Nursing research and evidence-based practice

Nursing Research and EVP

Nursing Research & Evidenced-Based Practice

The objective of this study is to examine how evidence-based practice and nursing research are supported and implemented throughout the organization. Secondly, this study will examine the nurses' role in research and evidence-based practice, the steps sued for research and evidence-based practice and the model for evidence-based practice.

Role of Nurse in Research and Evidence-Based Practice

Evidence-based practice is a term that is used to define the "conscientious use of current best evidence in making decisions about patient care." (Bauer, 2010, p.1) Evidence-based practice is an approach for problem solving that incorporates the following:

(1) A systematic search for and critical appraisal of the most relevant evidence to answer a burning clinical question;

(2) One's own clinical expertise; and (3) Patient preferences and values (Bauer, 2010, p.1)

There are several steps involved in the evidence-based practice including: (1) examination of the research evidence; (2) obtaining information from research and combining it with clinical experiences, resources that are available and then considering the patient's preference in determining the best possible care for the patient. (Bauer, 2010, p1.) The goal of evidence-based practice is bringing about an increase in the speed in obtaining knowledge from research and integrating that into the care of the patient. (Bauer, 2010, paraphrased)

II. Model

Evidence-based practice has resulted in several models that are commonly used. The model reviewed in this study and used in the organization at focus in this study is the Iowa Model. This model is reported to use "key triggers that can be either problem focused or knowledge focused to lead the clinical in utilization of the components of this model." (Bauer, 2010, p.1) This model involves the first step of generation of a question form a problem or "as a result of becoming aware of new knowledge." (Bauer, 2010, p.1) The second step in the Iowa Model is the determination if there is relevance to organizational priorities." (Bauer, 2010, p.3) If sufficient evidence exists, the third step involves a pilot of the practice change being performed. When there is not sufficient evidence the model supports that "new evidence should be generated through research." (Bauer, 2010, p.3)

Therefore, two outcomes to this model exist: (1) institution of a practice change based on the research available if following a trial period evaluation of the trial reveals "there is appropriateness to the practice change"; and (2) generation of research. (Bauer, 2010, p.3) Steps of the Iowa model are reported to be the formulation of a question.

III. Steps Used for Research and Evidence-Based Practice

Steps used for research and evidence-based practice under the Iowa Model include the following steps:

(1) Step One - Bauer (2010) states that the question asked in a PICO format is more effective for use rather than searching the literature. The PICO format uses the method as follows in framing the question:

P = Population of Interest

I= Intervention

C= Comparison of what you will do

O= Outcome (Bauer, 2010, p.3)

(2) Step Two -- "Determination of the relevance of the question to organizational priorities." (Bauer, 2010, p.3) This involves the discovery if "improved recovery or decreased hospital time post treatment was an organizational priority."

(3) Step-Three -- determination of whether the evidence answer the question. (Bauer, 2010, p.3) If a systematic review exists to answer the clinical question, it will be located in databases including those of CINAHL, MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews. (Bauer, 2010, paraphrased)

Stated as critical questions that should be asked when evidence is being appraised are those stated as follows: