Evidence Based Practice in Mental Health: Principles, Processes, and Barriers

Running head:
Evidence Based Practice
Name of the Student
Name of University
Author’s note

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Part A
Introduction
Evidence-based practice in nursing is defined as a process of collecting, processing and
implementation of the research findings in order to improve the clinical practice and the work
environment or other patients’ health-related outcomes (Dang & Dearholt, 2017). LoBiondo-
Wood and Haber (2017) are of the opinion that the nursing interventions must be practical and
methodical decisions based on the EBP research studies. The use EBP approach in nursing
professional practices helps to deliver highest quality and cost-effective care. The following
essay aims to analyse the principle, process and barriers/facilitators behind the application of the
EBP in the nursing care or research. In doing so, the paper will focus over a particular clinical
area: mental health ward. The paper will initiate by focusing on the barriers and facilitators of the
application of EBP guidelines in the mental health ward and the gap in current EBP in mental
health. The overall study will be conducted based on the extensive literature research.
Principles and Processes of evidence-based practice in nursing research
Evidence-based practice (EBP) in nursing deals about the decision making process with
the help of conscientious, explicit and judicious application of the best available evidences
collected from multiple sources (Dang & Dearholt, 2017). The main sources that must be
considered for the generation of the EBP include scientific literature, the facts and recovery
figures extracted from the healthcare organizations, the health-care practitioners and other
administrative stake-holders. Main principle of EBP is EBP interventions can be extracted from
the literature or peer reviewed articles that are being published by scientists or researchers in

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esteemed journals. However, before selection of the papers for the generation of the EBP, the
methodological quality of the research needs to be analysed and thus helping to estimate the
level of bias. Systematic review of the randomised-control trial falls in hierarchy of level 1 as it
has negligible level of bias. However, regardless of the evidences, healthcare practitioner must
discuss the recommended interventions, risks, benefits and alternatives in order to achieve the
best available EBP outcomes (LoBiondo-Wood & Haber, 2017).
Mental Health and EBP
Restraining
The EBP in mental health has helped to bring a significant change in the care delivery
and at the same time have helped to improve the overall outcome of the clinical care. For
example, restraining is regarded as one of the principal approach of care delivery among the
mental health professionals. The act of restraining is mainly to treat aggressive mental health
patient like the people who are suffering the schizophrenia or suffering a chronic anxiety
disorders or bipolar disorder (Wilson et al., 2017). Safeguarding and balancing the concept of
risk under the requirement of the public health protection and its overall application for the lives
of the individuals is regarded as an important concern in the contemporary mental health. An
integral concept towards safeguarding is protecting the human rights and the right of live, free
from torture and inhuman behaviour while respecting the dignity and privacy. EBP research
highlighted that re-straining affects the mental health outcome. It is leads to the generation of
fear, neglect and leading to the generation of negative implication inn care (Cusack, et al., 2016).

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Accidental Falls
Accidental fall among the older adults who are suffering from the mental health
complications like dementia or Parkinson’s increase the overall cost of care while decreasing the
quality outcome. Accidental falls are frequent and unwitnessed events in the long-term mental
healthcare and thus increasing the need for the EBP interventions for the prevention of
individualized fall among the older adults with dementia. The EBP research done through the
review of the randomised control trial studies showed that the high fall rate is associated with
cognitive impairment and disinhibited behaviour. It also increases the rate of mobility disability,
injury rate and increasing the cost of care. A multifactorial approach in order to manage and to
modify the risk factors associated with accidental fall is needed for the vulnerable older adults
with dementia. Limited amount of research in this area restricts the comprehensive application of
the EBP guidelines for the prevention of accidental falls among the older adults (Kosse, et al.,
2015). However, the research conducted by Phelan et al. (2016) highlighted that proper
assistance of the occupational therapists and making certain modifications in the living condition
helps to reduce the chances of accidental fall among the older adults. There modifications
include use of walker or walking stick, high traction shoes and raised beds. The study conducted
by Allison, Brooke-Wavell and Folland (2018) have found positive results in use of proper diet
plan and regular practice of the mild to moderate physical activities help to reduce the chances of
accidental fall among the dementia patient by increasing the muscle and joint flexibility.
However, encouraging the older adults in taking part in physical exercise sessions in both in-
patient and out-patient department is a complex issue moreover, overall effectiveness of physical
activity in prevention of fall among patients with neuro-degenerative disorder still requires
further research.