EBP in Nursing Care

Evidence Based Practice In Nursing
QSEN– Evidenced Based Practice Evidence based practice is an important priority in nursing
because it ensures that the best quality and most effective care is being used. Restraint use is an
intervention that is being minimized more and more. It can be an important intervention when
necessary but there are specific circumstances and guidelines that must be followed. Evidence based
practice is proving that restraint use may be eliminated due to safety concerns and more beneficial
interventions being used.
Use of Restraints Restraints is an intervention used to confine a person to prevent injury to self or
others. Different types of restraints include physical, chemical and seclusion. Aphysical restraint is
anything that prevents the patient from being able to freely move. This can include seat belts, wrist
restraints, vests, bed rails, etc. A chemical restraint is using a drug for sedation which also restricts
movement or freedom. An example of a chemical restraint can be an antipsychotic. These drugs can
be used to reduce anxiety, aggression, and violent behavior. Lastly, seclusion is isolating or
confining the patient to a room where they cannot leave. This form of restraint is also to protect the
patient from harming them self or others. The use of restraints or seclusion can be a useful
intervention if all other interventions have failed. Patients should not be harmed with these restraints
so it is crucial they are done properly. Patients who are put in restraints
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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 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

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

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

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

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
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

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

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

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 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

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, anurse 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 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

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 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 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

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

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,

EBP in Nursing Care

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