Abstract
This paper is aimed at discussing the phenomenon of evidence-based practice in the context of nursing. Part A of the paper exposes the reasons why it is important for nurses to use evidence-based practice in the clinical setting. Part B scrutinizes the importance of knowledge of research methods for utilization of evidence-based practice. Part C reports on a study concerned with the implementation of evidence-based practice in Sweden. Finally, part D summarizes the paper.
Introduction
Evidence-based practice (EBP) is an important concept that has gained popularity in medicine, nursing, and other types of clinical practice over the last few decades. It is of crucial importance for nurses to utilize EBP; they also need to understand the research methodology in order to use EBP. A study conducted by Swedish nurses (Johansson, Fogelberg-Dahm, & Wadensten, 2010) provides some additional insights about conditions that positively affect the utilization of EBP.
EBP as an Essential Principle
EBP has become an essential principle in nursing. There exist a variety of reasons why EBP is so important. It is an approach according to which nurses need to use the findings of the most recent and relevant research evidence, especially the findings of empirical studies (Fawcett, 2012), in combination with personal reflections on one’s own clinical experience, as well to take into account the patients’ preferences. EBP is associated with cognitive maturity (Nickerson & Thurkettle, 2013); it means that, while caring for patients, nurses should show some initiative. They need to clearly identify the problems they are facing, find recent and relevant scholarly sources on the topic, use them to obtain the evidence on the best ways to care for the patients, and decide what interventions to perform in order to maximally improve the patient outcomes.
EBP serves simultaneously as a powerful stimulus to develop and a forward-driving method, for using this principle provides nurses with a plan of action in unfamiliar situations (as well as in the familiar ones), encourages them to continuously gain new information and reflect upon both this information and their own clinical experience, and helps them to keep up with the rapidly advancing knowledge base. Thus, it reduces the gap between the current knowledge and the clinical practice. It also makes nurses constantly learn and improve. The implementation of valid and clinically significant data provided by recent research allows nurses not only to significantly improve the patient outcomes but also to enhance the health care system as a whole.
EBP Implementation
In order to effectively implement EBP, it is also crucial for nurses to understand research methods. The reasons for this lie in the nature of EBP. As it was mentioned, EBP requires nurses to perform a number of steps when facing a clinical situation. Identifying the situation and looking for relevant information is a stage of research and discovery for the nurse. Therefore, the skill to properly ask a question about the current situation allows a nurse to make the first step towards resolving it and begin the search for information. Furthermore, it is important not only to find some data but also to be able to process and assess it, “transform” it into usable materials (Brown, 2013, p. 5). The need to perform such an assessment means that the nurse has to be able to understand the methods using which the data was obtained; moreover, knowing the methods of a study might not only provide additional insights regarding the utilization of the gained information but, in fact, be essential for its implementation.
Next, after gathering the data, the nurse needs to synthesize the findings of multiple studies with their own experience, also taking into account the patients’ needs, requirements, and the peculiarities of their clinical setting, and to translate the obtained evidence into a practical guide. The nurse has to be able to assess the strength of the derived recommendations and how well they are supported by the gathered evidence to choose the best course of action among the many. To do that, it is crucial to comprehend and use the research methods, for only their implementation can allow for effective evaluation and for making the best choice. Finally, nurses may need to make some conclusions about the clinical situation and possibly perform a number of their own studies in order to establish the best way of using their knowledge.
Utilization of EBP
The utilization of EBP in Sweden was studied and reported by Johansson et al. (2010). The authors aimed to find out whether and how head nurses in Swedish hospitals use EBP, and what factors have an effect on such activities. Before conducting the study, the authors organized a special course on EBP for head nurses of two hospitals that took place at Uppsala University Hospital. To carry out the assessment, an Internet-based Evidence-based Practice Questionnaire (EviPraQ) was also in by the head nurses participating in the study (Johansson et al., 2010, p. 72).
The authors were able to identify the degree to which the participating head nurses utilized EBP, as well as factors contributing to and preventing them from using EBP. The research yielded the following results. First, it was found out that most head nurses had a positive attitude towards EBP; however, they complained that they had no time to read scholarly reports during work hours, and did not often discuss research findings with the personnel of their hospital. Second, the majority of the participants asserted that they had little opportunity to carry out studies during work hours, and only nearly half of them stated that they read new studies and discussed them with other head nurses. Third, a large part of the study’s population strongly claimed that they usually encouraged the members of their hospitals’ personnel to read research findings, and that they used such findings in their clinical setting; on the other hand, many of the participants added that their staff have time to look for and read scholarly literature. Fourth, a significant amount of the head nurses participating in the study strongly supported the statement that various development processes had taken or were taking place in their wards. Fifth, the analysis of the questionnaires showed no statistically significant correlation between any questions asked in the quiz, on the one hand, and the quantity of years that had passed after the head nurses had obtained their degrees. On the other hand, those participants who had occupied their positions as head nurses for greater amounts of time tended to have more time and opportunity for reading research, as well as for conducting studies during their work time; they also perceived interest or experience in research as a part of qualification while hiring new employees to their wards. Sixth, those head nurses who had experience of additional education, including the methodology of science, were more likely to make use of the findings of studies in their work, as well as to report “quality and development projects” in the written form (Johansson et al., 2010, p. 74). And, finally, 48% of participants stated that their immediate superiors highlight that it is essential to use EBP in their work.
The authors sum up that, while most head nurses have a distinctly favorable attitude towards EBP, many of them suffer from a dearth of time to look for and read the reports about scientific studies; more experienced head nurses, however, had more opportunity to do that. Also, additional education, including the studies of scientific methods, as well as the support from leaders, stimulate head nurses to employ the principles of EBP and encourage their staff to do so as well. Consequently, higher education levels, supportive leadership, and manageable workload are desirable if the rates of utilization of EBP are to be improved.
Conclusion
To sum up, using EBP is important in nursing because it reduces the gap between the current scientific knowledge and clinical practice, allows nurses to utilize the new findings in practice in a way that is appropriate for their current situation, and improves patient outcomes. Understanding research methods significantly helps nurses to employ EBP by allowing them to better understand and assess the situation, more effectively find the needed information, and more adequately implement the gathered knowledge. EBP is regarded positively around the world, by Swedish head nurses in particular; additional education, supportive leadership, and sufficient amount of time stimulate the use of EBP.
References
Brown, S. J. (2013). Evidence-based nursing: The research-practice connection. Burlington, MA: Jones & Bartlett Learning.
Fawcett, J. (2012). Thoughts about evidence-based nursing practice. Nursing Science Quarterly, 25(2), 199-200. Web.
Johansson, B., Fogelberg-Dahm, M., & Wadensten, B. (2010). Evidence-based practice: The importance of education and leadership. Journal of Nursing Management, 18(1), 70-77. Web.
Nickerson, C. J., & Thurkettle, M. A. (2013). Cognitive maturity and readiness for evidence-based nursing practice. Journal of Nursing Education, 52(1), 17-23. Web.