Evidenced Based Practice (EBP) is essential to enable all nurses to provide the most current up to date practises for their patients. This process involves research, systematic review of current practises, critical thinking skills, evaluation and application to the clinical setting. In addition to this, the nurse must take into account the patients’ preferences. For nurses to have professional autonomy they must be able to justify their actions and demonstrate an understanding of why they perform the tasks they do. This defines them as unique professionals judged by their knowledge and not simply by their hands on skills.
As stated by McSherry, Simmons & Pearce (2002);
“Nurses are responsible for the care they provide for their patient. They have to be active, competent and autonomous in providing this care and be able to justify what they do. It is no longer acceptable for nurses to base care on ritual and tradition- they must be able to justify the decision they have made about appropriate care and treatment on the basis of a professional expertise which includes using research evidence to inform practice.” (p.1).
One of the best known definitions of evidence based practice is; “The conscientious, explicit and judicious use of current best evidence about the care of individual patients.” (Sackett et al. 1997, as cited in Holland & Rees, 2010, p. 7). Individualised care and research is by no means a new concept. Florence Nightingale first demonstrated EBP through her note taking and analysis of data, this resulted in reduced mortality rates for medical and surgical patients as hygiene practises were improved. (Schmidt & Brown, 2009). For today’s nurse this transcribes into using the best research knowledge to make clinical decisions that benefits the patient. This involves questioning current practises, examining outcomes and analysing cost effectiveness. (Polit & Beck, 2010). As nursing is person-centred and relies on a multidisciplinary team approach it has to take into account the care setting, patient predilections, clinical judgement and best available evidence. (Holland & Rees, 2010).
The key steps involved in evidence based practice come from a thirst for knowledge that once ignited makes the next step to asking a well worded clinical question easier. A well formulated question improves patient outcomes and supports the implementation of change. One such method looks at foreground and background questions. A background question is usually a basic knowledge question and is usually answered by a textbook. Foreground questions are usually specific and once answered can help in clinical changes. An acronym useful for formulating a well worded question is PICOT. ( Stillwell, Fineout-Overholt, Melnyk, Williamson, 2010).
“PICOT is an acronym for the elements of the clinical question: patient population (P), intervention or issue of interest (I), comparison intervention or issue of interest (C), outcome(s) of interest (O), time it...