STEPS OF EVIDENCED BASED PRACTICE: Evidence based practice process involves 5 steps as: 1. Formulating a clear question based on a clinical problem 2. Literture review to search for the best available evidences 3. Evaluating and analyzing the strengths and weaknessof that evidence in terms of validity and genelisability 4 · In this essay, I am going to consider how evidence-based practice can be used to support, justify, legitimate and/or improve clinical practice. I am also going to explore and discuss primary and secondary research evidences about how nursing interventions can potentially improve the quality of life of patients in the community suffering from heart failure Evidence based practice is a complex experience that requires synthesizing study findings to establish the best research evidence and correlate ideas to form a body of empirical knowledge (Burns & Grove ). There are many definitions but the most commonly used is Sackett et al (). Sackett et al () as cited in Pearson, Field, & Jordon, () describes evidence based practice
Evidence Based Practice Essay | Bartleby
This assignment will be set around evidence based practice EBP and the nursing part of EBP essay on evidence based practice be discussed throughout this essay.
There will be two parts to this discussion, part 1 will be a clinical question chosen personally, and being researched through the internet using a variety of databases. The end result will then be discussed on how the question performed, and whether it was either easy to research or changes had to be made gain greater or less results. Below is the clinical research question that was chosen personally.
Researching this question, Ovid was used. Again using Ovid, on an advanced search, this yielded 0 results. After this a different database was tried, the CINAHL database, on this research the question had been broken down into words; silver dressings supporting evidence, healing open wounds, this yielded 0 results.
Ovid was the best site to ask this research question as even though the results were too much, essay on evidence based practice, I still had a good amount of hits, as for the CINAHL database this did not show any results. Therefore, Ovid does show to be a good research database. When researching this question, it was not clear enough, essay on evidence based practice, the question needed to be a bit more thorough when written, the results reflected off this by achieving results and on Ovid.
Ovid was used first as it is a well-known website, which is also a database used widely for nursing and medical journals. Regardless of how popular both databases are the research questioned failed as either too much or zero results appeared, and could not be met in the middle.
On reflection receiving hits and then essay on evidence based practice far too much and no matter how much the question was rephrased and broken down no results were satisfying. This question had too much academic material and could not be lessened in any way for the chosen topic.
I think that next time the MeSH database could be used to research the chosen question, this would increase more of a chance of a wider and more in depth result and maybe reworded using medical terms. Part 2 — The Critical Analysis of a Randomised Control Setting using the Casp Tool It has been 10 years since evidence based practice EBP appeared. Evidence based nursing is about making right choices towards a patient and towards client care. This may involve different essay on evidence based practice being made for treatment choices, provisions of services and competence.
Essay on evidence based practice the decision is being made about a patient and their care, the best available evidence should be used in their practice. The nurse should reflect on the requirements, values, circumstances and preferences together with their own professional experience, skills and when making choices for the patient Moule et al, The paper that has been chosen is a randomised control trial RCT.
Nelson, describes a RCT as being used to answer questions on two or more interventions and the difference it would have made on a trial Nelson, Nurses who are applying clinical decisions, evidence based research must be used. It is also important that all clinicians have the admittance to clinical trials and to understand these clinical trials, so well-versed decisions are made on the best dealings with interventions that are open, this created PICO.
This is a database that helps medical professionals to decide if the question that was asked in the trial is of high value, this will then help them to make a decision, on the value of one paper over another. The chosen research paper which a randomised controlled trial is being used, because alternating pressure mattresses together with alternating pressure overlays are being used for the avoidance of pressure ulcers Nixon et al This essay will be using a critical appraisal skills programme, which contains 11 questions, to help decide whether or not this paper is of good quality.
This essay on evidence based practice is to assess a pre-selected research paper using the Critical Appraisal Skills Programme, which is known as the CASP tool, this is a standardised assessment tool. The CASP tool will be used to evaluate the consistency, validity and practicality of the research issued. CASP, Together with this, the CASP tool will also be used study the research paper to see whether or it has an element of reliably extrapolated, essay on evidence based practice.
Dr Amanda Burls was the person who created the CASP tool back in Her aim for this programme was to help individuals improve on their skills on the basis of healthcare decisions by finding and critically assessing the best scientific evidence.
Essay on evidence based practice,describes this as being vital in all aspects of healthcare, especially nursing. This is because randomised control trials RCT are seen as the gold standard for answering questions towards efficiency, in evidence based practice EBP Essay on evidence based practice, R, The hierarchy of evidence is a framework for ranking evidence, and second to the top lies RCT Evans, D, This trial defines whether or not the trial has a cause-effect relationship between the treatment given and the conclusion.
The RCT will also decide the cost effective outcome of the trial Sibbald, R, This study asked a clearly focused question, the study did describe in detail of how they were to pick participants out of the population, essay on evidence based practice. They all weighed around the same, they looked at medical issues, essay on evidence based practice, and most important what type of skin condition these participants had.
The study was using grade 1 and 2 ulcers from the Braden scale and participants who did not have ulcer wounds at all to their skin. Furthermore, participants who were developing grade 3 or 4 ulcer wounds were removed from the trial. They took into account the main consideration of the participants, by asking consent from the patients or if patients were not able to communicate appropriately they would retrieve consent from relatives until the patient was able to communicate.
The outcome was also considered very carefully Nelson, The study was carried out as a Randomised Control Setting RCT because the trial was based on two types of mattresses. Participants who were involved were randomised to either mattress.
The right research was used for the RCT because the mattress and overlay are interventions which satisfy two or more interventions suitable for the RCT. However, comparing the two for any differences hence intervention and comparison granted, there is no control service. This determines this to be unethical as the patient is being denied patient care by not treating the risk that we know is there. The participants were accurately randomised. They used an independent secure, automated telephone system used with 24 hour randomisation, essay on evidence based practice.
This is to ensure allocation concealment. Minimisation was used to so that the groups were equal. Minimisation was also used on centre existing pressure ulcers, speciality and type of admission. Those who participated were assigned to an alternating mattress, within 24 hours of being essay on evidence based practice through a certain hospital.
The main limitation of the trial was that there was absence of blinding from the outcome of the assessment. However, essay on evidence based practice, taking the trial into account it is most likely to be impossible to achieve. This is due to the lack of disguising the mattress and is unethical for a more seriously ill patient.
The bias of the trial was minimised to some extent, this was done by the clinical research nurses and the ward staff, and they were collecting skin samples for assessment. Although, essay on evidence based practice, the nurses were not blinded by the treatment, so the care given cannot be vindicated. Being blinded to this trial is not needed, for patients who have been bought into hospital for a long stay, will be lying on a mattress in a bed, no matter what the situation and cannot really affect the trial, for the nurses they should not have to be blinded either, as turning a patient regularly is a part of patient-care and should not be any different due to a trial being in place.
Blinded does not matter in this study. All participants were accounted for in the conclusion. They describe how patients felt uncomfortable on certain mattresses and requested a change. They took into account that essay on evidence based practice preferred the mattress to the overlay for comfy reasons. They also mentioned that certain patients had to be taken out of the trial due to pressure sores becoming greater or death.
This did reduce the number of participants involved in the trial which they also mentioned. It does appear that the groups were treated equally, however there is the whole thing about patients requesting alternative devices because they was not satisfied with what they were given, also the nurses took it upon themselves to change people over as they saw fit, the nurses could be bias because they might have personal preferences of one device over the other.
Furthermore the results can be applied to the population because the statistics of the study show that there was not much difference between the two. The power analysis is applicable when concern is with the correct rejection, or not a null hypothesis. In many circumstances, if there is a difference or not, essay on evidence based practice, the issue would be less determining and would rather get a more refined evaluation of the outcome for the size of the population.
The power calculation was used in this trial. The results were given as a percentage of people experiencing outcome. The reasons for the percentage of people who had a significance effect from developing new pressure ulcers, were those who came from the acute condition ward, or had presence of a wound, or some skin trauma, also including, age and diabetes.
This trial was not statistically significant because the p value was more than 0. There was no differences found within the trial between the treatments. However, this does not mean clinical insignificance, it is actually clinically significant because essay on evidence based practice gives us information on which to base clinical decisions. Clinical status can be gained by calculating a confidence interval measured by mean, median and proportion. One hundred and six In the adjusted analysis the odds ratio for developing a new pressure ulcer using the overlay compared with the mattress was 0.
Overall, the people preferred the mattress over the overlay presuming for comfortable reasons. The point of the trial was to find out whether there was a difference in result, and it ended essay on evidence based practice no difference between two interventions. The trial and results all seemed too narrow for confidence intervals.
This end result gives readers of the study confidence in using either devise. This is because there is only a narrow difference between the upper confidence limit and the lower confidence limit.
This was a good trial; there was a lot of randomisation used. It was a quite large sample used for the trial, so no matter what was changed, essay on evidence based practice, it could not make a difference. Another important part of this trial was the statistical information in respect of cost. At £ for an alternating pressure mattress and £ for an alternating pressure mattress, it would be financially more cost effective to use the cheapest option.
However, it is important to notice that participants of the trial, who were given the overlays, requested a different device, opposed to the who were given the mattress.
However, the decision being made to which devise will be used within healthcare, should be decided on patients situations and not for financial reasons. How to Cite. Evans, D. Journal of Clinical Nursing, 77—84 Hierarchy of evidence: a framework for ranking evidence.
Nelson, A. Evidence Based Nursing ; Nixon, J. and Cullum, N. British Medical Journal;
Introduction to Evidence Based Practice
, time: 3:59What Is Evidence Based Practice Essay - Words
Evidence based practice is a complex experience that requires synthesizing study findings to establish the best research evidence and correlate ideas to form a body of empirical knowledge (Burns & Grove ). There are many definitions but the most commonly used is Sackett et al (). Sackett et al () as cited in Pearson, Field, & Jordon, () describes evidence based practice This assignment will be set around evidence based practice (EBP) and the nursing part of EBP will be discussed throughout this essay. There will be two parts to this discussion, part 1 will be a clinical question chosen personally, and being researched through the internet using a variety of databases · In this essay, I am going to consider how evidence-based practice can be used to support, justify, legitimate and/or improve clinical practice. I am also going to explore and discuss primary and secondary research evidences about how nursing interventions can potentially improve the quality of life of patients in the community suffering from heart failure
No comments:
Post a Comment