires an integration of the evidence with the practitioner’s clinical expertise which must also align with the patient’s preferences. The fifth step is to evaluate the outcome of the solution on an ongoing basis and make changes when needed, based on the evidence. Step six is the point where the case has been completed and the outcome is disseminated through the database of medical information used at the hospital or clinic. The information must also be coded when it is put into the system so as to be easily recalled when specific criteria is put into an inquiry report (Melnyk & Fineout-Overholt, 2011). All six steps provide the environment for igniting and sustaining the culture of inquiry. References Allred, S.K., Smith, K.F., & Flowers, L. (2004). Electronic Implementation of National Nursing Standards-NANDA, NOC and NIC as an Effective Teaching Tool. Journal of Healthcare Information Management, 18(4). Available at http://www.himss.org/content/files/jhim/18-4/original1.pdf LoBiondo-Wood, G, & Haber, J. (2013). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice (8th ed.). St. Louis, MO: Elsevier/Mosby McEwen, M., & Wills, E.M. (2010). Theoretical Basis for Nursing, (3rd ed.). Dallas, TX: Lippincott Williams & Wilkins. Melnyk, B.M., & Fineout-Overholt, E. (2011). Evidence-Based Practice in Nursing & Healthcare (2nd ed.). Baltimore, MD: Wolters Kluwer Health. Webb, J.J. (2011) Nursing Research and Evidence-Based Practice. Chapter 6. In Cherry, B. & Jacob, S.R. (Eds.), Contemporary Nursing: Issues, Trends & Management (5th ed.), (pp. 104-124). St. Louis, MO: Elsevier/Mosby. Available at http://www.coursewareobjects.com/objects/evolve/E2/book_pages/cherry/pdf/SAMPLE.pdf Terms Used: EBP = Evidence-Based Practice ECIS - Electronic Clinical Information Systems NANDA = North American Nursing Diagnosis Association NIC = Nursing Interventions Classifications NOC = Nursing Outcomes Classifications SNLs = Standardized Nursing Languages Read More