Evidence-based practice (EBP)

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Evidence-based practice (EBP)

Evidence-based practice (EBP) is a problem-solving concept in healthcare that aims to achieve the best patient outcomes by providing the best available method of care (Parrish, 2018). Physicians try to give the most effective care based on clinical research. Although researchers in the 1900s introduced the concept of EBP, there are still misconceptions and misunderstandings in people’s perceptions (Parrish, 2018). Most of these misunderstandings are due to the literature and how they fail to cite sources of the concept or lack new elements that do not relate to the original concepts (Gambill, 2016). There are also disagreements among scholars and skeptics about the main concepts of this practice.

EBP and Issue in Leadership

EBP is a concept that continues to grow among leaders in different concepts, including nursing. This practice combines scientific evidence and nursing practices to generate good patient outcomes. Healthcare leaders are one of the most important determinants in how EBP is implemented by other members of the staff and the organization as a whole. All leaders in practice continue to use different evidence-based practices in their work. There are, however, challenges in identifying whether these leaders make the most of other forms of evidence they can access. There are also questions on the quality and amount of data available for use (Shuman et al., 2020). Leaders can face issues when trying to implement these concepts due to a lack of adequate modes of interpreting the available data (Shuman et al., 2020). The information available to these leaders can also be contradictory to their norms. Many leaders display forms of biasness towards some data and prefer to use what they choose.

History of EBP

Evidence-based practice is a concept in nursing that continues to exist from the 1800s where it first began with Florence Nightingale (Mackey & Bassendowski, 2017). Her work in the military war during the Crimean war in 1853 is widely recognized by individuals worldwide. In the barrack hospital in Scutari, Turkey, Nightingale started her research on how the environment can impact patient health outcomes, leading to publishing a book, Notes of Nursing, in 1859 (Mackey & Bassendowski, 2017). At the time, nurses considered the book to offer the best guidelines for nurses and predict morbidity and mortality. Professor, Archie Cochrane is a medical doctor and researcher who resides in the United Kingdom. In 1972, the professor made deductions of how treatment-related decisions in the health unit did not follow a systematic based review (Drisko & Grady, 2019). Professor Archie tried to make suggestions of the need for the international collaboration of researchers to help review clinical trials by specialty.

This statement played a role in highlighting the existing gap between clinical practice and research. It also played a role in convincing practitioners about the various benefits they can experience through evidence-based research. This practice continued to evolve through the 1960s until the late 1990s (Mackey & Bassendowski, 2017). At the time, the professor noticed that a lack of funding and resources influenced how healthcare takes place. Cochrane advised the physician to make use and give priority to the most effective practices at the time. Gordon Guyatt and his team introduced evidence-based medicine in 1996 (Mackey & Bassendowski, 2017). The term was to help shift the process of decision-making from an unsystematic clinical experience to one that relies on scientific, clinically relevant research. In the 1990s, David Sacket and a group of researchers defined evidence-based practice(Stannard, 2019). The researchers tried to show the importance of using patient values to device research for patient care and centered care.

Evidence-based practice in nursing care continues to produce the best patient outcomes. Duff et al. (2020) state that, despite the introduction of new models of EBP, the practice is not consistently or uniformly adopted by the nurses in clinical practice. Research reveals that the health industry uses several guidelines to help introduce such models into clinical practice. Many patients do not receive evidence-based care even though numerous clinical trials prove the advantages of this practice. The implementation process continues to get tasking as there is an increasing rate of journals and research introduced into the industry. Studies identify that physicians are finding it challenging to continue to provide care to the patients while still acknowledging and practicing the new trends. Chien (2019) states that, although research and investigations on new practices in EBP are essential, they should be accompanied by effective implementation.

 Literature review

According to Abu-Baker et al. (2021), integrating the practice into the daily practice of health practitioners can improve outcomes and practice environments. The researchers explain how earlier attempts to implement the practice into the clinical practice have yielded a low level of results. The health industry tries to solve this problem by implementing studies of EBP into the curriculum for nurses and other health practices. However, the researchers identify that this practice does not lead to the practitioners implementing EBP in their everyday practice. Nilsen et al. (2017) Also state how introducing the developing and implementing professional education that allows for the introduction of EBP is difficult. Assuring patients of best care requires effective incorporation of proper knowledge, skills, and attitudes in EBP to professionals. Research into EBP reveals several challenges that professionals should address for the trend to be adopted effectively within the system.

 Summary of Issues

According to the studies, the challenges in implementing an evidence-based system are within the education system and clinical practice. A random sample of a nationwide survey in the United States reveals that four do not receive evidence-based care out of ten patients. (Duff et al., 2020). Some records reveal that some practitioners are offering care that is harmful to the patient. The models of implementing EBP into clinical practices are a challenge to many facilities and physicians. Most of the challenges of implementing the practice into clinical practice are due to ever-increasing research in the system and the lack of a conducive environment (Duff et al., 2020). The staff also report on the lack of adequate guidance on incorporating the new trend into their practice.

Introducing the concept of EBP into the education system does not necessarily guarantee its adoption into clinical practice (Abu-Baker et al., 2021). There is an increasing need to increase EBP among nursing students. Many nursing students have positive attitudes about the concept yet lack the belief system to implement what they learn. Some of the factors affecting how different graduates implement the practice include age, sex, training, and awareness of EBP (Abu-Baker et al., 2021). Research reveals an existing gap in the education system. The system mostly concentrated on research on EBP and did not continue to offer training due to inconsistencies in how professionals teach the subject. This issue reveals the lack of appropriate infrastructure in educational facilities to help implement EBP learning effectively.

Solutions to the Issues

Effective implementation of the EBP into the clinical system requires a conducive environment. Nurses should have a supportive manager and team to facilitate the changes. Developing an effective implementation model for EBP care and optimizing the practice environment also plays a significant role (Duff et al., 2020). Studies reveal the need for adequate training, education, and staff support. The support of leaders and effective policies facilitate the implementation of any project into a health system. Enhancing EBP care starts at the education level. Nursing students should receive adequate practice and training. Enhancing positive belief in the concept starts with teaching the practice, presenting evidence, applying this evidence, and evaluating the effectiveness (Abu-Baker et al., 2021). Knowledge and understanding help students implement what they learn.

Conclusion

Evidence-based practice (EBP) encourages accurate, timely, and up-to-date methods in clinical practice to enhance patient outcomes. EBP can influence the way leaders to make decisions and implement the practice. EBP implementation is successful when leaders plan and make necessary processes and structures to facilitate the practice. EBP is a concept introduced by researchers as early as the 1900s. The definition of the concept has continuously changed with the introduction of new models and practices within clinical practices. There are, however, limitations to the way EBP is implemented into practice. Addressing several issues within the educational system and clinical implementation process can help facilitate learning, training, and efficient application of the concept in modern healthcare.

  References

Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate nursing students. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-020-00522-x

Chien, L. Y. (2019). Evidence-Based Practice and Nursing Research. The Journal of Nursing Research, 27(4). https://doi.org/10.1097/jnr.0000000000000346

Drisko, J. W., & Grady, M. D. (2019). Conclusion: The evidence for evidence-based practice. Essential Clinical Social Work Series, 311-319. https://doi.org/10.1007/978-3-030-15224-6_21

Duff, J., Cullen, L., Hanrahan, K., & Steelman, V. (2020). Connect failed: User ‘942227_alan’ has exceeded the ‘max_user_connections’ resource (current value: 5). Implementation Science Communications, 1(1). https://doi.org/10.1186/s43058-020-00070-0

 Gambrill, E. (2016). Is social work evidence-based? Does saying so make it so? Ongoing challenges in integrating research, practice, and policy. Journal of Social Work Education, 52(sup1), S110-S125. https://doi.org/10.1080/10437797.2016.1174642

Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55. https://doi.org/10.1016/j.profnurs.2016.05.009

Nilsen, P., Neher, M., Ellström, P., & Gardner, B. (2017). undefined. Worldviews on Evidence-Based Nursing, 14(3), 192-199. https://doi.org/10.1111/wvn.12212

Parrish, D. E. (2018). Evidence-based practice: A common definition matters. Journal of Social Work Education, 54(3), 407-411. https://doi.org/10.1080/10437797.2018.1498691

Shuman, C. J., Ehrhart, M. G., Torres, E. M., Veliz, P., Kath, L. M., VanAntwerp, K., Banaszak‐Holl, J., Titler, M. G., & Aarons, G. A. (2020). EBP implementation leadership of frontline nurse managers: Validation of the implementation leadership scale in acute care. Worldviews on Evidence-Based Nursing, 17(1), 82-91. https://doi.org/10.1111/wvn.12402

Stannard, D. (2019). A practical definition of evidence-based practice for nursing. Journal of PeriAnesthesia Nursing, 34(5), 1080-1084. https://doi.org/10.1016/j.jopan.2019.07.002