EVIDENCE-BASED PRACTICE & APPLIED NURSING RESEARCH

Introduction

Today, the medical and health care sector is one of the most vibrant disciplines undertaken by man. The sector has been using huge amounts of money to carry out sophisticated and high quality research annually. Consequently, there has been a tremendous growth in medical as well as health care literature. New and more efficient medical procedures, medical devices, as well as medicine are invented on a regular basis (Sackett et al., 2007). All these efforts are aimed at assisting nurses and other medical practitioners to provide the patients with the best possible treatment and health care. Aside from using the well-established procedures and traditional practices, new innovative inventions are also being implemented by health care practitioners. These innovations are founded on concrete research based evidence and best practices. Such techniques and innovations include evidence-based practice (EBP) and nursing research, these techniques are gaining more recognition because of their potential to provide care for patients and to carry out clinical issues.

Discussion

The concept of evidence based practice within the medical and health care sector emerge in the 1980s. The emergence of evidence based practice marked a shift of practice among the nurses and other medical practitioners from well-established procedures, and traditional practices, to an emphasis on information and evidence derived from previous studies and research. According to McKenna et al., (2004) evidence based practice entails the utilization of current best evidence and practices carefully, explicitly, and judiciously for purposes of making suitable decisions about providing the best care for individual patients. According to LoBiondo-Wood & Haber, (2006) research is a study or a systematic inquiry process conducted for purposes of developing knowledge in a particular field. Nursing research is therefore, a systematic method that is used for purposes of investigating facts that is crucial for nurses and the nursing profession. Since nursing career involves clinical practice it is vital for all practices undertaken by nurses to be founded on scientific facts. The evidence derived from nursing research offers support for a cost effective as well as a quality of nursing intercessions. Consequently, health care recipients are more likely to benefit through applied nursing research.

Some of the obstacles of applying evidence based practice and nursing research may include: unavailability of research journals and reports by nurses for reference purposes during their practice; some nurses also lack mentors who can be an example for purposes of implementing evidence based practice and nursing research in various tasks practiced by nurses; finally, most nurses continue to apply the knowledge they acquired during their college year, which is outdated. The only way to overcome these obstacles is identifying them and designing appropriate solutions (Kania-Lachance et al., 2006). For purposes of assisting nurses and medical practitioners to apply evidence-based practice and nursing research, nurses should be provided with current journal and reports on a particular task in nursing care. Such reports and journals can be very vital for purposes of providing quality and up to date health care to patients. In addition, nurses should also develop a culture of applying nursing research and evidence based practice in their day-to-day tasks of nursing. The administration should also organize activities such as nursing grand rounds, and nursing clubs for purposes of emphasizing the importance of applying evidence based practice and nursing research particularly in nursing care.

According to Melnyk & Fineout-Overholt, (2005) a single discipline perspective should not be used to solve numerous practice problems. In light of this, members of the nursing profession have to undertake a number of responsibilities in an effort to effectively apply evidence based practice and nursing research. To begin with, nurses must be conscious of how a particular decision taken in previous practice may affect the outcome of individual care of a patient. Secondly, nurses should remain open minded to the ideas of their colleagues. In addition, they must identify and alleviate their understanding of various methods of developing knowledge and solving problems in different areas. The nurses should also identify opportunities and develop substantial literature. The foregoing strategies can be very useful for purposes of providing the necessary evidence in relation to perioperational procedure.

One of the perioperational procedure that evidence based practice and applied nursing research could be of paramount importance is the routine shaving of the surgical site. Routine shaving of the surgical site is a procedure that involves shaving of hair found in the surgical site. Patients must undergo this procedure before any surgical operation. routine shaving of the surgical site can be carried out in three ways, which include: use of creams that dissolve the hair, shaving the hair with a razor, and using a clipper. Several studies have indicated that some of the methods used in routine shaving of the surgical site causes higher levels of infection on the surgical sites compared to others (Alexander, Fawcett and Runcinman, 2006). In light of the forgoing findings, there is no doubt that the need to transform the routine shaving of the surgical site is of atmost importance especially in relation to the method used.

Utilization of evidence based practice and applied nursing research, can go a long way in assisting nurses to make the appropriate decision on the most viable method that they can use to carry out preoperation shaving with lower rate of infection on surgical site. Study shows that the use of a razor to shave surgical site causes higher rate of infection in surgical site (Alexander,et al., 2006). Undertaking research for purposes of understanding the advantages and disadvantages of all methods used in preoperational shaving procedure is therefore, very important. The evidence found in such reports and journals can be used to provide quality health care to surgical patient resulting to better patient outcome.

Most studies indicate that the utilization of shaving cream causes less infections in the surgical site than the use of any other methods(Martin and Marin, 2007). This may be explained by the fact that using a razor to shave might cause cuts that may inturn be easily infected. The use of evidence based practice and applied nursing research can assist nurses to single out the use of depilatory creams as the most effective method of shaving with minimal chances of patient infection.

Certainly, there are numerous benefits that are associated with evidence-based practice and applied nursing research. Such benefits range from providing quality health care to patients, ensuring that the nursing practice is up to date and relevant, to enabling nurses take full control of their practice. That notwithstanding, there are a number of challenges and barriers that obstructs implementation of evidence based practice and nursing research in the day to day activities carried out by nurses. In a study conducted by McKenna et al., (2004) one of the major obstacle is the vast literature on health care that is published in numerous sources making it very difficult for nurses to access such literature for purposes of updating their knowledge. It is estimated that due to the advancement in technology and the dynamics in the health care sector an average of 8,000 relevant articles in different areas are published every month. In an effort to stay abreast of new facts, therefore, it is estimated that a nurse requires approximately 20 hours dedicated to reading such literature. This situation presents a huge barrier to adopting evidence-based practice and applied nursing research.

In an investigation conducted by O’Connor & Pettigrew, (2009) lack of adequate time to implement novel ideas during the working hours, and lack of enough authority to change the procedure of patient care, stands in the way of implementation and adoption of evidence based practice and applied nursing research. In addition, Sackett et al., (2007) noted that difficulty in appreciating statistical investigation, as well as lack of sufficient resources presented a huge barrier to the adoption of evidence-based practice and applied nursing research. It is important to note that lack of sufficient time is the most significant obstacle as the nurses cannot be able to carry out substantial research, appreciate it, and interpret the findings of such a report. Finally, inadequate access to information technology and limited skills on how to use modern technology is also a barrier to adopting evidence based practice and applied nursing research. Nurses with limited IT skills would find it very hard to search for relevant information.

Conclusion

Indeed, there are numerous benefits that are associated with evidence-based practice and applied nursing research. These benefits include providing quality health care to patients, ensuring that the nursing practice is up to date and relevant and enabling nurses to take full control of their practice, among others. Evidence base practice and nursing research can be applied in perioperative shaving procedure for purposes of providing quality health care and better patient outcome. Perioperational shaving procedure require high quality data for purposes of informing their clinical decision and better results. What is more, they require such information for purposes of verifying the effectiveness of changes in practice. There are three steps through which, evidence based practice and applied nursing research can be implemented and these steps include nurses formulating a question, finding and evaluating the applicable information, and finally, using such information in their daily practice.

Some of the challenges and barriers that obstruct implementation of evidence based practice and nursing research in the day to day activities carried out by nurses include: the vast literature on health care that is published in numerous sources making it very difficult for nurses to get such literature for purposes of updating their knowledge, lack of adequate time to implement novel ideas during working hours, lack of enough authority to change the procedure of patient care, inadequate access to information technology as well as limited skills on how to use modern technology present a barrier to adopting evidence based practice and applied nursing research, and difficulty in appreciating statistical investigation, as well as lack of sufficient resources. It should however be noted that lack of sufficient time is the most significant obstacle as the nurses cannot be able to carry out substantial research, appreciate it, and interpret the findings of such a report.

References

Alexander, M. F., Fawcett, J. N., &Runcinman, P. J. (2006). Nursing practice. Hospital and home: the adult . Washington: Elsevier Health Sciences press.

Kania-Lachance, M., et al. (2006). Evidence-based practice and the nurse practitioner. Nursing Practice, 31 (10), 46–54.

Martin, S., & Marin S. Y. (2007). Minor surgical procedures for nurses and allied healthcare professionals. New York: John Wiley and Sons.

(2004). Barriers to evidence-based practice in primary care. J Adv Nurse, 45 (2), 178–189.

Melnyk, B., & Fineout-Overholt, E. (2005). Evidence-based practice in nursing and health care. Philadelphia: LippincottWilliams & Wilkins.

LoBiondo-Wood, G., & Haber, J. (2006). Nursing Research: methods and critical appraisal for evidence-based practice. St. Louis: Elsevier.

O’Connor, S., & Pettigrew, C. (2009). The barriers perceived to prevent the successful implementation of evidence-based practice. Nurse Practice, 44(6), 1018–1035.

Sackett, D., et al. (2007) Evidence-based medicine: how to practice and teach EBM. Edinburgh, UK: Churchill Livingstone.