In an endeavor to develop an Evidence-based practice (EBP) project on a key concept pertinent to advanced practices in nursing, this outline prepares the EBP committee to apply the foundational knowledge required to develop this project effectively. The outline will help to:
- Identify knowledge gaps related to EBP.
- Formulate critical questions related to advanced practices in nursing
- Understand the importance of providing care based on evidence.
Moreover, it is imperative to focus on first things first by exploring scientific paradigms of nursing science, nursing theory, and research, and EBP approaches for advanced nursing practice.
Understanding first the scientific paradigms of nursing, nursing theory and research, and EBP approaches for advanced nursing practice will help the EBP committee to:
- Execute the most vital priorities first.
- Remain disciplined and focused on the EBP project.
Scientific Paradigms of Nursing Science
Paradigms refer to a set of practices and beliefs shared by researchers and regulate inquiry within a given discipline (Ryan, 2018).
There are four main paradigms used for nursing inquiry. They include:
- Positivism paradigm
- Postpositivism paradigm
- Interpretive paradigm, and
- Critical social theory paradigm
- Positivism Paradigm
The positivism paradigm assumes that everyone values objectivity and reality (Polit & Beck, 2020).
- The paradigm uses quantitative research, implying that data is collected in numerals and analyzed statistically.
- Truth is understood as certainty.
Some of the contributions include:
- There is the generalizability of findings
- Believes that scientific methods employed in investigating the physical world can investigate the social world.
This paradigm’s main limitation is that explanations, descriptions, and predictions are required to guide nursing interventions. Absolute truth cannot be recognized as reasonable in nursing research (Corry et al., 2018).
The postpositivism paradigm is the current manifestation of the nursing paradigm, which is an advancement of the positivism paradigm (Corry et al., 2018).
- This paradigm recognizes an absolute truth that cannot be ascertained.
- Reality and truth are assumed to be conditional, and they can be understood in different ways.
Absolute truth and certainty are viewed more cautiously because of:
- Human limitations
- Some characteristics hinder the possibility of understanding everything in the world.
The postpositivism approach seeks to minimize preconceptions or biases related to using one research method (Ryan, 2018).
- Researchers use different approaches to develop knowledge by recognizing their strengths and weaknesses.
- Knowledge is developed after diverse engagements and data interpretation.
The main limitation of this paradigm is that:
- It neglects the “entire” person by focusing on specific elements or parts.
- The paradigm’s knowledge claims represent possibilities about human existence rather than representing universal governing laws.
Interpretive paradigm values and fosters intersubjectivity between researchers and participants (Ryan, 2018).
- A person’s comprehension of events and experiences is more profound than what an external person might quantify.
- Reality is based on perception, and thus there is no existence of objective reality.
This paradigm contributes to:
- Holistic nursing
- Personal ethical and aesthetic values.
Lack of objectivity limits the paradigm’s ability to discriminate patterns vital to humans.
Critical Social Theory
This paradigm is pivotal in nursing as it focuses on domination and social struggles to build an egalitarian society.
- There is no objective fact since knowledge is a product of social values and influences (Ryan, 2018).
This paradigm resonates with the nursing profession;
- Nurses practice changing their patient’s beliefs to change their health.
The main contributions include:
- There is a direct link between theory and practice as nursing research goes beyond description.
- Health practitioners can develop in-depth knowledge from practice through reflection and criticism (Ryan, 2018).
Nursing Theory and Research
Science is a combination of the process of inquiry, which is research, and the product of knowledge, which is a theory (McEwen & Wills, 2019).
- The research aims to generate knowledge through the generation of theory.
- Nursing leaders have used research to develop nursing concepts and knowledge, while the theory has been used to organize the knowledge.
According to McEwen & Wills (2019), the nursing theory provides a structure, organization, and a defined way of collecting data to explain, describe, and predict nursing practice.
- Through nursing theory, nursing becomes more focused and purposeful
- Nursing theory guides nursing care.
- Facilitates coordinated and well-focused nursing care.
The nursing theory offers a systematic nursing approach that describes the relationship between nurses and clients.
- Defines data to be collected
- Describes, explains, and predicts patient’s responses.
- It helps to determine interventions to be provided.
- It helps identify research areas (McEwen & Wills, 2019).
Nursing theory and nursing research are both closely linked in that:
- Both advocate for professional practice
- Both aim to improve the quality of healthcare the patients receive.
Nursing theory significantly contributes to nursing research, which facilitates:
- Improved nursing care
- Nursing education, and
- Evidence-based practice (EBP)
Evidence-Based Practice Approach for Advanced Nursing Practice
McEwen & Wills (2019) asserts that evidence-based practice requires health professionals to center their practice on sound information and data supported by research findings and science.
- Nursing practice should not be based on tradition and belief.
- EBP involves integrating clinical expertise with credible and reliable clinical evidence obtained from systematic research.
Evidence-based practice has various features. Some of the critical features of evidence-based practice include:
- EBP is a problem-based approach that considers the context of healthcare’s current expertise and experience (Mackey & Bassendowski, 2017).
- EBP consolidates the best available evidence and practice.
- It factors in patients’ and their family members’ values, beliefs, and perceptions.
- Facilitates the use of research findings.
Despite the increased acceptance of the evidence-based nursing practice, several concerns and criticisms have been voiced about it (McEwen & Wills, 2019).
- There is a concern that evidence-based practice as an approach to advanced nursing practice is primarily centered on the science of nursing rather than the art of nursing.
- Strict dependence on EBP will transform the role of nurses into medical technicians.
- Since research on humans is complex and findings are open to interpretation, EBP should not be the sole basis of nursing practice.
- EBP is linked to several ethical issues and questions.
- Strict adherence to evidence-based practice can cause voids when coming up with a care plan.
However, despite these concerns and issues, the benefits of incorporating the EBP approach into advanced nursing practice outweigh the demerits.
- The inclusion of EBP in advanced nursing practice helps nurses make well-founded clinical decisions (Saunders & Vehviläinen‐Julkunen, 2017).
- Nurses can evaluate research, thus understanding the effectiveness or risks of intervention.
- Healthcare organizations can minimize medical expenses.
Evidence-based practice (EBP) has gained a lot of importance in nursing, and it has also continued to develop.
The history of nursing science is premised on theory and research that are articulated through various scientific paradigms.
The four main scientific paradigms in nursing science enumerated include the positivism paradigm, postpositivism paradigm, interpretive paradigm, and critical social theory.
Besides, nursing theory and nursing research are closely connected in that they guide nursing in evidence-based practice and patient care.
Moreover, the EBP approach for advanced nursing practice helps increase medical care quality and save costs, among other numerous benefits.
Corry, M., Porter, S., & McKenna, H. (2019). The redundancy of positivism as a paradigm for nursing research. Nursing Philosophy, 20(1), e12230. Web.
Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55. Web.
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.
Polit, D. F., & Beck, C.T. (2020). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Wolters Kluwer.
Ryan, G. (2018). Introduction to positivism, interpretivism and critical theory. Nurse researcher, 25(4), 41-49. Web.
Saunders, H., & Vehviläinen‐Julkunen, K. (2017). Nurses’ evidence-based practice beliefs and the role of evidence‐based practice mentors at university hospitals in Finland. Worldviews on Evidence‐Based Nursing, 14(1), 35-45. Web.