Using Evidence To Inform Clinical Decision-Making Essay

Evidence for Nursing

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Task: You have been provided with three clinical scenarios. Each scenario indicates an area of clinical uncertainty. Select a scenario that interests you and using your evidenced based practice skills answer the question that follows.

Scenario 1:

In the course of your clinical placement in a surgical ward, you noted inconsistency in wound care. While some nurses use a sterile technique, others employ a clean dressing change technique.

Is clean wound dressing a safe option for dressing of surgical wounds?

Scenario 2:

You are working on a hospital ward where you encounter stroke patients. You notice that some doctors order compression stockings for prevention of deep venous thrombosis while others not.

Should antithrombotic stockings be routinely used for patients with stroke or not?

Scenario 3:

You are working as an RN in an emergency department. A 10-year-old child has been admitted to the department with a diagnosis of exacerbation of asthma secondary to bronchitis. The patient has been prescribed salbutamol.

What is the more effective method of delivery- a nebuliser or a spacer?

Format

Written paper with well-structured paragraphs. Headings can be used if they help structure your work.Using Evidence To Inform Clinical Decision-Making Essay

Introduction (500 words)

Briefly describe the process you used to answer the question. i.e. how you formulated a searchable question and developed a search strategy. Justify the approach you took in accessing the evidence. Describe the rationale behind the selection of each paper (hint: level of the evidence, quality of the evidence, relevance). Both quantitative and/or qualitative articles can be used, as appropriate to the clinical scenario and question you have developed. It is not necessary to present all the evidence you found (and you have limited word count to do this). The key thing is quality not quantity – so four or five research-based articles are better than a large number of low-level papers. Provide the print screens of the abstracts of the papers you have chosen.

Main body of the paper (800 words)

Briefly present each paper and their main findings. What does the research show?

Conclusion (200 words)

This is where you clearly state what you think the answer to your question is and why.Using Evidence To Inform Clinical Decision-Making Essay

Introduction

The integration of various functions that requires decision making in the clinical field is what is referred to as EBP. Clinical skills, education, and the accumulation of clinician’s experience are what we refer to as clinical expertise. The expectations, values, personal and unique concerns are what the patient brings out as his/her encounter. To ensure that the best evidence is found and presented, best clinically researches should conducted while sound methodologies are used to ensure that best results are presented. In the knowledge of nurses, they know that their decisions are important to the patients hence, making them to make decisions that are evidenced in determining the outcome. The role of evidence decision making in the recent past, has been considered to be one of the fundamental areas by the decision makers due to its active role in the healthcare sector. It has been considered as one of the important base of policy making in the health sector as the players in this sector depend much in evidence in ensuring that professionals are getting up to date information. This impact has been felt to an extent that in the UK nurses were asked to show professional judgment and also being able to make critical clinical decisions; the Chief Nursing Officer has outlined tasks that nurses are expected to ensure that the healthcare sector has been modernized to ensure that the boundary that exists between medicine and nursing is broken down. However, nurses are expected to show their capability in making all these decisions (Sakkett, 2014).Using Evidence To Inform Clinical Decision-Making Essay

Main Body

When one takes of Evidence-based decision making, it means basing your decisions on the combination of knowledge one has gained throughout his clinical expertise experience, the preferences of the patient and the researchers have done it from the available in different resources. In this type of decision making, one has a wide range of options that he/she can choose from including doing nothing and waiting and seeing what will happen. The choices used at the end always inform by evaluating the available information basing it in the process of clinical judgment. When it comes to making evidence-based decisions, then it is required that research evidence not to be taken according to its face value, rather critical analysis should be done to ensure that the internal and external validity of the research is known. When it comes to the Integration of research evidence in decision-making, it involves the formation of a focused clinical question to act as a response to a recognized need for information. The search of the most appropriate evidence that will be needed to meet the desired needs being able to appraise the retrieved evidence critically, ensuring the incorporation of the evidence into an actionable strategy, and finally, evaluation of the effects of the taken decisions and actions. All the steps mentioned above are very important components when it comes to the process of active evidence-based decision making (Yan, 2015).

In its nature, the way decision making is done is said to be a prescriptive approach towards the decision that are made in clinical judgment. Considering the idea of theoretical approaches and the way they are used for the improvement of real life decision-making challenges. It is important for those involved in the process of decision making first to ensure that they identify the starting point, before planning on the strategy that will enable them to attain this ideal. A question asked on how nurses view researchers based on the information of decision making by evidence. What is so surprising, is the fact that the research that has been conducted based on this topic is very little. However, there are some studies that have managed to use self-report data which is obtained from nurses and use it as a source of evidence. It’s a norm that there is a rejection of self-report to be used as the the major support in the attempt to answer the questions that are in favor of immediate observations which are clinical and also doing in-depth interviews which are meant to make us feel reflected in our actual decisions in different frequencies and also the observation of information (PICO, 2015).Using Evidence To Inform Clinical Decision-Making Essay

Most of the theoretical models are used in the utilization of research implicitly way have recognized how important the process of making decisions is very necessary in putting the acquired information into action. Though it is regarded as an implicit way of doing things, most of the models have failed to recognize the relationship that exists between the characteristics of decisions, how to use the information, and how to process this information. An example of this is the Lomas who has proposed a coordinated research model in its implementation. It has proposed that the diffusion of knowledge can be negotiated and be applied in the research findings as they deal with patients during clinical practice. Other works done by Lomas have suggested that both types of research and decision makers have to increase their level of understanding to one another regarding thinking to ensure that both research and policy linked in a better way. The argument that those practicing clinical work is trying to make efforts that will enable them to get insights about research through initiating programs like critically training appraisals and trying to read journals that will give them information which is evidence based nursing. Those who are researchers and practitioners have frequently failed to fully comprehend which product do the decisions made meant to be applied. According to decisions taken in organizations and their policies, Lomas have suggested that the researchers always should seek to understand the structures that are within the organization for them to take decisions, they should also understand their values by expression of ideologies, interests, and beliefs. The fact proven by the fact the evidence that there are some producers of evidence existing within organizations and their source of information is from evidence-based decision making. There are other theorists who have tried to come up with a context which they turn into models that research utilizes while neglecting the micro context of those actual decisions. They consider the following factors, the type of information required, how complex that research is perceived to be, the amount of information that is available for support and challenge, and also, those principles that are present and absent meant for organizing the information (Middleton, 2014).Using Evidence To Inform Clinical Decision-Making Essay

Some researchers have resorted to using clinical questions that are generated by clinical decisions to express the potential information needed for the whole process. The argument that should be in place is that all researchers should start to think deeper and begin the process of developing exploration of relationships that exist between the needs of information which include the information presented by questions and that information that come out of the behavior of the nurses. In addition to this, there is a need for recognition that simple mapping of the core choices to be at the heart of decision-making. This decision should involve the answering of uncertainty that that rose about given treatment, diagnosis, and prognosis. Where information may be sufficient, and the condition used are known well, then the insufficient information can be rejected at the end (Torin, 2011).

Throughout our discussion, the connection that exists between information behavior and the clinical decisions made from the researcher’s point of view are the one that we have been focusing. It is prudent that we recognize how those strategies available for the purpose of clinical decisions. Using Evidence To Inform Clinical Decision-Making Essay Those who are the decision makers can also be allowed to alter the relationship that exists with the information. According to the cognitive continuum rule, it expresses that it is evident that it can be at a position of simplifying decisions through the removal of some of the complex inducements by individuals in the application of the search and appraisal of the behavior of those involved. Taking this as an example, there are several nurses who have expressed themselves on the importance of the structured approach as a way of collecting more information that will be used as a way of simple collection of those valuable facts that are used when confronted with situations that require critical judgment. The task of determining solution to complex diseases is one that needs the doctor to be at the top level of judgement to enure that correct decicions are taken. These group of structured facts that include history, size and Doppler reading are formed on the basis of the decisions that are taken by the management. They are always formed on the informed national decisions that are generally based on guidelines that are approved and known to be the best. In addition to this, where single are decision making is used to observe text based information which is relatively common but it is said to be uncertain about use in the medication purpose. The accounts of the nurses have clearly indicated that the sources of information used in ensuring that they are fit for the questions that rose as they were taking decisions that were entirely focused on the well-structured decisions. This will lead to a collect mix that will lead to a particular desired outcome (NRGDS, 2016).Using Evidence To Inform Clinical Decision-Making Essay

When simplification is done then automatically we will result to the shift of the desired rational to the end of the continuum. When looking things from this point, then one can easily imagine how this particular thinking about a given decision nurses will face in their daily practice of clinical decisions then an impact will be felt on how information will behave. This proves that there are some basic elements that are based on the evidence that is brought out in the nursing process that will be used as decisions in the clinical process. Narrowing down the scoop, when we develop clinical questions that are focused the it is easy to conceptualize them as a mechanism of removing some of the hiccups that may be surrounding the choices that are to be used and therefore enable us turn our attentions to the relevancy of population, interventions, the outcomes, and the other core types of uncertainty like intervention, prognostic or diagnostic. According to Croskery, he tries to come up with some proposals that are somehow more sophisticated, and the technique which is under cognitive forcing process. The techniques used here involve the act of retraining clinicians so as to think in a manner that is different regarding the problems they face through accounting the effects that are associated with limited memory, some erroneous perspective which include ignoring of the rates of the diseases in which they are based when trying to investigate which is tied to the capacity of criticizing one’s self and other unworthy methods of selecting strategies. The results that we see at the end are heightened by the sense of meta-cognition or “thinking about thinking”. The researches have indicated that there are so many types of approaches that are missing in the nursing profession to ensure that correct decisions are taken (Penny, 2015).Using Evidence To Inform Clinical Decision-Making Essay

In the healthcare teams, nurses are regarded one of the most group of individuals who take critical decisions. While they are recognized as an important part in decision making, it is also required that they should use best available evidence when making their judgement ad decisions. Using the model that is prescriptive to make decisions with evidence and also trying to do searching, appraising, and implementing processes that should accompany this process should be active. Those clinic practitioners who need to put research findings in their practice at a point forget that active information seeks many possible responses that are faced with uncertainties of clinical practices. The observations that done by nurses who are exercising their responsibilities has suggested that search and appraise of information should occur to all. Nurses should always try to view their colleagues to be useful and they should access sources of information more that the way they should do with research. Colleagues should always be perceived as those who have relevant information that is needed to be taken into account and the judgmental or decisions from them should be minimal making time used to be minimal. This is one of the elements in clinical decision that is necessary and it leads to high quality decisions that are more important those who are involved. The approaches that have been mentioned above have been able to explain the disconnection that exists between the traditional ways of decision taking and the modern way of doing things. All the above discussed ways of decision taking should be put into practice. Nurses and those who are on the clinical practice should always use evidence based decision making approach.Using Evidence To Inform Clinical Decision-Making Essay

EVIDENCE AND CLINICAL DECISION-MAKING
“Best research evidence” refers to methodologically sound, clinically relevant research about the effectiveness and safety of nursing interventions, the accuracy and precision of nursing assessment measures, the power of prognostic indicators, the strength of causal relationships, the cost-effectiveness of nursing interventions and the meaning of illness or patient experiences. Research evidence alone, however, is never sufficient to make a clinical decision. As nurses, we must always trade the benefits and risks, inconvenience and costs associated with alternative management strategies, and in doing so consider the patient’s values (DiCenso et al. 1998). Patient values and preferences refer to the underlying assumptions and beliefs that are involved when we, along with patients, weigh what they will gain – or lose – when we make a management decision. The explicit enumeration and balancing of benefits and risks that are central to evidence-based nursing (EBN) bring into bold relief the underlying value judgments involved in making management decisions.Using Evidence To Inform Clinical Decision-Making Essay

The skills necessary to provide an evidence-based solution to a clinical dilemma include defining the problem; conducting an efficient search to locate the best evidence; critically appraising the evidence; and considering that evidence and its implications in the context of patients’ circumstances and values. Attaining these skills requires intensive study and frequent, time-consuming application (Guyatt et al. 2000).

The majority of nurses have a positive attitude about evidence-based practice (Upton 1999). However, there are substantial barriers to EBN at both the individual and organizational levels.

At the individual level, nurses lack skill in evaluating the quality of research (Parahoo 2000), are isolated from knowledgeable colleagues with whom to discuss research (Nilsson Kajermo et al. 1998) and lack confidence to implement change (Parahoo 2000).Using Evidence To Inform Clinical Decision-Making Essay

Organizational characteristics of healthcare settings are overwhelmingly the most significant barriers to research use among nurses (Parahoo 2000). Nurses speak about not having enough time to go to the library to read or to implement findings from research (Upton 1999). Related to this complaint is the inadequacy of library holdings in healthcare institutions, with many lacking nursing research journals (Mitchell et al. 1995). Nurses have identified a lack of organizational support for EBN, noting lack of interest, lack of motivation, lack of leadership and lack of vision, strategy and direction among managers (Parahoo 2000). Yet, this organizational support is crucial in situations where nurses do not believe they have the authority or autonomy to implement change in patient care (Parahoo 2000). For example, a physician may read about the effectiveness of a new pain medication and may choose to begin prescribing it immediately; nurses who identify a new, effective nursing intervention for pain management must often obtain approval from nursing administration before implementing it.Using Evidence To Inform Clinical Decision-Making Essay

Clinicians and patients recognize that while not the sole consideration, current, accurate information is a vital component of clinical decision-making. With advances in information technology and reporting of research findings in the media, patients, armed with “facts” they have read on the Internet or in the newspaper, are beginning to ask their care providers about the applicability of research findings to their particular health problem. A vivid example is the widely publicized study of the risks and benefits of estrogen and progestin in post-menopausal women that was stopped early because the investigators found a higher incidence of cardiovascular disease and breast cancer in women taking the combined hormones when compared to women taking placebo (Writing Group for the Women’s Health Initiative Investigators 2002). Physicians and nurse practitioners have been deluged with patient inquiries about whether they should discontinue their hormone replacement therapy, requiring these clinicians to be sufficiently aware of the study methods to judge the validity of the results and their applicability to individual patients.Using Evidence To Inform Clinical Decision-Making Essay

Grounding nursing practice in evidence, rather than tradition, is necessary to meet nursing’s social obligation of accountability, to gain and maintain credibility among other health disciplines and to build a nursing knowledge base that can be used to influence policy at agency and governmental levels (Rafael 2000). Governments around the world are encouraging evidence-based practice. In Canada, the National Health Forum, a federally funded group charged with making healthcare recommendations, has stated that “a key objective for the health sector should be to move rapidly toward the development of an evidence-based health system, in which decisions are made by healthcare providers, administrators, policy-makers, patients and the public on the bases of appropriate, balanced and high quality evidence” (National Forum on Health 1997). In the United Kingdom, the Department of Health has stipulated that, to enhance the quality of patient care, nursing, midwifery and health visiting, practice needs to be evidence based (UK Department of Health 1999).

NOW

In the United States, the Agency for Healthcare Research and Quality (AHRQ), formerly the Agency for Health Care Policy and Research (AHCPR), leads national efforts in the use of evidence to guide healthcare decisions through funding of Evidence-Based Practice Centers that undertake systematic reviews on selected clinical topics, sponsoring a National Guideline Clearinghouse of abstracts of evidence-based practice guidelines (www.guideline.gov) and funding studies that evaluate strategies for effectively disseminating research findings to practitioners and policy makers (Titler 2002). In December 2002, the Board of Directors of the Sigma Theta Tau International Honor Society of Nursing adopted a position statement supporting the development and implementation of EBN and committing itself to working closely with key partners to provide nurses with the most current and comprehensive resources to translate the best evidence into the best nursing research, education, administration, policy and practice (Honor Society of Nursing 2002).Using Evidence To Inform Clinical Decision-Making Essay

TOWARDS FULL DEVELOPMENT AS AN EVIDENCE-BASED PROFESSION
Various activities have been initiated to facilitate EBN practice, including the development and offering of undergraduate courses on locating and critically appraising research evidence (Kessenich et al. 1997), the development of clinical practice guidelines (Grinspun et al. 2002), the development of EBN committees in clinical settings and research to identify the most effective strategies for disseminating research findings to nurses. But there is a long way to go. How do we create a culture shift that ensures that a nursing student knows how to search the literature for high-quality studies as proficiently as she can measure a patient’s blood pressure, and that a staff nurse has access to the best research evidence to incorporate into clinical decision-making?

Let’s begin by considering changes to nursing education programs. A number of ideas come to mind related to curriculum development, faculty development, librarian resources and accreditation criteria. Rather than isolating the teaching of critical appraisal of research in its own undergraduate course, can we re-examine our nursing curricula and consider how critical appraisal of research can be integrated into each and every learning experience, whether learning of clinical skills such as taking blood pressure, or in-class nursing courses, or clinical experiences in healthcare settings? Can we see a world where students in classrooms or in clinical settings go off to learn about a specific patient or health problem and return with a clearly stated question, the search strategy they used and the strengths and limitations of the highest-quality study they found on the topic? If this were the approach to every course students took and every clinical experience they had, would consideration of best research evidence in their clinical decision-making become second nature for these future nurses? Clearly, none of this will happen if nursing faculty are not comfortable with critical appraisal skills.Using Evidence To Inform Clinical Decision-Making Essay

To be fair, the opportunities to develop these skills have been relatively scarce. There is much to be done in this area. Various models can be explored for faculty development; for example, at McMaster University, an interdisciplinary, week-long, intense workshop on How to Teach Evidence-based Clinical Practice is conducted every June that attracts clinician educators from around the world. To ensure that nurse educators of the future are prepared to teach in an EBN curriculum, it is vitally important that the graduate nursing programs include required courses on critical appraisal and application of research evidence.

Librarians are an indispensable resource to evidence-based practice. In a number of undergraduate and graduate nursing courses at McMaster University, a health sciences librarian has set up course-specific Web Sites providing ready access to numerous sources of evidence-based material. As well, she spends a half day with the students in the computer laboratory providing hands-on experience in efficient advanced searching strategies to locate high-quality research evidence and to link with resources that can automatically notify the student when new studies are published in a specific area of interest. She is also available to meet individually with students.Using Evidence To Inform Clinical Decision-Making Essay

These ideas, while promising, cannot be implemented without the buy-in and support of the deans and directors of schools and faculties of nursing. These are not resource-free ideas; instead, they are ideas that likely require financial and human resources as well as a supportive environment for change. Incorporation into the accreditation process of specific objectives and recommendations for transforming nursing education programs into evidence-based education programs are key to helping deans and directors obtain assistance with required resources from the university or college administration.

In clinical settings, let’s consider computer and librarian resources, development and introduction of the nurse educator/practitioner/researcher role, journal clubs, interdisciplinary rounds and accreditation. Asking nurses to practise nursing without the tools to locate best evidence to inform their clinical decision-making is comparable to asking them to take a blood pressure measurement without a stethoscope. Many nurses, while highly motivated to become evidence-based practitioners, have not had any opportunity in their nursing education to learn searching and critical appraisal skills. To complicate matters further, time is more limited than ever.Using Evidence To Inform Clinical Decision-Making Essay

There exist, however, numerous secondary sources of pre-appraised evidence that provide immediately applicable information for decision-making. Administrators of clinical settings can make a significant contribution to the development of evidence-based practice by providing access to these resources, along with opportunity for nurses to learn how to track down and efficiently use them. Such resources, which apply a methodological filter to original investigations and therefore ensure a minimum standard of validity, include Clinical Evidence, The Cochrane Library, Evidence-Based Nursing (and other discipline-specific abstraction journals, such as Evidence-Based Mental Health), high-quality clinical practice guidelines and an increasing number of computerized decision-support systems. Ready access to computers in the clinical setting and librarians is key. At a minimum, librarians can teach nurses how to frame an answerable question and how to use the secondary sources of pre-appraised evidence efficiently. The librarian becomes, in effect, a knowledge broker who is expert in sources of high-quality information and in teaching others how to access them efficiently.

For the most part, nursing educators are not active clinicians, and nurse clinicians are not nursing educators. At Rush University College of Nursing, they have developed the nurse educator/practitioner/researcher role in which faculty members have an ongoing research involvement and clinical practice alongside their responsibilities as educators, lecturers and advisers (“Inside the Rush Model” 2003). Picture clinical settings in which the nurse educator/practitioner/researcher works closely with nursing staff to produce and disseminate new knowledge and, as an advanced practice nurse, models and facilitates evidence-based practice.Using Evidence To Inform Clinical Decision-Making Essay

Should we consider bringing together, in the clinical setting, the nurse educator, the students and the nurse clinicians in the form of a journal club? Together, they can identify a patient problem; volunteers can then offer to search out the best evidence and bring it back for presentation and discussion with the group. This might provide a forum for learning from one another while at the same time helping nurses in the clinical setting, who lack time and critical appraisal skills.

There is an increasing awareness of the importance of interdisciplinary learning to facilitate the effective working of the multidisciplinary healthcare team in service delivery. We are beginning to see how challenging it is to promote interdisciplinary service when learning has occurred in unidisciplinary silos. Is there an opportunity in the clinical setting to bring together students from programs such as nursing, midwifery, medicine, occupational therapy and physiotherapy to consider a common patient problem and to search out and discuss relevant research findings? For example, at McMaster University, a multidisciplinary team has been awarded funds from the provincial government to develop models for collaborative education and collaborative service delivery in long-term care, including family medicine residents, nurse practitioner students and pharmacy students. It is envisioned that both models will include the opportunity for these interdisciplinary learners and clinicians to work together through patient problems, identifying and using best evidence in their clinical decision-making.Using Evidence To Inform Clinical Decision-Making Essay

Very little of this is possible without the support and provision of resources by the administrators of healthcare settings. Nurse managers may want to consider lobbying for inclusion of standards related to EBN practice in the accreditation mechanisms for their clinical settings. This action would appropriately highlight the importance of evidence-based practice and would ensure that essential resources be allocated to its development.

The ideas offered above are merely suggestions. The development of an evidence-based profession is an extremely important initiative in nursing, one that warrants national attention and collaboration. I encourage key nursing groups, including associations of nursing educators, executive nurses and national nursing organizations, to combine forces and create blue ribbon panels or task forces charged with making recommendations for changes in nursing education and practice that will move us rapidly towards full development as an evidence-based profession.Using Evidence To Inform Clinical Decision-Making Essay

The goals of the tutorial are to clearly outline the theory of EBP and to explain how that theory can be put to practice in the day-to-day work of caring for patients. The tutorial includes an introduction and modules that follow the “5A’s Cycle” of EBP that include assessing the patient and prioritizing questions about his/her care, asking a focused clinical question, acquiring the evidence to answer the question, appraising the research, applying the research findings to patient care, and finally auditing your performance.. The cycle begins again with an assessment of the patient and the patient’s care.1

The tutorial focuses largely on efficient literature searching and therefore on asking questions and acquiring the best evidence. In particular, it suggests specific strategies for finding evidence from primary studies, systematic reviews and meta-analyses using EBP tools. Appraisal is also touched upon, with suggestions for scanning search results to identify articles more likely to yield robust, applicable evidence.Using Evidence To Inform Clinical Decision-Making Essay

At the end of the tutorial, you should be able to:

Formulate a clinical question using the PICO framework;
Identify five common categories of clinical questions;
Identify which research methodologies provide the best evidence for your question type;
Distinguish between systematic reviews, meta-analyses and narrative or clinical topic reviews;
Search Medline/PubMed effectively for studies likely to provide the current best evidence by
Identifying appropriate search terms, including Medical Subject Headings (MeSH) terms; and
Employ evidence filters such as PubMed’s Clinical Queries;
Identify articles from your PubMed search results that are most likely to provide current, valid, reliable and relevant evidence to answer your question.
This tutorial assumes you already have some familiarity with basic and advanced PubMed search techniques, as well as with MeSH searching.Using Evidence To Inform Clinical Decision-Making Essay

There are many excellent on-line and print guides that address the critical appraisal of a research report and the application of evidence to an individual patient’s care. You will find links to selected resources that provide especially rich content in these areas in the Appraise and Apply modules of this tutorial.

It is best to work systematically through the various modules, starting with Introduction: About Evidence-Based Practice, and then the five modules.

Reference Shelf of EBP eBooks and Books
The Library has a vast range of books and ebooks about EBP that can be found via Library Search (the Library Catalogue). The Reference Shelf in this guide lists a range of the EBP eBooks and Books by category and discipline area.

What is Evidence-Based Practice
What is Evidence-Based Practice?
The classic definition of Evidence-Based Practice (EBP) is from Dr David Sackett. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research”.Using Evidence To Inform Clinical Decision-Making Essay

EBP has developed over time to now integrate the best research evidence, clinical expertise, the patient’s individual values and circumstances, and the characteristics of the practice in which the health professional works.3

So, EBP is not only about applying the best research evidence to your decision-making, but also using the experience, skills and training that you have as a health professional and taking into account the patient’s situation and values (e.g. social support, financial situation), as well as the practice context (e.g. limited funding) in which you are working. The process of integrating all of this information is known as clinical reasoning. When you consider all of these four elements in a way that allows you to make decisions about the care of a patient, you are engaging in EBP.Using Evidence To Inform Clinical Decision-Making Essay

Why is Evidence-Based Practice Important?
EBP is important because it aims to provide the most effective care that is available, with the aim of improving patient outcomes. Patients expect to receive the most effective care based on the best available evidence. EBP promotes an attitude of inquiry in health professionals and starts us thinking about: Why am I doing this in this way? Is there evidence that can guide me to do this in a more effective way? As health professionals, part of providing a professional service is ensuring that our practice is informed by the best available evidence. EBP also plays a role in ensuring that finite health resources are used wisely and that relevant evidence is considered when decisions are made about funding health services.4

What happened before Evidence-Based Practice?
Before EBP health professionals relied on the advice of more experienced colleagues, often taken at face value, their intuition, and on what they were taught as students. Experience is subject to flaws of bias and what we learn as students can quickly become outdated. Relying on older, more knowledgeable colleagues as a sole information source can provide dated, biased and incorrect information. This is not to say that clinical experience is not important – it is in fact part of the definition of EBP. However, rather than relying on clinical experience alone for decision making, health professionals need to use clinical experience together with other types of evidence-based information Using Evidence To Inform Clinical Decision-Making Essay

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