Evidence Based Practice - What is it?

sharann, BSN, RN · Aug 30, 2006

I think you need to look this up more but the basic premiss is you look at the research done on actual people in real situations and when something shows EVIDENCE (reproducible)of working well you use it in PRACTICE. This is my dummy version. I think it is a good thing to do.

KScott · Aug 30, 2006

Thanks. I guess what I'm looking for is people's personal experiences with it. I found some very helpful information about it here. It makes perfect sense to me. I guess I'm looking for more information on how it is put to use logistically. How are nurses practicing it as opposed to doctors, or should I say, in conjunction with doctors? Are nurses doing research on the problems of their patients and making decisions for their care in addition to what the doctors are doing? Also what makes it different from the way medicine has always been practiced.

I can read all the "textbook" information on it, and I'm doing so, but I'm looking for real life experiences. I suppose I'll change my topic heading to "What is it to you?"

Thanks again.

Medic/Nurse, BSN, RN · Aug 30, 2006

Actually, one of the "best" implementations of EBP that I've seen recently had to do with IV's and their site prep, placement, securing of IV catheters and care. Doing this = This result and Better Patient Outcome

I think it was something from the ?? infusion nurses ?? type organization

I sometimes think we put fancy words on stuff that is fairly simple.

EBP = Doing What Works!

RGN1 · Aug 30, 2006

My experience of evidence based practice is that the nurses read the research but when they try and implement it the docs/older nurses just go on doing what they've always done regardless!

:lol2:

Oh & then 10 tears down the line they implement this "new" idea they have "discovered" just as you've found out that actually that idea that you had tried to implement 10 years ago has been found to not be effective & actually what they used to do was better afterall!! :rotfl:

llg, PhD, RN · Aug 30, 2006

My experience in the past has been that there have many problems in implementing the goal of practicing based on the scientific evidence. But I am hopeful that the recent emphasis on the topic and recent renewed interest in upgrading the formal education of our nursing workforce will help resolve some of those problems. But that remains to be seen.

Some of the problems I have seen include:

1. There has not been a lot of nursing research suitable to use as a base for practice. Our science is a relatively young one and our profession was not well-developed as an academic discipline to begin with. It's been only recently in our history that we have begun to develop the science of nursing to the point at which it can be used as a basis for practice. There were no nursing PhD programs until the 1970's and the number of nurses prepared at the graduate level to conduct research studies has been small.

2. Many nurses practicing today were not educated for evidence-based practice. Many were/are not educated in how to evaluate the quality of research reports and make judgments about their application. Nor were/are people educated in how to evaluate the effects of any practice changes they make. It's not just a matter of old vs young. Many young nurses may have been taught to value evidence-based practice, but lack the skills and experience necessary to distinguish between good and bad quality evidence. Many experienced nurses are skeptical of new ideas because they have seen so many new ideas come and go -- each one touted as the next great thing based on evidence that is shown later to be incomplete. Evidence-based practice is an appealing idea that is not as easy to implement as it sounds. People need sophisticated, advanced skills to do it well.

3. Many people in nursing leadership roles are not given adequate resources to implement evidenced-based nursing projects. Our roles were created years ago with different emphases and we simply don't have the time or resources to do BOTH our old jobs AND ALSO implement new roles and projects. Many have poor access to the resources necessary to implement an evidence-based practice approach -- phyisical resources, financial resources, staffing resources, educational resources, statistical resources, etc.

Well ... that's enough for now. That's what came off the top of my head. Good luck with your presentation.

llg

KScott · Aug 30, 2006

RGN1 - Too funny and probably too true!

LLG - Thank you. This is exactly the type of information I was looking for. I'm a pre-nursing student at Arizona State University. They teach "evidence based practice" in the nursing program. As I've been reading about it, for this presentation, it seems so common "sensical" to me. I'm just having a hard time wrapping my head around the logistics of the whole thing. It seems, and you have stated, there is a time constraint on nurses and, I would think, any new patient-specific treatment would be directed by the doctor, anyway. Right?

On the other hand, NREMT-P/RN, has given an example of a procedure changed through apparent research by an association and then implemented in the field. Isn't this just "normal?" I mean why would that be different than anything done in the past? Is EBP more than a trendy buzz word? Is it really making a difference in patients lives?

Tweety, BSN, RN · Aug 30, 2006

Wether the people I work with realize it or not, we use an evidenced practice.

We have protocols. Whenever they are updated, it's because of research. Little things such as brushing ventilated patients teeth q4h to prevent ventilator associated pneumonias, now wasting only 5 cc of blood instead of 10 when drawing from a central line, are all based on current standards of practice based on research. new ways of doing wound care, etc.

Nuring practice is dynamic and changing and fueled by research. But as llg points out, there is scant out there.

Cynthia_S · Aug 30, 2006

"Evidence-informed nursing is the integration of professional judgment and research evidence about effectiveness of interventions. It provides a sound and rational basis for the decisions taken about patient care by nurses." McSherry, R., Simmons, M., & Abbott, P. (2002). Evidence-informed nursing: A guide for clinical nurses. New York: Routledge.

I am a graduate student in an Adult NP program and just finished the summer session in Research II- which we developed an EBP as our assignment. The class was divided into groups and each group had a different topic that was ours to choose. My friend and I got an "A" for the class!

I am going to try and email you some information (I hope it works).

Cynthia

KScott · Aug 30, 2006

Thanks, Cynthia! If you want, I can PM you my email address...