Evidence-Based Practice

Health and medical care are among the most spirited human disciplines. Every year, different organizations allocate large sums of money and other resources on sophisticated high-quality research. The investment in search for better practice results in an exponential growth of health care data. Moreover, innovative and more efficient medical procedures, devices, and treatments occur on the regular basis. One major intention behind all the endeavors is to supply nurses, doctors, and medical technicians with the best possible treatment methods to provide care to clients. Moreover, by utilizing well-established traditional practices and procedures, the health care practitioners embrace innovative involvements that come from experience and research-based evidence. The evidence-based practice, or EBP, is one of the approaches that rapidly gain popularity because of its potential to handle efficiently clinical matters and provide the best patient care.

Part A

The importance of evidence-based nurse practices has evidence from the historical perspective, because each treatment case of a patient has influence on the opinions and experiences of the medical personnel and community. Thus, EBP marks a change among the health treatment professionals from traditional accents on authoritative views to an emphasis on information extracted from the earlier studies and research (Majid et al., 2011).The meta-analysis proved that EB nursing practice significantly improves patient treatment if compared to traditional care methods. Moreover, more nurses participate in the medical decision-making. Their involvement signifies the presence of efficient solutions provided by the hands-on experience.

The significance of EBP is in its aim to hardwire contemporary knowledge into customary care solutions to improve care provision procedures and outcomes for a patient. The evidence-based practice keeps a considerable promise for making the intended health results possible in reality. The evidence-based practices decide recognize efficient health treatment as the practicing historic evidence to notify best practices (Stevens, 2013). The evidence-based practices are the attempts to move clinical treatment to a high level of positive outcomes. The gap between the current medical care and the evidence-based approaches requires the application of the new types of treatment to move the healthcare to the next levels.

The value of evidence-based care is manifesting because the approach guides the nurses in their jobs. Moreover, it ensures a high-quality patient treatment based on knowledge and research rather than the previous experiences, traditions, myths, advice of colleagues, or outdated textbooks. A recent study supported the evidence that most nurses provide treatment in conformity with what they studied in the school and utilized research reports, journal articles, and clinical libraries for reference (Beyea & Slattery, 2006). The results of the aforementioned investigation together with the fact that the average nurse is around 40 years old make it clear that plenty of nurses’ ideas regarding the practice might be outdated. The treatment that bases on the old knowledge does not transform into the qualitative health results. Therefore, the evidence-based practice gives a comprehensive approach to ensure that the treatment reflects the most recent research results.

Part B

In order to implement evidence-based practice, the nurse needs to understand the research methods. The research aims to produce new knowledge as well as validate the existing theories. The studying of research methods involves scientific systematic inquiry to respond to specific research questions or hypotheses through utilizing rigorous methods. The research involves exploring, investigating, and discovering data; thus, it requires an understanding of the science philosophy (Conner, 2014). Consequently, for the research results to be reliable and valid, explorers must employ the scientific approach in a sequential order.

The evidence-based practice corresponds to interpreting the evidence and transferring it to medical decision-making. The aim of EBP is to use the best available results and suggestions to find the patient-caring solutions. Evidence comes from the research. However, EBP goes beyond the research use and comprises medical expertise, patient values, and client preferences to derive the complete care provision approach (Conner, 2014). The utilization of the evidence-based practice ensures that opinion experts and leaders rarely provide quality suggestions, even though no exact knowledge of research outcomes occurs. The research aims to contribute and expand up to date knowledge. On the other hand, the evidence-based practice requires innovation for discovering and interpreting the finest evidence into medical practice.

The evidence-based practice has seven critical steps in the process. The first is to grow a spirit of query. Then, the researcher should ask a flaming medical question. Third, there is a need to accumulate the best and the most relevant evidence, followed by the critical evaluation. The researcher has to combine evidence with medical expertise, client values and preferences in taking a practice solution or alteration. The assessment of the practice change or decision and evaluation of the results of the evidence-based practice complete the process.

Growing a spirit of query means that collectively or individually nurses should constantly search for the ways to change the healthcare delivery methods for the better. The flaming medical questions commonly stem from either a knowledge focus or a problem focus. The problem-focus may appear from determining a medical problem or from overhead areas of finance, management, or quality assurance. The knowledge-focused approach may appear from updated research outcomes, various literature datum, or new regulations. The next step in the evidence-based process is to assess literature. When a literature review finds gaps in knowledge, the observation in evidence-based practice aims to discover the applicable evidence to fill in the gaps. Therefore, the nurses need to realize the hierarchy of applicable evidence and proofs, as most of the diverse hierarchies of evidence are alike to some degree (Conner, 2014).  For example, the strongest or highest level of evidence commonly goes from a systematized meta-analysis, a review, or a settled evidence-based medical practice guideline from a systematized review. Other ranks of evidence go from randomized managed trials, RCTs, or other types of qualitative studies, quantitative studies, and expert analyses and opinion.

When the collected evidence is ready, the researcher needs to appraise critically every study to ensure its significance and credibility. The evaluation is often a time-consuming and tedious process. However, the researcher needs to prove that the evidence is reliable, valid, and credible (Conner, 2014). The method of answering the key queries for conducting critical appraisal is an effective determinant of validity. The evaluation deals with the evidence or the outcomes of the study and trustfulness of the results. Moreover, the transferability of outcomes and applicability in treatment of other patients are the important factors.

The finishing steps of the evidence-based process incorporate integrating the evidence with the medical expertise, taking into consideration client preferences, and assessing the efficiency of the evidence. Reporting or disseminating the results of EBP may aid others to learn more about and implement the best suggestions. The instances of valuable evidence-based projects comprise EBP in medical practice to prevent or reduce CAUTIs. The approaches also include assessing an evidence-based involvement to improve wound healing, and enhance compliance with a particular treatment for a chronic sickness (Conner, 2014).

Part C

Following the above steps, the nurses can utilize the evidence-based practices in treating the diseases around the globe. In Canada, there is a treatment gap between the medical goals defined in evidence-based instructions for management of the diabetes and real-life practice. The treatment of people suffering from diabetes occurs in the hospital setting. However,  the move aimed at bringing diabetes care into the earliest care setting utilizing the chronic care model. The model is a coordination method and quality improvement. It is a strategy for treating the patients with chronic sicknesses wit utilization of evidence-based components. The above components ease coordination among the care providers by aiding patients to play a role in their care. The evidence-based nurses’ practice is centered on the daily obligation of the diabetes person to exercise self-management. The professional healthcare diabetes team supports the patient desire to exercise own disease control. Although self-management is a dramatic component of care for the diabetes, the newest evidence proposes that the chronic care model supports a structure for the optimal treatment of diabetes. The model includes care elements and habitual treatment beyond the healthcare provider and patient. Moreover, even if all the elements are similar to clinical diabetes care, the evidence-based practices optimize and improve the process by adding new efficient elements.

During many years, the diabetes was treated with the help of traditional methods in Canada. However, in the 1990s, the new approach occurred that started transforming the treatment of clients with chronic diseases from reactive and acute to proactive, population-based and planned. Many countries including Canada adopted the approach, suggesting its effectiveness. The previous studies displayed that the following involvements upgraded care among the chronically sick clients: supporting and educating the patient, team-based treatment, enlarging the skills of healthcare providers and utilization of registry-based systems of information (Shojania, et al., 2006). The contemporary evidence-based practice expanded on the suggestions to comprise the next six components, which operate together to strengthen the relationship between the provider and the patient and bring the health results: 1) self-management support 2), design of delivery systems, 3) solution support, 4) the community systems, 5) clinical information and, 6) health structures.

Not just evidence-based practices play crucial role in treating the diabetic patients but also nurses’ experience and knowledge. An analysis of the numerous cases proved that specialist nurses and dietitians exercised glycemic and CV risk factors control through effective case management (Welch, et al., 2010).  Another study found improved patients’ outcomes with usual care and compared them to interventions led by the nurses, the experiment was holding, especially in cases when nurses acted in accordance with medical algorithms and could prescribe the treatment methods. Moreover, a large study found that evidence-based, nurse-led, collaborative care associated with changes in lipids, A1C, depression and BP in clients with type 2 diabetes and depression. The patients treated with application of evidence-based methods and under control of experienced nurses have better health outcomes of the process than those engaging physician assistants exclusively or without evidence-based practices. Individualized nutrition guidance by a certified dietitian or experts in diabetes treatment is one more significant element of evidence-based care in the cases of control disease.

In the last years, meta-analyses that involved humans with type 1 and type 2 diabetes demonstrated a significant drop of 0.76% in A1C. In addition, they showed improvement in quality of life and decreases in adverse drug outcomes and LDL-C with collaborative medical intervention. The randomized experiment in Canada used the evidence-based practices to providing primary care to the diabetes patients showed a significant decrease in BP for type 2 diabetes people. Therefore, the evidence-based practices can play a crucial role in management of both types of diabetes. One more component in efficient operating of the evidence-based treatment is flexibility of the team. The team alterations, like connection a new team member, functioning and involvement of professionals from various departments also associates with ameliorated medical outcomes. The greatest results of the evidence-based approach show in diabetes patients with upgrading of individual control, weight loss, and great mood. A systematic meta-analysis and review of the evidence-based strategies, improved the medical outcomes for the patients. The areas of improvement included BP, cholesterol and A1C, as well as process results, medication utilization and screening for issues, facilitation of self-management, team alterations, case management, education of patient, eased relay, registries via electronic patient service system, patient reminders, feedback and audits, and medical reminders.

Part D

The project suggests that the evidence-based practice has obtained impetus in nursing. Knowledge from fundamental science, research findings, medical expertise, and professional opinion are all considered evidence in the health care field. However, the practices, which base on research outcomes, result in the desired patient results across diverse settings and geographic places. The momentum for evidence-based practice goes from healthcare pressures for expense control, abundance of information, and greater customer knowledge about care options and treatment. The evidence-based practice requires alterations in students’ education, practice-relevant research, as well as improved working relations between researchers and practitioners. The EBP also supplies opportunities for nursing treatment to be more individualized, efficient, dynamic, and streamlined, and to maximize outcomes of medical decision-making. When they use the evidence to define the finest practices rather than to maintain the existing ones, the nursing treatment keeps pace with the newest technological advances and benefit of developments of new knowledge.

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