NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

Writing an evidence based paper is a task that all students will have to accomplish at some part of their academic career. This type of written requirement greatly depends on research, evidence and facts as opposed to assumptions and common belief. If you are having a hard time with selecting the right topic for you, there are literature review writing services that can provide you the best academic help. More and more students are simply hiring professionals in order to effectively assist them in all aspects of writing their evidence based paper.

Evidence based practice (EBP) is to demonstrate the best practice, which has been supported, with a clear rationale to back it up. Whilst using (EBP), this also acknowledges the patient/clients best interest. (EBP) is ‘the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patient/clients’ (Sackett et al, 1996).NURS 5052 – Essentials of Evidence-Based Practice Assignment PapER

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In this definition Sackett facilitates an understanding between (EBP) and decisions we make in everyday practice. This demonstrates the strong connection between both aspects. Here, Sackett emphasises the importance of decisions we make as healthcare professionals, and how clearly they should be stated. This shows that decisions are well thought-out, which demonstrates that the use of evidence is used sensibly and carefully, which means that any care or support we deliver must be evidence based. It shows that Sackett understands that if care or support we provide has a rationale, then this enables us to deliver it with a meaningful purpose.Since back in the day, the medical field has been one of the most crucial fields in the society. Quality assurance is of very high value as this can draw the thin line between life and death. However this does not all start in the hospital as a head nurse or doctor but rather it starts right from nursing school. Evidence-based practice papers are simply written to prove a certain hypothesis that is at hand. Are you trying to reinvent the wheel? No! But rather just trying to modify it. These papers are important as they help keep up with trends, save cost, evaluate projected outcome and to do away with methods that are quite outdated. An evidence based practice contains a couple of sections and are basically written with the same formatting as essays, but with a bit of a twist that I will take you through. At the end of this trust me you’ll be a pro at it.

Here I shall formulate the question according the (PICO) method, which is population, intervention, comparison intervention, and outcome. This was devised by Sackett et al, which is a useful method in order to make questions more purposeful (1997).

My selected aspect of professional practice is the Treatment of Depression and its Effectiveness in Adults with Cancer.

The format of your nursing essay paper is basically the eye catcher and it snatches the attention of your reader. It is always good to maintain a certain level of professionalism even as you write your paper. The best formatting to go for at this juncture is the APA formatting. You will find out that when you have mastered this formatting then all you need to take care of is the content and the rest will flow. Basically, the APA formatting is the kind of formatting used in social sciences and it gives a continuous flow of ideas which explains its dominance. It is divided into four main sections that are;

1. Title- This hints what they appear is all about and gives the reader the direction to take and what facts to use during their evaluation.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper
2. Abstract- This is the basis of your thesis and your try explaining it in not more than 250 words and not less than 150 words. Let your reader know that you really know what you are talking about
3. Main body- This is the ‘flesh’ of your paper as it contains all the facts, figures and arguments placed. This is the platform that you have to put all your ideas and arguments all together to boost your thesis.
4. References- Many who have had their papers rejected will tell you that they lacked this part of the paper. This is where you let your reader know from where you sourced this information. But first hold that thought, I will be expounding it in a few

Right down from the basics you will need a title for your evidence based practice. This is majorly to guide you on what you are to write and it creates the basis for your hypothesis. Your title should be quite brief and pinpoint clearly what your evaluation will be on. Your tile can take a couple of forms as well. It can take the form of a question, a simple statement or an opposing fact. This way you will have set the direction right from the start and you will give the reader something to anticipate at the end of it. Simply think of it as a pacesetter.

A thesis is basically the controlling statement that you are standing with. Have in mind that a thesis is different from a hypothesis in that: a hypothesis is an idea that you can either prove or put claims against it. However a thesis is basically what you stand for and it gives the agenda that you will be pushing all through. Any evidence based practice without a thesis is a considered an incomplete paper as it leaves a lot to guesswork and imagination.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

I personally feel there is a high prevalence of depression in cancer patients. In my experience, I have found that there are many cancer patients, which may be suffering from depression. According to Barraclough (1994) states that depression is the most common psychiatric illness in patients with terminal cancer. The high prevalence of depression in cancer patient has influenced me carry out my own research, which will effectively enhance my knowledge. Personally, I feel that by developing my knowledge on my chosen topic will help enable me to have a greater understanding, t in my future practice.

Hinton (1963) found that 24% of patients dying in an acute hospital were depressed. It has been found by Casey that patients suffering with depression may be assessed by asking them if they have symptoms such as ; loss of pleasure in activities, feelings of guilt and worthlessness, or thoughts of self harm, which may help in recognizing a diagnosis in depression (1994).NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

The objective of a qualitative research is to describe, explore, and give explanation to the phenomenon what is being studied (Marshall & Rossman, 2006. (Morse & Richards 2002) established that there many techniques used in the collection of data involved in the production of a qualitative study, but the commonly used are observing and interviewing partakers. A meta-analysis is within a qualitative study, whereby the findings of qualitative are carefully examined, the methods and theories from different studies, to form an overview or conclusive ways of thinking about phenomena Thorne et al (2004).

In my experience I have found that many patients whom have cancer have been low in mood, but often go left untreated. Maguire found that up to 80% of psychological and psychiatric morbidity, which develops in cancer patients often goes unrecognised and untreated (1985).

It speaks about how patients are non-compliant in discussing symptoms unreservedly with nursing and medical staff. It mentions that in the United Kingdom (U.K) clinical nurse specialists play an important role in assessing the symptoms and providing advice to cancer patient with highly developed and metastatic cancer (Gray et al,1999).NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

This qualitative study was purposely carried to deter how clinical nurse specialist manage, assess, and perceive depression in such patients, in both hospital and community settings. Atkin et al (1993) found that 43.4% of nurses reported that early recognition of, signs of anxiety and depression was part of their role. It shows the difficulty nurses are faced with in convincing medical staff to follow up assessment or prescribe antidepressant medication.

I shall now critique the study. Firstly, none of the nurses had any form of mental health training. Therefore, I feel their lack of knowledge may have falsified the findings of the study. Lastly, the demographic area may have been expanded further afield, which subsequently makes the findings minimalistic.

The view proposed by Long (1995, p94) that the most problematic characteristic of the hierarchy of evidence model, is that it completely lacks recognition of qualitative study methods. According to Sackett et al (1996) a qualitative is in the ranking of research evidence at the base. Here, it shows that a qualitative study has inadequate efficacy, whereby it lacks randomization, it also has scarce before and after studies.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

However, it does give emphasis to the fact that open ended question were asked in a qualitative study, which demonstrates its feasibility. An open ended question can have many answers, whereby it can be answered in many ways than one. If in depth answers are obtained, then this may enable the researchers to capture a greater insight of the situation.

Nevertheless, it has been discovered that identifying the findings in a qualitative study can be complex, this may due the style of reports, or they may be perceived wrongly (Sandelowski & Barroso 2004).

Systematic reviews were first defined as ‘concise of the best available evidence that address sharply defined clinical questions’ (Murlow et al 1997). Here, it states that a systematic review involves gathering quality information, which is then analysed, whereby it is then summarised. A systematic review is a vital source of evidence-informed policy and practice movement, which connects research in decision-making (Chalmers, 2003).

According to the Nursing and Midwifery Council (NMC) we as healthcare professionals must deliver care on the best evidence or best practice (2008). The code of conduct clearly states that any advice we give must be evidence based. If we fail to adhere to the code, then this may result in disciplinary action by the (NMC) (2008).NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

As healthcare professionals I feel any care we deliver should have a rational to justify anything we carry out. I believe that as healthcare professionals we are expected to understand why we are caring for patient/clients, whereby a rationale is provided for the care that we provide. (EBP) helps us as healthcare professionals keep updated with policies and procedures (ref). It is fundamental that we keep our skills and knowledge current, which enables us to provide effective care.

(EBP) in its earlier days of evidence based medicine, which provides a suitable way in producing efficient clinical decisions, avoiding routinely work practice, which increases clinical performance (Evidence Based Medicine Working Group 1992, Davidoff et al ,1995). In the above statement it demonstrates that (EBP) contributes to significant clinical decisions, which may subsequently develop

It is important that we adhere to policies and procedures for the best practice available, which may prevent us from making any errors. As practitioners we are accountable for our actions. Justifying what we do is vital, which must have a rationale behind it. Failure to adhere to (NMC) may result in professional misconduct (2008).NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

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Evidence based practice is a complex experience that requires synthesizing study findings to establish the best research evidence and correlate ideas to form a body of empirical knowledge (Burns & Grove 2007). There are many definitions but the most commonly used is Sackett et al (1996). Sackett et al (1996) as cited in Pearson, Field, & Jordon, (2007) describes evidence based practice:

In this assignment I shall discuss the concepts of Evidence Based Practice (EBP), and briefly outline its importance to my professional practice. I shall select a relevant aspect of my practice in relation to my professional discipline. I will provide a rationale for selecting my aspect of professional discipline, which will be within the context of (EBP). I will discuss the extent to which my selected aspect of professional practice is informed by various types of evidence. In relation my chosen aspect of professional practice, I shall then identify factors that may facilitate and hinder the implementation of (EBP).

“the conscientious, explicit and judicious use of current best available evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical experience with the best available external evidence from systematic research”. (Sackett et al 1996 page 5).

The author will discuss the importance of evidence for practice, different types and levels of evidence. The research process, dissemination of evidence, barriers and will conduct a critique of two research articles.

The importance of evidence based practice is to enable nurses to provide high quality care, improve outcomes for patient and families and to run a more efficient health service. Therefore other agencies within the health service will benefit when interventions and care is based on research (Burns & Grove 2007). According to the Nursing and Midwifery Council (NMC) code nurses are accountable to society to provide a high quality of care so therefore it is important that nurses reflect, evaluate the care and keep abreast of new knowledge and evidence that is available (Burns & Grove 2007). Providing a streamlined service, which is cost effective and based on current evidence based practice has shown to reduce cost but also to enhances the quality of care the patient receives (Melnyk et al2010). Working in partnership with the nurse the patient is able to participate in decisions about their care. This is not only beneficial for the patient but also increases the satisfaction of the nurse treating the patient (Craig & Smyth 2007). Furthermore Craig & Smyth (2007) suggests evidence based practice is a problem-solving approach to the delivery of health care. In using a problem solving approach the nurse is able to integrate clinician expertise and patient preferences to provide individualized care suitable for the patient.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

To acquire knowledge in the past, nurses have relied on decisions based on trail or error, personal experience, tradition and ritual. Parahoo (2006) suggests learning by tradition and ritual are important means of transferring knowledge, for example learning the ward routine. According to Brooker and Waugh (2007) Students learn from effective colleagues who practice safety and on the basis of best evidence. However, a disadvantage of this method of learning may lead to transmission of invalid information and may put the patient and nurse at risk (Brooker & Waugh 2007). According to Burns and Grove (2007) to generate knowledge a variety of research methods are needed. The two different research methods are quantitative and qualitative. According to Burns and Grove (2007) quantitative research is an objective formal systematic process and demonstrates its findings in numerical data. According Munhall (2001) qualitative research is gathering information to describe life experiences through a systematic and subjective approach and does not use figures or statistics to produce findings. In nursing practice the quantitative approach has been considered to provide stronger evidence than qualitative (Pearson, Field, & Jordon, 2007). Pearson, Field, & Jordon (2007) suggest health professionals and servicer users require a variety of information to facilitate change and to include evidence not only of effectiveness but feasibility, appropriateness and meaningfulness to achieve evidence based health care practice.

Evidence based practice promotes the application of research evidence as a basis on which to make health care decisions so it is important to search for the truth and knowledge logically. Robust research which may draw on expertise and experience represent a higher level of evidence because of the discipline involved (Burns &Grove 2007). There are thirteen steps in the quantitative research process and one step gradually builds on another (Burns & Grove2007). The beginning of the research process starts with a problem which usually highlights a gap in knowledge (Melnyk & Fine-Overholt 2005). The next step is the purpose of the research. This is produced from the problem and identifies the aim of the study (Burns & Grove2007). To build a picture up of what is known or not known about the problem a literature review is conducted. This will provide current theoretical and scientific knowledge about the problem and highlight gaps in the knowledge base (Burns & Grove 2007). This is followed by the study framework and research objectives, questions and hypotheses. This continues to the end till all the steps are covered. The final step is the research outcome.

Hierarchy of evidence is generated from the quality of information from different evidence. Practitioners are able to use the hierarchy of evidence to inform them on which information is most likely to have the maximum impact on clinical decisions (Leach 2006). Leach (2006) suggests hierarchy of evidence may be used to discover research findings that supersede and invalidate earlier accepted treatments and change them with interventions that are safer, efficient and cost-effective. If findings from a controlled trial are inadequate, choices should be guided by the next best available evidence (Leach 2006).NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

According to Scottish Intercollegiate Guidelines Network (SIGN 2009) the revised grading system is planned to place greater weight on the quality of the evidence supporting each recommendation, and to highlight that the body of evidence should be considered as a whole, and not rely on a single study to support each recommendation. The grading system currently in use with the SIGN guidelines starts with 1++ and ends in 4. For the evidence to be rated at 1++ it must include a high quality meta-analyses, systematic reviews of random controlled trails (RCT) or RCT with a low risk of bias. Level 4 is based on expert opinion (SIGN 2009).

There are many barriers to implementing evidence based practice. One of the common barriers is staff information and skill deficit. Health professionals lack of knowledge in regarding results of clinical research or current recommendations may not have the sufficient technical training skill or expertise to implement change (Pearson, Field, & Jordon 2007). Nurses have also highlighted lack of time as a barrier in applying research to practice. As the number of patients increases nurses face the challenge of providing safe, high-quality care within a short time frame. Nurse educators and researchers have developed a “toolkit” to ease the implementation of evidence based practice into nursing (Smith, Donez & Maghiaro 2007).NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

According to Gerrish and Lacey (2006) dissemination is a process of informing people about the results of a particular research. There are many ways to present results, video, seminars and the most accepted is through professional journals. However with the internet being more assessable the researcher is able to post details on the website hosted by NHS trust or university. One disadvantage in using the internet is that it provides no guarantee of quality (Gerrish & Lacey 2006). SIGN guidelines are circulated free of charge throughout Nation Health Service (NHS) Scotland. For this to happen they must be made widely available as soon as possible to facilitate implementation. Furthermore guidelines on their own have proved ineffective and more likely if they are disseminated by active educational intervention and implemented by patient-specific reminders relating directly to professional activity (SIGN 2009).

Rydstrom I, Dalheim-Englund A, Holritz-Rasmussen B, Moller C, Sandman P-O (2005). Asthma – quality of life for Swedish children.Journal of Clinical Nursing 14, 739-749. Blackwell Publishing Ltd.

As the title suggests this was a research to find out how Swedish children with asthma experience their quality of life and to look for potential links between their experience of quality of life and some determinants. This study was accomplished by using a quantitative research approach which adhered to the aims and objectives. Quantitative research is formal, objective, systematic inquiry that involves numerical data (Burns & Grove 2007). The two stages used in the quantitative research were correlation and quasi-experimental (Burns & Grove 2007). This is an acceptable method to use as the study was trying to explore the relationship between two variables and the findings were produced in a numerical format.

In previous literature it was noted investigations in children with asthma around the world all had similar experiences (Rydstrom et al2005).It also highlighted that girls and boys perceived asthma in a different way and girls were more likely to include asthma in their social and personal identities where boys would exclude the condition (Williams 2000). The researchers wanted to ask the children how they experience their life living with asthma. Also to look at possible links between children’s quality of life and determinants such as age, sex, pets, siblings, location and social status (Rydstrom et.al. 2005).

Some common types of sampling used in quantitative research are random and non-random samples (Burns and Grove 2007). In the article for the purpose of this study all hospitals and clinics were used and fifteen were chosen randomly for the study (Rydstrom et al2005). Both children and parents were asked to participate in the study but children had to meet the inclusion criteria before being selected (Rydstrom et al2005). By using a random sample the general population becomes representative of the larger whole (Parahoo 2006).

Validity was established by cross-matching Paediatric Asthma Quality of life Questionnaire (PAQLQ) with About my Asthma (AMA), by Mishoe et.al.(1998). Warschburger (1998) recommended that PAQLQ was a reliable instrument and Reichenberg & Brogerg (2000) found that there was no difference concerning reliability between the Swedish and the original PAQLQ.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

The study was approved by The Ethics Committee at the Medical Faculty of Umea University in Sweden and consent was received from parents and children. Burns and Grove (2007) define sampling as a process of selecting groups of people who are representative of the population.

Data was collected through self administration questionnaires. There advantages and disadvantages in using questionnaires. Advantage firstly, the data is gathered is standardised and therefore easy to analyse. Secondly, respondents can answer anonymously which may produce more honest answers. A disadvantage is the responses may be inaccurate especially through misinterpretation of questions in self completing questionnaires. (Gerrish & Lacey 2006). Children age seven to seventeen were required to fill in Paediatric Asthma Quality of life Questionnaire (PAQLQ) which was used to measure the children’s quality of life in different domains. Parents were required to fill in Paediatric Asthma Caregivers Quality of life Questionnaire (PACQLQ) (Rydstrom et al2005). Children and parents filled in questionnaires separately and a nurse was on hand to help children who could not manage on their own.

The researchers clearly identify what statistical tests were undertaken. However the results are presented in a complex manner. The results showed the majority of children estimated their quality of life at the positive end of the scale. Children reported impairment in the domain of activities than emotions and symptoms for example not being able to run around. Living in the south of Sweden and being a boy were reported to have a better quality of life. Furthermore children living with a Mum over forty or with cohabiting parents had a better quality of life (Rydstrom et al2005).NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

The researchers brought to the attention of the reader the laminations within the study. Children view friends and their social environment being important to them however there were no questions relating to this and also it did not take into consideration the child’s stage of development (Rydstrom et al2005). Also the research was done within a week, therefore would the results be different if it was done over a longer period. This was not a controlled research so there is a possibility that some data may be missing as nobody was checking to see if the children had filled in all the questions.

The findings highlight it is important for the nurse to look at all aspects of the child development. Furthermore caring tends to focus on the patients’ limitations, another important issue for nurses is to try to discover those aspects in a child’s daily life that contribute to a high QoL in order to improve and maintain the child’s wellbeing.

As the title suggests this research article will focus on review management for children with asthma within a primary care setting. This study was accomplished by using a qualitative case study design. In using a qualitative case study design it can provide much more comprehensive information than what is available through other methods, such as surveys (Neale, Thapa & Boyce 2006). Neale, Thapa & Boyce (2006) suggest case studies also allow one to present data collected from multiple methods (i.e., surveys, interviews, document review, and observation) to provide the complete story. Qualitative research is systematic, subjective approach (Burns & Grove 2007) which describes life experiences, meanings, practices and views of those involved (Craig & Smyth 2007).NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

In the UK one in eight children suffers from the effects of asthma and the majority of cases are now being managed in the primary care setting (National Asthma Campaign 2001). With improvement in management of asthma over the years there is still a high level of morbidity and mortality (Lyte et al2005). Out of Sight, Out of Mind (Asthma UK 2005) agrees with Lyte et al(2005) that death rates are high. In Scotland the death rates due to asthma vary each year. Furthermore inquires have shown at least 90% of those deaths could have been avoided. However child admissions to hospital due to asthma have fallen slightly (Out of Sight, Out of Mind Asthma UK 2005). Furthermore it was highlighted through a systematic review of literature published at the time of research that it was unknown whether primary care based asthma clinics were effective. Additionally it concluded that patients’ views on asthma clinics were also unknown (Fay et al2003). One cannot ignore the fact that there are evident gaps in generic knowledge of primary care asthma services for children in the UK (Lyte et al2005). Therefore the aim of the study is to investigate current review management of children’s asthma in one primary care trust and to consider the views of children, their parents/carers and the role of the practice nurse in asthma care in one primary care trust (Lyte et al2005).

For the purpose of this research Lyte et al(2005) used purposive sampling to gather information. Craig & Smyth (2007) suggests there are various methods can be applied to data collection. Lyte et al(2005) used interviews, observations and reviews of available documentation regarding asthma (Artefactual). In using this type of sampling the researchers can be specific on the groups they wanted to target. However they may be an element of bias as the practice nurse selected the parents and children for this research. To strengthen the research the researchers used triangulated methods for data collection. According to Craig & Smyth (2007) the theory behind triangulation if multiple sources, methods, investigators or theories provide similar findings their creditability is strengthened.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

The study was approved by the Local Research Ethics Committee and the University’s Senate Ethics Committee. Throughout the research during the data collection consent was treated as an ongoing process. However there was difficulty in communicating with children. To solve this problem, when meeting with the children the researchers would go through the informed consent and voluntary participation again. Confidentially of all participants were protected and guaranteed by the Data Protection Act.

Children expressed a wish to participate and share information in the research (Lyte et al 2005). However some children felt through the research of not being involved. Lyte et al (2005) suggested it is the child’s personality that determines how much response the practice nurse receives. It is often said good communication in nursing is crucial and is the foundation of building trust and encourages children to seek advice. It is important to communicate with children appropriately to match the stage of development (The Common Core of Skills & Knowledge 2010). Ultimately effective communication allows for the exchange of information, needs and preferences of the patient between herself and the patient (The Common Core of Skills & Knowledge 2010). However Hobbs (1995) suggests that some practice nurses may not have the training in regarding complexities of caring for children and their families. One cannot deny that it is important for practitioners to have the appropriate training (Alderson 2000) because children have equal rights to contribute to their care as well as adults (Save the Children 1997).NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

It was noted that children did not have sufficient knowledge about asthma. Furthermore parents and children highlighted that there was insufficient information on asthma in the primary care setting. For children and adults to make informed choices regarding their asthma they require having up to date information to help them in making decisions. Equally in one practice it was identify that the practice nurse lack confidence in caring for children with asthma and Hobbs (1995) confirms this lack of confidence and points out that practice nurses deal with arrange of illnesses.

Parents and children in the study both agreed that one area for improvement was the waiting room (Lyte 2005). Some children may find going to the doctor a very frightening experience. The first expression needs to be reassuring and non-threatening. (Making Your Waiting Room Kid-Friendly 2006). The waiting room should be child friendly and also have books, television/video for older children. With today’s technology many children use computers in the classroom. Some computer programs are touch-screen driven, making them friendly to all levels. Providing a computer in the waiting room may be ideal opportunity to encourage children to show off their technical skills by accessing the computer for health-related information (Making Your Waiting Room Kid-Friendly 2006).

It might be concluded from this research the strengths outweigh the weaknesses, despite the research being conducted in one primary care trust. The most satisfactory conclusion that can come from this, to facilitate children and parents a comprehensive package of care needs to be put in place in order to manage their asthma effectively.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

Since back in the day, the medical field has been one of the most crucial fields in the society. Quality assurance is of very high value as this can draw the thin line between life and death. However this does not all start in the hospital as a head nurse or doctor but rather it starts right from nursing school. Evidence-based practice papers are simply written to prove a certain hypothesis that is at hand. Are you trying to reinvent the wheel? No! But rather just trying to modify it. These papers are important as they help keep up with trends, save cost, evaluate projected outcome and to do away with methods that are quite outdated. An evidence based practice contains a couple of sections and are basically written with the same formatting as essays, but with a bit of a twist that I will take you through. At the end of this trust me you’ll be a pro at it.

Right down from the basics you will need a title for your evidence based practice. This is majorly to guide you on what you are to write and it creates the basis for your hypothesis. Your title should be quite brief and pinpoint clearly what your evaluation will be on. Your tile can take a couple of forms as well. It can take the form of a question, a simple statement or an opposing fact. This way you will have set the direction right from the start and you will give the reader something to anticipate at the end of it. Simply think of it as a pacesetter.

A thesis is basically the controlling statement that you are standing with. Have in mind that a thesis is different from a hypothesis in that: a hypothesis is an idea that you can either prove or put claims against it. However a thesis is basically what you stand for and it gives the agenda that you will be pushing all through. Any evidence based practice without a thesis is a considered an incomplete paper as it leaves a lot to guesswork and imagination.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

The format of your nursing essay paper is basically the eye catcher and it snatches the attention of your reader. It is always good to maintain a certain level of professionalism even as you write your paper. The best formatting to go for at this juncture is the APA formatting. You will find out that when you have mastered this formatting then all you need to take care of is the content and the rest will flow. Basically, the APA formatting is the kind of formatting used in social sciences and it gives a continuous flow of ideas which explains its dominance. It is divided into four main sections that are;

1. Title- This hints what they appear is all about and gives the reader the direction to take and what facts to use during their evaluation.
2. Abstract- This is the basis of your thesis and your try explaining it in not more than 250 words and not less than 150 words. Let your reader know that you really know what you are talking about
3. Main body- This is the ‘flesh’ of your paper as it contains all the facts, figures and arguments placed. This is the platform that you have to put all your ideas and arguments all together to boost your thesis.
4. References- Many who have had their papers rejected will tell you that they lacked this part of the paper. This is where you let your reader know from where you sourced this information. But first hold that thought, I will be expounding it in a few.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

Evidence Based Practice, also known as EBP according to (Liamputtong, 2013) is a “process that requires the practitioner to find best empirical evidence about the effectiveness or efficacy of different treatment options and then determine the relevance of the evidence to a particular client’s situation”. EBP values, enhances, and builds on the clinical proficiency, knowledge of the disease mechanisms, and pathophysiology. It involves complex and conscientious decision making built not only on the available evidence but also on patient physiognomies, circumstances, and preferences. It also recognizes health care as an individualized and ever changing that involves uncertainties and probabilities. Ultimately EBP is the formalization of the care process that the best clinicians have practiced for generations (McKibbon, 1998).One of the most essential aspects of doing a job well, no matter what job it is, is the ability to think critically about a situation. Finn (2011) defines critical thinking as “the ability and willingness to assess claims and make objective judgments on the basis of well-supported reasons and evidence rather than emotion or anecdote”. The difference between assessing a certain situation critically and assessing it without any evidence to corroborate your claims is that when you look at something critically, you are using your ability to “come up with the alternative explanations for events, think of research findings and apply new knowledge to social and personal problems” (Finn, 2011). When you can come up with other explanations using evidence, you can also create an alternative way of enhancing the situation. Critical thinking skills are especially important to nurses in a fast-paced setting. Nursing is a very demanding and rewarding field to enter into; it becomes enjoyable when you are good at it. In order to be good at their jobs, nurses need to learn the skills required to think critically and also, relate those skills to their everyday routines. This is known as evidence-based practice. Evidence-based practice is defined as “using the best scientific evidence available to guide clinical decisions and interventions with the goals of fostering self-management skills and improving health outcomes” (Miller, 2011). This paper examines the skills required for critical thinking, how to learn these skills, and how to apply them in clinical settings. (Miller, 2011; Finn, 2011; Noonan, 2011; Lunney, 2010; Wangensteen, Johansson, Bjorkstrom & Nordstrom, 2010; Chitty & Black, 2011).Pain is experienced by almost all patients regardless of age or sex. Virtually all healthcare professionals help patients who are experiencing pain. To provide comprehensive team-based care, professionals must understand the limits of their own expertise, while gaining insight from and an appreciation for that of other disciplines. This requires health professionals to collaborate to better assess, understand and manage patients with complex pain.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

Evidence-based practice is a clinical decision-making process in which clinicians use theory-derived, research-based knowledge to inform their decisions about care delivery. Consideration of individual needs, preferences and resources are also included. EBP replaces policies and procedures based on other sources of evidence such as tradition or authority. It takes into account three things nursing students should consider at all times: best practice evidence, patient preferences and clinical expertise.

Here are just a few examples of how EBP has changed nursing care. You can find many more examples in the literature.

The BRAT (Bananas, Rice, Applesauce, and Toast) diet is no longer a nutritional recommendation for gastrointestinal upset in children. The American Academy of Pediatrics now recommends that children be return to a well-balanced diet as soon as possible.

• Nurse-driven protocols now guide nursing practice regarding the best time for removing urinary catheters to prevent urinary tract infections.

• Aspirin was previously used to control fever in the pediatric population, but it is no longer a standard practice because it increases the risk of Reye’s syndrome.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

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• ICU ABCDEF Bundle is a combination of multiple evidence-based interventions that can collectively reduce delirium, improve pain management and reduce long-term consequences for patients in the ICU. (A: Awakening trials for ventilated patients; B: Spontaneous breathing trials; C: Coordinated effort between the RN and respiratory therapist to perform the spontaneous breathing trial when the patient is awakened by reducing or stopping the patient’s sedation; D: A standardized delirium assessment program, including treatment and prevention options; E: Early mobilization and ambulation of critical care patients.)

•  Turning patients every two hours is no longer a standard of care. The timing for turning patients should be dependent upon their condition and their risk for skin breakdown. For example, one patient may need to be turned every 15 minutes and another patient may need to be turned every hour.

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.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

You probably will notice on the units where you work there are specialty populations and patients with similar diseases. To provide a higher level of care, look up evidence-based practices for that particular population. Hospital units or your university library usually have nursing databases to search for specific journal articles.

One of my clinical assignments each semester is to find new evidence-based practices that can help nurses on the unit improve care. Not only do we as nursing students have the power to educate staff, but we also can serve as a great resource, helping staff to provide better care and improve patient outcomes.

As a student, you can suggest implementing evidence-based practices as a standard of practice. Embrace its positivity knowing it will help the care of your patients. You can print out evidence-based practices for your unit and perhaps leave it at the nurses’ desk or in the break room. Start a journal club or join one and come together with nurses who are willing to bring change to the units where you work.

Evidence-based practice change starts with you as a student. Be the change agent, and never be afraid to advocate for the care of your patients.

• It’s important for student nurses to learn the value of evidence-based practice, in order to provide high-quality care. It is never too early.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

• EBP is a based on research, evidence on best practices, and the consideration of individual patient’s needs, preferences.

• During clinicals, do research on the medical conditions your patients have. It will help you provide a higher level of care.

• Be proactive in suggesting EBP during clinicals or helping to bring more attention to EBP research.

There was a time when milking chest tubes and bathing children in alcohol were standard practices. Although at the time the nursing interventions may have seemed rational, evidence-based practice has proven otherwise. EBP continues to change the way nurses care for their patients. For example, during one of my clinical rotations, a seasoned nurse corrected me for not aspirating a syringe during an intramuscular injection. Current evidence-based research suggests that aspirating intramuscularly is no longer a standard of practice since no evidence supports its practice and it can cause trauma to patients.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

One of the key points we learn in nursing school is about the importance of evidence-based practice. As students we are taught to be a generation that provides high-quality care. This high-quality care is supported by evidence, which took many years to become standards of care through translation from research to clinical practice. Nursing EBP continues to expand and several resources such as journals, models and books are available to help nurses understand the concepts and process. Gaining knowledge of EBP and learning strategies for implementation are critical skills for nurses, no matter the setting.

Wanda has been involved in a research study of the causes of tooth decay in elementary school children. Twenty-five percent of the students in the free breakfast program at a local school have been screened by a local dental hygienist. The dental hygienist finds an average of 3.5 cavities per student. The same dental hygienist recently screened 25% of the students in a school with no free breakfast program, and found an average of only 1.5 cavities per student. Wanda concludes that the breakfast served to students is the cause of higher tooth decay. Do you agree with Wanda? Can you think of other causes for the higher number of cavities among the students from the school with free breakfast?
Jerry is conducting a phone survey to determine public opinions on Medicaid reform. In order to get a random sample, Jerry decides to call the tenth number on the second column of every fifth page of the phone book. He also decides to stop sampling when he has completed 50 surveys. After reaching the target number, Jerry begins to analyze the data he has gathered and is surprised to find that opposition to reform is running about 18% higher than the national average. He is at a quandary to explain this significant difference in numbers. What are some reasons you can think of for the higher rate of opposition?NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper
As you consider these scenarios, you may note issues or problems related to the validity of the research and conclusions. This week, you assess validity in quantitative research. You are introduced to the different types of validity and why they are important to consider when evaluating evidence and research studies. You also examine common threats to validity and consider how to minimize those threats.
Learning Objectives

Effective evidence based practice takes time, extensive research, proper understanding and is dependent on its five steps. The first of these is formulating a searchable clinical question or questions which than needs to be answered to satisfy the health carer or other specific needs of the patient. The second step involves the retrieval of best evidence such as textbooks, verified journal literature/article etc. to answer the questions. Appraising the retrieved information to help make a clinical decision forms the third step. The fourth steps involves applyingthe evidence with clinical expertise, taking the patient’s wants/needs into consideration and the fifth step involves the evaluatingtheeffectiveness and efficiency of the process. (McKibbon, 1998).

Evidence based practice is vital, demanding and highly respected amongst health care disciplines because of its ambitions to provide the most effective care that is accessible, with the aim of improving patients outcomes. It promotes an attitude of inquiry in health professionals and gets them into thinking about questions such as: Why am I doing this in this way? Is there evidence that can guide me to do this in a more effective way? Therefore, facilitating their practice into professional accountability. Evidence based practice also plays an important role in ensuring that health resources are used wisely and that relevant evidence is considered when decisions such as funding health services are made (Hoffmann, Bennett, & Mar, 2010).NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

Most health professionals use both individual clinical expertise and the best available external evidence as a guidance to their decision making. Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients (McKibbon, 1998). Clinical Expertise is important as it depends on the knowledge and skills of health care professionals providing care. The clinical expertise of a health professional depends on his/her year of clinical experience, current knowledge of research/clinical literature and educational preparation. The stronger the health professional’s clinical expertise the better his or her judgement in using the best research evidence in practice. Extensive research is needed to develop sound empirical knowledge for synthesis into the best research evidence needed for practice. This research evidence might be synthesized to develop guidelines, standards, protocols and policies to direct the implementation of a variety of health practice interventions (Burns & Grove, 2010).

Personal Protective Equipment (PPE) such as gloves is an essential component when practicing in any health care setting. Published Evidence based articles indicates that wearing of gloves in infection control practice can reduce the incidence of healthcare associated infection and exposure to communicable disease among healthcare workers (Olsen, et al.). Therefore, the correct use of gloves is vital in the healthcare environment.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

To make sure gloves are effective evidently on the health practice the 5 steps of evidence based practice can be implemented. The first step can involve developing a clinical question regarding the gloves such as what kind of gloves are relevant and effective in my practice which can then be answered i.e.- Non sterile single use medical glovesto satisfy the health professional. The second step can involve the retrieval of best evidence such as verified journal literature/article about the Non sterile single use medical gloves. The third step can involve appraising the information from the journal literature/article regarding the gloves to help make a clinical decision. The fourth step can involves applyingthe Non sterile single use medical gloveswith clinical expertise whilst taking health professional’s wants/needs into consideration and the fifth step involves evaluatingtheeffectiveness and efficiency of the Non sterile single use medical gloves. Once these measures has been taken, the effectiveness of the specific gloves can be taken into account and if satisfied can be used for the practice.

While implementing the five step of EBP in the gloves, the major facilitators that are most likely to be found are organization and communication whilst the barriers while implementing the EBP are most likely to be lack of time and lack of autonomy to change practice (Kitson, Harvey, & McCormack, 1998). Thus, implementing Effective EBP requires time, energy, knowledge and authority and without these vital components, there is always bound to be barriers and proper EBP cannot be achieved.NURS 5052 – Essentials of Evidence-Based Practice Assignment Paper

In conclusion, the emergence of Evidence based practice has been rapid, dramatic, spreading in popularity amongst many health care disciplines and is changing the way health care is undertaken. The dependence on the partnership among hard scientific evidence, clinical expertise, individual patient needs and choices is the reason why evidence based practice is vital, demanding and highly respected amongst health care disciplines (Hoffmann, Bennett, & Mar, 2010). Despite this, Evidence based practice does have limitations and therefore, research is always needed to improve retrieval methods for EBP information and this is the reason why health professionals need to constantly develop and retain their research skills durable.