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The practice of applying the findings of research in the delivery of healthcare services is critical in ensuring that healthcare and patients’ outcomes have been improved. Over time, nursing science has continued to improve on the dimensions of depth and breadth paving a way to the existence of evidence that guides our practices in areas such as pressure ulcers prevention, pain management and transitional care among others. The application of this scientific knowledge has however proved to be challenging when it comes to its application in different fields. To come up with the final translation hurdle, it is necessary to promote the uptake and use of the findings of research at the point where healthcare services are delivered (Avorn, 2010). Nurses have been seen to so much strive to incorporate the use of evidence in their practices. Nonetheless, the struggle to deliver quality care and improvement of the results of healthcare has always been seen to fail because it is subject to delay where the scientific findings do not reach the patients on time (Doughety and Conway, 2008).
EBP is a very critical part of quality care. It refers to the judicious employment of the best empirical evidence in conjunction with clinical expertise as well as patients’ value in guiding healthcare decisions (Sackett et al., 2000). Contrally to this, implementation science refers to the process of methods examination, involvements and the constantly changing factors swaying the enactment of evidence-based practice by officialdoms. Therefore, integration of evidence into the provision of healthcare services is what is referred to as EBP while translation science refers to the study of how to foster the employment of proof into medication. The extent to which the adoption of EBPs takes place is subject to mode of communication of EBP to the involved and concerned parties in the context of practice and the type of the evidence-based topic (Titler, 2011). There are some principles that guide the employment of evidence-based practice into nursing care. They include; consideration of the context and engagement of the healthcare personnel as well as improving the evidence. The second principle is that there should be illustration through quantitative or qualitative data from the setting. The third principle refers to the necessity for an organization to invest in the skills and tools needed to come about with an evidence-based practice culture through encouraging of questions and systems that make doing the right thing easy. The fourth principle is that it is necessary to address the context of practice and step by step implementation of the process must also be addressed. The last principle refers to the necessity of evaluating the process and outcomes of implementation.
The entire spectrum of clinical, biomedical as well as the general healthcare providers are always in need of good evidence. However, the type of good evidence that can be applied to all the patients and care settings is unavailable for much of the medicine today. It is stated that more than a half of the medical treatments are not yet validated by medical trials. A committee of the US Institute of Medicine states that a strong to modest evidence only exists for about 4% of the services offered while more than 50 % of the amenitieslack any evidence or ere extremely feeble (Titler, 2011). Intensification of clinical services and research has been seen in the recent years with the additional increase in technology. Nonetheless, the spectrum of diseases has also widened which shows the existence of a wide gap for research to fill. There exists a major challenge for the development of systematic review on clinical as well as healthcare topics.
Additionally, the evidence that is available is rarely infinitive. The existence of confidence on some certain evidence depends largely on the robustness of the research and the quality and quantity of analysis and synthesis done on the same (Avorn, 2010). Users are always known to reach and arrive at a personal judgment about how sound a practice, technology and the science behind a certain work is. Personal judgment may considerably differ in the complexity and inexistence of bias in which they were built. This can be through disputing the evidence that is most applicable for assessment, examining only some evidence available, having a disagreement regarding the inclusion factors such as the cost and the satisfaction of the patient in the diagnostics, treatment or even effectiveness of a method; and differing about the quality of the evidence. Such disagreements can then lead to a concern by the public indicating that there is something bad about the evidence or even the experts had personal interests thus they cannot be trusted.
The strength of evidence can be defined in some ways all which consider the factors such as the size, robustness and the credibility of the available evidence. In this sense, there is the incorporation of the judgment of the quality of study which involves the level of confidence that one has on whether a finding is true and if others have been able to detect the same finding via the use of different studies or even different people. Other ideas that are used by the medical practitioners are; how close to the idea the finding is, how much effect the finding has and its applicability (Avorn, 2010). The methodology of judging how strong the available evidence is made use of the extent of the internal validity to which the studies were done on a certain population yield valid information. It also focuses on the external validity which refers to the extent of the relevance of studies and the way the studies can be generalized to serve a wider patients populace of concern. The consistency or coherence refers to the extent to which a piece of evidence makes sense with the fundamental prototype for the medical condition (Eccles and Mittman, 2006).
Strong evidence distinguishes itself from the rest with its magnitude of the effect or the impact as reported on the papers of research. Such evidence is not easy to be confused with the nature and extent of its effects and outcomes (Eccles and Mittman, 2006). Robust evidence proves to be far more useful in favour of minute clinical interventions than weak evidence since its employment, in any case, brings about spectacular results. If such factors are considered, then the possibilities of harm are very minimal which gives such evidence an advantage over the others.
Strength and quality are practically and conceptually related. Rather, a more coherent and consistent evidence has a higher advantage compared to the others. Evidence that relates to the clinical case is the most desirable. This is because such evidence is bound to make more sense since its procedure of application to the situation at hand can easily be followed and employed to come up with desirable results. Such evidence is also not easily disputable since and it can win the hearts of many people (both the medical practitioners and the patients) (Doughety and Conway, 2008).
The validity (both external and internal) is also another advantage that a piece of evidence can possess which makes it be strong evidence. Validity in this sense refers to how the evidence yields valid information about the case in question (Doughety and Conway, 2008). This can also be referred to as the closeness of the evidence to the truth. If the evidence can also be generalized for use to a wider patients’ population, its validity to the case at hand increase thus this makes it stronger. Therefore, the more valid the evidence is, the stronger it is considered to be.
To promote patients outcome in a clinical setting, nurses, as well as the educators, are endorsed with a chance of promoting EBP within clinical nursing education. It has made it possible to support the students in their practices through the help of the faculty of nursing. The faculties help the students to advance their skills of analyzing the most relevant evidence and the way to improve the patients’ outcome. In the profession of nursing, the nurses are making sure that they deliver evidence-based practice form of care. This has helped them to rely on care based on know-how and research rather than the one based on traditions, myths outdated textbooks and colleagues (Beyea and Slattery, 2006). Nonetheless, it is essential to work more on this field since, despite the ability of the EBP to benefit both the patients and the nurses, there exist barriers that deter the implementation of the same within areas of clinical practice.
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