Connection Between Research and Evidence- Based Practice

1 ChapterConnectionBetween Researchand evidence - Based PracticeSharon Cannon and Carol Boswell evidence - Based Practice (EBP) Research process Obstacle Research utilization PICOTAt the conclusion of this chapter, the learner will be able the need for Research to validate evidence - Based practice2. Define evidence - Based obstacles to evidence - Based the nurse s role in evidence - Based how evidence - Based Practice affects nursing practiceKey Terms1 Chapter 12/27/06 10:47 AM Page 1 Jones and Bartlett Publishers. NOT FOR SALE OR DISTRIBUTIONI ntroductionRegardless of the specific health care setting a nurse may select for prac-ticing the art and science of nursing care, the overarching principle forthe Practice is the provision of quality nursing care to all clients with-out consideration of social, financial, cultural, ethnic heritage, or otherindividual characteristics.

2 As the nurse initiates contact with the client,the client should be confident that the care provided by that nurse isbased on the most current, up-to-date health information established the currency of the health information to be utilized,the nurse and client must also agree that individualized application ofthis information is , the need for evidence - Based Practice (EBP)is confirmed by our expectations related to nursing nurse who receives the assignment to care for an elderlywoman, a young child, or a critically ill husband must come to thenursing Practice arena with more than the latest infor-mation must be tested and confirmed.

3 Let s consider the idea of asthmainformation, although any disease process could be utilized. Withinnursing Practice , certain health information concerning the managementof asthma is accepted. The initial question that should be asked by anurse would be: Is this disease management information corroboratedby Research results? The answer to this question is frequently a informational basis for each aspect of the nursing care tobe provided should be analyzed to determine its source. Does the infor-mation come from general usage or is it Based on information that hasbeen established through Research endeavors to be accurate?

4 Havingdetermined the basis for the care to be provided, the nurse must thendetermine the application of the information Based on the individual-ity of the client situation. The application of the information for eachof the client situations presented here would depend on the specifics ofthe client s needs, the client s expectations concerning health, and manyother aspects requiring modification of the confirmed Research foundation of nursing care delivery must be Research -testedand Research -confirmed knowledge tempered by an awareness of theuniqueness of the client and the situation. Although we realize that thehealth care field defines client and patientdifferently, for purposes of thistext, these terms are used , Tanner, and Pierce (2005) described the process of EBPto include assessing and delineating a problem through verbalizationof an identifiable question, pursuing and evaluating the available facts,implementing a Practice intervention as a result of the evidence , andevaluating the entire process for effectiveness.

5 Initially, EBP requires theidentification of the Practice problem, then, the utilization of testedresearch results to improve the care provided for the clients. Accordingto Ciliska, Cullum, and Marks (2001), the three basic appraisal ques-2|Chapter 1 Connection Between Research and evidence - Based 12/27/06 10:47 AM Page 2 Jones and Bartlett Publishers. NOT FOR SALE OR DISTRIBUTION?tions are the same whether the clinical question is about treatment, di-agnosis, prognosis, or causation: Are the results of the study valid? What were the results? Will the results help me in caring for my patients?

6 (p. 1 of 10)It was this need to incorporate proven practices into the provision ofhealth care that fostered the expectations and development of EBP in thecurrent health care a Line of Reasoning for EBP and evidence - Based ResearchHealth care is a complex system addressing multiple health-related as-pects in an endeavor to accomplish the anticipated outcome for the health care arena, nursing care is provided to in-dividuals in need of assistance related to their health status. This atten-tion requires nurses to identify a core foundation of information thatreflects quality care. Thus, the need for EBP to be developed around aresearch-centered foundation was envisioned.

7 Porter-O Grady (2006)suggested that the management of EBP requires the use of unique clin-ical applications Based on accessible, up-to-date Research . In the questfor quality nursing care, the nurse must use both reliable clinical knowl-edge and high-quality clinical process of establishinga core foundation of knowledge has been called many things over theyears, such as best practices , evidence - Based Practice , and quality ofcare. No matter what the Practice is called, the basis for the care to beprovided must be grounded in Research . According to Melnyk andFineout-Overholt (2005), when healthcare providers know how tofind, critically appraise, and use the best evidence , and when patientsIntroduction|3 Make a list of the tasks that are routinely done by nurses dur-ing a typical clinical day.

8 Carefully consider what evidence youhave used as the foundation for these tasks. Are the skills forthe tasks Based on Research , personal preferences, clinicalguidelines, or traditions? Think Outsidethe Boxare confident that their healthcare providers are using Evidence- basedcare, optimal outcomes are achieved for all (p. 3). It is this assurancethat the care being provided is confirmed from a tested Research foun-dation that allows for patient confidence in the nurses commitment toquality health should not rely on unsubstantiated treatmentplans but must endeavor to critically analyze aspects of the care to beprovided to ensure that quality, tested practices are utilized in the pro-vision of nursing care for each 12/27/06 10:47 AM Page 3 Jones and Bartlett Publishers.

9 NOT FOR SALE OR DISTRIBUTIONThe practicing nurse has to value the idea of the EBP process inorder to facilitate its complete incorporation and must understand the value of integrating Research results withpersonal experiences and client values when determining the treat-ment plan that best addresses a situation s identified to the Oncology Nursing Society (2005), even though ahealth care provider may utilize the optimum evidence available, eachencounter with an individual continues to be unique. The treatmentsand outcomes will change Based on the uniqueness of the client s val-ues, preferences, interests, and/or diagnoses.

10 According to Fonteyn(2005), a bonus of nurses involvement in EBP activities is their im-proved ability to think critically and their increased understanding ofand comfort with Research ; all of which seems to perpetuate their in-terest and success in subsequent EBP pursuits (p. 439). Nurses aretaught, encouraged, and expected to think critically. This process ofcritical thinking corresponds to the use of EBP on clinical units and inprimary care settings. Critical thinking embraces the need for health careto be Based on a foundation of proven researched data and to includethe client s use of unconfirmed reports, hearsay, and un-founded information, and the lack of client input do not fit with theprovision of sound, quality nursing care at this point in and Melnyk (2005)