Evidence-Based Practice in Nursing

Clinical Question

The clinical questions which guided this paper were related to the problem of utilization of traditional practices by nurses instead of using practices that are established to be best by evidence. The clinical question guiding a search for a qualitative article was: What are some of the traditional practices that are inconsistent with the evidence, but are often utilized by nurses in clinics? The clinical question guiding a search for a quantitative article was: Do nurses often employ traditional practices which are inconsistent with evidence? The asked questions, therefore, are mainly Therapy questions.

The search was conducted over a number of databases, such as Ovid, PubMed, Sage Publications, and EBSCOhost. The key words utilized in the search were “evidence,” “practice,” “traditional practice,” and “nursing” in different combinations.

Description of the Problem

The problem that this paper is concerned with is the opposition between the evidence-based nursing practice and the nursing practices that are carried out traditionally, regardless of what research and evidence show to be the best approach. The traditional practices usually take place due to the fact that nurses have always acted in these or similar ways, and thus act in accordance with the habits or traditions. For instance, a nurse practitioner might prompt their preoperative adult patients to be nil per oral after midnight because it is traditionally believed that this reduces the likelihood of aspiration, whereas evidence shows that other, less strict fasting measures should be enough in order to reduce the aspiration risk (Miller, Hayes, & Carey, 2015, p. 52).

Significance of the Problem

The status-quo practices, which are in some cases dubbed “sacred cows” of nursing (Miller et al., 2015), are caused by a multitude of factors, such as the dearth of evidence-based education and skills among the nursing personnel, the culture in a particular hospital or ward, and so on. The main problem pertaining to these practices is that they may adversely influence patient outcomes; another problem is that traditional but ineffective routines may increase the amount of work a nurse does, thus decreasing their efficiency and, again, negatively influencing patient outcomes. The consequences of status quo practices that are inconsistent with evidence are as follows (Makic, Martin, Burns, Philbrick, & Rauen, 2013):

  1. Inaccurate measurements of vitals and other indicators;
  2. Confused cause-effect connections;
  3. Inadequate interventions which result in complications;
  4. The jeopardized safety of both patients and nurses.

For instance, it is generally accepted safe to use a large catheter (gauge 18-20) for PRBC infusions to avoid cells hemolysis. Research has established that there is no positive association between smaller catheters and hemolysis, while the insertion of large catheters into narrower veins (e.g., in pre-adolescent or elderly clients) can cause discomfort (Makic et al., 2013).

Thus, basing the practice on beliefs and tradition is capable of worsening the clients’ medical experiences and endangering their health further, which bespeaks for the significance of the issue.

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