Evidence-Based Practice...your thoughts
- 0Apr 24, '12 by ThePrincessBride, BSNWhat do you think of this move toward Evidence-Based Practice in nursing? Has your place of worked pushed you to integrate EBP into your patient care? It is a hot topic and my school is really advocating for EBP, stating if you do not perform EBP, you are guilty of performing malpractice.Do you agree with this?
- 2Apr 24, '12 by fakebeeCan you give some examples of current nursing interventions that are not evidence based? What is being practiced in your clinicals by licensed RNs that is considered malpractice by your school? I am an ICU nurse and our practice is hopefully completely evidence based. Do tell more.
- 3Apr 24, '12 by yvfairBasically, EBP has been around all along, we just didn't call it that. For example, we've been taught for years that early ambulation prevents pneumonia and DVT after abdominal and other surgeries. Now, there is studies and research to actually back that theory up, hence EBP
- 0Apr 24, '12 by RNperdiemOur hospital has a nursing practice committee which writes our nursing policies/procedures/protocols.
Practices change over time because of evidence based nursing.
I remember when pain scales were introduced, concentrated potassium vials disappeared, and a whole new skin care policy based on the latest research was started.
The way I practice nursing today is not the same way I practiced 14 years ago.
- 7Apr 24, '12 by Altra GuideI can't stand the term -- I think it's meaningless. Any clinical practice -- the latest and greatest gold standard or the very dubious -- I can probably find you some study, some evidence -- that it's best. And if you practice long enough you will find returns to "old" practices based on "new" evidence.
- 1Apr 24, '12 by CompleteUnknownI'm a bit inclined to agree with Altra.
EBP has always been around, just not called that and perhaps the studies hadn't been done as rigorously or 'correctly' as would be insisted upon today.
Anecdotal evidence is sort of frowned upon now but years of anecdotal evidence all pointing the same way does show something.
I find that often you're still going to be fighting facility policy which states 'you shall do x' when x has been shown to be unnecessary or of no benefit. It's usually not the nursing staff fighting to retain outdated practices. It's true that there's sometimes some resistance to new practices though.
Best practice, current guidelines, call it what you will, it doesn't necessarily mean that anything outside the guidelines is harmful. Guidelines become rules far too quickly in my experience and you run the risk of suddenly finding that what was fine in the vast majority of circumstances has now become unacceptable in all circumstances. It gets silly all too easily.
There's a certain amount of 'we've always done it this way' in every field - we do need to keep in mind that sometimes it's always been done that way because it works.
- 5Apr 25, '12 by Esme12, BSN, RN Senior Moderatori think the term "evidence based practice" is just the newly coined "buzz" word. just like we used ami for acute mi and now it's stemi (whatever)......they are both heart attacks with ekg changes that include st elevation. there will always be the new "buzz" words out there making it the "new and improved" something or other........bu the fact remains, nursing has always had the "approved and best" practice developed into policy and procedure as the "standard". these standards were the tried and true ways to care for the patient and they were the standard to be followed and taught to students on how to care for the patient safely and properly.
these practices became the "golden rule" on how to care for patients that any "reasonable and prudent" practitioner would use in the care for the patient to maintain safety and consistency. someone came along and said......."prove it"......and so someone said "ok"......and so, they did studies and proved why it was the best way to do something......tada!!......evidence based practice. then they figured out that if they published and charged people they could make money off the stuff we already knew and give it a fancy name. bingo! evidence based practice....can you imagine the new jobs that were created when the government developed the ahrq........agency for healthcare research and quality (ahrq) who is the lead federal agency charged with improving the quality, safety, efficiency, and effectiveness of patient quality and care that is a branch of the us department of health and human services. (another bureaucracy)
evidence-based practice health care: evidence-based practice subdirectory page
as far as calling it "evidence based practice",whatever, it's the new buzz word. as far as having a standard of care.....yes it's necessary to keep patient care safe and practiced similar across the board......and we have done it for years. they are kind of like the nursing care plans for all. every profession has a standard that you should be measured by. variances are better tolerated in other professions. we are dealing with people lives. there has to be an approved method to their care that is safe and sound. if everyone was allowed to do whatever they want there would be no consistency nor safety for the patients entrusted to our care. anyone who goes rogue and decides they are going to do whatever they wish should be held accountable and is malpractice.....you are acting outside the rules. if you hurt someone you should be sued and loose your license. it's that simple.
there are rules to playing this game and they must be followed......there are people lives at stake.
- 6Apr 25, '12 by classicdame GuideYes, I "believe" in it, just like Florence Nightingale did > 100 years ago. Whenever I write policies I reference the evidence. Whenever I teach I reference the evidence. Staying on top of the evidence thru journals, etc is what makes us professional.
It is not necessary to change. Survival is not mandatory - E. Edward Deming
- 4Apr 25, '12 by GrnTea, BSN, MSN, RNthere's a nifty little book called "ritualistic practices in nursing" (you can google it) that may make you change your mind. nothing new under the sun.
and when i went to nursing school in nineteen-smumblemumble and in grad school a decade later, our faculty called it evidence-based practice.
- 0Apr 25, '12 by HouTx GuideIn my organization, we have specific EBP standards that must be followed to create/modify any clinical policies, procedures or guidelines. Each document must have references - since they are all online now, these are embedded as links. We are also integrating EBP references into our electronic charting system to provide real-time decision support.
My clinical educators have also adopted EBP - to ensure that instructional design, test construction, competency assessment, curriculum, etc. is congruent with current professional education practice rather than "that's the way we have always done it" design.