In health care, evidence-based approach refers to one that aims to show the most effective care while standardizing practice and reducing variation in care (Buccheri & Sharifi, 2017). This practice must encompass a patient’s preferences and values, and should be implemented together with professionalism and judgment of healthcare experts. While professional knowledge should not be ignored, dependency on it can lead to hampered innovation and perpetuation of suboptimal practice (McNaughton & Rowles, 2017). That is why it is suggested that study should be utilized to encourage clinical knowledge and judgment via the importance application of reliable and valid research.
For a long time, nursing has been a conventional, hierarchical, and ritualistic profession. A majority of conventional practices are still in use today without being investigated or questioned, such as preoperative fasting for those awaiting surgery (Glasper & Rees, 2016). Such approaches are considered to be the precursors to the professional perspective of the hierarchy of evidence, which measures the strength of research founded on the firmness of the study techniques applied. This paper will take a closer look at the different kinds of evidence-based research and levels of evidence such as control trail without randomization, systematic reviews, and randomized controlled trial, among others. It will also identify the methodology of ‘randomized controlled trial’, providing a conclusion at the end.
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Discussion
Systematic Reviews
Systematic reviews are a summary of the outcomes of available carefully formulated health care researches, also referred to as controlled trials, providing a superior level of proof on the effectiveness of healthcare interventions (Fineout-Overholt, et al., 2010). A systematic review is usually complex and relies on what clinical trials are present, how they were performed and the health results that were gauged.
Randomized Controlled Trial (RCT)
This is a research whereby individuals are allocated at random to get one of the many clinical interventions. It is regarded as the gold standard in study and is utilized mainly to gauge distinctions in results between two groups, for instance the difference between patients taking standard medicine for managing hypertension, and those taking a new generation drug (Buccheri & Sharifi, 2017). A RCT is able to indicate the superiority of new treatments over existing normal treatments or placebos.
Controlled Trial without Randomization
A non-randomised control trial is a form of quasi-experimental design that does not meet the standard for a genuine experimental design such as unsystematic assignment of individuals to groups of having a control group (McNaughton & Rowles, 2017). Here, participants are assigned to the process, intervention, or treatment options by a technique that is not random. Notably, there are instances when controlled trial without randomization can be used, for instance, when the act or unsystematic allocation may minimize the efficiency of the intervention (Glasper & Rees, 2016). It can also be used where there is lawful or political hindrance to unsystematic allocation, when it is unreasonable to conduct unsystematic allocation, and when it would be considered immoral to do such an allocation.
Case-Control or Cohort Study
This type of study compared individuals with particular result of interest with those from similar source population but without that result, to investigate the link between the result and previous exposure (Fineout-Overholt, et al., 2010). The cohort study is generally beneficial when the result is rare. It is also considered useful if there is a long term period between exposure and result, for instance lung cancer and smoking (Buccheri & Sharifi, 2017).
Systematic Review of Qualitative or Descriptive Studies
A systematic review of qualitative or descriptive studies is one that combines study on a given topic, systematically looks for research proof from main qualitative researches, and draws the findings together (McNaughton & Rowles, 2017). It normally gets information from interviews, verbal interactions, or observations, concentrating on the interpretations and meanings of those involved. It also incorporates diaries, observations, focus groups, and interviews.
Qualitative or Descriptive Study
A qualitative or descriptive research is one that emphasizes on comprehending a person’s behavior and presenting findings via words rather than numbers (Glasper & Rees, 2016). Here, literature is assessed and implemented once evaluation has occurred to support or oppose current findings. The main focus of a qualitative or descriptive study is on the ability to comprehend and get insights from the information provided.
Expert Opinion or Consensus
This is the authoritative opinion of professional committees. Expert consensus or opinions are necessary in verifying that daily practice aligns with what is recommended in the clinical practice guidelines, thus closing the gap between clinical study, writing of directives, distributing them, and applying them into clinical practice (Fineout-Overholt, et al., 2010). Opinion or consensus statements generally address issues in which the proof foundation is less extensive compared to clinical guidelines, and that is why their creation should be methodologically honest and thorough.
The Methodology of ‘Randomized Controlled Trial’
As already indicated, a randomized controlled trial examines the extent to which particular, organized impacts are being attained. The main differentiating characteristic of an RCT is the unsystematic assignment of units to the intervention or control groups (Buccheri & Sharifi, 2017). Among its major strengths is its ability to provide an authoritative reaction to questions of programme implementers, assisting evaluators, and causality to know what is being attained as an outcome of the intervention and nothing else.
Conclusion
It would not be recommendable for nurses and other health care practitioners to get a definite conclusion from one research having numerous limitations. The evidence-based approach or research enables trainee researchers to develop their skills in discovering the basis for clinical practices. Furthermore, nurses and health care professionals have a duty to apply evidence based research in providing most favorable patient care, while utilizing their clinical judgment and keeping in mind the patients’ preferences and values.
References
Buccheri, R.K., & Sharifi, C. (2017). ‘Critical appraisal tools and reporting guidelines for evidence-based practice.’ Worldviews on Evidence-Based Nursing , 14(6). Pp. 463 – 472.
Fineout-Overholt, E., et al. (2010). ‘Evidence-based practice step by step.’ Annual Journal of Nursing , Vol. 110, No. 7. Pp. 47 – 52.
Glasper, A., & Rees, C. (2016). Nursing and health care at a glance . Hoboken, N.J.: John Wiley & Sons.
McNaughton, A., & Rowles, E. (2017). ‘An overview of the evidence-based practice process for novice researchers.’ Nursing Standard , Volume 31, Number 43. Pp. 50 - 60.
