Evidence Based Nursing

Evidence Based Nursing


EvidenceBased Nursing


EvidenceBased Nursing

Accordingto Beckstead (2009) evidence-based nursing is an effort to replaceoutdated nursing practices that contribute to increased length ofstay by patients. It challenges the nurses to identify the ‘why’behind various processes as a way to improve the practice. Thepractice involves the formulation of an evaluation criteria and theuse of research findings and various opinions from experts toidentify improvement information. Consequently, nurses can identifythe various approaches applicable to improve their services. Themajor challenge to the practice is the identification of theevidence-based practice from research. However, the practice is usedto bridge the gap between the current practice and researchconducted.

Itis possible to apply evidence-based practice nursing in theworkplace. The first step involves the differentiation ofevidence-based practice from research utilization. The evidence-basedpractice entails a separate process compared to research utilization.Research utilization comprises the various steps involved incompleting the assessment of a given research. It involves theevaluation of the strengths behind the assumption in a given study.It is a process in the evidence-based practice, only a single piece.However, for the nurses to carry out the evidence-based practice,they must be able to carry out research. Besides, they need thetraining to understand the intricacies involved in the researchprocess. It involves how to arrange the process and various aspectsthat can limit or improve the applicability of the results. Thetraining enables nurses to understand the various justificationsprovided by the researcher for the choice of the method and theprocess. Consequently, nurses need to understand the applicability ofthe findings to practice for them to identify the specific researchthat is of use to the development of the evidence-based practice(Neuman, 2006).

Evidence-basedpractice involves five distinct processes. The first processinvolves developing the nurses ability to raise the researchhypothesis or question via a format that outlines the main prospectsof the problem (Neuman, 2006).

Thesecond is combining the various appropriate evidence that attempts toaddress the identified issues. The third is determining the validity,applicability and relevance via a Critical evaluation of the existingevidence. The fourth is incorporating the various generated evidenceinto nursing practice and finally, assessing the changes that occurfrom the utilization of the best evidence. Each step requires athorough completion to create the identified best practices innursing. Without the above steps, the research fails to incorporatethe various available evidence for the clinical hypothesis (Leedy, &ampOrmrod, 2010).

Second,the nurses require the training on the various evidence-basedpractice models. There are various models for evaluation such asPICOT. The model requires great attention and time to develop andimplement. The acronym PICOT represents five aspects that are P-Population, I-intervention of interest, C- condition of interest, O-outcome of interest and T- the time frame to expect the outcome. The model assists the nurses in developing clear and concise clinicalhypothesis or questions (Neuman, 2006).

Uponthe development of the questions, the nurses need a well-establishedlibrary. In collaboration with the librarian, nurses can identify thekeywords to use during the literature review. Keywords are necessaryfor use in the search engines. They enable the identification ofarticles with the best practices and relevance to the area ofinterest. The nature of analysis generated during the literaturereview enhances the decision making on whether there is the need forchange in the practice patterns. Besides, the nurses need training inconducting a meta-analysis. It is the ability to determine therigorousness in the findings obtained from a wide range of studies ona given question. Finally is the ability to conduct a systematicreview. It is the ability to summarize all the evidence gathered toensure a complete assessment (Leedy, &amp Ormrod,2010).

Theapplication of evidence-based practice in the nursing workingenvironment requires the enhancement of various skills in the nurses.First is the continuous evaluation of the current practice, theapplication of appropriate data collection and evaluation techniquesand finally, the dissemination of information through excellentcommunication (Neuman, 2006).

Qualitativedata emanates from qualitative research. It is mostly designed totest a hypothesis by use of semi –quantitative type of coding andanalysis and results into volumes of words. Similar to quantitativedata, qualitative information requires a socially constructed natureof reality. The classical content mode of analysis aims to assignmeaning to various data text that represents the participantsexperiences and beliefs. They are beliefs such as the effects ofemployment on happiness, the most enjoyable occupation orprofessional training. The increase of cases results into therecurring themes that are important to the identification ofchallenges to the researchers question (Norlyk &amp Harder, 2010).

Thefirst step to dealing with qualitative data is data management. Thequalitative information comes from focus groups or in-depthinterviews that aim at exploring issues related to the researchquestion. They may be as a result of document reviews orobservations. The recordings need transcription without names or anyidentifying information. Cleaning of the copied information revolvesaround its quality and relevance to the research questions. Wordingprocessing files are used to store the final product awaiting theupload into qualitative analysis programs such as Atlas and Nvivo(Beckstead, 2009).

Thesecond process includes structural coding. It is the first step inthe qualitative analysis. The step involves the creation of codesfrom a separate form of data. The structural codes need to relate tothe definite interview questions or the overall themes of analysis inthe study. The aim is to obtain a general organization of the data(Norlyk, &amp Harder, 2010).

Asan example, answers to the question, “ what are the characteristicsof a good organization” can be structurally coded as “characteristics of a good organization”. The various codesgenerated gets a link to their related pieces of texts. Thestructural coding step is important in deriving the general sensebehind qualitative data (Beckstead, 2009).

Thenext step in qualitative analysis involves axial coding. It aims atspecifying the specific dimensions of given codes. The subcodes areused to provide the properties identified from the various responsepatterns. The axial codes can assume a dichotomous pattern such as“yes&quot or “No”, “Good “, or “ bad”, or “employed”or &quotNot employed”. They can assume ordinal values such as “long&quot or “short”. Similarly, nominal values such as (running errands for the seniors” or,” obtaining a hit for thecolleagues” (Norlyk, &amp Harder, 2010).

Thereare instances when the axially coded data overlap’s withstructurally and selectively coded data. Finally is hypothesistesting. The process involves the creation and performance of asearch function. The function is carried out on all the data with anaim to test the research question behind the study. The scope of thesearch may assume a broad perspective, for example, “ good companycharacteristics” or a short dimension such as, “ the degree ofbrand identity—High” (Beckstead, 2009).

Theresultant subset of data files from the hypothesis testing activityis examined to determine the general relationships between dependent,controlled and independent variable fields. The examinations aimalso to identify the various nuances that enhance the interpretationof the results.

Forexample, obvious relationships are likely to be observed amongsubjects that assess themselves based on the high degree of brandidentity with those that are most likely to pursue advertisements andhigh promotional efforts (Beckstead, 2009).

Uponthe examination of what makes up a good company, they believe that itis extremely important for the company to have a well-structuredemployee benefits system. The reply might also explain why there is ahigh employee turnover in the company due to their dissatisfaction(Norlyk, &amp Harder, 2010).

Accordingto Berg, et al.,(2011) purposefully hourly rounding is meant toreduce the number of call lights usage by an average 3.7 times andincreasing patient satisfaction. Decreased call lights improve staffsatisfaction. It involves asking the patients about the four P’sthat include potty, position, personal belonging and pain. It is aproactive approach that creates patient centered nursing care.

Bedto bed reporting is a practice that increases the nursesaccountability, patient satisfaction scores , the quality of careratings and patient safety scores. It is implemented by asking nursesto leave a report to the next nurse taking care of the patient forthe next shift. The report is given at the patient’s bedside .Patients like the method because it provides for them to participatein their own care and understand the healing process(Alexander,2013).

Theprevention of skin breakdown is a good approach to enhance nursingbased care. It is an approach to offer cutting edge, cost effective ,timely and patient centered nursing services. It is applied byturning and responding to immobile patients after every two hours.Besides it involves airing the mattress to potential patients thatcan develop pressure ulcers and use of skin barriers such ascalmoseptine. Other treatments include the application of supplementsto heal the wound and providing supplements as ordered by the woundspecialist. The practice is effected by conducting frequent in-housetrainings to assistant nurses (Kirsner, 2007).

Surgicalsite infections are prevented via a number of ways. First, the use ofclipper tools rather than razors prevents the creation breaches ofskin integrity and decreases the room for bacteria entry. Similar to the practice is having the patient to shower at home with specialanti bacterial soaps such as hibicleanse . Research has alsorecommended for the use of chin to toe chlohexidine wipes before thepreparation of surgery. The processes are applied in the work placeby avoiding post operative hyper glycemia to prevent surgicalinfection. Consequently PACU nurses frequently check the blood sugarin the recovery room for surgeries lasting more than 60 minutes.Similar is done for the nurses attire to the surgical room. Thenurses use the hospital laundered scrubs since they are free ofbacteria. In addition, nurses have dedicated footwear and mustcover their hair as well as wear masks while in the operating rooms(Institute for Healthcare Improvement, 2015).


Beckstead,J. (2009). Peer-reviewed scientific journals in nursing: To whom arewe writing? International Journal of Nursing Studies, 46,(9), 1166-1167.

Leedy,P. D., &amp Ormrod, J. E. (2010). Practical research planning anddesign (9th ed.). Upper Saddle River, NJ: John Wiley &amp Sons,

Neuman,W. L. (2006). Social research methods: Qualitative andquantitative approaches (6th ed.). Boston, MA: Pearson Education

Norlyk,A., &amp Harder, I. (2010). What makes a phenomenological studyphenomenological? An analysis of peer-reviewed empirical nursingstudies. Qualitative Health Research, 20(3), 420-431.Doi: 10.1177/1049732309357435.

Institutefor Healthcare Improvement (2015). Retrieved 10/12/2015 fromhttp://www.ihi.org/resources/pages/changes/changestopreventsurgicalsiteinfection.aspx.

Rubin,A. (2008). Practitioner’s guide to using research forevidence-based practice. Hoboken, NJ: John Wiley &amp Sons, Inc.

Berg,K., Sailors, C., Reimer, R., O’Brien, Y., &amp Ward-Smith, P.(2011, December 1). Hourly Rounding with a Purpose. Iowa NurseReporter, 12-14.

Alexander,A. (2013, January 28.2013). Bedside Report. Advance HealthcareNetwork for Nurses. Retrieved from


Kirsner,R.S. (2007). The Evidence Base of Advanced Wound Care Technologies.Evidence Based Wound Care Standards in the Clinical Setting: Applyingthe Knowledge to Real-World Practice. Retrieved from:http://www.woundsresearch.com/files/docs/EBM_WOUNDS_SEPT_07.pdf