According to Duke University, the most common definition of evidence-based practice in healthcare is Dr. David Sackett’s that states, “The conscientious, explicit judicious use of current best evidence in making decisions about the care of the individual patients. It means integrating individual clinical expertise with the best available external clinical evidence.” Evidence-based health care practices are available for several health conditions such as, heart failure, diabetes and asthma. However, these practices are not always implemented, and numerous variations exist (Titler, 2010; Grove, Burns & Gray, 2014).
Traditionally, research on patient’s safety has focused on the analysis of data to identify patient safety issues and to determine new practices that improve quality and patients safety (Titler, 2010). Little research has been done on how to implement this practices, which is very important in the development of healthcare provision.
Implementation of evidence-based practices is difficult and requires proper strategies to address the complexity of care systems, individual care givers, senior health officers, and changing the culture of care to one of evidence –based practice (Titler, 2010); like in the case study involving Emily’s (nursing practitioner) personal decision to use an oscillometric device against her senior’s (senior doctor) orders to use an auscultating Calf blood pressure on a child.
Statement of the Problem
The main problem in the case study was the implementation of an evidence-based health care practice on a patient, by an individual practitioner (Emily, who was on probation), without approval by the hospital management. Nevertheless, the Australian law protects the rights of its citizens to have access to quality healthcare: a right that would have been violated if the Emily would have followed procedures instead of concentrating on providing quality health services to the child (Anderson & Deravin-Malone, 2016, p. 25). She was careering for a child who was being subjected to an uncomfortable healthcare routine, when a better way was available. However, both Titler (2010) and Townsend (2014) stated that its implementation is complex and strategies should involve all levels of caregivers for ultimate effectiveness in changing the healthcare culture of a given environment.
Therefore, the nurse was wrong in going against orders and implementing an evidence-based practice without involving the necessary personnel. Though she knew the existence of a new and more effective practice, she was ignorant of the critical process of implementation. This is in agreement with Titler (2010) who claimed that “less research attention has been paid to how to implement practices.”
What is the right procedure that the nurse should have used before deciding to implement the evidence-based healthcare practice?
In conclusion, according to the case study and other researches, it is evident that a lot of evidence-based healthcare practices have been developed; however, more research needs to be conducted to establish clear guidelines on the implementation practices. Nursing has a rich history of applying this research in practice, started by Florence Nightingale. Contemporary nursing professionals have continued with this trend, providing improved care through the application of research findings in practice.
Overview - Introduction to Evidence-Based Practice - LibGuides at Duke University Medical Center. (2016). Guides.mclibrary.duke.edu.
Titler, M. (2010). The Evidence for Evidence-Based Practice Implementation. Agency for Healthcare Research and Quality (US).
Grove, S. K., Burns, N., & Gray, J. R. (2014). Understanding nursing research: Building an evidence-based practice. Elsevier Health Sciences.
Townsend, M. C. (2014). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
Anderson, J., & Deravin-Malone, L. (2016). Chronic Care Nursing. Cambridge University Press.