STEPS OF EVIDENCED BASED PRACTICE: Evidence based practice process involves 5 steps as: 1. Formulating a clear question based on a clinical problem 2. Literture review to search for the best available evidences 3. Evaluating and analyzing the strengths and weaknessof that evidence in terms of validity and genelisability blogger.comted Reading Time: 11 mins 17/3/ · Essay, Pages 10 ( words) Views. This assignment will be set around evidence based practice (EBP) and the nursing part of EBP will be discussed throughout this essay. There will be two parts to this discussion, part 1 will be a clinical question chosen personally, and being researched through the internet using a variety of blogger.comted Reading Time: 9 mins Evidence based practice is a complex experience that requires synthesizing study findings to establish the best research evidence and correlate ideas to form a body of empirical knowledge (Burns & Grove ). There are many definitions but the most commonly used is Sackett et al (). Sackett et al () as cited in Pearson, Field, & Jordon
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This assignment will be set around evidence based practice EBP and the nursing part of EBP will be discussed throughout this essay. There will be two parts to this discussion, part 1 will be a clinical question chosen personally, and being researched through the internet using a variety of databases.
The end result will then be discussed on how the question performed, and whether it was either easy to research or changes had to be made gain greater or less results. Below is the clinical research question that was chosen personally. Researching this question, Ovid was used. Again using Ovid, on an advanced search, this yielded 0 results.
After this a different database was tried, the CINAHL database, on this research the question had been broken down into words; silver dressings supporting evidence, healing open wounds, this yielded 0 results. Ovid was the best site to ask this research question as even though the results were too much, I still had a good amount of hits, as for the CINAHL database this did not show any results.
Therefore, Ovid does show to be a good research database. When researching this question, it was not clear enough, the question needed to be a bit more thorough when written, the results reflected off this by achieving results and on Ovid. Ovid was used first as it is a well-known website, which is also a database used widely for nursing and medical journals. Regardless of how popular both databases are the research questioned failed as either too much or zero results appeared, and could not be met in the middle.
On reflection receiving hits and then is far too much and no matter how much the evidence based practice essay was rephrased and broken down no results were satisfying. This question had too much academic material and could not be lessened in any way for the chosen topic. I think that next time the MeSH database could be used to research the chosen question, this would increase more of evidence based practice essay chance of a wider and more in depth result and maybe reworded using medical terms, evidence based practice essay.
Part 2 — The Critical Analysis of evidence based practice essay Randomised Control Setting using the Casp Tool It has been 10 years since evidence based practice EBP evidence based practice essay. Evidence based nursing is about making right choices towards a patient and towards client care. This may involve different decisions being made for treatment choices, provisions evidence based practice essay services and competence.
When the decision is being made about a patient and their care, the best available evidence should be used in their practice. The nurse should reflect on the requirements, values, evidence based practice essay, circumstances and preferences together with their own professional experience, skills and when making choices for the patient Moule et al, The paper that has been chosen is a randomised control trial RCT.
Nelson, describes a RCT as being used to answer questions on two or more interventions and the difference it would have made on a trial Nelson, Nurses who are applying clinical decisions, evidence based research must be used. It is also important that all clinicians have the admittance to clinical trials and to understand these clinical trials, so well-versed decisions are made on the best dealings with interventions that are open, this created PICO.
This is a database that helps medical professionals to decide if the question that was asked in the trial is of high value, this will then help them to make a decision, on the value of one paper over another. The chosen research paper which a randomised controlled trial is being used, evidence based practice essay, evidence based practice essay alternating pressure mattresses together with alternating pressure overlays are being used for the avoidance of pressure ulcers Nixon et al This essay will be using a critical appraisal skills programme, which contains 11 questions, to help decide whether or not this paper is of good quality.
This assignment is to assess a pre-selected research paper using the Critical Appraisal Skills Programme, which is known as the CASP tool, this is a standardised assessment tool. The CASP tool will be used to evaluate the consistency, validity and practicality of the research issued. CASP, Together with this, the CASP tool will also be used study the research paper to see whether or it has an element of reliably extrapolated.
Dr Amanda Burls was the person who created the CASP tool back in Her aim for this programme was to help individuals improve on their skills on the basis of healthcare decisions by finding and critically assessing the best scientific evidence. Roland,describes this as being vital in all aspects of healthcare, especially nursing.
This is because randomised control trials RCT are seen as the gold standard for answering questions towards efficiency, in evidence based practice EBP Sibbald, R, The hierarchy of evidence is a framework for ranking evidence, and second to the top lies RCT Evans, D, This trial defines whether or not the trial has a cause-effect relationship between the treatment given and the conclusion.
The RCT will also decide the cost effective outcome of the trial Sibbald, R, This study asked a clearly focused question, the study did describe in detail of how they were to pick participants out of the population. They all weighed around the same, evidence based practice essay, they looked at medical issues, and most important what type of skin condition these participants had.
The study was using grade 1 and 2 ulcers from the Braden scale and participants who did not have ulcer wounds at all to their skin. Furthermore, participants who were developing grade 3 or 4 ulcer wounds were removed from the trial, evidence based practice essay. They took into account the main consideration of the participants, by asking consent from the patients or if patients were not able to communicate appropriately they would retrieve consent from relatives until the patient was able to communicate.
The outcome was also considered very carefully Nelson, The study was carried out as a Randomised Control Setting RCT because the trial was based on two types of mattresses, evidence based practice essay.
Participants who were involved were evidence based practice essay to either mattress. The right research was used for the RCT because the mattress and overlay are interventions which satisfy two or more interventions suitable for the RCT. However, comparing the two for any differences hence intervention and comparison granted, there is no control service.
This determines this to be unethical as the patient is being denied patient care by not treating the risk that we know is there. The participants were accurately randomised. They used an independent secure, automated telephone system used with 24 hour randomisation. This is to ensure allocation concealment. Minimisation was used to so that the groups were equal. Minimisation was also used on centre existing pressure ulcers, speciality and type of admission.
Those who participated were assigned to an alternating mattress, within 24 hours of being admitted through a certain hospital, evidence based practice essay.
The main limitation of the trial was that there was absence of blinding from the outcome of the assessment. However, taking the trial into account it is most likely to be impossible evidence based practice essay achieve. This is due to the lack of disguising the mattress and is unethical for a more seriously ill patient.
The bias of the trial was minimised to some extent, this was done by the clinical research nurses and the ward staff, and they were collecting skin samples for assessment. Although, the nurses were not blinded by the treatment, so the care given cannot be vindicated. Being blinded to this trial is not needed, for patients who have been bought into hospital for a long stay, will be lying on a mattress in a bed, no matter what the situation and cannot really affect the trial, for the nurses they should not have to be blinded either, as turning a patient regularly is a part of patient-care and should not be any different due to evidence based practice essay trial being in place.
Blinded does not matter in this study. All participants were accounted for in the conclusion. They describe how patients felt uncomfortable on certain mattresses and requested a change, evidence based practice essay. They took into account that participants preferred the mattress to the overlay for comfy reasons. They also mentioned that certain patients had to be taken out of the trial due to pressure sores becoming greater or death. This did reduce the number of participants involved in the trial which they also mentioned.
It does appear that the groups were treated equally, however there is the whole thing about evidence based practice essay requesting alternative devices because they was not satisfied with what they were given, evidence based practice essay the nurses took it upon themselves to change people over as they saw fit, the nurses could be bias because they might have personal preferences of one device over the other.
Furthermore the results can be evidence based practice essay to the population because the statistics of the study show that there was not much difference between the two. The power analysis is applicable when concern is with the correct rejection, or not a null hypothesis.
In many circumstances, if there is a difference or not, the issue would be less determining and would rather get a more refined evaluation of the outcome for the size of the population. The power calculation was used in this trial. The results were given as a percentage of people experiencing outcome, evidence based practice essay.
The reasons for the percentage of people who had a significance effect from developing new pressure ulcers, were those who came from the acute condition ward, or had presence of a wound, or some skin trauma, also including, age and diabetes, evidence based practice essay.
This trial was not statistically significant because the p value was more than 0. There was no differences found within the trial between the treatments. However, this does not mean clinical insignificance, it is actually clinically significant because it gives us information on which to base clinical decisions, evidence based practice essay.
Clinical status can be gained by calculating a confidence interval measured by mean, median and proportion. One hundred and six In the adjusted analysis the odds ratio for developing a new pressure ulcer using the overlay compared with the mattress was 0. Overall, the people preferred the mattress over the overlay presuming for comfortable reasons.
The point of the trial was evidence based practice essay find out whether there was a difference in result, and it ended with no difference between two interventions. The trial and results all seemed too narrow for confidence intervals. This end result gives readers of the study confidence in using either devise.
This is because there is only a narrow difference between the upper confidence limit and the lower confidence limit.
This was a good trial; there was a lot of randomisation used. It was a quite large sample used for the trial, so no matter what was changed, it could not make a difference, evidence based practice essay.
Another important part of this trial was the statistical information in respect of cost. At £ for an alternating pressure mattress and £ for an alternating pressure mattress, it would be financially more cost effective to use the cheapest option.
However, it is important to notice that participants of the trial, who were given the overlays, requested a different device, opposed to the who were given the mattress. However, the decision being made to which devise will be used within healthcare, should be decided on patients situations and not for financial reasons.
How to Cite. Evans, D. Journal of Clinical Nursing, 77—84 Hierarchy of evidence: a framework for ranking evidence. Nelson, A. Evidence Based Nursing ; Nixon, J. and Cullum, N. British Medical Journal;
How To Write An Essay: Evidence and Citation
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Evidence-based practice nursing essay examples Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for blogger.comted Reading Time: 10 mins 10/11/ · evidence based practice Essay. Examine the ways that health professionals can use the five steps of evidence - based practice (EBP) as a practical framework to overcoming barriers to locating, appraising and applying best research evidence. Use an occupational health and safety practice as an example 25/9/ · Evidence-based practice is the process of applying existing research findings that has shown to work when considering a chosen strategy. It is based on analysing the collection of data that has contributed towards a specific knowledge base, which has been shared amongst fellow practitioners within a specific field, with the aim to inform current practice within a profession
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