Forensic Nurse Guide: Evidence-Based Nursing
The last thirty years have seen a rise in a new form of medical practice and treatment. Seeking a more scientific basis for patient care, medical professionals, in particular Archie Cochrane, began to develop a more informed method of medical treatment. Evidence-based medicine (EBM) is the result of an increased emphasis on utilizing the vast field of medical knowledge and research for individual patient cases. In EBM, the treatment provider identifies the patients condition and then seeks medical research that relates, in order to provide the most modern and effective treatment possible. This extra scholarly effort follows a series of steps as medical professionals seek out, analyze and apply qualified research to a patients treatment. Generally, this process has been broken down into 5 or 6 steps and, in keeping with the scientific theme, is largely standardized across the field. While different interpretations are circulated, the basic steps in EBM are; formulating a question, finding evidence that answers the question, analyzing evidence for quality and validity, applying the evidence and acquired knowledge to patient treatment and finally, assessment of the entire process.
The focus on evidence and research in patient treatment has gained traction in recent decades and is now regarded as a standard method for medical treatment. As its popularity has increased, evidenced-based medicine has further been applied to multiple medical professions, including nursing. Registered nurses are now expected to be able to competently research and synthesize medical knowledge for patient treatment. Termed evidence based nursing (EBN), this method of nursing is now taught in most nursing schools and is an integral part of the industry. While this increases the workload and educational requirements of nurses, it also allows for them to interact more intimately with patients, by allowing them to further understand the best possible treatment methods, a task traditionally reserved for doctors and specialists. Additionally, nurses are also in much closer and frequent contact with patients than doctors and the benefits of EBN can be applied to more routine aspects of medical care.
As part of an ongoing effort to bring you the best information on nursing, and medicine in general, we have created this guide to increase understanding of the various steps and processes inherent in evidence-based nursing.To accomplish this we have included resources that will aid in performing efficient EBN. These resources cover the basics of EBN, as well as tools, guides and data for finding, analyzing and implementing relevant medical research. The hope is that this guide will prove useful to nurses and nursing students, as well as anyone else interested in this standardized form of medical practice.
Basics of Evidence Based Nursing
In keeping with its scientific and scholarly roots, EBN is a standardized process, following formatted steps and regulations. This standardization ensures uniformity of patient care and research analysis in the medical field, and allows less room for individual errors. Analysis and interpretation are important aspects of EBN, as nurses must know what research is applicable to specific patients and their medical condition. Furthermore, the process of implementing the findings of research can also be complicated, as general findings must be applied to individual cases. The following resources provide information and guidance for understanding this multi-part process.
- Centre for Evidence Based Medicine – A comprehensive guide from Oxford University on evidence based healthcare, featuring information for both learning and teaching this practice. Also includes a toolbox for statistical and research analysis, as well as a glossary of terminology.
- Patient Safety and Quality – A handbook for evidence based nursing from the US Department of Health and Human Services. Features dozens of scholarly articles from doctors on using established research to improve patient care.
- Using Evidence Based Nursing in Practice – A guide to EBN from the Health Sciences Library at the University of North Carolina. Resources are organized by the 6 A’s of EBN; ask, acquire, acquire, appraise, apply and assess.
- Evidence-Based Practice in Nursing – A professional guide covering just about every aspect of EBN. Covers the basics of this form of medical practice as well as its current status, role and acceptance in western medicine.
- A Critique of Evidence-Based Practice in Nursing – A scholarly analysis of the current state and effectiveness of EBN in the medical field. Debates the benefits and drawbacks of EBN and its underlying assumptions by examining its history and key publications.
Tools and Tutorials
The proliferation of the Internet has made it much easier for medical professionals to access medical research and bodies of knowledge. Additionally, it has also allowed for much greater access to help and guidance on various aspects of research acquisition. Rather than relying on libraries and librarians, nurses can quickly access this information themselves. The following resources provide both tools and tutorials to enhance exploration of medical research.
- Evidence Based Practice Tutorials – Two lesson plans for learning how to use evidence based practice, covering the basics of the 5-step process and case study examples of evidence based practice.
- Tutorial: How to Form an Answerable Clinical Question – A tutorial walkthrough of the first step in evidence based nursing, forming a clinical question for patient treatment. Follows the PICO format which focuses, in order, on the patient, intervention, comparison and outcome.
- Medical Practice Manuals – A collection of Reusable Learning Objects (RLO’s) from the University of Nottingham, which are mostly interactive forms of tutorials covering various aspects of medical practice and nursing. Includes a good deal of RLO’s related to EBN research and implementation.
- Evidence Based Medicine Tools – A collection of tools to aid in evidence based medical practice, provided by the Center for Evidence Based Medicine. Features tool sets for understanding and performing each of the steps in evidence based practice.
- Evidence Implementation Tools – A selection of links to tools for helping implementation of evidence into nursing practice. Includes worksheets for analyzing and comparing established medical research, and applying its findings to individual patients.
- Evidence Based Practice – A collection of resources from the Health Links database at the University of Washington. Provides access tools for statistical analysis, access to medical statistics, evidence based practice literature and more.
Research and Implementation
Accessing medical research can sometimes be both expensive and time consuming. The following resources provide free access to medical research databases, as well as providing guidance for implementation of findings and recommendations in research.
- Implementation Science – An open-source database of health and medicine research. This online journal is geared towards providing research that can improve healthcare and clinical performance.
- Nursing Research: Show Me the Evidence! – The blog of St. Joseph Hospital’s nursing department covering EBN research and practice. Features regular posts by registered nurses and doctors on implementing evidence based practice and advice on researching medical literature.
- SUMSearch – A search engine that explores three major medical research databases; MEDLINE, DARE and NGC. A useful tool for finding relevant research for patient care.
- Evaluating and Critiquing Nursing Research – Guidelines and discussion on how to critically evaluate research for use in nursing. This article is part of a larger website, Nursing Research, which provides a open access to research and review articles.
- Trip Database – A powerful clinical search engine for finding recent and archived medical studies and reviews.
- National Registry of Evidence-based Programs and Practices – A national database of established practices, programs and methods that utilize evidence-based principles. Analyzes each program by breaking down its associated research and its historical success and viability.
- Evidence in Health and Social Care – A research database from the UK National Health Service. Features NICE Pathways, which are interactive topic based diagrams that provide established research information on selected diseases, disorders and medical issues.