Evidence Based Practice (EBP)
The focus of this assignment is to look at Evidence Based Practice (EBP), why it is important for nursing to be evidence based and the barriers to implementation of EBP. EBP is a medical philosophy invented by Archie Cochrane a British epidemiologist, Cochrane believed that disease prevention and medical care should be contingent and collected analysed data from randomized controlled trials. (RCTS) in order to provide effective patient care.
EBP according to Sackett et al (1996) is current best evidence in making decisions about the care of individual patients. This definition highlights both professional’s clinical experimental knowledge and the best external evidence, neither is enough on its own. Current best evidence includes clinical
practice guidelines which are usually nationally developed by expert researchers and which have undergone research trials. The National Institute for Health and Clinical Excellence (NICE) and National Service Frameworks (NSFs) are examples of authoritive national guidance developed to achieve consistent clinical standards across the NHS (Department of Health 1998). Fleming (2008) argues a well built question can go a long way towards focusing your search in the right area. She has developed a framework to facilitate this which has four basic elements to it they are as follows Problem,Population,Issue Intervention, Comparison (not always needed) Outcome. (PICO).
The importance of EBP is practices based on research findings are more likely to result in the desire to patient’s outcomes. It also provides opportunities for nursing care to be more individualised and more effective. Melynk et al.’s (2004) study support the view that knowledge and beliefs about EBP are important indicators for changing behaviours it is important for nurses to believe that EBP will result in better patient’s outcomes in order for changes to occur.
The clinical guidelines used in nursing should be updated by nurses and other health care professionals as new empirical evidence becomes available. It is important to bare in mind that not all research is of best quality in practices maybe described as research based even when the research process is questionable. Some published can be poor quality and result in conflicting evidence. Cullum et al (1997) point to the paucity of evaluative research undertaken to distinguish between effective and no effective nursing practices. Careful searching for evidence is therefore important.
Getting research into practice is a complex and time consuming task and involves behaviour change on the part of the individuals, teams and organisations involved (Royle and Blythe, 1998). Making decisions about care is an iterative process that involves consideration of the potential benefits and harm of treatment and needs of the individual (Wulff and Gotzsche, 2000). These factors can create uncertainty about how and whether research evidence can be put into practice.
Overall, nurses need the ability to take into account not just the evidence but the evidence of case- based knowledge in clinical practice patient preferences and factors and the particular clinical scenario before deciding on appropriate management (Jennings and Loan, 2001; Rycroft-Malone et al., 2004).
A number of barriers to EBP can be overworked staff, lack of knowledge, and access to new literature lack of support from higher management, Lack of patient compliance, Lack of confidence in reading and understanding the research process. Armstrong (2002) EBP reduces professional autonomy by encouraging rigid and prescriptive practices that fail to take into account the complexities of clinical situations.
Evidence is not a static concept; Practioners must make every effort to keep abreast of the latest research of the latest research data pertaining to their area, bearing in mind that they are accountable for their practice. Well resourced facilities and effective managerial support for EBP will be seen as a positive step for other members of the health care professions to regard evidence based practice as a way of thinking and practising.
EBP according to Sackett et al (1996) is current best evidence in making decisions about the care of individual patients. This definition highlights both professional’s clinical experimental knowledge and the best external evidence, neither is enough on its own. Current best evidence includes clinical
practice guidelines which are usually nationally developed by expert researchers and which have undergone research trials. The National Institute for Health and Clinical Excellence (NICE) and National Service Frameworks (NSFs) are examples of authoritive national guidance developed to achieve consistent clinical standards across the NHS (Department of Health 1998). Fleming (2008) argues a well built question can go a long way towards focusing your search in the right area. She has developed a framework to facilitate this which has four basic elements to it they are as follows Problem,Population,Issue Intervention, Comparison (not always needed) Outcome. (PICO).
The importance of EBP is practices based on research findings are more likely to result in the desire to patient’s outcomes. It also provides opportunities for nursing care to be more individualised and more effective. Melynk et al.’s (2004) study support the view that knowledge and beliefs about EBP are important indicators for changing behaviours it is important for nurses to believe that EBP will result in better patient’s outcomes in order for changes to occur.
The clinical guidelines used in nursing should be updated by nurses and other health care professionals as new empirical evidence becomes available. It is important to bare in mind that not all research is of best quality in practices maybe described as research based even when the research process is questionable. Some published can be poor quality and result in conflicting evidence. Cullum et al (1997) point to the paucity of evaluative research undertaken to distinguish between effective and no effective nursing practices. Careful searching for evidence is therefore important.
Getting research into practice is a complex and time consuming task and involves behaviour change on the part of the individuals, teams and organisations involved (Royle and Blythe, 1998). Making decisions about care is an iterative process that involves consideration of the potential benefits and harm of treatment and needs of the individual (Wulff and Gotzsche, 2000). These factors can create uncertainty about how and whether research evidence can be put into practice.
Overall, nurses need the ability to take into account not just the evidence but the evidence of case- based knowledge in clinical practice patient preferences and factors and the particular clinical scenario before deciding on appropriate management (Jennings and Loan, 2001; Rycroft-Malone et al., 2004).
A number of barriers to EBP can be overworked staff, lack of knowledge, and access to new literature lack of support from higher management, Lack of patient compliance, Lack of confidence in reading and understanding the research process. Armstrong (2002) EBP reduces professional autonomy by encouraging rigid and prescriptive practices that fail to take into account the complexities of clinical situations.
Evidence is not a static concept; Practioners must make every effort to keep abreast of the latest research of the latest research data pertaining to their area, bearing in mind that they are accountable for their practice. Well resourced facilities and effective managerial support for EBP will be seen as a positive step for other members of the health care professions to regard evidence based practice as a way of thinking and practising.