Approach to Nursing care Assignment

Introduction

Evidence-based nursing is acknowledged as an approach to nursing care that guides to enhance patient outcomes. Qouting McEwen (2002) Kelly L. Penz and Sandra L. Bassenski pointed out that in nursing practice, formalities, remote, unsystematic clinical experiences and ungrounded opinions, and traditions as the basis of practice should be de-emphasized by incorporating into clinical practice evidence-based approach to nursing care.

In explaining what evidence-based approach means, Penz and Bassendowski cited Estabrook’s (1998) explanation that evidence-based nursing “is a discipline in which nurses make clinical decisions using current best research evidence, which is then blended with approved policies and clinical guidelines, clinical expertise and judgment, and patient preferences” (Penz & Bassendowski 2006, p 250). In other words, evidence-based nursing practice is more than just a research; it is more than a theory or practice.

Approach to Nursing care Assignment

However, evidence-based practice of nursing is currently subject of debate among nursing scholars and educators. Gail J. Mitchell (1999) contends that the concept of evidence-based practice “is not only a barren possibility but also obstructs nursing process, human care, and professional accountability” (Mitchell 1999, p. 271). Mitchell argued that the usefulness of the evidence has been “wrongfully cast in the context of legitimizing nursing as a profession instead of describing evidence as one possible resource for supporting client’s decision making” (Mitchell, p. 271).

The Relationship between Theory and Evidenced-Based Nursing Practice

In nursing practice, theory is a pattern of knowing, Jacqueline Fawcett noted that theory comes from Greek word theoria, “To see” which means to reveal phenomena that is previously hidden from our awareness and attention. Deborah Upton (1999) pointed out that theory, practice, and research identify the science of nursing. Upton emphasized that theories embrace nursing as a science, which, in the case of evidence- based practice, the basic tenet is on sound information anchored on research findings and scientific development.

Fawcett pointed out that theories constitute much of the knowledge of a discipline and theory and experiences are the lenses through which we conduct inquiry. The outcome of the inquiry comprises the evidence that finds out the adequacy of the theory. In nursing practice, theory guided practice means the traditional scientific approach to clinical care while in evidence-based practice a nurse can decide on the relevance of the evidence for the patient care.

According to Penz and Baseendowski evidence-based practice fills the gap between theory, research, and practice. It means that theory alone or evidence alone is insufficient basis of clinical care, but combining the two make a useful clinical approach that has potential “to improve patient care in all clinical practice setting” (Penz & Bassendowski p. 251). The relationship therefore of theory and evidence-based nursing practice is that evidence-based practice absorbed theories and incorporating it including research, patient’s preferences, and other approved guidelines of the clinical practice.

Penz and Bassendowski noted the study of Alligood and Tomey (2002) suggesting that theoretical knowledge when blended into the practice of nursing, results to enhanced professional autonomy. Alligood and Tomey pointed out that when nursing theory is used to direct clinical opinion and decision making , nurses can comprehend what they do and why, and they are capable to explain this to other health professional.

Further explanation of the relationship between theory and evidence-based practice can be established in the meaning and purpose of theory it self. Lynn Rew pointed out that it is theory that framed or determined what really count as evidence. Based on the premise that “theory is the reason for and the value of the evidence,” Rew provided a framework based on three factors: Components, Purpose, and Outcomes, which depicts ideal relationship between theory and evidence-based nursing practice.

Approach to Nursing care Assignment

Rew pointed out that the components of theory are concepts and statement, while practice, is phenomena of concern and problems to be solved. The Purpose of theory is to organize ideas, while Practice delimits ideas, the Outcomes are theory construction framework for practice, and policies while in practice, evidence-based practice, generalizable programs, and interventions.

She explained that concepts of theory reflect the phenomena of concern in a practice discipline, while the definition and purpose are abstractions of the practical problems to be solved in the practice arena. The outcomes of theory construction guides practice and policy development. Thus theory is highly related to evidence-based practice by virtue of determining the evidence.

Conclusion

Despite of the different emphasis of theory based nursing and evidence-based nursing practice, the aim of both camps is to advance the clinical care of the nursing practice for the benefit of the patient. However, the conflict of emphasis threatened to abolished the long established processes of clinical care in favor of evidence based nursing practice which are not really completely proven very successful in clinical treatment.

Tracing therefore the relationship between theory and evidence-based nursing practice helps not only to understand what the conflict was all about but also it gives proper understanding of the nursing practice particularly the evidence-based nursing. Whether theory guided practice or evidence-based nursing practice, what is important is that the nursing practice should be understandable to nurses and to the patient.

Reference

Fawcett, J.; Watson, J.; Neuman, B.; Walker, P.; & Fitzpatrick, J. (2001) On Nursing

Theories and Evicence. USA: Sigma Theta Tau International.

http://classes.kumc.edu/son/nrsg750/articles/nursing_theories.pdf

Mitchell, G. J. Evidence-Based Practice: Critique and Alternative View.

Penz, K. L. & Bassendowski, S. L. ( 2006)Evidence-Based Nursing in Clinical

Practice: Implications for Nurse Educators. Canada. The Journal of Continuing Education in Nursing. Vol.37, No. 6 (November/December) http://www.orthonurse.org/portals/0/EBP%20Clinical%20Practice.pdf

Rew, L (2005) Adolescent Health: A Multidisciplinary Approach to Theory, Research.

United States of America: SAGE Publication

Upton, D. J., (1999) How Can We Achieved Evidence-based Practice if we a Theory-

Practice Gap in Nursing Today? Journal of Advanced Nursing Vol. 29 (3) England: Blackwell Science Ltd.

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