DNP 820 TOPIC 3 DQ 2 Compare practice-based evidence, research, and evidence-based practice and discuss how all three complement and support one another. Use examples and relevant literature to support your response.

DNP 820 TOPIC 3 DQ 2 Compare practice-based evidence, research, and evidence-based practice and discuss how all three complement and support one another. Use examples and relevant literature to support your response.

Evidence-based practice (EBP) is defined as a lifelong problem-solving approach used in the delivery of a patient-centered health care preference incorporating the best evidence from well-designed studies and integrating it with the clinician expertise noted as practice-based evidence accumulated over the course of care for patients with similar diagnoses, which includes internal evidence gathered from patient data. EBP uses systematic search and critical appraisal of the most relevant and best research to answer a burning clinical question;  (Melnyk  & Fineout-Overhold, 2020, p. 8).

Practice-based evidence (PBE) is a data-gathering approach for the evaluation of efficacy in a practical situation to determine gaps in performance and guide in solution approach (Fink et al., 2019).

Research is focused on generating new evidence for practice by using a systematic approach to assembling and analyzing information. It often carries risks to patient safety, which is one of the reasons for informed consent ( Melnyk  & Fineout-Overhold, 2020, p. 689).

Practice-based evidence leads to assists in recognizing how asymptomatic bacteriuria is treated which leads to overtreatment and possible antimicrobial resistance. This prompts into researching for the best articles that support the best evidence for antimicrobial stewardship to change treatment approaches and mitigate the adverse effect of unnecessary antibiotic prescriptions.

In an evolving healthcare system and practice, Evidence-based practice, Practice-based evidence, and Research are vital patient care approaches for the best result.

Reference

Fink Chorzempa, B., Smith, M. D., & Sileo, J. M. (2019). Practice-based evidence: A model for helping educators make evidence-based decisions. Teacher Education and Special Education, 42(1), 82-92.

Melnyk, B. M., & Fineout-Overhold, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.

PATIENCE it is true that evidence-based practice (EBP) is a lifelong problem-solving approach. The approach seeks to improve on healthcare services delivery through the incorporation of factual information.  The best evidence may be generated from research and other well-designed studies (Unadkat et al., 2021). EBP utilizes systematic search and critical appraisal of the most relevant and best research to answer a crucial clinical question.  Most healthcare organizations have implemented EBP due to its impact on healthcare services. Factual information from well-designed studies reduces chances of medication errors and inaccurate decision-making (Rutten et al., 2021). Adequate time is allocated in gathering data through different statistical strategies. Practice-based evidence (PBE) is a data-gathering approach that can also be integrated in evidence-based practice. PBE evaluates efficacy in a practical situation to determine gaps in performance.  The data-gathering strategy also guide in solution approach. Evidence-based practice, Practice-based evidence, and Research are essentials to healthcare institutions that are concerned with providing quality healthcare services.

References

Rutten, L. J. F., Zhu, X., Leppin, A. L., Ridgeway, J. L., Swift, M. D., Griffin, J. M., … & Jacobson, R. M. (2021, March). Evidence-based strategies for clinical organizations to address COVID-19 vaccine hesitancy. In Mayo Clinic Proceedings (Vol. 96, No. 3, pp. 699-707). Elsevier. https://doi.org/10.1016/j.mayocp.2020.12.024

Unadkat, M. B., Mbuba, C. K., Ngugi, A. K., & Kamya, D. (2021). Self-reported knowledge, attitudes, practices and barriers in use of evidence-based medicine among resident physicians in Kenya: a mixed methods study. BMC medical education, 21(1), 1-10.

In a national effort toward accountability and effectiveness of health care, evidence-based practices (EBP) are forging to be the standard for clinical care. Health disciplines have various examples of historical treatment approaches and often fall back on the thought process of “this is the way we’ve always done it without objective evidence that it works. The same trend is occurring in prevention as the United States begins shifting from high-cost interventions to preventative care. Unfortunately, the mentality of historical treatment and prevention approaches are not always practical and have sometimes resulted in no improvement in some cases and fatalities at worst. The move toward demonstrating evidence or research based on the effectiveness of prevention, treatment, and intervention approaches was a step toward ensuring the best care for patients and their communities (Jones & Haydon-Laurelut, 2019). However, the pendulum is now swinging toward the sole use of clinical practices with the formalized research base; new challenges and limitations emerge, especially for ethnic minority populations and historically underserved groups.  Evidence refers to scientific controlled trials and research data, expert or user consensus, evaluation, or anecdotal information. The purpose of conducting research is to generate new knowledge or validate existing knowledge based on a theory. Research studies involve systematic, scientific inquiry to answer specific research questions or test hypotheses using disciplined, rigorous methods.

While research is about investigation, exploration, and discovery, it also requires an understanding of the philosophy of science. For research results to be considered reliable and valid, researchers must use the scientific method in orderly, sequential steps. Unlike research, EBP isn’t about developing new knowledge or validating existing knowledge. It’s about translating the evidence and applying it to clinical decision-making. The purpose of EBP is to use the best evidence available to make patient-care decisions. Most of the best proof stems from research. But EBP goes beyond research use and includes clinical expertise, patient preferences, and values. The use of EBP considers that sometimes the best evidence is that of opinion leaders and experts, even though no definitive knowledge from research results exists. Whereas research is about developing new knowledge, EBP involves innovation in finding and translating the best evidence into clinical practice. However, there are overlapping areas between practice-based evidence, research, and evidence-based approach, demonstrating their intertwined support of each other. It is essential to focus on their difference, including when, where, and why either is appropriate.

Jones, V., & Haydon-Laurelut, M. (2019). Evidence-based practice and practice-based evidence. Working with People with Learning Disabilities: Systemic Approaches, Red Globe Press, London, 205–211.

REPLY

ROSELYN I concur with you that evidence-based practices (EBP) are forging to be the standard for clinical care. Therefore, healthcare providers are working towards integrating evidence-based practice in their service delivery. EBP is an approach that focuses on using factual information to handle different healthcare situations. Many healthcare organizations with EBP have reported exceptional performance (Barker et al., 2019). As a result, most stakeholders have advocated for EBP. Health disciplines have various examples of historical treatment approaches. Some of these historical treatment approaches have been deemed less significant and outdated due to their inability to handle emerging health issues. Hence, EBP has received huge traction in the modern healthcare settings (Rosen et al., 2018).  Similarly, the need to improve affordability and the quality of healthcare services have compelled healthcare stakeholders to prioritize the use of evidence-based practice over historical treatment approaches. The move toward demonstrating evidence or research based on the effectiveness of prevention, treatment, and intervention approaches was a step toward ensuring the best care for patients and their communities.

References

Barker, J. H., Kane, R., & Linsley, P. (2019). Evidence-based practice for nurses and healthcare professionals. Evidence-based Practice for Nurses and Healthcare Professionals, 1-264.

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433. https://doi.org/10.1037/amp0000298

 Research is an investigation systematically handle into study of materials and sources to enable establish facts and draw conclusions. They are categorized into levels based on methodology and quality of design (Liao et al 2017).

 Practice-based Evidence (PBE) is performed in laboratory and will help generate and bridge the chasm between recommended care and improved care. It is not controlled; it is real world practice documented and measured as it occurs. For example, giving oxygen to COPD patients. It is the process of the process of measurement and tracking that matters instead of controlling how practice is delivered and they could be synthesized into practice guidelines. It fills in for clinical, health base policy decisions. Practice-based evidence can uncover better practices more quickly than Random Controlled trials or sophisticated methods while achieving same advantages. Evidenced-Based (EVB) are random control trials and meta-analysis help confirm whether a new treatment cause and effect, they  may not discover interventions or practices that are effective and efficient in routine care. It integrates clinical expertise and best research (Castonguay et al 2021)

PPE deals with a rang of treatment approaches and supports that are derived from and supportive of the positive cultural of the traditions. Best practices describe guidelines or practices driven more by clinical wisdom; organizations that does not necessarily occlude systematize research evidence. EBP allows for more accountability for consumers while PBE allows for cultural contexts. These two represent two differing orientations to what is viewed as effective and within specific parameters with same goals of improving lives (Eppley et al 2018)

Castonguay, L. G., Barkham, M., Youn, S. J., & Page, A. C. (2021). Practice-based evidence—Findings from routine clinical settings. In M. Barkham, W. Lutz, & L. G. Castonguay (Eds.), Bergin and Garfield’s handbook of psychotherapy and behavior change: 50th anniversary edition (pp. 191–222). John Wiley & Sons, Inc..

Eppley, K., Azano, A. P., Brenner, D. G., & Shannon, P. (2018). What counts as evidence in rural schools? Evidence-based practice and practice-based evidence for diverse settings. The Rural Educator, 39(2).

Liao, Y., Deschamps, F., Loures, E. D. F. R., & Ramos, L. F. P. (2017). Past, present and future of Industry 4.0-a systematic literature review and research agenda proposal. International journal of production research, 55(12), 3609-3629.

RESPOND HERE

IRENE it is true that research is an investigation systematically handle into study of materials and sources to enable establish facts and draw conclusions. Frequently, research provide accurate information that is resourceful in problem-solving and handling other healthcare concerns.  Most healthcare organizations use nursing research to handle emerging healthcare issues.  Research is categorized into levels based on methodology and quality of design (Wiltsey Stirman et al., 2019).  Therefore, researchers have the liberty to choose the most suitable research approach depending on the nature of their study. Practice-based Evidence (PBE) is performed in laboratory. These activities in the laboratory ensures that researchers obtain accurate and reliable information. The information is important in shaping up healthcare activities and decisions. Therefore, researchers ensure that they generate accurate information (Shelton et al., 2018). Adhering to the scientific procedure of fact-finding in PBE makes the approach more suitable in nursing research. EBP allows for more accountability for consumers while PBE allows for cultural contexts. The integration of both approaches is vital in providing factual information in nursing practice.

References

Shelton, R. C., Cooper, B. R., & Stirman, S. W. (2018). The sustainability of evidence-based interventions and practices in public health and health care. Annual review of public health.  https://doi.org/10.1146/annurev-publhealth-040617-014731

Wiltsey Stirman, S., Baumann, A. A., & Miller, C. J. (2019). The FRAME: an expanded framework for reporting adaptations and modifications to evidence-based interventions. Implementation Science, 14(1), 1-10.