Evidence based nursing practice – A review

Evidence based nursing practice – A reviewReview Article Evidence based nursing practice – A review Hinal Rathod1* 1 Staff nurse, V.S. General Hospital, Ahmedabad, Gujarat, India.AbstractEvidence based practice, evidence based medicine, evidence based nursing etc. are not newterminology in the recent era. For implementation of evidence based nursing practice, onlyknowledge is not sufficient among core workers but nursing community must have attitude andintention to practice it by their heart. In current Indian scenario, there are plenty of challenges inintegrated evidence based nursing practice. For effective implementation of evidence based nursingpractice, a nurse must be able to decide either the evidence is relevant and appropriate for theparticular patient or not before its application. All patients must receive safe, effective personcentred care, based on the best available evidence is the aim of evidence based nursing and nurseshave to play a key role in it.Key wordsEvidence based nursing practice, Strategy, Current situation.Introduction by introduction of course of up-to-date training and skills or the use of clinical reasoning – theEvidence based practice, evidence based ability to concern evidence according to themedicine, evidence based nursing etc. are not needs or circumstance of the individual patient.new terminology in the recent era. Most of the Hunt noted that nursing has tremendousexperts in these fields are agreed to accept research potential and it is truly a research-current trends. For implementation of evidence based profession [1]. Evidence-based nursingbased nursing practice, only knowledge is not practice (EBNP) involves assimilation of asufficient among core workers but nursing problem-solving approach within thecommunity must have attitude and intention to background of caring, considering best evidencepractice it by their heart. Application is possible from studies, patient care data, clinical knowledge and expertise, and patients’*Corresponding Author: Hinal Rathod, preferences and values with its application inV.S. General Hospital, Ahmedabad, India. current practice for the benefit of communityE mail: [email protected] [2].Received on: 31-07-2014 How to cite this article: Rathod H. Evidence based nursing practice – ARevised on: 13-08-2014 review. IAIM, 2014; 1(1): 26-29.Accepted on: 25-08-2014 Available online at www.iaimjournal.comInternational Archives of Integrated Medicine, Vol. 1, Issue. 1, September, 2014. Page 26Copy right © 2014, IAIM, All Rights Reserved.

Evidence based nursing practice – A reviewConcept of EBNP databases or how to search for it. If we are expecting great future in evidence based nursingEvidence-Based Nursing Practice deals with in India, then faculty members must be firstevidence based practice of medicine in which trained and then implement among students forany problem can be addressed by support of betterment of evidence based practice.evidence, theory, research and its application.Actually research in particular field provide One more aspect is most of the research workframework for practice and evidence will be occurred in nursing field till date is almostgenerated by application of theory into practice qualitative in nature in different regions andof research and thus cycle of theory, research, setup which required thorough systematicevidence and practice goes on and on and needs review and meta analysis before itsto be evaluated and checked with time for its implementation at grass root level. A commonaccuracy. misconception of evidence based nursing practice is that it is simply a compilation ofAim of EBNP statistical summaries, blind application of evidence to all with ignoring the patient values,The goal of evidence based nursing practice is to humanity and preferences [4].provide evidence based data for practicingnurses to deliver effective and efficient patient Mitchell et al. noted that nursing researchcare based on the best research evidence; journals were present in only 35% of smallresolve trouble in the clinical setting; accomplish hospitals of less than 250 beds in their libraries;brilliance in care delivery, even beyond quality change in nursing practice on base of researchassurance principles; and to introduce outcome had been adopted by only 38% ofmodernization with humanity to serve society health agencies; 15% implemented research[3]. utilisation programmes for nursing staff; and 97% wanted assistance in teaching their nursingCurrent situation of EBNP staff about research utilisation [5].In current Indian scenario, there are plenty of Strategy to implement EBNPchallenges in integrated evidence based nursingpractice. Nursing community have basic For effective implementation of evidence basedknowledge and understanding of research and nursing practice, a nurse must be able to decidetheory but no practical experience of best either the evidence is relevant and appropriateutilization of research, generating evidence, for the particular patient or not before itsdeveloping standard research protocol, application. There must be positive and effectiveidentification of best search engine and search balance between clinical expertise, personalfilters for collection of database, or doing critical experience and recent evidences for planningappraisals etc. Many times, nurses assume they management of particular patient. One mustare effectively practicing evidence based nursing think for merits and demerits as well asbut in reality they are utilizing remote and advantage and danger to patient. Ultimate aiminappropriate research results. Equally, nursing is the patient satisfaction and cure. The modelfaculty members are still not constantly familiar for evidence based clinical decisions by Hayneswith evidence based nursing or the connected et al. consisted of 4 components which includesInternational Archives of Integrated Medicine, Vol. 1, Issue. 1, September, 2014. Page 27Copy right © 2014, IAIM, All Rights Reserved.

Evidence based nursing practice – A reviewResources, Clinical expertise, Research evidence must not forget that these all steps areand Patients’ preferences [6]. intermingled to each other. With the use of these steps one can practice evidence basedIt is significant to note that in many cases clinical nursing in effective manner. The accessibleexpertise and patient preference will be given research may be qualitative, quantitative, ormore importance and they may override the evidence-based depending upon problems. Allother components of the model for a given these researches when applied on an individualjudgment in routine practice. Before basis to improve patient care one must notimplementation of any new practice, authority forget goal of EBNP that is to deliver besthas to think for resources and various factors available care to patients.have to be well calculated in the luminosity ofthe fact that resources for health care are very Dream of evidence based nursing practice canlimited. Best evidence can’t be practice if it is come true by collaboration of all other healthtoo much expensive to effort by patient or care professionals, NGOs, health policy makershealth care authority even though it is effective in government etc. by their input and set up.and efficient and nursing staff has to keep it in Today we have to struggle for how to makemind in day to day practice. EBNP happen in future for better outcome. This struggle is not restricted to nursing but commonSteps of evidence-based practice to all health professions, including medicine, dental, physiotherapy, pharmacy and manyLarrabee demonstrated following steps for more.evidence based practice [7].Step 1: Collect internal data on current practice, Conclusionlink problems, interventions, comparison andoutcome with time constraint. All patients must receive safe, effective personStep 2: Identify sources of evidence, refine centred care, based on the best availableresearch strategy and conduct the research. evidence is the aim of evidence based nursingStep 3: Appraise the value of the evidence, and nurses have to play a key role in it. Thesynthesize the best evidence, and assess the ability to apply a balanced combination ofrisks and benefits of the new practice. technical expertise, clinical reasoning, patientStep 4: Define proposed changes, identify the values, and evidence appropriate to individualnecessary resources, and design the need in healthcare settings develops over time,implementation. and this can be true by effective teaching,Step 5: Implement the proposed changes, experiential learning, effective mentorship,evaluate process and outcome, and generate hands on effort and reflective practice. We allconclusions. must have to agree on ‘out today’s effort willStep 6: Recommend broader changes, integrate make better tomorrow’.changes into standards of practice, and monitorprocess and outcome periodically. AcknowledgementThe first four steps can be taught in classroom Authors acknowledge the immense helpand are frequently given to students as a received from the scholars whose articles areresearch paper assignment. Steps five and six cited and included in references of thisrequire help of healthcare environment. One manuscript. The authors are also grateful toInternational Archives of Integrated Medicine, Vol. 1, Issue. 1, September, 2014. Page 28Copy right © 2014, IAIM, All Rights Reserved.

Evidence based nursing practice – A review Sigma Theta Tau International Biennial Convention. Toronto, Canada, 2003.authors / editors /publishers of all those articles, 5. Mitchell A, Janzen K, Pask E, et al.journals and books from where the literature for Assessment of nursing researchthis article has been reviewed and discussed. utilization needs in Ontario health agencies. Can J Nurs Admin, 1995; 8: 77-References 91. 6. Haynes RB, Sackett DL, Gray JAM, et al. 1. Hunt J. Indicators for nursing practice: Transferring evidence from research The use of research findings. J Adv Nurs, into practice. 1. The role of clinical care 1981; 6: 189–94. research evidence in clinical decisions [editorial]. ACP Journal Club, 1996; 2. Melynk BM, Fineout-Overholt E, Stillwell N125: A14–6. SB, Williamson KM. Evidence based 7. Larrabee J. H. Nurse to nurse: Evidence- practice: Step by step—igniting a spirit based practice. New York: McGraw-Hill, of inquiry and essential foundation for 2009. evidence-based practice. Am J Nurs., 2009; 109(11): 49-52. Source of support: Nil Conflict of interest: None declared. 3. Grinspun D., Virani T., Bajnok. Nursing best practice guidelines: The RNAO project. Hospital Quarterly, 2001/2002, 54-58. 4. DiCenso A., Bayley L. Evidence-based nursing: Searching for the literature.International Archives of Integrated Medicine, Vol. 1, Issue. 1, September, 2014. Page 29Copy right © 2014, IAIM, All Rights Reserved.