Evidence Based Nursing Implications
When it comes to being a nurse today, there are going to be a lot more information that you have to become aware of than just blindly helping a patient. The latest movement in the industry is known as evidence based nursing and it has significant impacts on the treatment that a patient is going to receive. Evidence based nursing or EBN is the practice of implementing a treatment based on prior evidence, fact, research and opinion. So when you see a nurse about an ailment, the treatment that she orders and follows will be according to a historical treatment. Although some adhere to a strict EBN meaning that only medical studies are used to dictate treatment, others use studies and opinions of experts as well. This is a hit or miss method of treatment that seems to be gaining in popularity as treatment is beginning to become much more institutional and monitored by government programs.
No Thinking Method
Whenever there are advances created in any industry, there is a significant risk that the people who are practicing something like EBN are not thinking of the long term effects of their decisions but merely making choices that are prescribed by a certain protocol described by case histories from the past. This can lead to a large portion of the healthcare system working without much thought and not being able to adjust as new information or personal history becomes available. It would seem that there is the significant potential for even more damage to be done.
Often times, the EBN approach can leave patients on the outside looking in at their treatment options. The wants, needs and desires of the patients are placed on the back burner as those in charge of treatment move blindly ahead with a treatment option that may or may not be in the best interest of overall health of the patient.
The major problem is going to be that some nurses are going to be able to evaluate the case study information and other facts quicker and more efficiently than others. That means that the quality of care a patient receives is going to be directly proportional to the mental abilities of the nurse that fate puts them in contact with. This will make the EBN system to seem viable in some cases and not so viable in others. If a patient should be stuck with a really poor nurse who either lacks the skill or ability to read case studies appropriately then there is a chance the patient could be actually harmed.
Relationship between the research process and evidence based practice
rodrigo | April 7, 2014
WritePass - Essay Writing - Dissertation Topics [TOC]
The aim of this essay is to explore the relationship between the research process and evidence based practice. The author of this essay intends to explore and illustrate an understanding of the various types of evidence used within nursing practice. There are barriers to implementing research into practice, the author intends to give explanation to these barriers and detail strategies/organisations that assist to putting research into nurse’s everyday practice. Two journal articles will be critiqued within this essay; the aim of this is to indicate which evidence has been used, to assess the strengths and weaknesses in the research process and to evaluate its usefulness in practice.
Principles of Evidence Based Practice
Research can be described as a method of investigating a chosen area to illicit new information on the topic or to build on previous knowledge. In nursing research the aim of this research is to provide clients, their carers and their families with the best possible care in all aspects of their treatment to promote wellbeing (Burns and Grove 2001).
“The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external evidence from systematic research.” (Sackett et al 1996;72)
Nurses are at the frontline of healthcare and have most one to one contact time with clients; therefore it is essential that the foundation of their practice be formed from reliable evidence (Parahoo 2006). Evidence based practice sets out to integrate the best possible evidence, nursing knowledge and patient views into practice. It is vital that nursing staff be knowledgeable of the latest findings in nursing research and are able to access and opt for the most suitable evidence to inform and implement into their practice. (Gerrish 2006) suggest that evidence based practice consists of research, patient experience and clinical expertise.
It is important to address which research findings nurses should consult to inform their clinical practice in order for them to deliver adequate care to their patients. There are many different types of evidence available to practitioners; Gray Muir (1997) as cited in Gerrish (2006) outlines a hierarchy of evidence and indicates which types are more superior. Placed at the top of the hierarchy are systematic reviews and multiple randomised controlled trials (RCTs). A systematic review is essentially a study done on prior research; this is then deemed as secondary research (Parahoo 2006). The aim of this type of review is to carry out an extensive and thorough search of material already available on this topic. The most fitting material in relation to the topic is chosen, this is then evaluated, the findings are then collaborated and summarised to answer the original question. This process should be performed in a clear manner so that it would be possible for others to carry out this research. In second place on the hierarchy is randomised controlled trials, third; non-randomised controlled trials, fourth; non-experimental studies and fifth; descriptive studies/expert committees. This hierarchy is more suited to quantitative research and is deemed inappropriate if outcomes are not measurable (Gerrish 2006).
There are many organisations that provide information on research and guidance to how it should be implemented into clinical practice. The National Institute for Health and Clinical Excellence (NICE) offer clinicians guidelines and criteria to follow with the aim of developing nursing care to the benefit of the clients health (NICE). The Cochrane Collaboration supply research material which is available to everyone. Their aim as an organisation is to provide health care workers, clients and their carers with information on the most current and reliable evidence used within health care settings.
There are several different barriers to implementing evidence into clinical practice; Gerrish (2006) suggests that these barriers can be set into four categories; the nature of the evidence, communication of the evidence, knowledge and skill of the nurse and organisational barriers. Barriers with regard to the nature of the evidence may include research questions unsuitable to clinical practice. In relation to communication of evidence the language used in the research may be deemed as inaccessible due to complex terminology. It has been identified that barriers concerning the nurses skill include troubles identifying or appraising evidence and also lack of confidence of the individual in using resources to access the research. Organisational barriers seem to indicate that lack of support from senior staff in providing information and time to implement changes are the main cause for concern.
Parahoo (2006) suggests that there are four main components in the research process. Identification and formulation of the research question is the first stage in the process, this is where the researcher determines what is being researched and a question is created. Previous literature researched in the chosen field may be consulted by the researcher to help define concepts. The final question must be clearly set out. The second stage of the process is the collection of data, in this part of the process several decisions will have to be made before data is collected. The design of the study, methods used within it and sometimes piloting need to be decided upon. The population that will be participating needs to be defined at this point consent may need to be sought from ethical committees. Once these arrangements are in place the data can be collected. The third stage in this process is the analysis of data, at this stage the researcher would analyse, translate and display their findings. It is important to note that before the data was collected the researcher would have decided on how the analysis would be conducted. After analysis the researcher would typically translate findings, examine the limitations and make suggestion as to how to implement into practice. Recommendations may be made for additional research needed. The final stage in research process is the dissemination of findings. An organisation that might be responsible for this area would be NICE, the barriers to the implementation of evidence are outlined above.
There are many ethical issues involved in the research process; the author of this essay intends to discuss some of these implications. Beneficence is an important ethical issue, it is essential that the study should be of the benefit of its participants and in the best interests of the overall public. Confidentiality is another ethical issue within the research process, any information gathered should be respected. Consultation to the participant’s wishes should be sought throughout the process and care must be taken by the researcher when publishing results so not to unintentionally expose the identity or information of its participants.
The author of this essay has explored the relationship between evidence and the clinical setting. Research, evidence based practice and the research process was considered. Barriers to implementing evidence based practice and the strategies/organisations used to avoid these barriers were discussed. Critiques of two research articles are included in this essay; these critiques aim to illustrate the author’s understanding of the research process and knowledge of the various types of research and the methods used.
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