Evidenced based practice (EBP) factors scientific evidence, patient values and clinical experience into the determination of clinical judgement and selection of patient centered care.  It is the application of evidenced based practice in nursing that yields the initiatives research has shown to give patients the best results.  The very nature of the EBP course required that I think critically and to thoughtfully question the information being presented.  In EBP task one, I learned to objectively judge and weigh the evidence being presented and draw my own conclusions, either agreeing or disagreeing with the researchers findings.  Evaluation of this type of research is what we base our current nursing practices on, which is why careful scrutiny is imperative.  In order to choose the best care for a patient, one must consider previous outcomes, the findings of scientific research and what will be best for that particular patient in his/her situation.  This can be one of the most challenging aspects of nursing but when it can be broken down into the steps of a methodical process, one can reach a sound conclusion on which to base their judgement.  All commonly followed policies and procedures should be held a high level of scientific inspection.  In the evolving world of healthcare, one must be able to consider and evaluate the validity and pertinence of current practices to maintain a high level quality of evidenced based nursing care. 

            Quality improvement is ongoing process.  It is identifying a problem and then finding solutions for the problem.  It is constantly happening in the hospital and allows for immediate, continuous feedback.  A QI success can be determined by staff evaluation or patient satisfaction survey.  As a nurse in the hospital, we are constantly working on quality improvement processes.  QI goals can be to make the unit quieter at night, distribute meal trays more effectively or balance staffing ratios.  Research is based on collection of data and measurement of variables and seeks to answer a question.  Research will use pertinent data to answer the effectiveness of a dressing for wound care or the effectiveness of a diabetes medication.

            Where primary research conducts the research themselves, secondary research utilizes data that others have collected.  Primary research is more current than secondary.  Where primary sources may provide a foundation of data it also has limitations.  Secondary sources can be more useful in the clinical setting as they draw from multiple primary sources and are less prone to bias.   I have found that secondary sources that draw information from multiple studies often provide a better understanding of the topic and are easier to draw conclusions from when making decisions for clinical practice. 

            The EBP course taught me to discriminate which research I base clinical decisions on.  Having learned to discern between the types of research and being able to recognize bias, relevance of data and study limitations will continue aid my selection of interventions I implement when selecting best practices for patient outcomes.  Being able to extract relevant data from any type of primary, secondary or expert opinion source that applies to my clinical setting will assist my decision making process and enable me to deliver the highest level quality of patient care.