Substantive practice involves meticulous and shrewd exploitation of the best accessible evidence from multiple sources to direct nursing care, which is patient-focused. Therefore involves a problem-solving procedure to quantifiable running of healthcare that uses the best verification after research comprising clinician’s proficiency. It involves internal evidence sick people’s evaluation and run-through information besides their preferences plus values. Internal evidence involves process improvement, while external evidence comprises research. In internal evidence, there is a systematic approach to enable the optimization of patient care procedures to attain improved patient outcomes while external evidence is a technical method which authenticates and enriches existing experience thereby generating new understanding that impacts the nursing practice (Burns, 2010). Moreover, internal evidence entails knowledge obtained from formal education and overall experience as a result of daily practice. It is also a definite experience acquired from personal clinician to patient relationship. External evidence is the exploitation of useable outward evidence such as randomized measured examinations joined by supporting internal evidence that describes proven decisions to be substantive.
Utilization of evidence for quality improvement in a clinical environment
Practicing nursing professionals can utilize evidence-based approaches in their practice. Realizing the full process, which involves internal and external evidence, could lead to discovery evidence that verifies the internal evidence (Melnyk, 2014). Therefore the outcome validates and strengthens the clinician’s confidence in the decision. Moreover, the process can uncover situations where little evidence survives to support the decision. It can also reveal cases where the available evidence is misleading. Therefore it warrants deliberating on the inconvenience or cost the patient may incur. In circumstances where external evidence does not agree with internal evidence, the clinician can avoid making unwanted decisions. Towards improved healthcare, it demonstrates the imperfection of making conclusions on unclear grounds that solely consider internal evidence. Therefore it is encouraged to promote the regular integration of external evidence in medical decision-making.
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References
Burns, N., & Grove, S. K. (2010). Understanding nursing research-eBook: Building an evidence-based practice . Elsevier Health Sciences.
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.
