2 Evidence based Nursing P.B.BSc 1 Unit EBN .pptx

Evidence based Nursing

1. Evidence Based Nursing (EBN) Prof.Dr.Chinna Chadayan.N RN.RM., B.Sc (N)., M.Sc (N)., Ph.D (N)., Professor, Enam Nursing College – Savar , Bangladesh UNIT-1 2 yr PB.BSc (N) 1 Evidence Based Nursing

2. DEFINITIONS Evidence: It is something that furnishes proof or testimony or something legally submitted to ascertain in the truth of matter. Evidence based practice: (EBP) is applying or translating research findings in our daily patient care practices and clinical decision-making.  Evidence based nursing-   is an approach to making quality decisions and providing nursing care based upon personal clinical expertise in combination with the most current, relevant research available on the topic. EBP in nursing “the practice of nursing in which the nurse makes clinical decisions on the basis of the best available, current research evidence , their own clinical expertise, and the needs and preferences of the patient ” Evidence Based Nursing 2

3. AIMS OF EBN • To provide the high quality and most cost- efficient nursing care possible. • To advance quality of care provided by nurses. • To increase satisfaction among patients. • To focus on nursing practice away from habits and tradition to evidence and research. • It results in better patient outcomes. • It contributes to the science of nursing. • It keeps practices current and relevant. • It increases confidence in decision-making. Evidence Based Nursing 3

4. Importance OF EBN:- • Evidence-based Nursing practice helps nurses provide high- quality patient care based on research and knowledge rather than because “this is the way we have always done it,” or based on traditions, myths, hunches, advice of colleagues, or outdated textbooks. It results in better patient outcomes It contributes to the science of nursing It keeps practice current and relevant It increases confidence in decision-making Policies and procedures are current and include the latest research, Integration of EBP into nursing practice is essential for high-quality patient care and achievement. Evidence Based Nursing 4

5. Components of EBN There are four components of EBN Evidence triggers Evidence support Evidence observed Evidence -based Evidence Based Nursing 5

6. Evidence triggers: Practice trigger and knowledge trigger: Practice trigger refers to clinical questions often raised by clinicians and from data sources within organizational systems that monitor practice patterns.   For examples Variability in practice related to n ushing solutions of intravenous catheter lines Method related to maintaining patency of feeding tubes Emergent knowledge related to developments in clinical practice Advances in technology and program development. Program for complementary interventions. Evidence support It focuses on a review of existing evidence for best practice with an area of emphasis on the evidence triggers to guide the search process. Sources may include  Reported scientific research Outcome-based research Authoritative literature National clinical standards National practice guidelines Manufacturer to equipment recommendations Best practice (reported by experts) Evidence Based Nursing 6

7. Evidence observed The proposed practice or comprehensive program initiative is designed and implemented using appropriate methods and measurements .   Proposed initiative may be   Research, A clinical study, A pi lot study, A poi n t prevalence study, Product evaluation, cost/benefit / analysis, Patient and clinician survey, and Comprehensive program development and evaluation Evidence -based: A critical analysis is perf orm ed u sing information .. from the evidence supported p h a s e a nd s tudy findi n gs from the evidence-observed phase. Evidence va ri es de pe nd i ng on the scope of the initiative. For th i s ph a se, b e s t practice can be e st a b l ished, cost/benefit a na l y s i s i s conducted, and contribution t o advances i n pr ofessional practice and outcome i mprovement i s es t abli s hed and reported Other components are: EBP mentors Partnerships between academic and clinical settings EBP champions, Clear written research Time and resources and Administrative support Evidence Based Nursing 7

8. Steps in EBN Select a topic Collect appropriate and accurate data to generate evidence for nursing practice. Analyze data from clinical practice. Design interventions based on evidence. Predict and analyze outcomes. Examine patterns of behavior and outcomes. Identify gaps in evidence for practice. Evaluate project to determine and implement best practices Evidence Based Nursing 8

9. Factors Contributing to Evidence-Based Nursing • Scientific knowledge expansion • Knowledge availability -- The Internet • Highly educated nurses in clinical settings – APNs – focusing on evidence-based clinical problem-solving – Clinical Nurse Researchers – DNP Movement ( Doctor of Nursing Practice ) • Aggressive chasing / pushing of cost-effectiveness • Focus on quality of care, Risk & error reduction • Highly educated consumers • JCAHO/Accreditation expectations ( Joint Commission on Accreditation of Healthcare Organizations ) • Increased attention to institutional image – Magnet hospital movement  Evidence Based Nursing 9

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21. Nurse’s role in EBN Read widely and critically: – Professionally accountable nurses keep abreast of important developments and real journals relating to their specialty, including research report in them. • Attend professional gathering : – Conferences, workshops, CNEs include presentation of studies that have clinical relevance. Attendees get opportunities to meet researches and to explore practice implications. • Learn to expect evidence that a procedure is effective : – Standardization of any procedure is based on the effectiveness of its outcome. Nurses need to develop expectations that the made decision is based on sound evidence based rationales. • Involve in journal club: – Many organizations employ nurses sponsor journal clubs that review research articles that have potential relevance to practice. • Pursue and participate in research utilization/ evidence based practice projects : – Nurses need to develop more positive attitude towards research and better research skills. Evidence Based Nursing 21

22. Barriers of Evidence Based Nursing The lack of knowledge and skill to use evidence like research findings, Lack of belief on EBP outcome the lack of motivation, the lack of resources and training  organizational issues regarding cost, changes in work, time mismanagement, patient compliance, lack of motivation to use EBP Lack of motivational incentives Lack of workforce Lack of time to implement new ideas Reluctance to expend resources Reluctance to change organisational policies Lack of resources Lack of Library materials, internet access, financials etc., Lack of commitment from managers and administrators Lack of Strong Leaders in the health care organization were the perceived barriers to the implementation of evidence-based practice. Evidence Based Nursing 22

23. Strategies to overcome Barriers of EBN Adopt an EBP Model. Commit Through EBP actions. Ask the Right Questions. Critically Appraise Evidence. Integrate Evidence With Clinicians and Patient Foster a Climate of Intellectual Curiosity Develop Journal Clubs Serve as Role Models for Staff Nurses Offer Financial or Resource support for EBP Utilization Reward efforts for using Research Seek opportunities for Institutional EBP Projects Evidence Based Nursing 23

24. THANK YOU 24 Evidence Based Nursing