INTERNATIONAL NURSES WEEK THEME FOR 2012 CLOSING THE GAP :FROM EVIDENCE TO ACTION
Introduction Now, more than ever, nurses need to learnnot only how to gather evidence but alsohow to put that knowledge into everydayuse. The use of an evidence-based approachenables us to seek new and more effectiveand efficient ways of doing things, therebyincreasing access and to care and wellbeing
Understanding Evidence-based Practice What is evidence?As Lomas et al. (2005) note:" evidenceconcerns facts (actual or asserted) intendedfor use in support of a conclusion”.A fact is something that is known throughobservation or experience.
Evidence-based PracticeThe practice of health care in which thepractitioner systematically finds, appraises,and uses the most current and valid researchfindings as the basis for clinical decisions.
Identifying the evidenceThe first place to start by asking a goodquestion. Once a problem is identified, it ismuch easier to move on with the help ofappropriate questions to identify theevidence you need to tackle the problem.
There are a number of methods for buildingquestions but most contain four elementsThe problem: the patient or client, population orcondition you are dealing with.The intervention you are considering.A comparison (this may not be always needed)with which to compare the existing intervention.The outcomes of interest.Having a defined question it is now possible tolocate the evidence.
Potential sources of evidence Research by health professionals or academics Research by companies e.g. pharmaceutical companies Reviews of research and clinical guidelines Expert opinion Opinion of colleagues Clinical experience Experience of patients or clients Clinical audit data
Sources of Evidence Specialist organizations dedicated to summarizing research findings which may make these available in a variety of media. Specialist journals with a focus in the area of interest. Specialized databases. The internetLibraries.
From Evidence to Action Changing any part of the health care system requires careful thought and planning; an individual nurse’s decision to change an element of practice can rapidly have consequences for colleagues and patients.
Changes are rarely easy as it involveschanging the way people and the systembehave. Change can frequently be messy,waste time and can have unpredictedconsequences. However change can beexciting and motivating. Understanding andplanning how to take evidence into practice,to action knowledge, is important
Making the CaseIt is not simply enough to have strongclinical evidence for change it may not beaffordable or it may require other resourcesto be allocated to ensure its success.In many situations implementing a serviceinnovation will involve stopping doingsomething else
To determine the success of practice changesit is helpful to identify outcome measures. Itis also helpful if these can be easilymeasured and reported upon.
SUMMARYFinally, in terms of making sure that the changes inoutcomes are a result of your intervention, it maybe appropriate to build in some form of monitoringor impact evaluation. Monitoring is useful if youwant to know what is actually happening.The use of an evidence based approach enables usto do just that. It allows us to constantly review ourpractice and to seek new and more effective waysof doing things.