Evidence-Based Practice Report: Surgical Wound Care, Patient Outcomes

This report delves into the application of evidence-based practice (EBP) within the context of surgical wound care. It begins by highlighting the significance of EBP in improving healthcare quality and patient outcomes, emphasizing the integration of best practices, clinical expertise, and patient values. The report outlines the five key steps of EBP, including finding, appraising, and implementing research findings. It then explores procedural and propositional knowledge relevant to wound care, detailing historical contexts, assessment techniques, and the importance of standardized documentation to prevent surgical site infections. Recommendations are provided for infection prevention, including the use of prophylactic antibiotics and appropriate wound dressings. The report concludes by emphasizing the need for healthcare professionals to align their practices with evidence-based guidelines to ensure optimal surgical wound care and patient outcomes.

Running head: Evidence Based Practice
Evidence-Based Practice
Name of the Student
Name of the University
Author Note

1Evidence Based Practice
Introduction
Scientific literature suggests that improvement in evidence-based treatment has
strengthened care systems and improved health quality for patients. Experts agree that care
professionals worldwide can play an essential part in establishing evidence and cooperating in
the acceleration of its implementation with interdisciplinary healthcare teams and systems
(Correa-de-Araujo 2016). Evidence-based care is targeted at standardising the current and best
available clinical practices to reduce service disparities and eliminate adverse health outcomes
(Black et al. 2014). In addition to these, the procedure in which the findings of evidence-based
research are transposed into relevant nursing practices and also the policies by which a
significant impact on the health outcome is established while improving the health care system
and the performance of the individual and groups (Black et al. 2014). Evidence shows that
patient outcomes increase under evidence-based care procedures. It has been proven that
Description as an approach to solving challenges of clinical care that involves the conscience
incorporating best practice from well-designed trials, the expertise of a clinician, and patient
beliefs and desires, Evidence-Based Practice (EBP) helps in increasing the safety of the patient.
Research shows that funding for use and execution of evidence by their working organisations is
the most crucial factor in EBP. External facilitators include the participation of qualified
professional nurses, study advisors and research mentors in the clinical setting, internships of
nursing science and designated caregivers (Mafwiri et al. 2017).
Evidence-Based Practice
Evidence-based practice (EBP) is characterised as careful, precise and judicious use of
proven best evidence to determine the care of a patient. This is the process of integrating the best

2Evidence Based Practice
research evidence with patient values and clinical expertise. The term clinical expertise means
that clinician has accumulated experience, education and clinical skills. Five steps are followed
for the finding of best evidence for an underpinning research study. Then the best available
evidence are found, appraise the evidence, implement the collected evidence, evaluate the
outcome after the research is performed. The best evidence are unusually found in clinically
relevant research studies, which are conducted using the same methodology. This requires
combining human scientific experience in systemic studies with the latest known scientifically
available evidence. While this concept was established for evidence-based treatment, it was
created to describe the general movement toward evidence-based treatment throughout all
professional contexts, including nursing (Battat et al. 2010). The healthcare professionals in the
hospital are provided with necessary recommendations following the significant reduction in the
spreading of infection to the areas where surgery is conducted. All the suggestions are classified
based on the existing evidence and scientific data, applicability and theoretical rationale. EBP is
a strategy that advocates on clinical decision-making to be focused on the best evidence, up to
date, accurate and appropriate. Therefore, evidence-based actions should be made in light of the
available resources by caregivers, who are guided by an implicit and explicit awareness of
caregivers. EBP covers research issues, the search for and selection of most appropriate best
evidence, the critical evaluation of proof, the incorporation of information in the professional
experience, patient needs and beliefs and the review of realistic judgment findings or evidence
adjustment. The application of the EBP entails the use of EBP measures and methods to facilitate
the incorporation of the best evidence with experience and other solutions (Müller et al. 2015).
Several international directives are available for chronic wounds such as venous, arterial,
pressure, and diabetic foot ulcers. There are fewer recommendations on incidents in severe

3Evidence Based Practice
aetiology. Nonetheless, the large number of wound dressing required, the large number of
clinicians concerned and the many opinions on appropriate management indicate an
unacceptable disparity in the application of wound dressing. It needs more proof-based and
standardized care to prevent unintended medical discrepancies (Ubbink et al 2015).
Procedural (Practical) knowledge-
Procedural knowledge is attained from an instruction manual by the system of
questioning an expert about the ways f completion of a task. It is based on practical knowledge
and is achieved over time. Procedural knowledge contains detailed information that will be
useful for gaining a deeper insight of the study. In procedural knowledge, the fact or the
information is coded in procedural forms and are concerned with skills and a high level of
knowledge. Procedural knowledge contains a set of implicit information or clear instructions for
performing a set of operations. Therefore, nurses and other healthcare professionals must use the
procedural knowledge that will guide them with the treatment process and help them achieve an
improved outcome (Star 2005).
Propositional (Empirical) Knowledge-
Empirical knowledge comes through the senses. Scientific knowledge is a type of
Empirical knowledge and science is the best common method for determining the accuracy of
those knowledge. Every healthcare professionals including nurses must use empirical evidences
that are attained through experimentation or observation. This is done by recording and analysing
the data. Prior to collection of the empirical data, researchers carefully design the methods of the
research for ensuring the accuracy, integrity or quality of the data. Empirical method are based
on lab experiments and examinations repeatedly resulting into quantitative data in the form of

4Evidence Based Practice
statistics and numbers. In addition to the quantitative process, there are also other processes for
gathering information for supporting the studies and the theory (Voevodin 2019).

5Evidence Based Practice
Historical Context
Historical researches have supported that the first step towards preventing and/or
managing surgical wounds include completing a holistic approach to care by identifying the
factors affecting surgical wound healing in the pre- intra and post-operative stages (Clarke et al.
2015). In addition to that, it is important to know that reassessment occurs in the post-operative
phase and therefore, post-operative stage is a critical time that prevents complications related to
surgical wound infections. The first step is to assess the surgical wound and the findings should
be documented using a standardized approach. Assessment should be conducted using a
comprehensive wound assessment tool that assist in identifying wound change by providing a
baseline for the identification process (Dumville et al. 2015). The assessment also identify the
risk and causative factors that may affect the integrity and healing of wound. It is important to
assess the wound in order to avoid further complications (Bryant and Nix 2015). It is speculated
that after the completion of the surgery that complications which are inevitable for the patient
that decreases the health outcome and the recovery rate of the patient is the infection in the area
where the surgery is conducted. Therefore, careful observations must be made to prevent the
occurrence of infections at the surgical site. Previous evidences show that surgical site infection
following a surgery consist of 20% of the heath care associated infections which can be
prevented easily by following some precautionary measures (Cotogni, Barbero and Rinaldi
2015). It is suggested by historical evidences, that if the quality of the care after the surgery is
improved as per the needs of the patient, then there is a high chance to reduce the occurrence of
surgical complications and thus, leading to an elevated and improved outcome of health for the
patient. In order to prevent surgical site infection, it is important for the health professionals to be
competent enough and possess adequate knowledge required according to the guidelines. It is

6Evidence Based Practice
important for the nursing professionals to implement strategies to prevent the spreading of
infection in the site of the surgery and hence, improving the health condition for the patient
(Ignatavicius and Workmen 2015). It is essential for the nurses to contain adequate knowledge of
the care and the management of the nursing interventions based upon the evidence (World
Health Organization 2016). In addition, it is crucial for them to acknowledge the various risk
factors that are associated with infection in the surgical site and proper identification of the
population. Moreover, skin care treatments in the pre-operative and post-operative stage for the
patient is vital to increase the level of positive health outcome for the patient. Studies conducted
previously in this area suggest that nurses need a set of evidence based guidelines that will help
and direct them in taking decisions. Thus, every health professionals including nurse must
strengthen their level of knowledge, thereby, promoting the application of guidelines of anti-
infection that will improve patient’s health outcomes.
Historical evidences have also supported the fact that in addition to the accurate
assessment, wound documentation by healthcare staff also have the potential to reduce and
prevent surgical site infections, reduce the rate of mortality and morbidity and also reduce the
economic burden from the patients, health care workers and also the healthcare systems (Boga
2019).
Recommendation
Scientific evidence concerning about the surgical wound care defines numerous advanced
modalities for wound care that have been established over the previous 40 years. The U.S.
Centers for Disease Control and Prevention (CDC) has published the guidelines which are
incorporated in to the healthcare system after multiple evidences have been presented for their
lapses. The healthcare professionals in the hospital are provided with necessary

7Evidence Based Practice
recommendations in accordance with the significant reduction in the spreading of infection to the
areas where surgery is conducted. All the recommendations are classified based on the existing
evidence and scientific data, applicability and theoretical rationale. After going through with the
guidelines, the post-operative care after incision involves the analysis of the type of incision
which examines the openness of the skin edge which could later be closed, or are always left
open. If the wound is to be closed after the surgery is to be conducted, it is vital for the nurses to
keep in mind that the wound should be enclosed with a sterile dressing for about 24 to 48 hours
after the surgery is conducted. However, in some of the cases, it is still not much clear as to
whether the wound is to be covered or exposed to air. Therefore, careful observations must be
made in order to prevent complications and infections of the surgical site (Centers for Disease
Control and Prevention, 2017).
Surgical site infections can be prevented by using appropriate prophylactic antibiotics. It
has been fund that many hospitalized patients develop infections due to Clostridium difficile. It
has been found that an inappropriate or prolonged use of antibiotics that are broad spectrum
increases the risk in all patient because of the development of antibiotic-resistant antibiotics
(Centers for Disease Control and Prevention, 2017).
Conclusion
As it can be found here that the care plan focused on evidenced based practice can lead to
an enhanced care and improve the patient’s health outcome. Therefore, in order to ensure the
delivery of a quality outcome, it is important the nurse practice by aligning with evidence based
guidelines. Surgical wound care involves many steps and precautionary measures and each of the
steps must be followed in order to ensure better care. Heath care professionals must implement
knowledge and incorporate in their practice the best available healthcare guidelines that will

8Evidence Based Practice
improve care plan for the surgical patients. There are many considerations for surgical wound
care and the nurses must use the best available knowledge to ensure better care.
Surgical wounds are provided with care when healing by preserving a humid wound
environment in order to foster healing. There are a many types of dressings available for the
wound area including both gauze and bandages and current agents that include antiseptics and
enzymes that are available for management of surgical wounds. In addition to that, it is important
to know that reassessment occurs in the post-operative phase and therefore, post-operative stage
is a critical time that prevents complications related to surgical wound infections. The first step is
to assess the surgical wound and the findings should be documented using a standardized
approach. Assessment should be conducted using a comprehensive wound assessment tool that
assist in identifying wound change by providing a baseline for the identification process. The
best dressing for wounds healing has many features that includes the capacity of absorption and
also constitute exudate without the fear of leakage, impermeability to bacteria and water, lack of
particulate or contaminants that can be sill left in the wound, and preventing wound trauma on
dressing removal. However, topical agents and dressing are irregularly used inappropriately and
inefficiently.

9Evidence Based Practice
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