Numerous definitions delineate the multistep process of integrating EBP into clinical practice.

One that is simply stated and apt is referred to as the 5 A’s (Wichita State University Libraries,
2020):

1. Ask a question. Identify a problem or need for change for a specific patient or situation.

2. Acquire literature. Search the literature for scientific studies and articles that address the
issue(s) of concern.

3. Appraise the literature. Evaluate and synthesize the research evidence regarding its validity,
relevance, and applicability using criteria of scientific merit.

4. Apply the evidence. Choose interventions that are based on the best available evidence with
the understanding of the patient’s preference and needs.

5. Assess the performance. Evaluate the outcomes, using clearly defined criteria and reports,
and document the results.

Systematic reviews or meta-analyses of randomized controlled studies and evidence-based

clinical practice guidelines provide the strongest evidence

Recovery model:- recovery model is more of a social model of disability

the focus shifts from one of illness and disease to an emphasis on rehabilitation and recovery.

Empowering patients to realize their full potential and independence within the limitations of
their illness is the main goal of this model

The focus of the recovery model has the following mandates (Jacob, 2015):

• Mental health care is to be consumer and family driven, with patients being partners in all
aspects of care.

• Care must focus on increasing consumer success in coping with life’s challenges and building
resilience, not just managing symptoms.

• An individualized care plan is to be at the core of consumer-centered recovery.

Trauma-Informed Care

Trauma occurs in many forms, including physical, sexual, and emotional abuse; war; natural
disasters; and other harmful experiences.

Key principles also include avoiding retraumatizing through restraints

QSEN defines KSAs in each of the following six standards:

• Patient-centered care

• Teamwork and collaboration

• Evidence-based practice

• Quality improvement

• Safety

• Informatics.

The art of nursing:- Three areas inherent in the art of nursing addressed here are (1) caring,
(2) attending, and (3) advocating.

Caring:

1. Caring is evidenced by empathic understanding, actions, and patience on another’s behalf.

2. Caring for another through actions, words, and presence leads to happiness and touches the
heart.

3. Caring is giving of self while preserving the importance of self.

Comforting as a part of caring includes providing social, emotional, physical, and spiritual
support for a patient consistent with holistic nursing care.

Attending :- Attending refers to an intensity of presence Being present is a practice of

awareness, attention, and an intention to understand and connect and goes beyond acts of
basic care.

Advocating: commitment to patients’ health, well-being,

Advocating demonstrates respect and value for human life while saving lives or bringing comfort
to those who are dying.

Key Points to Remember

• Nursing integrates both scientific knowledge and caring arts into a holistic practice.

• Evidence-based practice (EBP) is a process by which the best available research evidence,
clinical expertise, and patient preferences are synthesized while making clinical decisions.

• The 5 A’s process of integrating best evidence into clinical practice includes (1) asking, (2)
acquiring, (3) appraising, (4) applying, and (5) assessing.
• Application of the recovery model assists people with psychiatric disabilities in effectively
managing symptoms, reducing psychosocial disability, and finding a meaningful life in a
community of their choosing.

• Trauma-informed care recognizes that various traumas contribute to mental illness and
substance abuse. Awareness of trauma can assist health care providers in giving appropriate
care and avoiding retraumatization of patients.

• Some sources for obtaining research findings are (1) Internet resources, (2) clinical practice
guidelines, (3) clinical algorithms, and (4) clinical/critical pathways.

• The art of nursing is accomplished through the therapeutic use of self.

• Three specific areas are inherent within the art of nursing: (1) caring, (2) attending, and (3)
advocating

1. In which scenario is it most urgent for the nurse to act as a patient advocate?

a. An adult cries and experiences anxiety after a near-miss automobile accident on the way to
work.

b. A homeless adult diagnosed with schizophrenia lives in a community expecting a category 5

hurricane.

c. A 14-year-old girl’s grades decline because she consistently focuses on her appearance and
social networking.

d. The parents allow the prescription to lapse for 1 day for their 8-year-old child’s medication for
attention-deficit/hyperactivity disorder.

The nurse interacts with a veteran of World War II. The veteran says, “Veterans of modern wars
whine and complain all the time. Back when I was in service, you kept your feelings to yourself.”
Select the nurse’s best response.

a. “American society in the 1940s expected World War II soldiers to be strong.”

b. “World War II was fought in a traditional way, but the enemy is more difficult to identify in
today’s wars.”

c. “We now have a better understanding of how trauma affects people and the importance of
research-based, compassionate care.”

d. “Intermittent explosive devices (IEDs), which were not in use during World War II, produce
traumatic brain injuries that must be treated.”

3. A patient reports sleeplessness, fatigue, and sadness to the primary care provider. In our
current health care climate, what is the most likely treatment approach that will be offered to
the patient?

a. Group therapy

b. Individual psychotherapy

c. Complementary therapy

d. Psychopharmacological treatment

4. The nurse prepares outcomes to the plan of care for an adult diagnosed with mental illness.
Which strategy recognizes the current focus of treatment services for this population?

a. The patient’s diagnoses are confirmed using advanced neuroimaging techniques.

b. The nurse confers with the treatment team to verify the patient’s most significant disability.
c. The nurse prioritizes the patient’s problems in accordance with Maslow’s hierarchy of needs.

d. The patient and family participate actively in establishing priorities and selecting
interventions.