Evidence-based practice is a systematic process that involves sufficient clinical innovation that is guided by the application of evidence as well as experiential learning. This implies that there should be systematic inquiry within the clinical setting to help identify the knowledge gaps that have otherwise diminished the expected outcomes (Melnyk & Fineout-Overholt, 2011). This activity helps the practitioners to move away from the ritualistic practice and towards a desired change and an ongoing evaluation. A majority of EBP processes seek to improve quality within a particular setting or at other times improve outcomes. All these are enabled by two major inquiries into literature and evidence (Melnyk, Gallagher‐Ford, Long & Fineout‐Overholt, 2014).
On one hand, the internal evidence which is described as the evidence that is gathered from within a healthcare institution. Such evidence can be acquired from the review of the existing quality improvement initiatives within the institution, outcome management programs as well as clinical expertise data (Fowler & Forshner, 2010). On the other hand, external evidence describes all the evidence that can be acquired from randomized controlled trials, systematic reviews, clinical practice standards and guidelines as well as best practice that seek to accomplish a change within clinical practice (Fowler & Forshner, 2010).
In respect to the PICOT question “Are adult African American patients (P), who are monitored remotely (I) compared with those that are not monitored (C) at a decreased risk of hypertensive complications and noncompliance (O) over a six-month period after initiation of antihypertensive medications (T)?” external evidence will be acquired from the various databanks such as PubMed, Medline, CINAHL and Medscape as well as web-based engines in this case Google. The search strategy will seek to narrow the research so that the ultimate evidence will be time sensitive and relevant to the question. For the internal evidence, the focus will be on gathering all records and facts from reliable government and non-government stakeholders as it relates to the hypertension in African American adult population. The selected sources for gathering internal evidence will include the Centers for Disease Control and Prevention website, the Robert Wood Johnson Foundation (RWJF) website and resources and the Quickfacts website (Melnyk & Fineout-Overholt, 2011).
Databanks and web-based search engines are two tools that will provide the required evidence and data for this study. Databases are the more reliable tools that allow the user to acquire sufficient published data as it relates to their topic of interest. The database will allow you to search within a narrowed path and within a specific discipline. Such examples that have been utilized in this case include the PubMed and Medline databanks and they will be vital in providing the links to external evidence (Melnyk, Gallagher‐Ford, Long & Fineout‐Overholt, 2014). The web-based search engines on the other hand will utilize all the search terms, characters and keywords input by the user to identify the necessary materials. In essence, the web-based search engine will be vital for the internal evidence sources as it will provide links to government, organizations, groups and individuals who have analyzed data on the topic of interest (Melnyk & Fineout-Overholt, 2011).
References
Fowler, S. B., & Forshner, B. S. (2010). How to conduct an evidence-based practice investigation. American Nurse Today Online, 5.
Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The establishment of evidence‐based practice competencies for practicing registered nurses and advanced practice nurses in real‐world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15.
