NRS 433 Define evidence-based practice
NRS 433 Define evidence-based practice
NRS 433 Define evidence-based practice
Evidence-based practices are what healthcare professionals use to deliver healthcare practices that are proven to improve patient outcomes and increase patient satisfaction. These practices are based on clinical expertise, patient preferences, and values (American Journal of Nursing, 2016, para.1). Evidence-based practices are discovered by looking at nursing and medical research that has already been conducted. To determine evidenced-based practices researchers must gather the information that supports their hypothesis.
Nurses’ researchers utilize the PICOT acronym to gather and organize clinical information to determine evidence-based practices. It is important for nurses to understand the differences between nursing practice problems and medical practice problems. Nursing practice problems are related to the emotional, spiritual and cognitive issues of a patients diagnoses (assingology, 2020). In contrast to the medical practice problems that are only the physiological state of the patient. One could use the diagnoses of diabetes to clarify the differences. When a patient has diabetes the medical practice problems are the patients’ physiological state when blood sugar get too high or to low; electrolytes become out of balance and patients become acidotic which affects respiratory and cardiac systems in the body. The nursing practice problems for a patient with diabetes deal with the way the diagnosis is going to affect their lifestyle, how the diagnosis makes them feel, and do they have the skills and necessities to manage their disease properly.
It is important that when a nurse is deciding to research an evidenced-based practice that they are asking PICOT problems that are based on nursing best practices because that is where they are going to have the biggest impact.
References:
American Journal of Nursing. (2016). Evidence-based practice step-by-step. Retrieved from https://journals.lww.com/ajnonline/pages/collectiondetails.aspx?TopicalCollectionId=10
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I agree with you that evidence-based helps healthcare professionals to improve patient outcomes. At the same time, healthcare providers use evidence-based practices to increase patient satisfaction. Therefore, healthcare organizations ensure that they have incorporated evidence-based practice in their routine. These practices are based on clinical expertise, patient preferences, and values. Thus, healthcare professionals use their nursing research skills to obtain information on patient taste and preferences. The information is important in shaping evidence-based practices (Beckett et al., 2021). Unfortunately, some nurses have limited information on EBP. As a result, incompetent healthcare professionals experience challenges when using evidence-based practices. Nurses’ researchers utilize the PICOT acronym to gather and organize clinical information to determine evidence-based practices (Wood et al., 2019). The acronym provides a framework that enables healthcare providers to organize their activities and clinic information. Adhering to all the requirements of PICOT allows nurses’ researchers to obtain accurate clinical details. Asking PICOT problems restricts healthcare professionals to the scope of the nursing research.
References
Beckett, C. D., Zadvinskis, I. M., Dean, J., Iseler, J., Powell, J. M., & Buck‐Maxwell, B. (2021). An integrative review of team nursing and delegation: implications for nurse staffing during COVID‐19. Worldviews on Evidence‐Based Nursing, 18(4), 251-260. https://doi.org/10.1111/wvn.12523
Wood, R. L., Migliore, L. A., Nasshan, S. J., Mirghani, S. R., & Contasti, A. C. (2019). Confronting challenges in reducing heart failure 30‐day readmissions: lessons learned with implications for evidence‐based practice. Worldviews on Evidence‐Based Nursing, 16(1), 43-50. https://doi.org/10.1111/wvn.12336
Evidence-based practice is defined by Chrisman as “the process of collecting, processing, and implementing research findings to improve clinical practice, the work environment, or patient outcomes.”(2014) In other words evidence-based practice is used to improve different processes throughout the healthcare system. When a problem is identified within the way nurses care for their parents, nurses have the opportunity to improve the processes through evidence-based practice. The goal of evidence-based practice is to provide patients with quality care that is safe and improves their overall outcome, this is done by making sure nurses are keeping up with and have access to the best research evidence, seek clinical expertise and always consider the patient values. (Helbig,2018)
A nursing practice problem pertains to the thing that falls under nursing diagnosis. A nursing diagnosis is defined as “A nursing diagnosis is a clinical judgment concerning a human response to health conditions/life processes, or a vulnerability for that response, by an individual, family, group or community”. (Nurselabs,2022) an example of a nursing diagnosis or a nursing problem would be the risk for unstable blood sugar. Whereas a medical problem would fall disease process or medical condition. An example of what this might be called is diabetes. The difference is a medical diagnosis can only be diagnosed by a doctor whereas a nursing diagnosis falls within the nursing scope.
It is important that the PICOT falls within the nursing process because nurses don’t want to operate outside of their scope of practice. There is a set list of nursing diagnoses that nurses can use and anything outside of those diagnoses falls out of their scope of practice. A nurse wouldn’t be able to research medical practices and implement processes of improvement for a medical practice, nurses don’t have experience in the arena of medical practice or knowledge of medical practices. But the nurse researcher has or should have experience in the area in which they are wanting to study and provide evidence-based practice.
Chrisman, J., Jordan, R., Davis, C., & Williams, W. (2014). Exploring evidence-based practice research. Nursing Made Incredibly Easy!, 12(4), 8–12. https://doi.org/10.1097/01.nme.0000450295.93626.e7
Matt Vera, B. S. N. (2022, May 11). Nursing diagnosis ultimate guide: Everything you need to know. Nurseslabs. Retrieved August 31, 2022, from https://nurseslabs.com/nursing-diagnosis/#h-what-is-a-nursing-diagnosis
Helbig, J. (2018) Nursing Research: Understanding Methods for Best Practice Grand Canyon University c.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/1
REPLY
It is true that evidence-based practice (EBP) is the process of collecting, processing, and implementing research findings. EBP targets at improving clinical practice, patient positive outcomes, and the work environment (O’Shea & Fischer-Cartlidge, 2020). Therefore, healthcare professionals rely on evidence-based practices when obtaining and using clinical information. Evidence-based practice is used to improve different processes throughout the healthcare system. The practice is based on factual information obtained through medical research. Therefore, evidence-based practices guarantees accurate and reliable clinical information. The goal of evidence-based practice is to provide patients with quality care that is safe and improves their overall outcome (Teolis, 2020). Healthcare professionals understand that obtaining accurate information improves the credibility of EBP. Hence, adequate information is directed towards collecting and processing research findings. It is important that the PICOT falls within the nursing process. Evidently, nurses may not want to operate outside of their scope of practice. PICOT ensures that healthcare providers remain within their profession.
References
O’Shea, D., & Fischer-Cartlidge, E. (2020). Building evidence-based practice competency through interactive workshops. Clinical Nurse Specialist, 34(5), 217-221. doi: 10.1097/NUR.0000000000000544
Teolis, M. G. (2020). Improving nurses’ skills and supporting a culture of evidence-based practice. Medical Reference Services Quarterly, 39(1), 60-66. https://doi.org/10.1080/02763869.2020.1688626
Evidence-based practice is the integration of clinical expertise, the most up-to-date research, and patient’s preferences to formulate and implement best practices for patient care (Helbig, 2018). A nursing practice problem is something that nurses encounter in a clinical setting and the extent to which they report being able to influence those patient problems (Kieft et al., 2017). An example of this is when a nurse works at a hospital and the focus is on the patient’s coping and adjustment of pain (Kieft et al., 2017). If a patient in this case has COPD, the nurse will know to make sure the patient has oxygen because of evidence-based practice. A medical practice problem is more related to medical illness or diseases (Cristancho et al., 2017). Based on the previous example, a doctor will be diagnosing and identifying the treatment of someone with COPD. It is important for PICOT to be based on a nursing practice problem to promote and provide safe, quality care and to improve outcomes (Helbig, 2018). It is also important to note that PICOT is evidence-based and associated with quality improvement (Helbig, 2018). Nurses developing PICOT questions who have already looked into evidence-based research that is already conducted (Helbig, 2018). It will also make sense that PICOT must be based on a nursing problem because it is a nurse researcher that will also decide what information is needed to answer the PICOT question (Helbig, 2018).
Reference:
Cristancho, S., Lingard, L., & Regehr, G. (2017). From problem solving to problem definition: scrutinizing the complex nature of clinical practice. Perspectives on medical education, 6(1), 54–57. https://doi.org/10.1007/s40037-016-0314-0
Helbig, J. (2018). History and Process of Nursing Research, Evidence-Based Nursing Practice, and Quantitative and Qualitative Research Process In Nursing Research: Understanding Methods for Best Practice. (Chapter 1). Grand Canyon University. https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/1
Kieft, R., de Veer, A., Francke, A., & Delnoij, D. (2017). A nationwide survey of patient problem occurrence across different nursing healthcare sectors. Nursing open, 4(4), 292–302. https://doi.org/10.1002/nop2.102
It is true that nurses encounter nursing practice problems in their clinical settings. However, healthcare providers are trained to handle various healthcare challenges. Evidence-based practice is the integration of clinical expertise and the most updated research in the clinical practice. Healthcare providers assume that evidence-based practices are resourceful in improving patient safety and positive patient outcomes (Stucky et al., 2020). Similarly, EBP can improve work environment. Many justifications attract healthcare professionals and providers to implement EBP. Implementing best practices for patient care is a routine that require competent healthcare providers. Unfortunately, most nurses have indicated their dissatisfaction with EBP due to their insufficient knowledge and experience. Still, EBP has transformed healthcare experience (Melnyk et al., 2022). As a result, healthcare organizations are increasingly integrating evidence-based routines in their workplace. Nurses developing PICOT questions who have already looked into evidence-based research. Most PICOT questions are synchronized with the evidence-based research. Thus, nurses can use PICOT questions and EBP to improve patient experience.
References
Melnyk, B. M., Hsieh, A. P., & Mu, J. (2022). Psychometric properties of the evidence‐based practice mentorship scale. Worldviews on Evidence‐Based Nursing. https://doi.org/10.1111/wvn.12596
Stucky, C. H., De Jong, M. J., & Rodriguez, J. A. (2020). A Five‐Step Evidence‐Based Practice Primer for Perioperative RNs. AORN journal, 112(5), 506-515. https://doi.org/10.1002/aorn.13220