Evidence based practice an essay
Evidence-based Practice – an essay. The concept of evidence-based nursing practice (EBP), has been described as, “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients”. (Sackett et al 1997 p 2) What constitutes ‘current best evidence’ will be explored later, but the concept of EBP started during the 1970’s when nursing was asserting itself academically (Salvage 1992). A requirement of this process was the production of a specific body of nursing knowledge (Henry & Pashley 1995) supported by the production of evidence, the comprehension of which, would be an important source of professional power (Newell 1997). ... Nursing’s professional body, The Nursing and Midwifery Council (NMC) state that nurses have: “a responsibility to deliver care based on current best evidence, best practice and, where applicable, validated research when it is available”. (NMC 2002) The nursing professional recognises that EBP leads to greater job satisfaction by knowing that practice is based on the latest scientific knowledge, rather than because an authority has said it must be so (Gardener 1992). ... The National Institute for Clinical Excellence – NICE - was set up to provide consistent guidelines for clinicians about best practice. ... Most of these policies are backed by evidence although not all (Muir Gray 2001). Having explored the concept of EBP, this essay will now explore what constitutes ‘best evidence’ and its usefulness to nursing practice. Up to the present day much nursing knowledge has been based on tradition, authority and borrowing from disciplines such as medicine, sociology, and education (McMurray 1982). ... Nevertheless they do lack a proven scientific basis upon which to inform best practice. ... that directly and indirectly influences nursing practice. ... used to describe variables, examine relationships among variables, and determine cause and effect interactions between variables (Burns & Grove 1995 p14-15) The most predominant method used in nursing research, some researchers believe quantitative research provides the best knowledge base for nursing practice (Norbeck 1987). ... Methods used to obtain data include interviews, focus groups, observations, questionnaires and documentary evidence. ... Together quantitative and qualitative research provide the evidence available to nursing and its usefulness depends largely on its quality. This quality has been determined in a ‘hierarchy of evidence’ (Muir Gray 2001). ... Despite any intrinsic usefulness of nursing research, its actual usefulness depends on getting it into practice. ... Clinical Governance requires that there be training in critical appraisal of evidence and the NHS Research and Development Strategy (DoH 1991) is to ensure that content and delivery of care is based on high quality research, and it recognises the need for a well trained workforce to carry this out (Henry & Pashley 1995). Whilst it should be a given that new EBP is automatically implemented, establishing best evidence, is not the same as implementing best practice (Dawes et al 1999). ... There can be a genuine or perceived lack of time for searching and reading papers and, unfortunately, a lack of high quality, or relevant evidence to their area of practice. ... This is an evidence-based initiative set out by Government in the NSF for Older People (DoH 2001). ... Members of the CMHT admitted to me that the latest evidence rarely plays any part in their practice and that they do not feel inclined to look for it partly due to a perception of lack of time, lack of computer skills and lack of computers!