Evidence Based Nursing Essay

INTRODUCTION Evidence Based Nursing or EBN is an approach to making quality decisions and providing nursing care based upon personal clinical expertise in combination with the most current,relevent research available. It is also known as evidence based practice. It is a thoughtful integration of the best available evidence coupled with the clinical expertise. TERMINOLOGIES Evidence Based Clinical Practice Guidelines:- Specific practice recommendations that are based on a methodologically rigorous review of the best evidence on a specific topic. Evidence Based Decision Making:- The integration of the best research evidence in making decisions about patient care, which should include the clinician’s expertise as well as patient preferences and values. Evidence Based Practice (EBP):- A problem solving approach to practice that involves the conscientious use of current best evidence in making decisions about patient care. Evidence Summaries:- Synthesis of studies, systematic literature review.Generalizability:- The extent to which the findings from a study can be generalized or applied to the larger population. DEFINITION Evidence Based Practice [EBP] is a problem solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. [Fineout-Overhott, E-2010] â€Å"Evidence Based Nursing is the incorporation of the best research evidence along with patient preferences the clinical settings and circumstances and health care resources into decisions about patient care† [Ciliska & Donna, 2006] â€Å"Evidence Based Nursing Practice is the conscientious , explicit and judicious use of theory derived, research base information in making decisions about care delivery to individuals or groups of patients and in consideration of individual needs and preferences† [Ingersoll, 2000] AIMS OF EPB To do the right thing,at the right time, for the right person, ensure quality care for client. PURPOSE Evidence based practice is to provide the highest quality and most cost effective nursing care possible. To advance quality of care provided by nurses To resolve problems in clinical settings To increases satisfaction of patient To focus on nursing practice away from habits& tradition to evidence and research IMPORTANCE OF EVIDENCE BASED NURSING PRACTICE It results in better patient outcomes. It contributes to the science of nursing. It keep practice current and relevant. It increases confidence in decision making. Policies and procedures are current and include the latest research, these supporting JCAHO readiness. Integration of EPB into nursing practice is essential for high quality patient care and achievement. COMPONENTS OF EVIDENCE BASED NURSING PRACTICE Key elements of a best practice culture are evidence based practice mentors, partnerships between academic and clinical settings, EPB champions, clearly written research, time and resources and administration support. When delivered in a context of caring and in a supportive organizational culture, evidence based practice can help to achieve the higher quality of care and best patient outcomes. SOURCES OF EVIDENCE BASED NURSING PRACTICE Primary sources of evidence:- These draw on original research findings. These sources include reports and articles about research. Secondary sources of evidences:- These draw on a range of source informing the topic of concern including. Systematic review Meta analysis Evidence based journals Clinical guidelines or protocols Cochrane collaboration Expertise opinion STEPS OF EBN Formulating a well built question Identifying articles and other evidence based resources Critical Appraisal Applying the evidence Re-evaluating the evidence Formulating the question:- A well built clinical question includes the following components The Patient’s disorder or disease Intervention or finding under review A Comparison intervention The Outcome [PICO] Applying PICO is a systematic way to identify important concepts in a case, and formulate a question for searching. Identifying Resources After successfully formulating the clinical question we need to find relevant evidence. There are generally three categories of resources. Background information Filtered resources Unfiltered resources Background information:- This category contains resources that provide background information about various disease conditions and clinical questions. Resources include upto date and other e-books such as diagnostic examination, current diagnosis, treatment. Filtered Resources:- In fitted resources, clinical experts and subject specialists pose a question and then synthesize evidence to state conclusions based on the available research. Unfiltered Resources:- It is up to you to access the resources quality, validity and applicability to your patient. Critical Appraisal:- When approaching a study, you want to know weather it was alone well, what the results were and weather it is relevant to your patients. After identifying an article you must appraise the information critically. Applying the evidence Once you have determined that the study and its results are valid, you used to decide if it is applied to your specific patient and situation. To reach your conclusion you may consult questions related to diagnosis, therapy, harm and prognosis. Apply the evidence in the clinical setting. Re-evaluating evidence:- Last step in evidence based practice. It is reevaluation. In tis process evaluate the effectiveness and efficiency of your decision in direct relation to your patient.