Evidence based nursing practice

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EVIDENCE BASED
NURSING PRACTICE
BY
Mr ananthakrishnan
asst.professor
Teerthanker mahaveer university
college of nursing

 EVIDENCED BASED NURSING PRACTICE
is the process by which nurses make clinical
decisions using the best available research
evidence, their clinical expertise and patient
preferences.

 30-45% of patients not receiving care
according to scientific evidence
 20-25% of care provided is not needed or
potentially harmful
(Schuster et al., 1998; Grol 2001)

Evidence Based nursing practice solves
problems encountered by nurses by
carrying out four Steps.
1. Clearly identify the issue or problem
based on accurate analysis of current
nursing knowledge and practice

2. Perform literature search for relevant
information .
3.Evaluate the research evidence for
scientific merit , using enabling criteria
4.Select interventions and justify them ,with
the most valid evidence

 These selected models and frameworks can
be used to understand the contextual factors
that could play important roles in the success
or failure of the knowledge translation effort
should be taken into consideration in all
stages of the knowledge translation( KT)
process.

Conceptual Model
• A set of relatively abstract & general
concepts that address phenomena of
central interest to a discipline
•Broad descriptions those concepts
•Propositions that state relatively abstract
& general relations between 2 or more of
the concepts

Assess + Evaluate Monitor
Practice
Environment
Potential
Adopters
Innovation
Interventions Adoption Outcomes

 Stetler model of research utilizatiion
 Iowa model of research in practice
 Ottawa model of research use
 Evidence based multi-disiplinary practice
model.
 Model for change to evidence based practice.
 Centre for advanced nursing practice model

 The Ottawa Model of Research Use (OMRU)
is an interactive model developed by Logan
and Graham (1998). The feasibility and
effectiveness of using the OMRU in actual
practice contexts was supported by findings
from a number of studies .

Cont…
 The OMRU views research use as a
dynamic process of interconnected
decisions and actions by different
individuals relating to each of the
model elements (Logan & Graham,
1998). This model addresses the
implementation of existing research
knowledge.

 The model has gone through some revisions
since its inception. The most recent version of
the OMRU (Graham & Logan, 2004)
Includes six key elements:
 Evidence-based innovation
 Potential adopters
 The practice environment
 Implementation of interventions
 Adoption of the innovation
 Outcomes resulting from implementation of the
innovation

 Critical thinker
 Culturally competent
 Knowledgeable co-ordinator
 Politically aware
 Ethically and Legally grounded
 Effective communicator
 Competent provider of health care
 Responsible manager
 Understands relationshiprelationships

Everything has changed but ourways of thinking.if thesedo not changewe
drift towards unparalleled catastrophe
(Albert Einstein)

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Evidence-based practice in nursing involves providing holistic, quality care based on the most up-to-date research and knowledge rather than traditional methods, advice from colleagues, or personal beliefs. Nurses can expand their knowledge and improve their clinical practice experience by collecting, processing, and implementing research findings. Evidence-based practice focuses on what's at the heart of nursing — your patient. Learn what evidence-based practice in nursing is, why it's essential, and how to incorporate it into your daily patient care. - American Nurses Association

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Clinical Journal of Oncology Nursing • Volume 18, Number 2 • Evidence-Based Practice 157 The Iowa Model of Evidence-Based Practice to Promote Quality Care: An Illustrated Example in Oncology Nursing Carlton G. Brown, PhD, RN, AOCN®, FAAN Evidence-based practice (EBP) improves the quality of patient care and helps control healthcare costs. Numerous EBP models exist to assist nurses and other healthcare providers to integrate best evidence into clinical practice. The Iowa Model of Evidence- Based Practice to Promote Quality Care is one model that should be considered. Using an actual clinical example, this article describes how the Iowa Model can be used effectively to implement an actual practice change at the unit or organizational level. Carlton G. Brown, PhD, RN, AOCN®, FAAN, is the director of Professional Services at the Oregon Nurses Association in Tualatin. The author takes full responsibility for the content of the article. The author did not receive honoraria for this work. No financial relationships relevant to the content of this article have been disclosed by the author or editorial staff. Brown can be reached at [email protected], with copy to editor at [email protected] Key words: evidence-based practice; research; decision making Digital Object Identifier: 10.1188/14.CJON.157-159 N urses understand that evidence- based practice (EBP) improves the quality of patient outcomes while controlling the cost of healthcare (Mel- nyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012). But even in the year 2014, barriers and roadblocks exist to implementing EBP at the bedside or chair side. The Institute of Medicine estimated that it takes more than 17 years to implement a research finding into clinical practice (Institute of Medicine, 2001). Although research may exist that should be trans- lated into practice, the time it takes to deliver these research-based interventions to patients takes too long. In their study of 1,054 RNs, Melnyk et al. (2012) discov- ered that although nurses value EBP, they required education, access to information, and time to implement EBP into daily practice. Nurses and other healthcare providers want their practice based in evidence, but they also acknowledge the barriers of lack of education and time to actually implement and use EBP. EBP is a problem-solving approach to clinical decision making that integrates the best evidence from well-designed studies with a clinician’s expertise along with patients’ preferences and values (Melnyk et al., 2012). Numerous EBP models are available to help nurses orga- nize and systematically track progress in implementing evidence into practice, including the Stetler Model of Research Uti- lization (Stetler, 2001), the Iowa Model of Evidence-Based Practice to Promote Qual- ity Care (hereafter referred to as the Iowa Model) (Titler et al., 2001), and the Johns Hopkins Nursing Model (Newhouse, Dear- holt, Poe, Pugh, &.

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