The accreditation standards set out by government initiatives in addressing the need for patient’s empowerment has made it difficult for nurses to deliver high-quality health care services. These services are effectively supported by evidence-based practices. This has presented a real challenge to nursing educators in their attempt to provide sufficient education foundation as a pre-requisite for nursing student, especially in enhancing their clinical experiences. However, the incorporation of evidence-based practice within the curriculum can help students in developing a supportive patient-centered approach as provided by the current evidence. It is through this aspect and review of various articles, this paper examines the concept of evidence-based practice and its relevance in establishing clinical settings for future and existing nurses.
According to Emanuel, Day & Diegnan (2011), evidence-based practice (EBP) denotes a formal problem–solving framework facilitated to improve clinical practice. They point out EBP as entailing a shift by healthcare professionals from traditional based culture of delivering care to guided and judicious use of current best evidence in making justifiable decision for the care of individual patients. They add that EBP has provided useful theoretical framework for health professionals as it links their knowledge to their study, thereby providing effective research-based practice in nursing. Therefore, EBP tends to limit healthcare professionals and consumer dependency on stipulated evidence as given out by either privileged persons or authorities, especially, in critically evaluating any nursing claim.
On the other hand, Emanuel, Day & Diegnan (2011) identifies clinical experience as an evidence-based practice that rationally allows healthcare professionals in accruing their person-centered care knowledge from their professional practice and life experience. They assert that through skilled facilitation, healthcare professionals are surfaced and articulated with reflective personal knowledge. This enables them to meld their knowledge with other forms of evidence in order to improve clinical practice.
In their article, “Adopting evidence-based practice in clinical decision making: nurses’ perceptions, knowledge, and barrier,” Majid, Schubet and Brendan (2011) note how EBP can be used critically and scientifically for delivering quality healthcare to a specific population. This concurs with the requirements for Graduate Achievement Portfolio (GAO), which points out the need for students to develop and assess their achievements of information literacy through their learning, in order to improve clinical practices.
According to Majid, Schubet & Brendan (2011), health care that is delivered to patients normally depends on the clinical experiences and opinions of health care professionals. To them, EBP has brought out this shift among health care professionals from authoritative traditional perspective to decision- making processes based on data extracted from research and studies. This technique has not only improved patient care, but it has helped nurses who are becoming increasingly involved in making out clinical decisions in justifying their conclusions.
By recognizing research, theory, and clinical practices as the sources of evidence in nursing, Melby (2012) notes EBP acts as a practical tool that can be used in student’s learning. This would allow students or nurses on continuous learning programs in developing, implementing and evaluating their practical nursing approaches based on current evidence, thereby, making judicious decisions. As Majid, Schubet & Brendan (2011) point out, incorporating a nursing approach, which addresses the nature of evidence within clinical practice, develop and synthesize such evidence, and more so, transfer and utilize such evidence in nursing practice. It provides an effective guidelines for not only implementing EBP, but rather, evaluating health care claims using clinical audit.
Melby (2012) establishes utilizing evidence-based practices by clinical educators as an essential researched teaching strategy. Such strategy allows nursing students in becoming more consistent with their clinical outcomes within the clinical setting. She notes that students and nurses normally gain clinical experiences after successfully completing an evidenced-based nursing program, thereby, impacting positively on their success, attitude, and satisfaction in delivering health care to patients. This is due to the fact that the continued shortage of effecting nursing practices have prompted both communities and patients in depending more confidently on not only well-educated, and satisfied nurses, but those who are confident, as well.
However, Majid, Schubet & Brendan (2011) point out to the availability of enormous health care literatures as published by varies sources as a major obstacle to the adopting and implementation of EBP. According to them, more than 8,000 articles are published on monthly basis for family practices, thereby, requiring a family medical practitioner to sacrifice almost 80 percent of his daily hours in trying to become abreast of the new evidence. Their study also noted the difficulty in understanding and interpreting statistical analysis and research findings as another barrier to the implementation of EBP. Additionally, lack of clinical experience by new nurses make it difficult for them in adopting EBP especially in reconciling patient’s values with evidence and clinical judgment. More significant was the inability of nurses to access information technology based on lack of apt searching skills in IT technologies or the inadequacy of such technologies.
As Majid, Schubet & Brendan (2011) note, implementing EBP requires nurses not only to apply credible evidence on individual’s by searching on relevant evidence, but rather considering the values of patients and system resources. Just like nurses, nursing educators are required to incorporate basic skills within student’s nursing work that would allow them to identify their knowledge deficiency, formulate appropriate question, and engage in effective literature search. The three, therefore, denote that EBP would enable nursing students as well as nurses to effectively apply evidence rules in validating their studies. Thereby, structuring their literature findings in addressing patient’s problem.
Based on Majid, Schubet & Brendan (2011) article, EBP training was highlighted as an essential tool in influencing the adoption of EBP among nurses. While the concept of understanding EBP was captured significantly in the processes of training, what came out essentially is how to identify clinical issues important for the implementation of EBP. Therefore, training nurses on how to access relevant, precise, and current nursing information is crucial for their knowledge update and the adoption of EBP (Majid, Schubet & Brendan, 2011). This would not only help nurses, but rather assist nursing educators in exploring how frequently nursing students or nurses access different information sources in addressing pertinent clinical issues.
As Melby (2012) points out, evidence-based practice should be incorporated within every educational program as a measure of competency for both the initial and on-going requirements for nursing staff. According to her, discussing an oriented nursing literature review within clinical setting would help in developing a standardized nursing language, which would be deemed useful for clinical practices. While she acknowledges EBP as having potential benefits to nursing practice, she calls for the need to have nurse educators supporting both the research and EPB processes within their staff. This would guarantee positive results.
According to Melby (2012), providing nurses or nursing students with effective nursing grand rounds introduce them to EBP, which is essential for their clinical expertise. These nursing grand rounds entail clinical issues, the outcome of research, or even a case study a patient’s care of which can be effectively described based on the best present nursing practices. By empowering nurses through supportive activities and development initiatives, they are able to increase their staff satisfaction due to their ability to learn and improve their presentation skills, as well. Moreover, providing consistency in nursing practice by embedding EBP with curriculum and clinical experiences would ensure that nurses do not only have important knowledge in research materials, but skills, as well.
In conclusion, evidence-based practice is an essential approach in setting out standardized clinical settings. The continued need for nurses to be familiar with nursing concept for their decision making process is an indicated that EBP is an accruing process that link their knowledge to their study. This is important for the growth of their confidence. It is, therefore, important for nurse educators who serve as mentors for the adoption and implementation of EBP to encourage and nurture an environment that embraces end results in nursing as based on evidence-based activities. This requires effective support of nursing students and nurses in participating in research activities that can help advance their clinical experiences.