APPLIED

MEDICAL SCIENCE COLLEGE FOR FEMALES, ALNAMAS

UNIVERSITY OF BISHA MINISTRY OF HIGHER EDUCATION
KINGDOM OF SAUDI ARABIA
Principles of Nursing Research

ASSIGNMENT PRESENTATION:
"Example for Applied Evidence Based Practice in Nursing"

Prepared
By:
Alyah Ali - Alanoud Mohammed
Rana Fayyez - Rahmah Mohammad
Raghad Fayez - Raghad Dhafer
Rawan Abdullah - Sara Awad
Sima Saeed - Najla Mohammad

Under Supervision:
Dr.Fransa Ali






25/11/2021 -20/4/1443
 Outline
* Introduction
* Meaning of Evidence-Based Nursing Practice (EBNP)
* Florence Nightingale
*Healthcare Financial Management Association article
* Protocols of Evidence-informed Practice in Nursing

* Evidence-informed Practice in Nursing and Population Health

* A Team Approach to Evidence-informed Practice in Nursing

* Example for applied evidence based practice in nursing

*Reference







* Introduction
The evidence-based interventions we learn can improve
patient outcomes, help to provide high quality care, reduce costs
and eliminate practices that have become obsolete or are not
effective. As nursing students and future nurses, we hold a promise
of continuous learning, and it is essential to build evidence-based
knowledge over time. As students, it is never too early to start
thinking like a nurse who is driven by evidence-based practices.

What is meaning of Evidence-Based Nursing Practice (EBNP)?
Sigma Theta Tau International defined EBP in nursing as an “
integration of the best evidence available, nursing expertise, and the
values and preferences of the individuals, families and communities
who are served ”

Florence Nightingale

first introduced the idea of evidence-informed practice in

nursing nearly 200 years ago. She used the strategy during her
time as a wartime nurse for the British Army when she observed
how poor ventilation and the unsanitary conditions of the
soldiers negatively impacted their health. Her findings led
to vast changes in the way hygiene in hospitals was viewed,
including layouts of hospitals to decrease the spread of
infection. This laid the groundwork for what would become
evidence-informed practice.

Today, evidence-informed practice in nursing is a foundational

part of the Doctor of Nursing Practice - Family Nurse
Practitioner program. It has become an increasingly important
element within the health care industry as a whole, and for
good reason. Significantly, evidence-informed practice in
nursing helps keep clinicians current on research and it
empowers them with numerous strengths that allows them to
have a positive effect on health care processes.

Evidence-informed practice stresses the use of individualized

patient care, encouraging more conversation between provider
and patient. That interaction leads to the creation of a better
overall treatment plan, increasing the chance of a better patient
outcome.

When better patient outcomes are achieved, the benefits

actually don’t stop there. Evidence-informed practice leads
to greater transparency and accountability as the patient is
brought into the conversation and decision-making process.
The approach leads to cost savings as the demands on health
care resources and providers are decreased.

A Healthcare Financial Management Association article

explains it best: “In addition to curbing cost, evidence-
based care addresses six components of healthcare quality:
safety, effectiveness, patient-centeredness, timeliness,
efficiency, and equitability.”

Protocols of Evidence-informed Practice in Nursing

The idea of evidence-informed practice in nursing has

developed greatly over the years. For decades after
Nightingale, there was no movement on the practice. Up until
the 1960s, nursing was still generally viewed as more of
an applied science that was based on theory rather than
research. Then came professor Archie Cochrane. Often called
the father of evidence-informed medicine, Cochrane noted that
problem in the 1970s, stressing the need for evidence in
medicine. By the mid-1990s, it was realized that new knowledge
alone wasn’t enough. It must be applied in clinical settings,
preferably across an entire team.

Evidence-informed medicine became more of a focus in

the 1980s and 1990s, and it replaced many protocols and
policies that were at one time standard.

For example, previously, a BRAT (bananas, rice, applesauce,

and toast) diet was standard for children with gastrointestinal
issues. Today, it’s known that children with gastrointestinal
issues should continue a well-balanced diet as quickly as
possible.
Previously, protocol said to turn a patient every two hours to
avoid skin breakdowns. Evidence-informed practice revealed
that patients should be turned when and if their condition
permits. Another protocol change is that at one time aspirin was
given to children to control fever. With evidence-informed
practice, however, this has changed because it has been proven
aspirin increases the risk of Reye’s syndrome.

Thankfully, evidence-informed practice has become a greater

part of the daily routines of nursing throughout the industry.
There are numerous examples of great strides in patient care
thanks to these practices. Let’s take a look at five protocols of
evidence-informed practice in nursing to better understand the
benefits to health care.

Evidence-informed Practice in Nursing and Population Health

It’s clear that evidence-informed practice in nursing has a

significant impact on finding and implementing methods to
improve patient care. The three-pronged approach—combining
solid research with clinical expertise and patient input—can
further impact overall population health.

As a noted evidence-informed handbook for nurses states, the

combination of research with clinical expertise leads to better
decision making by clinicians. But using solid research also
leads to better decision making in creating public policies and
practices, as noted by the Office of Disease Prevention and
Health Promotion (ODPHP).
ODPHP, under the U.S. Department of Health and Human
Services, states that “there is demand for evidence at many
levels.” This ranges from practitioners to senior managers within
the government and health care organizations that “use it to set
priorities and make policy and funding decisions.”
As explained in ODPHP’s “Healthy People Initiative” for 2020,
integrating proven research with clinical expertise helps avoid
pitfalls of creating treatments and plans without clear evidence.
For example, a breast cancer treatment was implemented in
the 1980s without proper testing.

Eventually, research proved it ineffective and that it actually

contributed to the premature death of thousands of women.

Evidence-informed practice has positively contributed to

population health as it has found many routine screening tests
unnecessary. Evidence shows routine screening in some cases
leads to false positives and unnecessary psychological harm.
Two separate studies concluded the inaccuracy of routine
testing: one regarding abdominal aortic aneurysms in
womenand another regarding men aged 65 to 75 who have
never smoked.

A Team Approach to Evidence-informed Practice in Nursing

The value of evidence-informed practice to patient

outcomes and overall population health is clear. That’s why
today more than ever, this is essential for nursing teams in
everyday tasks. According to the Institute for Healthcare
Improvement, evidence-informed practice is what helps
clinicians reach the Triple Aim:
• Improve patient experience: Improving patient health
and meeting their expectations, which includes access to
quality, coordinated care.
• Improve population health outcomes: Improving
population health is the primary goal of the Triple Aim.
This is believed to reduce per capita cost of care and
allow businesses to be more competitive and less
financially burdened.
• Decrease costs: The U.S. health care system is the most
expensive in the world. One evidence-informed practice
expert notes that “the U.S. healthcare system could
reduce its healthcare spending by a whopping 30% if all
patients received evidence-based healthcare.”
Yet for evidence-informed practice in nursing to truly be
successful, the entire team must buy-in. This starts from the top,
so nurse managers play a pivotal role in implementing the
method. Feeling supported by superiors encourages novice
nurses—and those at any level—to implement evidence-
informed protocols whenever possible.
Steve Risch, MSN, RN, CCRN, CCNS suggests that
interprofessional teams come together to establish
implementation strategies as “advanced practice nurses and
professional development educators are key stakeholders and
experts in implementing” evidence-informed practices.
The National Library of Medicine notes that while chief
executive nurses have not routinely placed a high priority on
implementing evidence-informed practices, they and the
hospital administrators must work toward creating the culture
so that clinicians will view evidence-informed practice as the
standard of care.
The Institute of Medicine has issued recommendations for
health care professionals to lead the way in implementing
evidence-informed practice in nursing, and the American
Nurses Association has updated its standards to put the
practice into place. That has paved the way for nurse
managers to create the workplace culture and empower
“nurses under their supervision to use EBP and drive change.”

Evidence-informed Practice Knowledge Is Power

Evidence-informed practice has become foundational to

the nursing profession. It’s needed for nurses in all settings and
in all skill sets. That’s why it’s critical to learn about the approach
and how to apply it to patients whenever possible.
"example for applied evidence based practice in nursing"

Applying Evidence-Based Nursing Practice to prove that changing

the patient's position every two hours prevents bed sores

Does changing bed positions every 2/hours prevent bed sores?

• 0 step:
change position every 2 hours cane prevent bedsore among
elderly people
• 2 second step:
P= nurses working in ICU
I= educational intervention for nurses around bedsores prevention
among bedridden patient
C = Comparison: Is there an alternative to the planned intervention?
(may compare to a different type of treatment)
O = Outcome: What is the desired outcome? (e.g., perceived
knowledge/skills for nurses)
T = Time: during working hours in hospital, within a specified period,
• step 3:
used number of taxonomies exist that can be used to rank the
strength of scientific evidence. Study design, quality of the evidence
and consistency are often used to make such determinations.
Randomized control trials (RCTs) and systematic reviews (SRs) are
considered the goal standards in the types of evidence hierarchical
structure
such as:http://www.ahrq.gov/clinic/uspstfix.htm
 • Step 4:
Integrate the evidence with clinical expertise and patient
preferences and values
Applying the best evidence to our clinical decision making involves
examining, critiquing, and synthesizing the available research
evidence. However, we must consider the science along with our
clinical experience and patients’ values, beliefs, and preferences. In
this article we’ll discuss how to incorporate patient preferences and
clinical judgment into evidence-based decision making.

• Step 5:
Evaluating our effectiveness education program for nurses and
efficiency in executing Steps 1-4 and seeking ways to improve them
both for next time
 Reference

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