The Importance of Evidence-Based Practice in Nursing

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Empirically validated treatments are biomedical measures and/or medications that have favored biological treatment of a specific illness. This involves the precise handling of a medical case using treatments that have been discovered to work in the past. Such an approach does not necessarily mean that this specific treatment is the best solution for that particular medical illness. Several criteria have been identified to facilitate confirmation of an empirically validated treatment. One criterion describes that an empirically validated treatment has been proven by at least two superior experiments that show that the treatment is effective. A treatment is deemed to be effective when the results generated by the administration of such procedure are superior over the other treatment or the placebo control.

This may be determined through robust statistical analyses. This may be proven by employing a placebo in the experiment or by observing effective treatments in a conventional experiment consisting of amply sample sizes.

An empirically validated treatment may also be confirmed through the use of a vast amount of defined studies that show the efficiency of that particular treatment.

It is understood that these defined studies followed a competent experimental design and that the particular treatment being tested has been compared to another treatment, just like the placebo controls. Empirically validated treatments are also generally conducted based on a treatment manual.

This piece of documentation serves as the guideline for the investigator so that any modifications will be avoided, because any minor or major changes to a certain treatment may cause a different output or experimental result. In addition, this type of treatment provides precise descriptions of the samples that are included in the trial experiment. It is also important that empirically validated treatments are verified by at least two independent research groups that did not conspire to generate similar or exact observational results.

The healthcare profession involves the augmentation of a patient’s condition through therapeutic intervention. The shared moment between a healthcare worker and a patient who is unbearably suffering by himself provides guidance for the proper course of action, often resulting in greater patient satisfaction and healing potentialities (Gooden et al., 2001).

During this interaction, the healthcare professional establishes his presence by using a human care transaction mind-body-soul with another’s mind-body-soul in a lived moment.

Presence has been defined as a relational style within healthcare professional interactions that involves being with, as well as doing with. The core of this interaction is to learn and understand the circumstances of the situation and to direct the course of action to achieve the desired outcome of healing and recuperation on the part of the patient (Rachagan and Sharon, 2003; Hagihara A and Tarumi K, 2006). In addition, the focused shared moments with the patient and his family teach the healthcare professional to identify the key turning point necessary for the patient’s healing process (Gore and Ogden, 1998; Street et al., 2003). The professional learns the needs of his patient by being fully present and consciously relating to his whole being, enabling the professional to use aesthetic ways of discovering the obstructions in the hidden pathways preventing the healing process (Murphy DD and Lam CL, 2002). The healthcare professional plays a major role as a therapeutic agent by getting deeply involved with the situation using his inner energy of caring, being open and listening with solid awareness, and developing and sustaining a helping-trusting, authentic caring relationship (Ornstein, 1977; Heszen-Klemens and Lapinska E, 1984; Berry, 2007). Healthcare guidelines highlight that every healthcare professional is accountable for his decision and action and for maintaining competencies in every day of practice. This strong foundation requires that all nurses provide a therapeutic professional-patient relationship and provide care to patients under the scope of practice according to their needs, which will, in turn, lead to significant outcomes (Clark, 2002).

Healthcare workers use different types of presence in order to learn from their patients, in order a therapeutic relationship and mutual understanding under any circumstance.

The evidence-based practice focuses on observational studies to improve the methodological quality and effectiveness of the intervention. There is currently a vast amount of information regarding the incidence and prevalence of healthcare-related infections, as well as mortality data. Unfortunately, these significant figures are not efficiently disseminated and more importantly, not integrated into the general protocol of healthcare, because they have not been discovered by healthcare personnel for their own perusal and for integration into their routine services. Health care informatics is a recent area that involves the integration of health science, computer science, information science, and cognitive science to assist in the management of healthcare information (Saba and McCormick, 2001). By using the statistical information offered by these different fields of science, healthcare informatics may be divided into the areas of medical informatics, health informatics, dental informatics, and nursing informatics. The areas of medical, dental, and nursing informatics overlap in several areas such as information retrieval, clinical care, ethics, imaging, computer security, electronic medical records, and computer-assisted instruction.

The use of statistical information via informatics has been used in the field of medicine for more than two decades and has resulted in the establishment of the specialty field of medical informatics. Such area uses information technologies in relation to functions carried out when performing their duties (Hannah, 1985). It covers the entire range of information technology that is useful to nursing, especially for patient care, nursing practice, and healthcare management. It essentially helps in the processing of medical data, knowledge, and information to aid in medical practice and delivery of health care.

A parallel global scheme has existed for clinical trials, namely the Cochrane Collaboration, as well as the World Health Organization (WHO) Department of Reproductive Health and Research, aim to provide a comprehensive tabulation of available data on their specific fields of investigation. Such reviews also aim to calculate case-fatality rates and the proportion of preventable deaths by specific interventions. The development of search and retrieval strategies using statistical information should be sensitive and specific enough because there is so much information available in the databases and internet sources that it would seem very difficult for healthcare personnel to sieve through all the unnecessary and irrelevant entries. Databases are technically pools of information that may be useful should the right search results be presented to the investigator, or these may be useless if the investigator ends up with more confusion than when he just started using the database.

Statistical information that has been pooled into a central registry may serve as a convenient and systematic resource for the retrieval of medical information that is very useful for critical care management in the healthcare setting.

Two of the most recognized and employed databases in the medical field are MEDLINE and EMBASE. Both are universal bibliographical records of primary literature, with MEDLINE covering mostly North American publications, while EMBASE covers more European reports. Unfortunately, these two databases only have 30 to 50% overlap in their entries (Topfer, 1999). Unfortunately, databases employing evidence-based practice do not include unpublished reports, either because the investigators assumed that nobody else would be interested in looking at their data or because the investigators thought that a report that shows no significant differences is not worth publishing. In addition, non-English reports are not included in most of the databases due to language restrictions, yet these types of reports usually show statistically significant results as well as larger treatment effects. CINAHL is another database that healthcare practitioners, especially nurses, utilize for information on patient care and delivery.

It has been very useful in medical specialties including descriptive and explanatory information on nursing topics.

The employment of statistical information as applied to nursing care is highly interdisciplinary, with certain areas overlapping with computer science and education.

Nursing informatics provides a direct route to information connecting nursing informatics to research, especially evidence-based practice, and this provides a quicker mode for nursing to gather information on specific patient cases. In the earlier days, a healthcare practitioner needs to read a lot of research reports, journals, and books in order to be up-to-date with the latest trends in health care diagnosis, treatment, and delivery. The use of statistical knowledge and information as directly applied to evidence-based nursing provides a quicker way to access so much information that is available around the globe. It also saves time for the healthcare practitioner in researching for answers to their healthcare questions, leaving them more time to provide quality health care to their patients. In addition, the networking and establishment of databases serves as an essential tool to the construction of virtual global hospitals, wherein doors do not exist, but actually, bridges are erected.

References

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Hagihara A and Tarumi K (2006): Doctor and patient perceptions of the level of doctor explanation and quality of patient-doctor communication. Scand. J. Caring Sci. 20(2):143-50.
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Street RL Jr, Krupat E, Bell RA, Kravitz RL and Haidet P (2003): Beliefs about control in the physician-patient relationship: effect on communication in medical encounters. J. Gen. Intern. Med. 18(8):609-16.
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The Importance of Evidence-Based Practice in Nursing

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