Basically, evidence-based practice refers to an approach of solving problem in the health care delivery that makes use of the best available evidence from past studies as well as data related to patient care. Together with expertise and the values and preferences of the patients, the identified best evidence is implemented. It has been identified that EBP in nursing can be utilized by various nurses to achieve positive outcomes. However, there is a need to use the correct research methods such as systematic reviews that provide a lot of information on the specific topics of interest. The paper examines evidence-based practice (EBP) in nursing and its contribution to the work of practitioners.
Keywords: method, evidence-based practice/EBP, heath care
In the nursing field, EBP is a type of practice that enables nurses to apply methods that can be critically appraised or proved on a scientific basis supported by evidence to enhance the delivery of quality health care to a particular population within the society. The practice combines clinical expertise and what the patient values, needs, and desires. In this paper, several aspects of EBP are examined, namely the importance of EBP for nurses, research methods nurses need to understand in their practice and the utilization of the practice to provide global health care.
Part A: Why It Is Important for Nurses to Utilize EBP
Practice based on proven evidence has continued to be a critical tenet of the nursing profession. Apparently, the idea that EBP is of paramount importance is not new in nursing. Existing literature proves that several researches have been conducted in the past to aid the implementation of EBP. As a complex process, EBP considers both individual and organizational factors. It implies that even though the role of nursing practitioners in the provision of highest quality of care cannot be underestimated, organizational response is equally important. Thus, effective application of the roles in EBP would require one to make policy changes, educational input, and clinical audit as well as promote effective change management. Therefore, Gerrish, Clayton, Nolan, Parker, and Morgan (1999) conducted a research to prove that EBP could be used to manage change. Specifically, the research focused on how change management could be helpful in assessing risks due to pressure damage. In the research, Gerrish and colleagues recorded that EBP could be used to advocate for change, but this would require a multifaceted strategy. Importantly, trust was identified as one of the aspects of the practice that was critical for change management. For instance, the researchers recorded that the nurse managers who were accorded the responsibility to discuss the findings by their directorates were more active. Moreover, the researchers formed evidence-based groups that comprised nurse managers, skin care practitioners and audit manager who reported that risk assessment needed to change to a more integrated approach to enhance patients’ outcomes. In this case, nurses utilized the practice to promote change management.
Evidence-based practice is also an important policy framework for knowledge management in risky nursing assignments. The assumption is that practitioners’ uncertainty regarding the effectiveness of health care intervention strategies may lead to variation in clinical practice. Various governments have recognized the effect of practitioners’ uncertainty on health care outcomes. Thus, they have put in place initiatives that would increase utilization of evidence-based methods for treatment of diseases. The implemented initiatives recognize that reduction of the level of practitioners’ uncertainty can positively impact on treatment through the improved patient outcome. According to French (2005), evidence-based nursing practitioners are required to evaluate the relevance and validity of researches at their disposal. Indeed, these practitioners have in place criteria for evaluation of research information.
Firstly, nurses prioritize information based on evidence. Apparently, such information is prescribed by others, but it is required for administration of treatments. Secondly, by making frequent references, EBP indicates that it focuses on functionality and efficiency. Hereby, even when there has been a dispute over the practice as well as its effectiveness on generating outcomes, its focus on process and incisiveness is a reflection of how professional competency can be enhanced from a health care perspective (French, 2005). Thirdly, EBP requires practitioners to assess how relevant their research is for the nursing practice, especially in areas of specialization. The outcome of the research of French (2005) indicates that the nurses who applied the principles of EBP in their work were likely to be contextual, client-specific, and not easily swayed by single solutions. Instead, they sought more information and matched it with clinical requirements. Thus, EBP is critical in expanding knowledge base in the various areas of specialization.
Moreover, through EBP, nurses can learn the importance of risk estimation. Apparently, amalgamating information obtained from various sources to make meaningful inference enhance qualitative knowledge. In such a way, learning how to estimate information can build knowledge and support clear decision-making (French, 2005).
Finally, nurses can utilize EBP to enhance spiritual care. According to Speck (2005), there are spiritual dimensions of people’s lives that strongly support reality. However, nurses have always faced the challenge of identifying the spiritual needs under their care. Nevertheless, spirituality has been shown to permeate nursing care in several ways (Speck, 2005). Therefore, nurse managers who use information gathered from evidenced-based studies have tended to support care planning. Furthermore, health care chaplains have worked closely with nurses to enhance patients’ outcomes (Speck, 2005).
Part B: Why Nurses Need to Understand Research Methods in Order to Implement Evidence-Based Practice
It is a well-known fact that nurses receive a lot of information. Therefore, it is important to learn how to utilize and filter it. Bridging the gap between information and EBP can improve the delivery of nursing care. In this section, research methods and their implementation in evidence-based practice are discussed. Apparently, qualitative research methods can be applied in EBP. On the one hand, qualitative research is based on a holistic worldview or people’s perceptions. On the other hand, EBP focuses on the findings of systematic literature reviews. In fact, qualitative research methods have been used in evidence-based nursing practices to find the meaning of phenomena that were never thoroughly or previously studied (Wood & Nelson, 2013). It is worth mentioning that each method uses a unique approach to study the topic of interest. Thus, nurses should use qualitative methods because of their holistic approach. For instance, in systematic reviews, research findings can be organized and analyzed in a manner that enhances quality of outcomes (Friesen-Storms, Moser, van der Loo, Beurskens, & Bours, 2015; Wood & Nelson, 2013). Moreover, the method insures consistency and quantity of research findings. Understanding this method helps to identify clinical guidelines and improve critiquing skills to achieve meaningful results. Likewise, non-experimental research methods act as huge data sources that could be used to fill gaps in EBP (Wood & Nelson, 2013). The methods clarify and assess relationships as well as provide more clues. They can be used to build knowledge and refine experimental and quasi-experimental methods among others.
Part C: How Nurses are Utilizing EBP around the World (Global Healthcare)
In Maldives, evidence-based practice has been used to create champions (Shafaza, Evans, Bradley, & Ullrich, 2013). The strategy was used to develop clinical leaders from different backgrounds to implement EBP. With regard to the approaches used, these were education and organization-centered one. The champions were expected to promote change and were identified as facilitators and trustworthy or influential individuals. In the end, it was recognized that evidence-based change was based on individuals who could play an important role in implementing the practice in Maldives (Shafaza et al., 2013).
In another instance, Karout et al. (2013) conducted a qualitative research to determine the experiences and perceptions of Saudi Arabia women of maternal health services. The research found that some of the values that affect maternal health care among Saudi women were gender, beliefs, values, and language.
It can be concluded that when utilized well by nurses, EBP can lead to positive outcomes. Specifically, it can promote change management and trust, expand knowledge and risk estimation, and enhance spiritual wellbeing of themselves and patients. However, the practitioners must learn to correctly use EBP methods to get the information required. For instance, both qualitative and quantitative research methods could be applied in practice to retrieve valuable information. Thus, a qualitative method such as systematic reviews has been found to be more applicable.