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Evidence-Based Practice in Psychiatric Nursing

Instructor: Leasha Roy

Leasha is licensed as a registered nurse and clinical nurse specialist. She has over 17 years of nursing experience in a variety of settings and roles including long-term care, acute care, critical care, education, and leadership.

With all the new medications, treatments, and protocols each year, psychiatric nurses must stay abreast of these changes to provide the best care. This lesson will define and discuss the role of evidence-based practice in psychiatric nursing.

Why Use Evidence-Based Practice?

Have you ever performed a certain task and wondered how or why it needed to be done the way it was done?

For example, why do we turn patients to prevent pressure ulcers? Evidence tells us that removal of the pressure source will reduce the chances of patients developing bedsores.

Why do we remove invasive lines as soon as they are no longer medically necessary? Evidence tells us this will greatly reduce the chances of developing a line-related infection.

Words like 'research', 'evidence-based', 'studies', and 'experiments' often bring on a groan and feelings of disdain for many nurses. Thoughts of long, boring articles with a ton of complex statements and tables does not usually elicit feelings of joy.

However, one only needs to look beyond this daunting wall to the benefits of research. While it is necessary to have a basic understanding of these different terms, there's no need to become overwhelmed with the minute details of each.

Definitions

Nursing research is answering a clinical question by working through a process of investigation. You can even think of it as being similar to those mystery shows on television where detectives work through a case to find out 'whodunit'.

In nursing research, the investigative process involves a series of steps to answer a clinical question related to nursing practice:

  • Ask the question
  • Design the study (i.e. variables, type of study, how the results will be interpreted, participants, etc.)
  • Perform the study
  • Analyze and interpret findings
  • Write and publish the results

Once the research has been completed and an answer is obtained to the original question, what happens to that information? Is it just written up in lengthy articles that are published in highly regarded journals that later sit on bookshelves collecting dust?

Well, that's only half true. What good is taking the time and energy to complete the research if it isn't used in practice? This is where evidence-based practice comes into play.

Evidence-based practice (EBP) involves using the best, most up-to-date information (or evidence) available to make clinical decisions about patient care. EBP uses a combination of the results of high quality research, expert opinion, and patient preferences to support high quality nursing care. This means that there is actually a good reason, backed by research, for the way we do things in nursing and healthcare.

Components of EPB
EBP Components

What is Psychiatric Nursing?

Now that we understand what evidence-based practice is, let's discuss how this concept is used in the world of psychiatric nursing.

Mental illness is frequently, and unfortunately, given a bad rap in our society. There is simply a strong stigma against these types of medical conditions. Psychiatric nurses provide nursing care to patients suffering from mental illness in a variety of settings.

When thinking of the average psychiatric nurse, you may conjure up thoughts of the evil Nurse Ratched from the classic movie One Flew Over the Cuckoo's Nest. However, these nurses play a very important role in helping those with mental illness cope with and/or recover from these challenging conditions.

They may provide counseling, administer medication, evaluate treatments, or facilitate group therapy sessions, all of which contribute to the healing process for the patient.

EBP in Psychiatric Nursing

What do those things have to do with evidence-based practice though? Let's look at a few examples. Within the mental health realm, nursing research has been done to review and evaluate:

  • crisis intervention techniques
  • psychodynamic therapies
  • stress management
  • safety protocols in inpatient psychiatric facilities

Let's say Kara is the manager of an inpatient psychiatric unit and wants to start a new group therapy session for patients aimed at preparing to go home. She wants to make sure the nurses she supervises are practicing with the highest quality nursing care for her patients.

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