Evidence Based Practice in Nursing Care

Question: Discuss about the Evidence Based Practice in Nursing Care. Answer: Introduction: Nursing care is concerned with investigation of the patients needs and then administration of interventions for addressing those needs. Evidence based practice is a scientific and realistic searching technique that yields optimal and high quality care results (DiCenso, Guyatt Ciliska, 2014). It is more of a problem solving approach that on one hand is highly cost effective and in other hand provides far more satisfactory results than the traditional approaches. This technique has seven steps starting with creating a valid enquiry, asking reasonable clinical PICO questions, searching nursing databases with the questions, critically evaluating the evidence and ending in the selection of the best intervention applicable for the respective patient (Hastings Fisher, 2014). This report will attempt to apply the first two steps of the evidence based practice in the case of a patient suffering from knee pain. Case scenario: In this case scenario a middle aged AFL player, Kasim, is suffering from knee pan and has been prescribed to use celecoxib 200 mg/day, an NSAID drug or glucosamine 1500 mg/day. Out of the two treatment options the patient has to choose one as per his convenience, and prior o that the patient is eager to discover knowledge about both the medications, the pro and cons of each in detail. Application of evidence based practice can help the nurse educate the patient about his treatment options in the most scientific and reasonable manner in just two simple steps: Clinical Questions: In men with knee pain which treatment option is more effective between celecoxib and glucosamine: Key words /search items/phrase Alternative words P In knee pain In a patient suffering from joint pain I Is celecoxib non steroidal medication C Compared to Glucosamine Steroidal pain medication O Best option for relieving pain without any side effects? Is the better alternative? Database search: The next step in the evidence based practice is selecting a nursing database for conducting key word search based on the PICO questions. There are a number of nursing databases that can be used for the purpose like MEDLINE or CINAHL. The purpose behind choosing theses two websites are their excellence in the field of nursing. Both of them are easily the largest databases existing that serve us with countless valuable journals and CINAHL with much more. This is the reason these two databases are abundantly used for the evidence based practice in nursing using PICO questioning, and among both of them the database chosen for the assignment is CINAHL or Cumulative Index to Nursing and Allied Health Literature as it covers more diversity within the field of nursing and health care and also for the fact that it includes books, dissertations, audio visual resources and conference papers as well. Actions Search mode Results Limiters (or expanders) Glucosamine or celecoxib in knee pain management Find all my search item 2010 Full Text; Published Date: 20100101-20171231; Abstract Available; English Language How are NSAID drugs more useful? Find all my search items 6 Full Text; Published Date: 20100101-20171231; Abstract Available; English Language Consequences of steroidal drugs and non-steroidal drugs Find all my search items 5231 Full Text; Published Date: 20100101-20171231; Abstract Available; English Language What are the benefits of using NSAID medication in joint pain? SmartText searching 2 Full Text; Published Date: 20100101-20171231; Abstract Available; English Language Patient recovery using steroidal drugs in pain management. Find all my search items 16 Full Text; Published Date: 20100101-20171231; Abstract Available; English Language Recovery rate of using non-steroidal drugs in pain management SmartText searching 1116 Full Text; Published Date: 20100101-20171231; Abstract Available; English Language (Table format used from Richardson-Tench et al., 2016) Accuracy: One of the major reasons where students and scholars of health care and biomedical sciences take the assistance of CINAHL is the accuracy and relevance of the search that it provides. The search result generated for the assignment provided the opportunity to address each and every aspect of the steroidal and non-steroidal medication in detail. Furthermore the database also provides various tools for us to use that helps in using PICO questions in the database like Boolean operators, truncation, wildcard and a customizable limiter edit section that contributes in tailoring the search according to convenience and reason. Relevance: According to the article on nonsteroidal drugs by Hakkarainen, the nonsteroidal drugs inhibit prostaglandin release by inhibiting cox2, and is highly functional in decreasing inflammation and pain sensation (Hakkarainen et al., 2015). The steroidal medication like glucasamine however, are similar in therapeutic activity but are narcotics hence can be dangerous in case overdosage of prolonged use. Nonsteroidal medication are definitely the safer option especially with celecoxi which is very effective in joint pain but nonsteroidal medication have a number of side effects as well like vomiting and nausea hence dosage should be carefully calculated according to the article by Wei at al. 2013 (Wei at al., 2013). Conclusion: Nursing is the noble profession of care, an occupation that is people focused, on their needs and grievances. The responsibility of a nurse is multidimensional, with interconnected spectrums coming together in a single outcome, optimal care delivery to each and every patient. Along the years the health care has advanced considerably and with it the operational strategies and techniques have advanced as well. Evidence based practice is another advanced trick that has emerged in the last decade that has changed the health care standards and with the new advancements like this coming everyday it will continue to do so. References: Ellis, P. (2016). Evidence-based practice in nursing. Learning Matters. DiCenso, A., Guyatt, G., Ciliska, D. (2014). Evidence-based nursing: A guide to clinical practice. Elsevier Health Sciences. Hastings, C., Fisher, C. A. (2014). Searching for proof: Creating and using an actionable PICO question. Nursing management, 45(8), 9-12. Hamlin, L., Davies, M., Richardson-Tench, M., Sutherland-Fraser, S. (2016). Perioperative Nursing-EBook-epub: An Introduction. Elsevier Health Sciences. Hakkarainen, T. W., Steele, S. R., Bastaworous, A., Dellinger, E. P., Farrokhi, E., Farjah, F., ... Flum, D. R. (2015). Nonsteroidal anti-inflammatory drugs and the risk for anastomotic failure: a report from Washington State's Surgical Care and Outcomes Assessment Program (SCOAP).JAMA Surgery,150(3), 223-228. doi:10.1001/jamasurg.2014.2239 Wei, L., Macdonald, T. M., Jennings, C., Sheng, X., Flynn, R. W., Murphy, M. J. (2013). Estimated GFR reporting is associated with decreased nonsteroidal anti-inflammatory drug prescribing and increased renal function.Kidney International,84(1), 174-178. doi:10.1038/ki.2013.76