Evidence-based care uses the findings of research to develop core practice. The aim is to find practice that provides the most effective care possible. The idea is to rule out practice that is not beneficial and focus on methods that are proven to work. To provide effective care, the decisions made and the practices implemented should be those that are considered to be the most beneficial for the recipient. Effective care also takes into consideration the beliefs and preferences of a patient and allows their voice to be heard. This essay will outline the pros and cons of evidence-based care and conclude as to whether the method is efficient in providing effective care.
One of the areas that evidence-based care has a positive impact is in that of care workers (Open University, 2014). Care workers are employed in a variety of areas. These areas include hospitals, nursing homes, residential care and community based care. Research is continuously undertaken and it would be unrealistic to expect care workers to keep up to date with new findings. So to answer to this, studies provide expert summaries that are far less time consuming to read. Summaries may come in the form of guidelines that care workers can directly implement into care practice without having to read through pages of evidence. This allows care workers to remain current and informed on beneficial practice. Research evidence can also provide an explanation to care workers as to why they are using certain practice. It has the ability to reassure them that practices are efficient in providing effective care by backing them up with facts drawn from research. Its is important that care workers are assured in the practices they provide as this will allow them to confidently provide effective care.
If care workers use up to date practice then the risk of harm to patients can be reduced (Open University, 2014). An example of this, is the removal of the practice of ‘bed rest’. Bed rest was often used a method of treatment for lower back pain. Though after a study was conducted, the findings showed that bed rest actually had the ability to make things worse by weakening muscles. It was found that, alongside muscle weakening, bed rest actually had no benefit for the recipient (Dahm et al., 2010). Without this study there would have been no grounds for care workers to change their practice and they would unknowingly be doing more harm than good to their patients. With care workers being aware of the results of this study, they now know the negative implications of bed rest and can remove it from their core practice. This reduces potential harm to patients and thus provides effective care buy ruling out non-beneficial, and even damaging, care practices.
Though evidence-based care is good at assuming what is commonly best for patients, it lacks in being person centred. What is generally considered best practice may not be what is most beneficial for an individual (Lambert et al., 2006). There are many reasons for this, one being that certain treatments may simply not be acceptable to the patient. This could be due to their beliefs, religion, culture or just personal preferences. For example, those with anaemia may be offered a red blood cell transfusion as a course of treatment (NHI, 2018). This could be considered as a suitable treatment but those who follow the Jehovah Witness faith would refuse this due to religious beliefs. Jehovah’s Witnesses don’t accept blood transfusions as they believe that the bible forbids taking in blood to sustain the body (Watch Tower, 2018). It is important that individuals are able to maintain their beliefs and receive care that is appropriate to their situation. Evidence-based care offers only the highest rated option based on research out comes and doesn’t take into account that care may be unwanted by an individual. Research for evidence-based care is generated using a sample of the population and generalises outcomes. It cannot take into account each individual situation within control groups and it is lacking when it comes to providing effective, person centred, care.
It can be difficult for service users to be involved in research studies and they rarely are (Fudge et al,. 2008). This has a negative impact in the empowerment of service users as their care is based on research they weren’t involved in. Being able to receive care of their choice can become more challenging if there is no research to back it up. If care is solely based on evidence it becomes limited as it doesn’t have the ability to respect choices. Another downfall is that of missing evidence. It is unrealistic to expect every study to implement every control and design studies that reflect every variety of situation. Evidence based care offers only the data based option and doesn’t take into account the unique person, reducing its capability to provide effective care.
Though it cannot take into account the personal requirements of every individual, evidence based care can successfully reduce the costly waste of resources (Open University, 2014). Antibiotics were often prescribed to treat ear infections in children. However, after a summary of research evidence established that the majority of ear infections will heal without intervention (Venekamp et at,. 2013), the costly use of unnecessary medication was reduced. This saving of resources could only have been achieved through the use of evidence-based care. This has a positive impact on care as new evidence can rule out unnecessary treatment for patients allowing more effective care to take place instead.
Similarly, research evidence can also impact positively on unnecessary interventions. A key aspect of providing effective care is that individuals receive care that is most beneficial and can maximise their potential. However, treatments may be offered that have the opposite affect. For example, during labour it was often routine to offer women enemas, with the intention of reducing the chance of infection (Open University, 2014). Though the results of research found that enemas did not decrease the rate of infections (Reveiz et al., 2013). The implementation into practice of the knowledge that enemas are an unnecessary intervention saves an uncomfortable and possibly painful experience for a labouring woman. This in turn helps provide effective care as only beneficial treatment will be offered. Without research evidence, practice may never be altered and individuals may consistently go though pointless courses of treatment.
Though studies often come with summaries, it can still be very difficult to keep up to date with all of the research. Evidence is constantly changing with new studies taking place regularly. A company may implement a change into core practice and maintain this without doing further research, meaning that the most effective treatment may not be offered. The NICE bedwetting guidelines offer a method of treating bedwetting. Part of guidelines suggests to consider whether the use of alarm treatment is appropriate (NICE, 2010). There is no further evidence offered on the guidelines to aid a care worker in deciding whether alarm treatment would be appropriate or not. A more recent study discovered that using alarm bell and pad treatment had a seventy percent success rate (Apos et al,. 2017). If care workers just refer to the NICE guidelines and are not aware of the results of this research, then it might mean that a patient may miss out on a course of treatment that could have benefited them. This means that the most effective care hasn’t been provided due to a lack of shared evidence.
One of the biggest flaws of evidence-based care is that it doesn’t allow for the experience and intuitive knowledge of care workers to be incorporated. The skills care workers possess are fundamental to care. They work directly with services users and witness the impacts of core practice on patients. There is the argument that knowledge based care should be considered instead (Pawson et al., 2003). The term is used by the Social Care Institute for Excellence (SCIE) and explain it to mean that decisions are made based on the best knowledge and information available (Open University, 2014) with this knowledge including that of what’s in people’s heads. This method puts more value on the experiences of service users and practitioners rather than on evidence from research. This creates a more tailored style of care with more ability of getting it right for each individual case.
As shown, evidence-based care has many positive attributes. Research evidence allows us to modernise and progress though methods of care. It aids in the development of more beneficial and economical courses of treatment. This has a positive impact on care and helps it to be effective. Though evidence-based care is not fully successful. A key part of providing suitable care is that it is person centred. Every case is different and there is no realistic way that evidence-based care can incorporate every individual’s situation. To truly provide effective care, patients values, experiences, preferences and expectations should be matched with the knowledge of professionals and modified with the use of research evidence. As a stand alone method, evidence-based care is not able to provide altogether effective care. It is a necessary part of developing effective core practice but it cannot cater to all. Though it aids in providing effective care, evidence-based care is not enough and is just one part of the jigsaw when it comes to providing effective care.