Analysis of Evidence-based Practice in Nursing

During 1980s, a trend of using scientific evidences to determine the best approach to treat patients emerged and it was initially coined as “evidence based medicine” and got acceptance in 1992. As this approach progressed from 1993 to 2000, the term changed to “evidence based practice (EBP)”. Beyea and Slattery (2006). Since its emergence, EBP has been defined in various ways, however the most popular definition is “the conscientious, explicit, and judicious use of the current best evidence in making decisions about the care of individual patients” (Sackett, Rosenberg, Gray, Hayes, & Richardson, 1996).

EBP allows healthcare practitioners to infer assessment of existing research, standard operating procedures of clinical treatments and many other available credible information to solve problems they faces daily. Thus EBP demands for the most recent and relevant information and observations to be used in solving clinical cases. EBP helps to eliminate the dated method of sole reliance on book knowledge healthcare workers tend to adhere as they do study lot of information from books during their courses. Karkada (2015).

Evidence based practice in nursing comprise of a problem solving process in terms of the caring that heavily relies on best available existing evidences, patients charts, records(patients ‘data), nurses’ prior experiences, expertise. In addition, EBP in nursing encompasses patients’ preferences and values as one of the integral component. Burns et al. (2013).

Use of EBP in Nursing

It is no secret that patients’ depends on nurses more than any other healthcare practitioners thus nurses’ accountability is immense regarding their patients’. As a result, the newly emerged EBP amalgamation to nursing courses will enhance their research knowledge that in turn will improve patient care no matter the setting. EBP will teach nurses’ how to do research and critically analyses, apply and asses the research in real situation in their practice. Teaching of EBP will create an environment among nurses and they will start giving importance to evidences in their daily duties which will have direct positive effect on quality and safety of patient care. Carlisle et al. (2017).

Salinas (2017) illustrates that during his clinical practicum a veteran nurse corrected him for not aspirating a syringe during an intramuscular injection. However EBP proves aspirating intramuscular is obsolete and is no longer a standard practice. Furthermore EBP has proven that aspirating during intramuscular injection can cause trauma to patients. EBP creates high quality care as a result of the best evidences that has been collected over many years which in turn gets formulated into standard care procedures.

(Beyea and Slattery., 2006 cited Madsen et al., 2005) who published EBP findings regarding routine practice of listening to the bowel sounds of patients recovering from abdominal surgeries. Madsen et al reviewed the literature and compared the existing practice and came up with a new practice procedure. The new EBP advocates to focus on Flatus (Gas in the intestinal tract or gas passed through the anus) and first bowel movement after the surgery to measure the gastrointestinal mobility after the surgery instead of bowel sounds. The new findings and practice emphasizes that nurses can save time and patient outcomes are also better with the new method.

Importance of EBP in Nursing

EBP make it possible for nurses to deliver high quality care by relying on research and findings instead of relying solely on outdated text book knowledge, dated methods followed for years or because it’s just the way some senior nurses have always done the treatment.Beyea and Slattery (2006).

Furthermore it is found that EBP results in better

• patient outcomes

• add essential knowledge into science of nursing

• helps nursing practice to stay relevant and up-to-date,

• gives nurses confidence in their decision making processes

• help in keeping the policies and procedures up-to-date through most recent research.

Many researches done concludes that combining EPB into nursing practice is immensely important to maintain high quality patient care. Holopainen et al. (2017) in their paper highlighted that EBP improves job satisfaction of nurses, give them a sense of empowerment through better decision making process, provides an environment to deliver patient centered care as EBP integrate patient preferences and values, encourage nurses professional growth and encourage them to be lifelong learners hence continuous learning throughout their carrier.

EBP has put forth lots of changes to the way nurses treat patients. One such example is use of oxygen in patients with COPD (Chronic Obstructive Pulmonary Disease). It is assumed for ages among nurses that use of oxygen in COPD patients eliminates “hypoxic drive”. As a result patient go through hypercarbia, acidosis, and ultimately death. However EBP proves that not giving oxygen to COPD patients are dangerous and oxygen must be given to eliminate hypoxia and organ failure. In addition mechanical ventilation is necessary to relax and give rest to respiratory muscles. Giving oxygen in chronic and acute COPD cases are recommended and implementing EBP correctly will enhance patients’ quality of life and life-span. Burns et al. (2013).

Like aforementioned practice with advancement of many aspects of healthcare, nurses must continually adapt to new changes. EPB plays a vital role in these changes as through EBP new evidences are available with sound research backing them over a period of time. Nurses must be willing to let go of traditional methods and embrace new practices to enhance patients’ outcomes. Burns et al. (2013). According to Holopainen et al. (2017), absence of EBP in work environment for nurses limits their carrier growth that results in reduction in job satisfaction and non-compliance to existing best practices. (Beyea and Slattery., 2006 cited Pravikoff,Tanner, & Pierce, 2005) points out that most nurses have the tendency to adhere to what they learned in school in caring patients so they rarely read journals, current research articles, thus hospital libraries are rarely used. However EBP nursing has made nurses to be current on research evidences so they could make best decisions on patient care to bring out the best outcomes.

All in all, EBP make it possible to develop nursing training & practices along with their experience according to current research. Furthermore, helps in refining their skills such as searching for relevant, current information, evaluate and apply to the correct clinical setting.

The following description is a reflection of critical incident that occurred while I was working in ER department of a main hospital in the city. Confidentiality of all the aspects of the incident will be maintained as required in nursing practice.

Reflection is an integral part of nursing and it enables enhancement of nursing practice by improving the practices, bringing required changes and identifying the gaps in training and support that could be modified in future to make the nursing more effective that in turn will give better outcomes. Tallo (2015)