There is a need to offer quality health care that is safe and effective. This can be done through implementation of evidence based care under which all nursing interventions and decisions regarding patient care are based on evidence drawn from credible research and not only on hospital culture. A recent case in my hospital that demonstrates the need for evidence based care is that of Mark, a 9 year old boy who presented in the ER with pain in the right ear and was diagnosed to suffer from recurrent otitis media. Otitis media is the inflammation of the middle ear that is common in children. Being an inflammation, the hospital guidelines recommend use of decongestants and antihistamines. Mark’s mother reckoned that antihistamines have not worked in the past. In addition, the reviewed evidence did not support use of decongestants and antihistamines in the management of otitis media due to low efficacy and significantly larger risk (Coleman & Moore, 2008). Therefore we opted to offer analgesics such as ibuprofen which have proven efficacy, safety and tolerability in the management of otitis media in children (Sattout & Jenner, 2008).
Implementing EBP is challenging due to barriers such as resistant to change, time constraints in generating evidence, limited knowledge in research among nurses, and limited capacity for nurses to influence hospital guidelines (Shaheen et al., 2011). The challenge of having limited time on the job to implement new EBP ideas can be addressed in various ways. First, the government should employ more nurses to reduce workload on individual nurses. The second solution is on training nurses on IT skills to enhance collection and evaluation of evidence through use of medical databases such as Cochrane which evaluates medical evidence.
References
Sattout, A.; Jenner, R. (February 2008). "Best evidence topic reports. Bet 1. The role of topical
analgesia in acute otitis media". Emerg Med J 25 (2): 103–4.
Coleman C, Moore M (2008). "Decongestants and antihistamines for acute otitis media in
children". In Coleman, Cassie. Cochrane Database Syst Rev (3): CD001727.
Shaheen, M., Foo, S., Luyt, B., Zhang, X., Theng, Y-L., Chang, Y-K., & Mokhtar, I. A. (2011).
Adopting evidence-based practice in clinical decision making: Nurses' perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229-236.
