Integrating Evidence-Based Practice in a Clinical Setting

Integrating Evidence-Based Practice in a Clinical Setting

Introduction

From a broader perspective in health, Evidence-Based practice in a clinical environment refers to the integration of research evidence, clinical proficiency, and patient’s predilections. Such facets play a pivotal role in clinical practice like nursing in the provision of individualized patient care. Multiple studies have portrayed that evidence-based practice produces higher quality care, improves patient’s results, the cost becomes useful, as well as producing significant nurse contentment as compared to traditional strategies (Chan, 2013). Therefore, integrating the evidence-based practice steps in the fields of clinical has provided a stable ground that is important for both care providers and patients and families. During the integration of actions, some barriers during implementation are significantly realized and the best approaches to prevent the need to established. Currently, EBP continuous to portray positive momentum with the health care industry as an approach of retaining health professionals updated, ensuring clinical judgment, and amplifying the prevailing provider-client with the decision-making process (Chan, 2013). The paper will primarily focus on the main steps of integrating EBP in a clinical set-up, the barriers of implementing a new practice, and strategies to increase success. Also, the paper will explore sources of internal evidence that can be incorporated to provide data to illustrate the improvement in results.

Steps of Integrating Evidence-Based Practice

In clinical practice, step zero is the initial process of integrating evidence-based practice. The stage offers a stable ground to start inquiring about new questions that are important for EBP. The next phase is step 1, which involves asking the queries in a PICOT layout (LoBiondo-Wood & Haber, 2014). Letter P comprises the type of patient population putting in considerations on sex, ethnicity, and patients with specific healthcare issues. The letter I focuses mainly on interventions or exact approaches or treatments of interest and C involves alternatives in treatments or responses to a problem. O in the format, concentrate on looking at desired results, and T is mainly for timing reasons.

The PICOT design is essential in grounding an efficient framework for finding electronic databases that are related to the clinical question. The second step involves searching for evidence that is critical enlightening clinical practice is streamlined when the queries are framed in a PICOT layout. The information databases are essential in answering the question being asked by utilizing the keyword and concepts through a combination of multiple searches. For example, those of nurse’s search platforms, include PubMed, OVID, and TRIP Database, among others (LoBiondo-Wood & Haber, 2014). Step 3 is appraising the evidence critically. The main aim of critically evaluating evidence is to determine study reliability, validity, and applicability to the client in the question enquired. The step is also done through assigning each study an evidence level that may be in hierarchies of designate, such as randomized control trials or systematic reviews. The fourth step is to assimilating the evidence with clinical knowledge and patient partialities and standards. Such elements are essential in EBP since institutional and clinical variables profoundly influence them. In this step, considering other factors beyond applicability, such as biologic, socio-economic, and epidemiologic issues, need to be put on the table (LoBiondo-Wood & Haber, 2014). Step five involves evaluating the results of the practice decisions or changes based on evidence. The stage is done after implementing EBP to monitor the positive outcome and remedy the negative ones. In step 6, the results are disseminated to colleagues within organizations. The internal or external department in service, journal clubs, or online media can play the role of circulating (LoBiondo-Wood & Haber, 2014). Other methods of dissemination are through the use of professional newsletters, publications for entire audiences, and reporting in peer-revised journals, which comprises the final step of integrating EBP in a clinical setting.

Barriers and Remedies to outcome them and increase the success of Implementation of New Practice in Addressing EBP in Chronic disease

Various studies have found that there are significant barriers associated with the implementation of a new approach, especially to individuals with chronic-related conditions. One of the chief obstacles is inadequate education regarding EBP and ineffective leadership to incorporate it fully in organizations (Harvey & Kitson, 2015). The structure of education mainly focuses on teaching rigorous research and not on how to integrate the research into practice hindering the implementation. The leadership that is supposed to evaluate the effectiveness and importance of new methods has failed, compromising the application of modern practice in clinical settings. As such, it can be solved by offering practicability of EBP and leadership support the spirit of inquiry. The hospitals and other health providers they need to create stable structures and processes, and upsurge access to the database by officials to promote EBP, especially the one concerning chronic disease management (Harvey & Kitson, 2015). The three-prong strategies of promoting EBP of leadership, education, and mentorship were recommended to organizations and healthcare systems. Another barrier that has compromised the implementation of a new practice of EBP in the management of the chronic disease is resistance. Top nurse managers and leaders mainly give resistance. The senior officials they are supposed to offer robust support required as role models in creating stable EBP. The support becomes a critical value in this case so that the EBP can have enough time and an organized organizational structure to cultivate EBP. The other conventional barriers realized included inadequate human resources, employment status, age, and hefty assignments.

Additionally, to increase success and overcome barriers in the implementation of new practices in clinical practice, engaging apposite stakeholders are relevant (Harvey & Kitson, 2015). Building trust mainly enables learning from their experience and provide significant input on the topic. The stakeholders can also help in recognizing the possible outcome measures that can help in establishing plans for a better project and implementation techniques.

Sources of Internal Evidence

The primary internal sources of evidence that can provide data to illustrate the improvement in outcome are the scientific literature. Through looking at scholarly publications that reflect on original empirical studies and theoretical works can give an idea or continuing approach to improve the outcome of evidence-based outcomes (Chan, 2013). The other source of internal evidence is an organization’s internal data. With internal documents within the health organizations, especially within the age of cloud computing, they offer robust sources of information that can be integrated significantly to produce positive outcomes. The other source evidence source is from stakeholders who primarily give values and concerns. The stakeholders in EBP can be involved in many ways, such as choosing a topic and scoping the guideline, contributing to the guideline and development group, among others (Chan, 2013). Practitioners that comprises of professional expertise are also a useful source of internal evidence. The professionals have substantial experience in the line of their duty, and it can significantly be used to offer helpful information that can illustrate the improvement in outcome. The patients can also act as primary data for the clinician to come up with the idea of evidence-based practice. They assess patients and reviewing records; they can help health practitioners have a good idea of information to improve a particular EBP outcome (Harvey & Kitson, 2015). Other sources can be extracted from already established platforms and databases that give robust data that can be merged to illustrate the improvement of outcome.

Conclusion

In summation, evidence-based practice plays a pivotal role in improving patients care and outcome, cost reduction, and increases nurses’ satisfaction. To realize these positive aspects, it is critical to categorically follow the steps of integrating EBP in a clinical environment. Starting with step zero that cultivates a spirit of inquiry to final disseminating EBL outcome into reliable sources and publications becomes substantial and most comprehensive format.

In the process of implementing the new practice to be used as an approach in solving various problems, multiple barriers are realized in the process. Barriers such as lack of adequate education, resistance, and ineffective leadership are primary barriers. Eradicating such obstacles by focusing on three-prolong techniques of training, guidance, mentorship, and offering support can produce effective EBP in hospitals and health care systems. As such, it can be enhanced through exploring some of the essential sources of internal evidence data such as from stakeholders, scientific research, internal organization data, and professional expertise, among others, to improve the overall outcome in an existing and new practice in the field.

References

Chan, S. (2013). Taking evidence-based nursing practice to the next level. International Journal of Nursing Practice, 19, 1-2. doi:10.1111/ijn.12208

Harvey, G., & Kitson, A. (2015). Implementing Evidence-Based Practice In Healthcare. doi:10.4324/9780203557334

LoBiondo-Wood, G., & Haber, J. (2014). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice. Journal of Nursing Regulation, 5(1), 60. doi:10.1016/s2155-8256(15)30102-2