Evidence-Based Practice in Nursing - A Review

Shivaleela S Sarawad

Assistant Professor, BLDEA'S College of Nursing, Jamkhandi, Karnataka State India.

*Corresponding Author E-mail: shivaleela.238@gmail.com

ABSTRACT:

Florence Nightingale, who pioneered the use of research in practise in nursing, has a long history of doing so. Although few nurses contributed to Nightingale's foundation in the early and mid-nineteenth centuries, the nursing profession has recently offered important leadership for enhancing care through the implementation of best clinical research evidences in practise. Evidence-based practise (EBP) is the careful and deliberate application of current best evidence, clinical skill, and patient values to inform health-care decisions. Expansion of scientific knowledge, highly educated customers, and nurses in clinical settings, relentless pursuit of cost-effectiveness, and accreditation expectations, among other factors, are all contributing to the increased focus on EBP. Ask, Acquire, Appraise, Apply, and Assess/Re Assess are the steps for adopting EBP. CINAHL, MEDLINE: (PubMed), and Evidence-based clinical practise guidelines, to name a few, are some of the tools that can be used to find the best evidence for practise. Empirical data from meta analyses and randomised controlled trials; evidence from other scientific approaches like descriptive and qualitative research; and usage of information from case reports, scientific principles, and expert opinion are all examples of best evidence. When enough research evidence is available, clinical experience and patient values should be used to guide practise. The ability to apply evidence in practise requires enough information, attitude, skill, and support. In order to apply EBP in clinical settings and provide high-quality nursing care, numerous professional and individual barriers must be addressed¹.

KEYWORDS: Evidence based practice, research evidence, strategy, high quality care.

INTRODUCTION:

Evidence-based nursing is a strategy of making healthcare decisions based on the most up-to-date research evidence, clinical expertise, and patient preferences.

EBP is a term used in nursing to describe a technique of providing care that is guided by the integration of the most up-to-date scientific information and nursing expertise.

Using this technique, nurses must critically assess relevant scientific data or research evidence and implement high-quality solutions into their nursing practise.

Definition:

“A problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinical expertise and patient preferences and values.”

Importance of Evidence Based Practice (EBP):

1. Health care delivery is filled with uncertainty and many questions arise in every day practice

2. Changing patient demographics require new approaches to care.

3. The evidence base for practice is rapidly expanding and growing in complexity for nursing and other disciplines.

4. How to search, evaluate, and apply evidence in practice is unknown by many or inconsistently used.

5. There continues to be a mismatch between what we know to be quality care and the quality of care that is delivered.

6. Quality problems occur even in the hands of dedicated, conscientious professionals².

The goal of Evidence-Based Practice (EBP) is to:

1. Provide evidence-based data to practising nurses so that they can provide effective care.

2. Resolve the issue in the clinical context.

3. Strive for excellence in the delivery of care.

4. Assists with efficient and effective decision-making by reducing variations in nursing care.

Evidence Sources :

· Filtered resources:

Clinical experts and subject specialists pose a query, then synthesise evidence to reach a decision based on the research available. These sources are useful because they have examined the literature and analysed the data to provide a solution to a clinical query.

· Unfiltered resources (primary literature):

It contains the most up-to-date data. MEDLINE, CINHAL, and other databases provide primary and secondary medical literature.

· Clinical experiences- The second pillar of evidence-based, person-centered care is knowledge gained from professional practise and life experiences.

· Patients' knowledge- Evidence derived from patients' understanding of themselves, their bodies, and their social life.

· Audit and performance data- Knowledge from the local context Patient narratives and stories Understanding of the organization's culture and the people who make it up. Professional and social networks. Information gathered from user feedback Policy at the local and national levels³.

Evidence-Based Practice (EBP) Key Components:

The following criteria are used to make healthcare decisions (Institute of Medicine, 2003):

A. Scientific evidence:

Clinical trials, epidemiological research, outcome research, and qualitative research are all examples of randomised controlled trials.

B. Clinical expertise:

Inductive reasoning, knowledge obtained via practise over time

C. Patient values and circumstances:

Individual choices, worries, and expectations, as well as financial and social resources⁴.

Steps of Evidence Based Practice (EBP):

Nurses' Obstacles to EBP:

1. The nurse doesn't have enough time to read research or put new ideas into practise.

2. Patient loads that are too heavy

3. The nurse is either uninformed of the research or does not believe it is relevant to her practise.

4. The nurse does not have the authority to modify the way things are done.

5. There's a lot of research to do.

6. Insufficient resources and administrative support.

7. There aren't enough EBP mentors to work with providers.

Other Nursing Shortcomings:

1. A lack of EBP knowledge and skills.

2. EBP is a relatively new addition to nursing education. 3. I've never learned how to search an electronic database.

3. inability to distinguish between research reports and other forms of literature

4. inability to appraise the quality of research reports or critically examine them

5. Lack of confidence, skills, time, and adequate materials to engage in EBP⁵.

CONCLUSION:

Evidence-based nursing care is a way of thinking about clinical decision-making and achieving excellence in practise that lasts a lifetime. Evidence-based nursing care is based on research findings, clinical experience, and the values of patients, and it can help patients achieve better outcomes. Nurses and health-care organizations are expected to use research evidence in clinical practise, yet there are several barriers that exist between new knowledge and implementation of that knowledge to improve patient care. Nurses can use the levels of evidence to assess the quality of research studies, appraise the findings, and evaluate the evidence for possible use in best practise.

REFERENCES:

1. https://library.health.nt.gov.au/EBP/overview

2. S. K. Mohanasundari, A. Padmaja. Evidence Based Practice–A Core Concept to Achieve Quality of Nursing Care. Int. J. Nur. Edu. and Research. 2018; 6(3): 295-298

3. Veerabhadrappa G Mendagudli. Evidence-Based Practice (EBP) - A Core Concept in Achieving High -Quality Nursing Care. Asian Journal of Nursing Education and Research. 2022; 12(2):247-8. doi: 10.52711/2349-2996.2022.00052 Available on: https://ajner.com/AbstractView.aspx?PID=2022-12-2-21

4. https://research.aota.org/ajot/article/64/1/164/5507/Facilitating-Evidence-Based-Practice-Process

5. Brae Kour Navdeep; HC Rawat, textbook of advance nursing practice first edition. Jaypee publisher; page no 533-541.

Received on 26.09.2022 Modified on 08.11.2022

Int. J. Nur. Edu. and Research. 2023; 11(1):82-84.

DOI: 10.52711/2454-2660.2023.00018