What is Evidence-Based Practice? Outcomes and Competencies

Evidence-based practice is the integration of best evidence with patient values and clinical expertise. After completing the assigned reading please read the Module 1 discussion questions (listed below). For this discussion you will need to post a total of 2 times. You answer two discussion question sets (for a total of 2 posts). Each post should be related to different questions. Please copy/include the question set you are answering at the top of your post. Posts are expected to be reflective and thoughtful (please see discussion rubric). Please cite any references used (your textbook or outside references) using 6th ed. APA format in-text and listed as a reference.
This my Posts discussion questions:
1. Discuss the differences between clinical expertise and nursing tradition. Give an example in your explanation. What are the implications and/or risks of each?
2. Nursing is often described as an art and a science. Do you think nursing traditions have a place in nursing practice? Why or Why not? Give an example.
The format of this essay is like this:
1. Discuss the differences between clinical expertise and nursing tradition. Give an example in your explanation. What are the implications and/or risks of each?
Answer of this question number 1 (please see the rubric).
One reference.
2. Nursing is often described as an art and a science. Do you think nursing traditions have a place in nursing practice? Why or Why not? Give an example.
Answer of this question number 2 (please see the rubric).
One reference.
What is Evidence-Based Practice?
Outcomes and Competencies
Use clinical reasoning when engaged in the work of a professional nurse
Use clinical reasoning to collect information about the level of care provided within a healthcare system for a selected patient population
Objectives
Define EBP in the context of professional nursing
Defend the importance of using evidence to make professional nursing decisions
Differentiate clinical decisions based on nursing traditions from those based on evidence
Discuss the influence of evidence-based practice toward achieving desired patient outcomes.
Discuss the meaning of best available research evidence.
Describe how clinical expertise, patient preference, and available resources influence clinical decision making.
Discuss how comprehensive models of evidence-based practice are congruent with the broader theoretical constructs important to nursing.
Discuss the challenges and barriers that frontline nurses confront in moving evidence into practice.
Content Overview
“The most common definition of Evidence-Based Practice (EBP) is from Dr. David Sackett. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”
EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician's accumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology.
A brief history of knowledge development in nursing:
Florence Nightingale paved the initial path to modern nursing, by using observation to promote health. She used observation at a very basic level of research to obtain evidence to provide quality patient care. Her legacy comes from establishing formal education and training for nurses. This is significant because education implies the necessity to learn a specific type of knowledge. At the end of the 19th and the early 20th century training programs in hospitals emerged. Nurses were trained in hospitals under physicians and provided free labor (Chinn & Kramer, 2015). However, nursing In the 1950's there was a shift of focus in nursing from technical competence to effective nursing practice (Chinn & Kramer, 2015). Nursing began to be viewed as a science, worthy of its own knowledge base. In the 1960's graduate and doctoral program emerged. Nurse educators fought to justify different levels of nursing education and the need to develop curricula for advancing degrees in nursing education (Meleis, 2012). Nurses were finally were able to obtain formal education in ways to advance nursing knowledge (Chinn & Kramer, 2015). The development of theories for nursing throughout the second half of the 20th century is significant in nursing history. Nursing theory is a structuring of ideas, assumptions, and beliefs that work to explain and guide nursing action (McEwen, 2011). Nursing theories moved nursing knowledge away from the medical model and provided a structure for what nursing could be (Chinn & Kramer, 2015). The original theories provided broad structures and ideas for nursing and focused on the nurse-patient relationship, nursing as caring, and health. The ideas we have about nursing come from these theories, including the nursing process. In the 1980's more specific theories were developed to highlight more specific ideas in nursing (Chinn & Kramer, 2015). Nursing research evidence is structured from nursing theory, with researchers using nursing theory to guide knowledge development. In the 1990's evidence-based practice began to inundate the literature (Chinn & Kramer, 2015). Evidence-based practice continues to be a trend in nursing today, with a focus on translating research knowledge to practice.
Research along with nursing expertise and patient considerations are what define evidence and evidence based practice.
The evidence, by itself, does not make the decision, but it can help support the patient care process. The full integration of these three components into clinical decisions enhances the opportunity for optimal clinical outcomes and quality of life. The practice of EBP is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, and/or the etiology of disorders” (Duke University Medical Center, 2015, para 1-3).