Evidence-Based Practice Is A Result Of Asking Questions

Evidence Based Practice Is A Result Of Asking Questions As A Nurse

Evidence-based practice (EBP) is fundamentally rooted in the process of asking pertinent clinical questions to inform decision-making and improve patient outcomes. As a nurse, engaging in EBP involves continuously questioning the rationale behind current practices, exploring alternative approaches, and evaluating evidence to determine the most effective interventions for patient care. The development of a well-formulated clinical question is critical for guiding research and clinical decision-making. Davies (2011) offers a mnemonic framework—PICO(T)—which facilitates constructing focused questions that can be systematically searched within scientific literature.

The PICO(T) model breaks down a clinical inquiry into five essential components: Patient/Problem, Intervention, Comparison, Outcome, and sometimes Time. This structured approach ensures clarity and relevance in formulating questions. For example, in addressing pressure ulcers among hospice patients, a nurse might consider "bedbound patients" as the population (P), "preventative dressings" as the intervention (I), "leaving areas open to air" as the comparison (C), and "prevention of pressure ulcer progression or promotion of healing" as the outcome (O).

Using this framework, a specific research question could be: "In bedbound patients, what is the effect of preventative/prophylactic dressings on the prevention of pressure ulcers compared to leaving areas open to air?" This targeted question guides the search for relevant evidence and informs clinical practices aimed at preventing pressure ulcers. The nurse’s review of literature often begins with broad searches—such as "pressure ulcers"—and utilizes filtering techniques like date ranges and peer-reviewed filters to refine results. Initially, broad searches yield thousands of results, but more specific questions using Boolean operators (AND, OR, NOT) help narrow findings to those most pertinent.

For instance, combining search terms with AND (e.g., "pressure ulcers" AND "prophylactic dressings") reduces the volume of studies to manageable numbers. Adding additional parameters such as patient population ("bedbound") further refines the search but risks eliminating relevant articles if over-specific. As such, familiarity with database functionalities and iterative searching are crucial skills. Employing multiple databases, such as CINAHL, Medline, and PubMed, enhances comprehensiveness and ensures diverse evidence sources are considered.

The process of formulating clinical questions and searching for evidence underscores the importance of critical appraisal skills among nurses. It allows clinicians to base interventions on current, high-quality evidence rather than tradition or anecdote alone. This systematic approach supports continuous improvement in patient care by aligning practice with the best available research findings.

Paper For Above instruction

Evidence-based practice (EBP) is a cornerstone of modern nursing, emphasizing the importance of asking well-structured questions to guide clinical decisions and improve patient outcomes. The foundation of EBP lies in a systematic inquiry into the clinical issues nurses encounter, ensuring that patient care strategies are grounded in the most current and rigorous scientific evidence. A critical step in this process involves formulating precise questions, often facilitated by frameworks such as the PICO(T) model, which helps extract meaningful data during literature searches (Davies, 2011).

The PICO(T) framework guides clinicians in developing questions that are specific and answerable. It divides the inquiry into five components: Patient or problem (P), Intervention (I), Comparison (C), Outcome (O), and sometimes Time. This structure enables nurses to clarify what they are investigating—such as whether prophylactic dressings prevent pressure ulcers among bedbound patients—by explicitly defining each element of the question. For example, a nurse concerned about pressure ulcer prevention may ask: "In bedbound patients, what is the effect of prophylactic dressings on preventing pressure ulcers compared to leaving the area open to air?" This question directs the subsequent literature search and critical appraisal process.

Effective literature searching requires understanding how to use medical databases such as CINAHL, Medline, and PubMed. Initial broad searches—like "pressure ulcers"—often generate thousands of results, many of which may not be directly relevant. To refine these results, filters such as publication date, peer-review status, and specific keywords are employed. Utilizing Boolean operators like AND, OR, and NOT improves search precision by combining or excluding terms. For example, adding "AND prophylactic dressings" reduces the volume of results targeted toward the specific intervention under consideration.

However, over-specificity can also lead to very narrow results, possibly missing relevant studies. It is important for nurses to calibrate the level of specificity carefully—sometimes broad searches are necessary to ensure comprehensive evidence gathering. Conducting searches across multiple databases broadens the evidence base, compensating for variations in indexing and coverage. This systematic search process is vital for locating high-quality evidence to support clinical decisions.

Critical appraisal of evidence is the next step, where the relevance, validity, and applicability of studies are examined. High-quality, peer-reviewed research provides reliable answers that can influence practice changes effectively. Evidence from recent studies might show that prophylactic dressings are more effective than leaving pressure areas open, leading to updated protocols aimed at pressure ulcer prevention. Continual questioning, searching, and appraising evidence form the backbone of EBP, enabling nurses to provide care that is not only current but also rooted in empirical science.

Ultimately, embracing an inquiry-based approach transforms nursing practice into a dynamic, evidence-informed process capable of advancing patient care quality, safety, and outcomes. This systematic approach supports a professional culture of lifelong learning and adaptability in ever-evolving healthcare environments, where evidence shapes every decision made at the bedside.

References

• Davies, K. S. (2011). Formulating the Evidence-Based Practice Question: A Review of the Frameworks. Evidence Based Library and Information Practice, 6(2), 75-80.
• Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. Lippincott Williams & Wilkins.
• Hoffmann, T. C., Glasziou, P. P., Boutron, I., et al. (2014). Better reporting of interventions: Template for Intervention Description and Replication (TIDieR) checklist and guide. BMJ, 348, g1687.
• Grove, S. K., Gray, J. R., & Burns, N. (2015). Understanding nursing research: building an evidence-based practice. Elsevier Health Sciences.
• Polit, D. F., & Beck, C. T. (2017). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Wolters Kluwer.
• Shaw, R. J., & Wills, J. (2015). Critical appraisal of research for healthcare professionals. Elsevier Health Sciences.
• LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier.
• LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier.
• JBI Manual of Evidence Synthesis (2017). Joanne Briggs Institute. Canberra, Australia.
• Reeves, S., Pelone, F., Harrison, R., et al. (2017). Collaboration and team planning in health care: a systematic review of the literature. Journal of Nursing Leadership, 2(4), 251-267.