Examine the ways that health professionals can use the five steps of evidence-based practice (EBP) as a practical framework to overcoming barriers to locating, appraising and applying best research evidence. Use an occupational health and safety practice as an example. Examples of occupational health and safety practices include: Use of professional protective equipment (e.g. gloves) Safety considerations when using equipment (e.g. sharps) (or a topic you select yourself in negotiation with your LIC)
Health professionals are very good at seeking information from their clients and their families and also from the settings in which they work but however they have not been as aware of the information that they can gain from research. Although they need information from many sources, evidence based practice shows how research can also play a role in informing clinical decisions, (Hoffmann ,2010). Health professionals use the five steps of evidence-based practice (EBP) as a structure to overcoming barriers and applying best research. Examples of this include use of professional protective equipment and safety considerations when using equipment.
Liamputtong (2010) states that evidence based practice is a “process that requires the practitioner to find empirical evidence about the effectiveness or efficacy of different treatment options and then determine the relevance of the evidence to a particular clients situation” (pp. 252). Sackett (1996, pp.71) states that “conscientious, explicit and judicious use of current best evidence in making decisions about the care of individuals patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external evidence from systematic research, and the more thoughtful identification and compassionate use of individual patients’ predicaments, rights and preferences.” The purpose of evidence-based practice is to assist in clinical decision-making. To make informed clinical decisions, we need to integrate lots of pieces of information, (Hoffmann ,2010). EBP reduces inconsistency in practice and increases efficiency and effectiveness, and therefor has been accepted by the government and funding bodies as essential to better health care. (Liamputtong, 2010).
Evidence based practice has 5 steps. The first step is to convert your information needs into an answerable clinical question. The process of EBP begins with the recognition that as a health professional, have clinical information need, these types of clinical information needs can be answered with assistance of research evidence. After converting your information into clinical questions, you then need to find the best evidence to answer your clinical question, and then upon finding the evidence, you will need to critically appraise it. This means you need to examine the evidence closely to determine whether its worthy of being used to inform your clinical practice. There are 3 main aspects of the evidence that need to be appraised; Internal validity – refers to whether the evidence is trustworthy, impact – health professionals need to determine the impact of the evidence and applicability – this means to evaluate whether you can apply the results of the study to your client. The fourth step is to integrate the evidence with clinical expertise, the clients values and circumstances, and information from the practice context. The final step consists of evaluating the effectiveness and efficiency with which steps 1-4 were carried out and think about ways to improve your performance of them next time. (Hoffmann ,2010, pp.4)
Evidence based practice is important because it aims to provide the most effective care that is available, with the aim of improving client outcomes. It is also important because when an individual seeks health care from a health professional, you would expect that they would provide you with most effective care and the most accurate health care information. It is also important because it reduces inconsistency in practice and increases efficiency and effectiveness. (Liamputtong ,2010, pp.253). Evidence based practice promotes an attitude of inquiry in health professionals and gets people thinking about things like ‘Why am I doing this in this way? , Is there evidence that can guide me to do this more effective way?. The most important role-played is that in ensuring that health resources are used wisely and that relevant evidence is considered when decisions are made about funding health services. Evidence-based practice provides a critical strategy to ensure that care is up to date and that it reflects the latest research evidence.
In summary, it is important because it results in better patient outcomes, it contributes to the science of nursing, it increases confidence in decision-making and policies and procedures are current and include the latest research. (Suzanne ,2006 pp. 8) Some safety considerations, prevention and control measures include hand hygiene; the health professionals checking that all their patients’ hands and fingernails are clean. Health professionals must always perform hand hygiene rules before and after each contact with client/patient or any contact with environmental surfaces near the client/patient. Another consideration is all personal protective equipment is to be removed/discarded before leaving the room of a patient who is suspected of having a infection. Health professionals know these health/safety measures are effective because of study and previous research. (Hoffman, 2010) They can firstly convert them into questions; for example – what equipment will best prevent myself from coming into contact with any infection?, from there research is done. Health professionals then apply this knowledge in the workplace and see whether it’s an effective method or not.
The barriers that prevent nurses from using research include; lack of value for research in practice, difficulty in changing practice, lack of administration support, lack of knowledgeable mentors, insufficient time to conduct research, lack of education about the research process, complexity of research reports and difficulty accessing research reports and articles. Another barrier is also the insufficient fund supply. (Suzanne , 2006 pp. 10)
A facilitating factor is that the organisation should support staff to practice evidence based practice by allocating time for individuals to pursue it. Newhouse (2007). Limitations consist of low response rate, health professionals passionate either positively or negatively more likely to respond and also the self reporting to assess knowledge, skills and attitudes may resulted in inflated or underestimated scores. “Systematic reviews may be of varying kinds, but all are based on rigorous protocols” (Liamputtong, 2010)
In conclusion health professionals seek information from patients/clients but they also turn a blind eye to the information that they can gain form research unintentionally. They do this by using the 5-step mechanism of evidence-based practice to overcome barriers and to find the most valid and reliable information. Examples of this consist of use of professional protective equipment and safety considerations such as disposing sharps after use.
Liamputtong (2010). Research methods in health (2nd ed.) Australia: Oxford University
Hoffmann (2010). Evidence based practice. Australia: Sunalie Silva Suzanne (2006) Evidence based practice in nursing. Australia: Mary Jo
Newhouse (2007) Evidence based practice. Monash University : Gulzar Malik
Vernel, E. (2011, December 9). Developing evidence based practice among students. Retrieved from http://www.nursingtimes.net/developing-evidence-based-practice-among-students/5038920.article