1. Introduction
Evidence-based practice (EBP) has become an area of concern in medical field because it is claimed to have the potential to improve the safety of patients and lead to better outcomes (Li, Cao & Zhao 2019, p. e17209). The purpose of this paper is to examine the implementation of EBP in detail.
It begins with a discussion of how EBP relates with research and knowledge and continues to examine the differences between EBP application in single nurse checking and double-checking of medications. Ethical considerations of research studies intended to gather the information required for clinical practice are also explained. The paper ends with a conclusion section, which summarizes the key points of the paper.
2. Relationship between knowledge, research and evidence-based practice
Evidence-based practice involves application of the most appropriate evidence when making decisions that relate to offering of efficient care (Li et al. 2019, p. e17209). EBP demands understanding of how the research findings and evidence from other sources inform and direct nursing practice. Research is a process whose primary objective is to create new knowledge, which may stand on its own or be used to validate knowledge that exists in given scientific areas (Mohammadi 2016, p.79).
Research methods focus on a problem that is clearly defined and changed into a question, which research procedures should help to answer. On the other hand, Knowledge is the set of facts or information and skills gained through education, training, or experience. Knowledge comes from research evidence, experienced clinicians or experts, personal experience, patient descriptions of their preferences, and relevant resources.
The Relationship between EBP, Research and Knowledge
First, the application of EBP is not complete without research and knowledge. In the process of offering personal care and treatment, Li et al. (2019, p. e17209) argued that nurses should combine their nursing skills, public heath knowledge, and the relevant social assistance. The authors argued that EBP fails to meet expectations in many instances because some nurses lack the knowledge and skills required to find the proper evidence. Again, application of EBP fail when nurses do not get adequate guidance on how to use their abilities in vocational context. Limited knowledge and training, time and resources, and low motivation cause failure to effectively implement EBP.
Secondly, research plays the key role of guiding the implementation of EBP. Implementation of EBP is about use of proper evidence (Mohammadi 2016, p.79), and research is one of the ways through which practitioners acquire evidence. EBP practices, thus, remain effective as long as its specific clinical applications are informed by the latest research. Lehane et al. (2019, p.103) explained that EBP requires nurses to rely on the best research evidence when conducting assessment and treatment. Relevance of research literature constantly changes, hence a method recommended today may not remain effective in a month or so. Tools of evidence-based medicine, thus, ensure that clinical practice stays current through tracking down and critically appraising evidence before incorporating it into the daily clinical practice.
Thirdly, without proper clinical skills and knowledge, practitioners may not implement EBP effectively. Mohammadi (2016, p.79) argued that insufficiency of knowledge on EBP causes some practitioners to confuse it with quality improvement, causing uncertainty about the associated practices. To improve knowledge of EBP, differences between its methodologies (and goals) and those of quality Improvement must clearly be highlighted.
Lastly, knowledge and research are interconnected. Research uses the existing knowledge to understand the phenomenon being investigated. Knowledge on processes, concepts, and propositions of the phenomenon enable researchers to describe and predict outcomes. In other words, research is the systematic and formal inquiry process that helps to evaluate or validate the existing knowledge (Mohammadi 2016, p.79). A strong relationship exists between knowledge and research, and both concepts direct evidence-based practice by building nursing knowledge.
3. Applying evidence-based practice
The key components of EBP are application of best research evidence that is available, clinical expertise of an individual, and a focus on the values and expectations of patients (Lehane et al. 2019, p.103). When practitioners combine these three factors, they get better patient outcomes. Best research evidence is generated from clinical studies that apply sound methodology while clinical expertise of a practitioner results from skills gained through education and experience within clinical setting. The unique expectations, concerns, and preferences that a patient presents are all part of patient’s values.
Application of EBP Components in Single Nurse Checking
In single checking, one healthcare personnel autonomously conducts the rights checking and administration of medication (Ting, Xufen, Li, Wen, Choo, Suchi and Dioso 2020, p. 18414). First step is gathering of details on the patient’s needs, cultural considerations, values and expectations. A practitioner should listen to the encounters of a patient carefully to think of the appropriate diagnosis, prognosis, and therapy (Abu-Baker, AbuAlrub, Obeidat , & Assmairan 2021, p.5). This information helps to construct clinical questions related to patient’s diagnosis and treatment. Formulated questions should be answerable.
Second step involves finding the best research evidence. Search terms from the questions developed in the first step aids the selection of proper resources (Abu-Baker et al. 2021, p.7). For medical purposes, best resources are those from sources like Cochrane Library, Medline, and PubMed. The search strategy is effective if it focuses on the major terms and highlights limitations of required outcomes.
The final step involves utilizing individual expertise to appraise the attained evidence and make clinical decisions. Appraisal enables filtering out of interesting studies that have weaknesses. Simple critical appraisal practices can help to complete this stage. Ensure to recheck the questions addressed in the study, validity of methods used, findings, and the relevance of outcomes to the situation at hand (Abu-Baker et al. 2021, p.9). After validating the research findings, clinical decisions should be derived. A combination of clinical expertise, patient’s values and best research evidence is critical in this stage. Clinical decisions from this stage are evidence-based. Still, the decision has to be evaluated for efficacy and effectiveness based on the expected patient outcomes. Main concern is the effectiveness of the new information and if it is appropriate to apply it to practice. Also, this stage involves evaluation of the involved steps and suggestion of improvement.
Application of EBP Components in Double Nurse Checking
Double-checking involves two healthcare personnel completing the relevant rights inspection before drugs are administered (Ting et al. 2020, p. 18415). For this process, the stages completed are the same as above except that two nurses are required to verify the same information. They will both collect data from the patient and use it to form research questions before going ahead to find proper resources. Their recommended diagnoses and treatment approaches are checked against each other. The process ensures that only the most effective and appropriate treatment methods are used in clinical settings.
4. Ethical principles in research
Ethical considerations of a study aim to ensure that the research does good and avoids causing harm. For practice purposes, research has to meet the requirements set out by the basic ethical principles. The following are major principles n research ethics:
Ø Controlling the risk of harm: Research study should not cause injury or discomfort to the participants, but if some level of harm is acceptable a strong justification must be given. A description of how the harm may be minimized is usually demanded. Moreover, the participants must get a detailed debriefing and sign informed consent (Yip, Han and Sng 2016, p.685). More ways of minimizing harm include maintenance of anonymity of participants, avoidance of deceptive practices, and allowing participants to withdraw from the study any time.
Ø Getting informed consent: ensures that understand their reason for participating in the study and recognize what the research requires them to do (Yip et al 2016, p.684). Key aspects participants should know are research purpose, methods, possible outcomes, and inconveniences it may cause. Informed consent is also proof that participants volunteered to take part in the research.
Ø Maintaining confidentiality of participants: Participants are more protected if research does not involve collection of identifying information (Abadie, Fisher & Dombrowski 2021, p.304). In the place of names, for instance, a researcher can assign codes to differentiate responses from various participants, so they remain anonymous. If the researcher finds it necessary to mention identifying information, he or she should seek permission from the participants.
Application of Ethical Principles in Primary Research
Ting et al. (2020) investigated whether nurses prefer single checking over double-checking, and vice versa. On ethical considerations, Ting and colleagues sought the informed consent of the research participants who came from Sime Darby Hospital. Additionally, the researchers allowed participants to withdraw from the study at any time. Anonymity and confidentiality of responses were assured and the researchers compared their research methods against the strategies recommended by the ethics protocol belonging to University of Hertfordshire. They received approval from the University’s ethics committee.
5. Conclusion
The interconnection between knowledge and research is what makes EBP effective in improving quality of care. This results in safety and better patient outcomes. The knowledge and theories that research tests relate to human experiences or processes and practices adopted by nurses when implementing EBP. Research is the source of knowledge and EBP is the practice that deliberately uses health-related knowledge to guide the activities of the nursing process.
Research promotes EBP and leads to better patient outcomes by creating a body of data-based knowledge, so nurses stop relying on instincts. Knowledge that research findings reveal helps to make clinical decisions. To make this knowledge reliable and effective in informing daily practices of nurses, ethical principles must guide the research process.
