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Evidence Founded Clinical Practice Medical Essay

Each agent of the medical profession certainly at least one time in life thought about the substance of healing fine art. The traditional response to this question is something like this: "healing artwork consists of the knowledge had a need to understand the causes and pathophysiological mechanisms of diseases, from scientific experience, intuition and a couple of qualities that along constitute the so-called "clinical thinking".

Cultivated in the traditional medical education idea "clinical thinking" does not have clear meaning and holistic perspective of curing and is based on analogies. At the flip of 80-90-ies the new fild of knowledge was shaped in treatments - professional medical epidemiology. Typically the most popular became the works of the band of Canadian experts - D. Sackett, B. Haynes, G. Guyatt and P. Tugwell from the McMaster School, Ontario. These were the first who tried to study the medical skill in conditions of rigorous methodical principles. These medical rules have a great impact on the design of medical practice and ideology of doctors.

Clinical epidemiology is growing the medical basis of medical practice - a set of rules for professional medical decision-making. The central tenet of medical epidemiology is the fact: every professional medical decision should be structured firmly on proven methodical facts. This postulate is called "evidence-based medicine".

Evidence-based medicine can be an approach to medical practice where decisions on the use of preventive, diagnostic and therapeutic measures are taken predicated on the available evidence of their efficacy and security, and such proof undergoes search, comparison, compilation, and wide dissemination to be used in the interest of patients (Proof Based Medicine Working Group, 1993).

Evidence-Based Treatments is a conscientious, explicit and judicious use of current best proof for making decisions about health care of person patients. The practice of evidence-based medication requires the union of individual skills with the best available external evidence obtained from systematic research. By specific clinical expertise experts indicate the professionalism and reliability and professional medical thinking, bought through the deposition of medical experience in scientific practice. Increasing professionalism and reliability is manifested in lots of ways, but most pronounced it is in the better and effective analysis, a lot more thoughtful identification and compassionate frame of mind to the difficulties of patients, their privileges and preferences in making clinical decisions regarding the provision of health care. Beneath the best available exterior proof, specialists mean clinically relevant research. External clinical justified research not only invalidates the prior diagnostic exams and treatments, but also replaces them with new, more powerful, precise, secure and efficient. (Sackett, DL et al. (1996) Information based medicine: what it is and what it is not. BMJ 312 (7023), 13 January, 71-72).

Principles of evidence-based treatments include the assessment of the effectiveness and safety ways of diagnosis, protection and treatment in clinical studies. The practice of evidence-based medication is the use of data from medical studies in daily scientific work of a doctor or a nurse.

In most countries there have been recognized some of the guidelines for conducting specialized medical studies specified in the standard GCP (Good Scientific Practice) as well as the rules of production of drugs (standard GMP) and perform lab testing (standard GLP).

The International System of evidence-based remedies evolves exponentially: since its establishment in the first 90's for this time the number of centers, books, publications and discussion boards on the situation is huge. The U. S. Agency of Health Insurance plan and Research subsidized in 1997 12 such centers founded at leading universities and research institutions of different states, a growing number of centers on specific issues (child health, main care, standard practice, mental health, etc. ). The normal thing for those directions is the utilization of the theory of facts at any level of decision-making - from the state program till the session of individual remedy.

Nowadays evidence-based practice is extensively applied in professional medical practice. The thought of evidence-based practice for medical was developed from the evidence based medicine movement.

Currently, nursing can be an integral area of the health system. It is a multifaceted health discipline that has a social health importance, as it is intended to keep up and protect public health. Medical is a technology and art, aimed at solving existing problems related to real human health in a changing environment.

Thus, evidence-based medical is the sort of evidence based remedies. It involves determining the required research and execution of them into practice health care to be able to increase the quality of patient treatment. The aim of EBN is to provide high quality and most cost-effective care ever before possible. EBN is an activity predicated on the collection, interpretation and integration of important research results. Some experts identify the EBN narrowly, considering only the use of randomized scientific trials, while some also include the use of case records and expert opinions. To be able to apply the practice in the right way, a nurse must understand the idea of research and know how to properly measure the study. These skills are educated in modern organizations of nursing education, as well as at training.

Nurses provide instrumental roles in guaranteeing and providing evidence-based practice. They must continually ask the questions, "What is the evidence for this intervention?" Or "How do we offer best practice?" And "Are these the highest achievable outcomes for the patient, family, and nurse?" Nurses are also well situated to utilize other associates of the professional medical team to recognize medical problems and use existing information to improve practice. Numerous opportunities are present for nurses to question current medical practices and use evidence to make care and attention far better.

For example, a just lately published evidence-based task describes the potential advantages of discontinuing the tedious practice of hearing the bowel may seem of patients who have undergone elective belly surgery. The creators reviewed the literature and conducted an diagnosis of current practice, and they consequently developed and assessed a fresh practice guideline. These authors reported that specialized medical parameters such as the go back of flatus and first postoperative bowel movement were more helpful than bowel sounds in determining the return of gastrointestinal range of motion after stomach surgery. The writers found that this evidence-based job resulted in saving nursing time without having negative patient outcomes (Madsen et al. , 2005).

To know very well what Evidence-based practice in nursing is way better while defining the procedure it describes. In every day activity of medical nursing, EBP provides nurses with an instrument with the aid of which they provides the best and safest health care ever possible. The new emphasis of the EBP nursing comes from the difficulties that have surfaced lately regarding the protection of the health system.

Formulating Questions

As it is written on the Yale School Nursing Catalogue website and the website of School of Minnesota, the first rung on the ladder in EPP is to formulate right, necessary questions. Such questions contain background questions such as "what causes some particular disease?" Such kind of questions has a request - the necessity to solve an exact scientific problem. The professional medical questions should include foreground questions also. These pertain to the way the disease or condition involved is usually treated.

Finding the Answers

As soon the right questions have been developed, the nurse can then look for possible answers to the problem by causing some necessary research. The aim of the study is to find options that tall about the possible treatments and final results of the disease. Nurses in clinics often use directories such as CINAHL and MEDLINE for executing their queries.


The next thing is to evaluate the evidence as soon as it is available. Not all professional medical treatments will be the same, and not all options that pretend to provide evidence of a possible professional medical treatment are the same. Utilizing the evidence-based practice in nursing process there's a need to understand that there not only various levels of possible treatment, but also various degrees of quality in terms of research sources. The research quality is dependant on the quality of the study design and its own applicability to the precise clinical circumstance.


Having evaluated the data, the nurse can begin its application in her practice. Among the primary questions that show up at this time is how the evidence can be applied in order to meet nurse's specific need or situation. Concerns of nurses are the validity of the diagnosis, how possible therapeutic techniques make a difference the individual, whether there may be any negative risk to the individual and the prognosis of the procedure. As soon as the decision is made about the provision of a certain treatment, program of the treatment is usually made.

Re-evaluation of the result

As soon as the treatment has been made, the clinical nurse should reevaluate if the applied evidence was enough and useful for the particular patient and situation. Clinical nurse should determine whether or not the intervention was successful. Nurses ought to know whether their findings might contribute new knowledge to the nursing field. In addition they ought to know how they will apply these studies throughout their future nursing practice. (Http://www. ehow. com/about_6728914_define-evidence_based-practice-nursing. html)


"Evidence based scientific practice is an method of decision making where the clinician uses the best available proof, in assessment with the individual, to decide after the choice which suits that patient best". (Muir Grey JA. (1997) Evidence-based health care: steps to make health insurance policy and management decisions. London: Churchill Livingstone).

So evidence-based practice helps nurses to provide high-quality patient health care based on research and knowledge rather than because "this is the way we have always done it, " or predicated on traditions, misconceptions, hunches, advice of fellow workers, or outdated textbooks.

For example, when scientific questions arise, should one look to a nursing textbook for the answers? Understand that books are not published every year, and new information might not exactly be contained in the model you have. Also, when using books, consider whether you contain the most current edition.

There are also issues to consider when asking acquaintances for advice-specifically, be mindful that their responses may be predicated on their personal experiences, their observations, what they discovered in school, what was reviewed during nursing orientation, or misconceptions and traditions discovered in specialized medical practice.

A recent study provided evidence that a lot of nurses provide health care in accordance with what they discovered in nursing school and hardly ever used journal articles, research information, and medical center libraries for reference point (Pravikoff, Tanner, & Pierce, 2005). That finding, combined with fact that the common nurse is more than 40 years, makes it visible that lots of nurses' knowledge is most likely outdated. Practice based on such knowledge will not result in quality patient good care or health effects. Evidence-based practice offers a critical strategy to ensure that care is current and this it displays the latest research proof.

So, EBP important to nursing practice since it leads to better patient outcomes; it plays a part in the technology of medical; it retains practice current and relevant; it increases self-assurance in decision-making; policies and types of procedures are current and include the latest research; integration of EBP into nursing practice is vital for high-quality patient health care. Thus, evidence-based practice is vital for modern professional nursing practice.

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