Nursing Evidence Based Practice

Nursing Evidence Based Practice
According to The American Nurses Association (ANA) Evidenced–based practice is a "scholarly and systematic problem–solving paradigm that results
in the delivery of high quality healthcare" (American Nurses Association, 2010, p. 65). Through the use of evidence–based practice nurse and other
health care professional have the ability to create clinical decisions, which allows clinical questions to be answered and aid in quality improvement.
Furthermore creating a safe, efficient, productive environment for patients and staff that may result in improving patient outcomes and reduce
expenses. Nursing research helps health care providers provide evidence–based practice, which may result in quality improvement (Rebar & Gersch,
2015). For example,
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Evidence Based Practice In Nursing
The Ganz et al. (2009) research was performed in order to evaluate the ICU nurses oral care routines and if they were using appropriate, up–to–date
evidenced based techniques and lastly if evidence–based practices (EBP) was associated with personal demographics and professional characteristics.
Ganz et al. (2009) had found that previous research and studies has shown that poor oral hygiene may contribute to greater risks for pneumonia which
results in an increase in mortality and morbidity (Ganz et al., p 133). In fact some of the research studies had stated that there was no documentation of
the nurses oral care practices and these practices were not even up–to–date with recent evidence (Ganz et al., p 133). In addition to that,
ventilator–associated...show more content...
One reason is that although the participants are expertise in their field of study, they still rely on the other group members to collaborate on the topic
which bring about changes on how to resolve the issue (Hasson, Keeney, & McKenna, 2000). This process consist of multiple feedback rounds
which tends to result in lower response rates due to the multiple questionnaires received by the participants and can also result in them not continuing
or withdrawing from the Delphi process (Hasson, Keeney, & McKenna, 2000). The Delphi process is often time consuming and arduous taking up a
large amount of time (several days or weeks) needed to complete the process (Hasson, Keeney, & McKenna, 2000). An experiment done by Scheibe,
Skutsch and Schofer has shown that Delphi group participants would change their answers after receiving a biased feedback (Adams, S. J. (2001).
When one look at the practice of evidence–based medicine it requires some level of clinical expertise combined with the best available evidence from
methodical research (Roddy et al., p 348). Despite my feelings on the Delphi technique, I also think that guidelines can be instituted in a clinical
setting to create or improve strength of recommendation. Roddy et al. (2006) however did use more reliable and valid statistical resources such as
visual analogue scale (VAS) and one way ANOVA analysis. The VAS is a measurement

Over the years nurses have relied on utilizing nursing interventions founded only on tradition. By following this trend nurses aren't giving the best care,
but the most popular care to patients. By choosing to care for patients using evidence based practice, nurses are giving the interventions they use
credibility. For example, many nurses know that the standard for repositioning patients is every two hours, however many nurses haven't explored why,
but they do it every shift. In research done with critical care nurses, it was found that "turning patients every 2 hours is essential to prevent poor
outcomes" and "turning critically ill patients is the first step to mobilizing patients" (Makic, Rauen, Watson, Poteet 2014). Furthermore, nurses are the
patients advocate, believing in this, a nurse should know why certain interventions are being used how they could positively or...show more content...
Meaning that facilities need nurses who will follow evidence based protocols that will keep patients safe and save the facility money down the line.
Inpatient falls is an event that no facility is happy about, it reflects negatively on the nurses and Medicare and Medicaid wont pay for the injuries
sustained, "Medicare and Medicaid Services that hospitals will no longer be reimbursed for certain nosocomial conditions (U.S. Department of Health
and Human Services, 2008). These hospital–acquired conditions, also called never events, include the cost of treating injuries obtained from hospital
falls" (Graham, 2012). In order to prevent hospital falls, evidence based care suggests that through medication management, environmental aids, fall
alarms and future technology such as video monitoring and fall prevention teams, the rate of hospital falls can be greatly

Evidence Based Nursing Essay
ed based
A Qualitative Study of Nursing Student Experiences of Clinical Practice
Farkhondeh Sharif1 & Sara Masoumi2
1Psychiatric Nursing Department, Fatemeh (P.B.U.H) College of Nursing & Midwifery Shiraz University of Medical Sciences, Zand BlvD, Shiraz, Iran
2English Department, Shiraz University, Shiraz, Iran
Published 9 November 2005
[pic]
Abstract
Background
Nursing student's experiences of their clinical practice provide greater insight to develop an effective clinical teaching strategy in nursing education.
The main objective of this study was to investigate student nurses' experience about their clinical practice.
Methods
Focus groups were used to obtain students' opinion and experiences about their clinical...show more content...
[2]
Clinical experience is one of the most anxiety producing components of the nursing program which has been identified by nursing students. In a
descriptive correlational study by Beck and Srivastava 94 second, third and fourth year nursing students reported that clinical experience was the most
stressful part of the nursing program[3]. Lack of clinical experience, unfamiliar areas, difficult patients, fear of making mistakes and being evaluated by
faculty members were expressed by the students as anxiety–producing situations in their initial clinical experience. In study done by Hart and Rotem
stressful events for nursing students during clinical practice have been studied. They found that the initial clinical experience was the most anxiety
producing part of their clinical experience [4]. The sources of stress during clinical practice have been studied by many researchers [5–10] and [11].
The researcher came to realize that nursing students have a great deal of anxiety when they begin their clinical practice in the second year. It is hoped
that an investigation of the student's view on their clinical experience can help to develop an effective clinical teaching strategy in nursing education.

Methods
A focus group design was used to investigate the nursing student's view about the clinical practice. Focus group involves organized discussion with a

Evidence Based Practice For Nursing Practice
According to Lewis, Dirksen, Heitkemper & Bucher (2014), "Evidence–based practice is a problem–solving approach to clinical decision making. It
involves the use of the best available evidence in combination with clinical expertise and patient preferences and values to achieve desired patient
outcomes." Using evidence based practice in nursing is extremely important, because evidence–based practice is the result of others trying a practice
one way but needing to change some of the guidelines to make the practice safer and over all better for patients.
Nurses always want what works best for their patients rather than having to struggle to find what works. The nurse plays a key role in implementing
evidence–based practice because it is the nurse who is the advocate and care giver to their patients. Because of evidence–based practice different
aspects of nursing care are always changing. It is crucial for nursing practice to evolve because through research other health care professionals have
found things that work best and is resulting in less patient deaths and furthering complications in a patient's illness. Some of the examples that will be
discussed here as result of evidence base practice are: better pain assessments in pediatric patients, preventing pressure ulcers, kangaroo care, music
therapy to help distract, better hand hygiene, and teaching parents about life saving techniques.
Pain assessments in pediatric patients can be extremely difficult because of the fact

Evidence–Based Practice and Applied Nursing Research Task 1
A1. Evidence Table
Quantitative
Article:
Conrad, A., Grotejohann, B., Schmoor, C., Cosic, D., & Dettenkofer, M. (2015). Safety and tolerability of virucidal hand rubs: a randomized,
double–blind, cross–over trial with healthy volunteers. Antimicrobial Resistance & Infection Control, 4(1), 1. doi:10.1186/s13756–015–0079–y
Background or Introduction
Hospital acquired infections are a big problem today, but the use of disinfectants by the medical staff can help to avoid or limit such exposures to
pathogens. The authors' main purpose of this research article was to educate and teach the importance of hand hygiene and test the reason why certain
virucidal hand–rubs result in poor compliance due to the poor tolerability of the products. The overall goal with the study would to show the reason
certain hand rubs are not being used and how to improve their formula to increase compliance. The article written by the author was very well written
with a thorough abstract. The study was very easy to follow and read, due to the well thought out structure of the article. The authors introduction starts
out by stating the approximate amount of hospital acquired infections in the European Union and why hand sanitizers play an important role to avoid
such infections. The introductions statement showed the importance of the topic. Although some of the results were complicated and confusing, the
discussion laid out the results in layman

Evidence based practice is important in nursing research. By implementing a plan to follow research that has been validated, nurses can create a
better chance of having the best outcome possible for their patients. In order to implement a plan, it is important to analyze the research being
used, as well as determining how this research can be used in the specific clinical field a nurse is practicing in? It is also very important to
determine which patients the evidence based practice plan will help based off of the research. A nurse must "balance the benefits and risk of the
evidenced based practice decision" (Godshall, M., 2009). The ideal setting for implementing further research on the mental and behavioral health of
a nurses working in a pediatric cardiac intensive care unit. The nurses working on the unit are ranged in age from 23 to 33. They have been on a
long, busy shift, with many patients under the age of 7. The nurses are showing "symptoms of headache, irritability, and stomach aches" (Tito, et al.,
2017). This is posing harm to their "psychological welfare" (Tito, et al., 2017). The plan will entail providing both self–reporting...show more content...
The questions will be listed asking how often the nurses experience headaches, do they feel anxious, do they experience anxiety more often during
their shifts, are they easily tired, have they noticed a loss of interest since they began working in this field, as well as other questions. This will be a
"self–reporting questionnaire" (Tito, et al., 2017). A questionnaire will also be provided to determine the characteristics of the nurse employees, asking
about their "socio–demographic area" (Tito, et al., 2017) to determine if this plays a role in the symptoms they are experiencing. The price of this
questionnaire must also be

Evidence-Based Practice Vs Evidence In Nursing
I also believe in using that best evidence should be incorporated into every nursing decision. Masic suggests the practice of evidence–based medicine is
a process of lifelong, self–directed, problem–based learning in which caring for one's own patients creates the need for clinically important information
about diagnosis, prognosis, therapy and other clinical and health care issues. He also points out nursing tradition as a "cookbook," full of recipes if
you will, as the way it's done (2008). Both take evidence into account; however, evidence based practice demands better evidence than has traditionally
been used. We as nurses must challenge nursing tradition in order to provide better health care. I would assume most nurses would express a

Evidenced Based Practice (EBP) is essential to enable all nurses to provide the most current up to date practises for their patients. This process involves
research, systematic review of current practises, critical thinking skills, evaluation and application to the clinical setting. In addition to this, the nurse
must take into account the patients' preferences. For nurses to have professional autonomy they must be able to justify their actions and demonstrate
an understanding of why they perform the tasks they do. This defines them as unique professionals judged by their knowledge and not simply by their
hands on skills. As stated by McSherry, Simmons & Pearce (2002); "Nurses are responsible for the care they provide for their patient....show more
content...
(Polit & Beck, 2010). As nursing is person–centred and relies on a multidisciplinary team approach it has to take into account the care setting, patient
predilections, clinical judgement and best available evidence. (Holland & Rees, 2010). The key steps involved in evidence based practice come from
a thirst for knowledge that once ignited makes the next step to asking a well worded clinical question easier. A well formulated question improves
patient outcomes and supports the implementation of change. One such method looks at foreground and background questions. A background question
is usually a basic knowledge question and is usually answered by a textbook. Foreground questions are usually specific and once answered can help in
clinical changes. An acronym useful for formulating a well worded question is PICOT. ( Stillwell, Fineout–Overholt, Melnyk, Williamson, 2010).
"PICOT is an acronym for the elements of the clinical question: patient population (P), intervention or issue of interest (I), comparison intervention or
issue of interest (C), outcome(s) of interest (O), time it takes for the intervention to achieve the outcome(s) (T)." (Stillwell et al., 2010, p. 59). When a
question has been identified the best study design can be chosen. For a prognosis question, a good quality cohort study would be used. For a
non–compliance question, a qualitative study would be appropriate and for the effectiveness of treatment a systematic

Essay on Evidence Based Practice in Nursing
Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored
in the implementation of Evidence Based Practice. Individuals need specific care tailored to them, it is vitality important to have the correct
professional and appropriate personal care. In order to receive this we need to get the patient involved in the decision process, listen to their views and
opinions and receive the relevant, accurate, professional and medical information. Once all the information is collaborated a personal care package can
be put into practice. Evidence – Based Nursing, An introduction (2008, p.1) " At is core evidence based 'anything' is concerned with using...show more
content...
This outlines the fact it is crucial to have the best external evidence including both clinical and professional inputs. It also highlights the patients' rights
preferences and their autonomy should be without doubt taken into account during the research process. The best method for treating patients for
nurses and any other medical professionals is to use Evidence Based Practice. This is because it brings together years of accurately recorded clinical
knowledge from previous cases with will be relevant in the treating of your patient. The process of using Evidence Based Practice in a patients care
plan consists of five key stages. Asses the patient and formulate the problems from this you will then need to access the relevant clinical articles. Using
this information you should then be able to assess which is the best method of treatment discarding any misleading or ambiguous articles. You then
need to incorporate this knowledge into the patients care plan. Finally you need to evaluate and assess the patient during treatment to ensure
effectiveness. Evidence – Based Nursing, An introduction (2008, p. 285 ) " The rapidity of change and the reorganization of nursing services within
the health care sector presents challenges for the advancement of EBP. Managers and administrators should facilitate the uptake of practice based on
current, high–quality research by formalizing the expectation that nurses care be Evidence Based".

Evidence Based Practice Reflection
Each clinical day, I am constantly thinking about what is evidence based; what have I learned for lecture. To be honest, I never thought I would be
thinking so much about evidence based practice, but I feel it's essential that each and every single one of my patients gets the best possible care that
they deserve. Some ways that I've incorporated EVP into my clinical is having discussions with employees about the correct needle length size,
observing employees do certain procedure and reflect back, as well as, if I see something that doesn't seem right, I'll ask the nurse a question. For
example, the nurse and I were doing a postpartum assessment and I noticed when the nurse was assessing the patient's lochia, that she didn't have the
patient turn to see if any blood was pooled under her....show more content...
So I kindly, asked the nurse if we are supposed to look under the patient to assess for any blood pooling under her. Because of this reminder, the
nurse realized she forgotten this step and thanked me. We looked under the patient, and thankfully there was no blood pooled under her. Another
example, of having an EVP mind, was when I watched a labor. I noticed that the residents kept putting their fingers in the patient's vagina. In lecture,
we learned that we want to limit the amount of times that we assess the patient's cervix due to the risk for infection. Because I don't know about
deliveries, and how many times the doctor is supposed to assess the cervix; I didn't say anything. I also didn't feel comfortable, as this delivery team,
offered for me to watch. I didn't know these employees or patient from earlier. In the second half of the semester, I plan to speak up, if I see something
that doesn't seem right, regardless, of the employee's title, and how long I've been working with

Evidence-Based Practice
The incorporation of evidenced–based practice (EBP) into nursing practice is supported by research to positively improve the quality of care and
improve patient outcomes. EBP is important to the nursing profession because it also leads to increased job satisfaction, teamwork, and levels of
engagement in clinicians (Melnyk, et al., 2017). Miniature research projects such as quality improvement projects, surveys, and clinical research
studies are frameworks used to get feedback and data from patients during their time spent in health care systems. EBP is not the standard of care in
many health care systems (Melnyk, et al., 2017). This due to many factors, including lack of EBP mentors, nursing programs that do not incorporate
EBP into the curriculum,...show more content...
The research process includes an intent, design, timeline, setting, measurable outcomes, and a plan for dissemination of the finding. The purpose of the
research is to generate knowledge or validate existing knowledge. Being able to identify the significance of these factors in different evidence–based
practices will help the practitioner evaluate whether that information is relevant to that population of care or individual. Understanding the research
process will help the clinician understand the purpose of the investigation, if the results are valid, why the results are important, and if the results will
improve patient outcomes (Arndt & Netsch, 2012). A quality improvement (QI) project involves data–guided activities with short timelines to improve
health care delivery systems (Arndt & Netsch, 2012). The setting of QI projects take place in a single setting and are monitored in the institution where
the QI project is conducted. The purpose of a QI project is to change practice outcomes and apply known solutions to a known problem in that
institution (Arndt & Netsch, 2012). Data obtained from the activities is disseminated through newsletters, flyers, through staff meetings, or submitted
for publication and presented in

Nursing Evidence Based Practice
Personally, I have never experience any type of research that can relate to nursing, however; I have experienced evidence based practice at work. The
institutions I'm at has changed the foley policy nevertheless, like countless nurses pulling a foley and given a patient lasix made no sense. This is
where EBP came into play because, what is effective for nurses might not be healthier for the patients. The struggle to understand the different between
EBP and primary research although, several nurses might feel they are the same entity and that the names remain interchangeable myself included.
Now I know that there is a vast difference between the two. Wherever EBP is useful it relies on the nurse expertise along with research moreover,
primary

Evidence based practice (EBP) is a systematic approach that integrates the best currently available evidence, along with clinical expertise and each
individual's preference to make clinical decision, in order to deliver the most optimal care to patients (Baigis & Hughes, 2001). EBP in nursing refers
to the adaptation of the latest best nursing research findings with nurses' clinical experience and the value and preference of patients, families and
communities to make the patient care better (The Honor Society of Nursing, 2005).
The contribution of clinical trial nurses in promoting EBP in nursing can be traced back to the nineteenth century. During the Crimean War in 1850s, the
rates of fatality and morbidity of English soldiers were...show more content...
An in–home intervention designed by a group of nurse researchers supported women diagnosed with breast cancer to save marriage. The intervention
strengthened husbands' sense of control in taking care of the sick wives and alleviate their depression (McHale, 1998).
Although a great number of nursing studies have been conducted and research findings have been published, many nurses were not aware of the
recent available research findings. They continued providing nursing care with their intuition, tradition and the authority of policies and procedures.
Some nurses realized EBP, but several barriers hindered them to implement it. The most recognized obstacles were lack of enough time to read
research and implement new findings in nursing practice, lack of knowledge with respect to evaluation of research paper, and statistical and analysis
interpretation, lack of authority to transfer the practice, and lack of support from their colleagues, such as physicians, administration, and staff to
reform the procedures of patient care (Chummun Harry & Tiran, 2008; Niederhauser & Kohr, 2005; Olade, 2004). Some other nurses stated that they
didn't have the knowledge pertinent to databases, and had the difficult time to access research materials (Cadmus, 2008). I think a clinical trials nurse
(CTN), as a member of an interdisciplinary research team and being in a leadership role, can help change the

Evidence Based Practice In Nursing Research
Essential III: Scholarship for Evidence–Based Practice
I can demonstrate competency for this Essential because I can understand the concept of an evidence–based practice (EBP). The American Association
of Colleges of Nursing stated "the national voice for baccalaureate and graduate nursing programs, believes that education has a significant impact on
the knowledge and competencies of the nurse clinician, as it does for all health care providers" (The Impact of Education on Nursing Practice, 2016, p.
1). Nursing research is crucial to the nursing practice. Nursing research provides the scientific basis of knowledge impacting the health of society. The
goal of nursing research is to promote wellness, safety, and health.
I have had the opportunity to...show more content...
In my long–term care and rehab facility, we are involved in applications of evidence–based practices. We recently started a new initiative due to
evidence based practice for our increase in UTIs, the outcome for this EBPs is still pending, but I am hopeful for a positive outcome to improve the
quality of care for our patients. One EBP we have initiated with positive patient outcomes were from our fall prevention interventions. We implemented
Fluid, Ask, Bathroom (FAB) rounds at shift change due to a high number of falls occurring during this time. Implemented monthly meetings with the
multidisciplinary team to address recent falls. Each disciplinary making individualized patient recommendations, such as physical therapy, occupational
therapy, speech therapy for cognition if there is a recent decline noted. We evaluate the need for a specialty bed, impact mats or

Importance Of Evidence Based Practice In Nursing
New Practice Approaches The effect and importance for evidence–based practice in nursing profession has reverberated across nursing practice, our
educational institutions and in the field of science. The cry–out for improvement and the need to transform our healthcare industry calls for
evidence–based practices to be inculcated into our health which would in turn usher in effectiveness, safety and efficiency into our health care.
Therefore new practice approaches are those ideas with evidence–based practices that would help us move our healthcare in the desired direction. There
is no doubt that we need evidence–based practices in tackling the issue of hospital acquired pressure ulcers (HAPUs). For some time now in the
facility where I work, we perform thorough skin assessment upon admission, utilizing Braden scores, revised skin protocol, fluidized patient
positioners, and silicone gel adhesive dressings. Most importantly, efforts were made to motivate the staff and also educate them to be more
enterprising in discovering patients at risk of developing hospital acquired pressure ulcer. And since we started this, the result has been tremendous;
the incidence of HAPUs in our facility has been reduced considerably. There is no doubt in my mind that by the end of 2018 our facility would have
achieved a great deal in tackling the issue of HAPUs. Intraprofessional Collaboration Intraprofessional collaboration nursing is the collaboration
between different disciplines in

Evidence Based Practice
The purpose of this essay will be to discuss evidence based practise and its use in nursing, I will be discussing, the types of research and various
forms of data, including the principles of evidence based practise and research. Evidence Based practice is finding the most effective, research
proven, evidence to make decisions regarding the service users individual needs and the best decisions for them. As David Sackett quotes, "evidence
based practise is the integration of best research evidence with clinical expertise and patient values." (Sackett D, et al 1996, p.71) Evidence based
practice is good practice, assist practitioners, avoiding information overload and applying the most useful information. Hek and Moule defined evidence
based...show more content...
It is essentially research based on numerical data, including collection and analysis. For example, asking questions with yes or no answers to be able to
gather a number of statistics for the search. There are a number of methods used for data collection with the quantitative approach to research, these
include, questionnaires, surveys, experiments observation schedules and measuring tools. With quantitative research there are two types of sampling
methods, probability and non–probability. Probability is the likelihood of the population of the research will be included into the final sample, when
every unit has more than zero chance of being selected. Whereas non–probability is when the researcher is unable to state that the chances will be
likely, units with chance of selection cannot be identified. (Parahoo 2006,

Evidence based practice is a practice that is based upon the best available evidence, patient preferences, and clinical judgments (Schmidt & Brown,
2012). According to Schmidt and Brown the nurse's standpoint of patient care obliges nurses to form their own body of evidence through scientific
research (Schmidt & Brown, 2012). A nurse encounters many patients with various disease processes throughout their careers. Overtime the nurse will
be able to see which treatments work and which ones need improvements or can even do without. Nurses are key players when it comes to evidence
based practice. The Nurses of the Future Nursing Core Competencies are designed to be appropriate across all care settings and to incorporate all
patient populations

Evidence Based Practice
Part A: Importance for Nurses to Utilize Evidence Base Practice Utilizing evidence based practice in nursing is paramount today in the always
evolving field of nursing. Having the clinical expertise and knowledge of a nurse is just the first step in making decisions for the treatment of a
client. Adding the most recent and up to date evidence alongside with the client's values and preferences is ideal to guiding the process of
healthcare (Kelly & Tazbir, 2010). When evidence based guidelines are set forth in the plan of care for a client, the clinician has an abundant of
amount of data to make sound decisions on. This allows the nurse to make the best decision or develop the best strategy to deliver care. Evidence
based practice also allows...show more content...
It has been shown that in studies that pain management is not always touched with wound care (Maddox, 2012). Uncontrolled and untreated pain has a
negative impact on the healing process thus having a negative in quality of life. When nurses conducted a research study on the experience patients
with venous ulcers, what led the patients to consult practitioners was pain (Maddox, 2012). This study led to the realizations that pain was being
properly addressed by doctors and nurses. This was the constant recurring physical symptom in venous ulcers, acute and chronic. Even in some cases
the pain was so severe that it interfered with activities of daily living, and normal tasks such as walking became

Nursing Evidence Based Practice

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