Nursing Research and EBN Practice



Nursing Research and EBN Practice

Terri L. Sand

Ferris State University

Abstract

This paper is an introduction of the author including a brief background of the authors work history and professional experience. The author’s experience with the use of Evidence-Based Nursing Practice (EBNP) is evaluated along with their nursing research history. Concepts related to EBNP are discussed including the relationship between nursing research, nursing theory, and professional nursing practice.

Nursing Research and EBN Practice

The purpose of this paper is to present an overview of my personal professional experience during my career as a nurse. Along with an introduction, a background analysis of my professional experiences, specifically the use of Evidence-Based Nursing Practice (EBNP) within my nursing practice will be presented. Providing a summary of my nursing experiences, and identifying my professional development throughout my nursing career will assist me in evaluating my nursing career professionalism in terms of the past, present, and future. Identifying my past accomplishments and comparing these to my current practice will assist me in making career advancements by setting goals for personal and professional growth as a baccalaureate prepared nurse. Evaluating my nursing practice experiences and identifying the use of EBNP throughout my established career will provide a foundation for me to advance my practice guided by research based evidence and the ANA (American Nurses Association) standards of care.

Generalist Nursing Practice

My nursing career began in 1986. I graduated from Oakland Community College with an Associate Degree in Nursing (ADN). I started my career as a Registered Nurse (RN) in Rehabilitation on a 25 bed hospital based unit. After 2 years of nursing experience, and getting married, I moved to Florida and began nursing in the Newborn Nursery. This was a level 2 Nursery. We were prepared for well-baby care, and stabilizing infants who required transporting to a level 1 facility. After 4 years in the Nursery, I transferred to Labor/Delivery. I worked full-time in Labor/Delivery as a staff nurse. I was offered a position in a busy private practice office working for an Obstetrician/Gynecologist. I worked there for a short while, and then moved back to Michigan after the birth of my first child. In Michigan, I returned to Labor/Delivery nursing in a 400-bed hospital. I continued to work in the same area for a number of years. With the restructuring of the hospital, the traditional Labor/Delivery title had changed to the Family Birthing Center. Upon expecting my second child, I transferred to Pediatric Home Health Nursing. I needed a shift change and Home Health offered a first-shift position. I worked for a Home Health Agency which was affiliated with the hospital where I had originally worked. I stayed in Home Health care working Pediatrics and a federally funded infant support program (ISSP) for 2 years. Over that period of time, I found that I missed the hospital setting and returned to the Family Birthing Center. There I worked full-time until my son started first grade. In order to meet the needs of my family, I took a position working full-time 12 hour shifts in a weekend position in the Operating Room. After an extensive orientation, I continued to work in this position for seven years. I am currently working on the same unit but recently transferred to a Monday through Friday position. I am working 8 hour shifts with weekends off, except for a weekend rotational on-call commitment in which I cover a Neuro-Surgery specialty service.

My experience as a Registered Nurse has involved primarily staff nursing. I have not worked in a management position, although I have worked as a clinical facilitator on a shift to shift basis. Clinical facilitators are similar to the traditional nursing role of a Charge Nurse. Each shift has a designated Clinical Facilitator who is responsible for coordinating the staff assignments, room placement for patients, and keeping nurse managers for the hospital updated with the activities of the unit. The experience that I have gained practicing as a Clinical Facilitator has given me exposure to some of the responsibilities required of a clinical manager. Management has never been one of my nursing career goals. Staff nursing and direct patient care has always provided me with the satisfaction I needed to feel accomplished within my nursing career. I am undecided regarding what my career changes will include once I obtain my baccalaureate degree in Nursing.

Health Care Environment

Upon evaluating my nursing career, I believe it is difficult to determine whether my nursing practice is based on researched evidence or acquired by an eclectic traditional method. According to Burns and Grove (2011), “Nursing has historically acquired knowledge through traditions, authority, borrowing, trial and error, personal experience, role modeling, intuition, and reasoning” (p. 16). Considering this, I would have to agree that most of my learning experiences were through traditional methods. Orienting to different facilities or units requires learning new procedures, and most of the time these orientations are taught by nursing mentors or preceptors. Many times procedures explained by one nurse may be slightly different compared to another nurse’s explanation. This is where I think nursing research and evidenced based protocols prove their importance within the professionalism of nursing. “Evidence for practice, obtained through research is synthesized to develop guidelines, standards, protocols, or policies to direct the implementation of a variety of nursing interventions” (Burns and Grove, 2011, p. 5). Using nursing practice protocols provides set guidelines for procedures within the clinical setting. This reduces the amount of variations in interventions that are produced when following the traditional methods of practice orientation. My personal experience with research and evidence based practice is through the use of practice protocols developed specifically for the procedures which are performed on my unit.

At one time, nurses were encouraged to be active in the researching of evidence required to write procedure protocols and policies within their practice. There were pay incentives, clinical advancement potentials, and education funds available for nurses to expand their knowledge related to clinical interests. With a reduction in these incentives, through budget cuts and staffing reductions, it has made a big impact on the influence for nurses to participate in these committees. Currently, the hospital where I work does not have an active nursing committee responsible for protocol research and we are not required to read any research articles related to our clinical setting. Unit policies are updated every 2 years; policies are updated by the clinical managers. Although I have not been one to be devoted to reading nursing research journals, most of the care that I provide to my patients is based on evidence from the existing protocols and policies on the unit. These policies are designed to provide effective practices which promote patient outcomes. Based on the American Nurses Association (ANA) standards of practice, “research promotes quality health outcomes for individuals, families, communities and health care system through evidence-based policy’s developed through evidence-based policies” (Nursing World, 2012). The ANA recognizes that research within the nursing profession is part of the standards of practice (ANA, 2004).

Professionalism

Advancing my practice and level of professionalism within my nursing career is the goal that I have set for myself when I decided to return to school. Attaining my baccalaureate degree is the first step toward reaching these goals. My clinical expertise is based on my knowledge and skills clinically, but also relies on my “advancement through the use of research and clinical literature” (Burns and Grove, 2011, p. 5). “It is through the use of nursing research that empirical knowledge can be developed to improve nursing care, patient outcomes, and the healthcare delivery system” (Burns and Grove, 2011, p. 6). Learning the importance of research and evidence-based practice, and the impact that these concepts have made through nursing history have made an impression on my own nursing practice. In nursing, research commitments change “as the educational expertise of nurse’s advance; the research role that they assume also expands” (Burns and Grove, 2011, p.27). Understanding the importance of nursing research and how research affects nursing practice and patient outcomes is an important concept that I plan to incorporate into my personal practice. “As active participants in the field of nursing, we can be developers of research or we can be consumers of research” (Burns and Grove, 2011, p. 27). Actively participating in nursing research is a responsibility that nurses as a group must incorporate into their practice. According to Burns and Grove (2011), “generating a scientifically knowledge based practice and using research evidence in practice requires the participation of all nurses in order to improve their nursing practice” (Burns and Grove, 2011, p. 26). I think that the future of nursing depends on the commitment of every nurse to support a practice which is evidence based. Overall, I think the use of nursing research and following an EBNP will prove to be an asset to the professional transformation of nursing in the future.

Theoretical Base for Practice

The relationship of research and theory are truly a symbiotic relationship. The two go hand-in-hand when we look back at the initial stages of their formation. Through the history of nursing, some of the first nursing curriculums recognized the importance of research and nursing theory. “The research era came about when nurses embraced in seeking higher education and began to participate in research” (Tomey and Alligood, 2006, p. 4). “With the emphasis of research, and nurses realizing its importance within the practice, many nursing educational programs included nursing research courses in their nursing curriculums” (Tomey and Alligood, 2006, p. 4). During this time, “it was also recognized that master’s nursing programs include the concept development of the early nursing theorists and knowledge development process” (Tomey and Alligood, 2006, p. 4). The relationship between these two areas of nursing truly support the impact that both have made in the professional development of nursing.

When we look at the overall picture of nursing and its growth over the years, it is exciting to see how much the profession has managed to accomplish in such a short period of time. Nursing truly is a profession. Integrating nursing research and adhering to the theory of evidenced-based practice will reinforce nursing’s potential for the future. Adopting the inclusion of nursing research within our own individual practice will contribute to our personal professionalism as nurses.

References

American Nurses Association, (2004). Standards of Professional Nursing Practice. In ANA standards of Professional Performance: American Nurses Association (ANA) Scope and Standards of Nursing Practice, 2004). doi: Nursing-Practice.htm

Burns, N., & Grove, S. K. (2011). Introduction to Nursing Research and Evidence-Based Practice. M. Iannuzzi (Ed.), Understanding Nursing Research (5th edition). Maryland Heights, MO: Elsevier.

Nursing World (2012, January). American Nurses Association, Inc. Retrieved from

Tomey, A., & Alligood, M., (2006). Evolution of Nursing Theories. Y.Alexopoulos (Ed.), Nursing Theorists and Their Work (6th edition). St. Louis, MO: Elsevier.

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