NURSING - EVIDENCE BASED PRACTICE

Nursing- Evidence Based Practice



Nursing- Evidence Based Practice

Introduction to the person and the setting

In the present drive towards evidence-based health care, it is essential to define and measure the nursing contribution to health to ensure that professional and training resources are deployed most effectively. Thomas and Bond1 have undertaken a review of the effectiveness of nursing in general that presents a disappointing picture of research in this area, with a lack of rigour in study design, small sample sizes, and no studies of cost-effectiveness. Despite a limited search strategy, nine of the 29 studies considered in their review were concerned with people experiencing mental health problems, which suggests a relatively rich vein of outcome research in this particular branch of nursing. Mr. Anil Gawda has been selected as a community patient. Mr. Anil has been living in the UK for more than 3 decades and suffers now with certain symtoms of Dementia. We report a systematic review of rigorously selected evidence of the effectiveness of community mental health nursing. The problems found in conventional reviews of publications have been summarised by Cullum:2 reviewers fail to acknowledge the strengths and weaknesses in the primary research; they use only a subset of available material and fail to identify the criteria for including research in their review; discussion is limited to published research; assessment of the validity of cited research is difficult as methods are rarely described; and reviewers often draw inaccurate conclusions from study findings. Various guidelines have been compiled by which literature can be assessed systematically according to pre-agreed criteria to arrive at a judgement of a study's relative value and place it within the wider corpus of literature. The key points to emerge from these can be summarised as a process of critical review.

Identification and description of statutory and non-statutory initiatives in relation to mental health promotion generally; and then specifically in relation to the person's mental health promotion need as identified.

Referring to the Mental Heact act 1983 and the progress that has grown with leaps andbounds. The notion of clinical effectiveness has arisen, most notably, since the inception of the health service reforms in the early 1990s and the introduction of the purchaser/ provider split. Once political and local imperatives have been met there are compelling reasons for purchasers with limited resources to contract for interventions that are known to be most clinically effective. That is, interventions at either the service or practitioner level that are based on research evidence of improved outcome for the client/patient. In view of the problems associated with the generalisability of single studies, clinical protocols are most usefully based on the aggregated results of carefully appraised studies in the area. A number of reviews and meta-analyses in the area of mental health have been published over the last 5 years and the work of the Cochrane Collaboration has prioritised schizophrenia as an area for critical review of existing research results.

However, the findings of these reviews have been ...