Questions that spark the spirit of enquiry
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Questions that spark the spirit of enquiry
Who can I seek out to assist me in enhancing my evidence-based practice (EBP) knowledge and skills and serve as my EBP mentor? EBP is an invaluable practice that brings to bear a systematic combination of clinical expertise, evidence based research and patient preferences and values; and helps improve patient experiences and outcomes (Melnyk and Fineout-Overholt, 2011). It is important to understand that administrative support and role of the mentors in an EBP program is critical. The selection of the right mentors will ensure that some of the barriers to EBP can be overcome effectively. EBP involves new concepts in change management and behavior - the use of research, application of the research in clinical settings, new ways of innovating and thinking and demonstrating leadership among nursing teams. A mentoring program should have a mix of professionals. According to Neville and Horbatt (2008), a Librarian, to help search the right databases was a very important mentor in their EBP study conducted among nurses. Other mentors include clinicians with expertise in EBP, Nurse Managers with EBP expertise, Advance Practice nurses, academic faculty members or even experts in change management.
Which of my practices are currently evidence based and which don’t have any evidence to support them? Clinical nurses are faced with many challenges on an ongoing basis. The EBP model is constantly evolving to keep pace with new evidence based research and implementation in day-to-day activities. The PICO approach is suggested as an effective way to identify the practices that are based on evidence. PICO approach is based on four parameters – statement of the patient population, statement of intervention, comparison of the intervention and the outcome.
When is the best time to question my current clinical practices and with whom? As envisaged by Parse’s theory on the Leading-Following model (Bournes, 2013), a spirit of research is really important to deliver high quality patient experiences. The spirit of inquiry needs to be cultivated within; which will help question current clinical practices. The model suggests the behavioral development of qualities among nurse leaders and staff - deliberately innovating, potent engaging, and persistently pursuing excellence. The approach to questioning should be ingrained in oneself and guided by other mentors chosen for the EBP program.
Where can I find the best evidence to answer my clinical questions? Library databases are the key to finding the evidence to clinical questions. Here the role of mentors also comes into play – mainly nurse mangers and clinicians. Some of the databases which can be used to find answers include - The Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, National Center for Complementary and Alternative Medicine, The Agency for Healthcare Research and Quality and TRIP Database (Neville and Horbatt, 2008).
Why am I doing what I do with my patients? Traditional healthcare practices have fostered an environment and a thinking that staff nurses are not required to innovate, lead and help deliver quality healthcare services. On the contrary, the role of nurses in implementing an ever-evolving EBP goes a long way in improving patient experiences and outcomes.
According to Bournes (2013), the Leading-Following model can be implemented by anyone seeking to become skilled in the spirit of discovery in EBP. Being committed to the vision of EBP, innovating, being inspiring as a leader, managing risk and change, mentoring effectively and respecting the uniqueness of team members; will help enhance skills in EBP and mentorship.
References
Bournes, D., (2013). Cultivating a Spirit of Inquiry using a Nursing Leading-Following Model.
Nursing Science Quarterly, 26(2), 182–188. DOI: 10.1177/0894318413477154
Melnyk, B., Fineout-Overholt, E., (2011). Evidence-based Practice in Nursing & Healthcare: A
Guide to Best Practice. Philadelphia, PA: Lippincott, Williams L., & Wilkins.
Neville, K., Horbatt, S., (2008). Evidence-Based Practice - Creating a Spirit of Inquiry to Solve
Clinical Nursing Problems. Orthopaedic Nursing, 27(6), 331-337.
