Evidence Based Practice and Applied Nursing Research


Evidence based practice is a nursing and clinical process that involves identifying actual medical problems and using resultant nursing findings in constructive nursing practices (Keele, 2010). The purpose of carrying out evidence based and applied nursing research is to ensure quality and cost effective medical and nursing care to patients and other individuals who may seek treatment and preventive services. The evidence based practice research involves collection, analyzing, interpretation actual research findings to important applicable research in medical and clinical processes.

There are many preoperative clinical procedures that occur at treatment sites both before and after surgical operations.  Melnyk and Overholt (2010) note that all the procedures are crucial in improving the conduct of surgical processes as well as creating appropriate environment for the healing of patients. Preoperative hair removal is one of such nursing procedures and practices which is designed to reduce the Surgical Site infections (SSIs) and other related healthcare infections among hospitalized patients, surgical staff and other surrounding living things. This procedure is considered in this review because of its potentiality in eliminating surgical infections and its flexibility to accommodate new features to suit the current surgical practices.

Pravikoff, Tanner and Pierce (2005) point out that preoperative surgical hair removal has shifted from its previous version as a treatment measure to the now most practiced preventive measure of SSIs. This has been brought about by the consideration of costs that accompany surgical infections such as the resources that patients use in treating these infections, the suffering they undergo in addition to the increased speed of the spread of bacteria that causes these infections. Preoperative hair removal process is conducted by a preoperative team whose goal is usually to prevent any chances of development of surgical infections to patient before, during and after treatment. This procedure involves removing hair from patients body parts scheduled to undergo treatment that is likely to interfere with treatment or surgical operation. This process is however done as per the consent and interest of the patient and is conducted the day of treatment outside but close to the treatment premise (Burns and Grove, 2003). 

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 Surgical hair removal practice has received much attention in the nursing world because of its ability to reduce patient mortality and morbidity, reduce the ever increasing time that patients stay in hospital and increased hospital bills (Hamlin et al, 2008). Though this procedure has successfully aided in addressing all the problems affecting patients and surgical staff, the level of growth and spread of surgical site infections has called for the re-evaluation of the procedure to provide a more appropriate practice that will be able to contain these surgical infections. This will only be possible through implementation of appropriate and accepted research findings that are geared towards improving the functionality of surgical hair removal procedures.

The choice of this procedure has been triggered by its capability to facilitate successful surgical operations and the long time results of saving resources on the sides of the patients and nursing centers. Additionally, the procedure provides adequate scientific evidence in nursing and medical problem solving and decision making. This procedure, like many other nursing procedures can be used to make decisions about the clinical care of both individual and group type of patients. Exceptionally, the surgical hair removal procedure has a positive projected future performance once necessary scientific and applied changes have been effected. On the other hand, the practical process of surgical hair removal procedure has evolved to adopt new and modern surgical technologies to improve its quality and performance. The hair removal procedure has for along time used safety razors as major surgical instruments. However, with time these razors have been replaced with less-risk electric clippers which have been tested to cause minimal harm to human skin. Shaving antibiotics have also recommended improving on the quality of preoperative hair removal.

However, the clinical implications of surgical hair removal are extensive especially to the surgical staff. Since nursing and surgical staff are critical in providing any nursing practice and ensuring the success of nursing procedures, they are most likely to carry out this procedure according to set clinical standards and thus medical ethics can’t be compromised practices (Keele, 2010).  The clinical implication of this procedure is that nursing and medical practices need constant reevaluation to ensure that clinical goals which are patient satisfaction and quality health care provision are achieved. This practice shall improve patient outcomes, confidence in clinical decision making as well as keeping the practice up to date and relevant.

Proposing changes to the surgical hair removal procedure and consequent follow up of the implementation process is the most challenging part in evidence based and applied nursing research process. There are many obstacles to suggesting and implementing changes to preoperative surgical procedures which range from research process barriers, administrative complexities, financial constraints as well as social cultural factors. A more common barrier in implementing change in this procedure is the low value that the nursing and surgical community attaches to research findings. Though the findings on improving the conduct of this practice may seem to alleviate this practice to a more promising level when put into action, incorporating such findings to a running procedure is a difficult task because many medical and nursing staff won’t like to own and facilitate the changes. Additionally, nursing and surgical field is a hectic and busy health care sector thus getting enough time to create awareness to all the parties involved in this procedure may take a long time to implement. Administrative barriers which include seeking support of the relevant authorities and provision of required resources may delay or shadow the implementation of these changes.

Research utilization is a key solution to some of these barriers because it involves the critical analysis, interpretation and utilization of available research findings concerning this procedure to improve the nursing procedure. Incorporating appropriate clinical research findings and evaluating their performance is crucial to overcoming barriers involved in conducting this procedure. However, this strategy will only be successful in a situation where all the parties involved in transition process accept the value research in improving surgical and nursing procedures. Performance improvement is another strategy that focuses on improving the systems, resources and processes to ensure patient satisfaction using the reasonable costs. Performance improvement is intended to address the nursing problems, examine the clinical performance as well as determine indicators that help the improvement of nursing procedures.

Though conducting evidence based research and implementing the findings takes a lot of resources in terms of time and funds the results of implemented findings are far much worthwhile (Hamlin et al, 2008). Engaging organizational efforts and resources in the implementation process of the findings is important to ensure that there is intended change to the practice. Organizing nursing clubs and providing research articles stipulating the proposed changes to the clinical practice are some of the important strategies that can guide in the implementation process. Seeking the support of the related authorities and convincing them of the importance of the intended change can also add value to the implementation process. The support of the patients is also very valuable because their satisfaction is the objective of any nursing procedure and findings that will incorporate important scientific knowledge, improve quality of nursing service as well as ensure cost effective care will earn a majority support of the patients.

All patients expect their treatment to be smooth and less of unpleasant events. However, the presence of surgical site infections is a potential risk to complicating the treatment of patients. Such infections are causes of extended days of patients in healthcares, increased hospitals charges and unnecessary patient discomfort. The members of any surgical team therefore play crucial role in minimizing the possibilities of surgical infections to patients. While these teams understand the risks of preoperative hair removal as well as the implications for the need to prevent surgical infections, then such a team can design and implement the best surgical hair removal processes and procedures.


Burns, N and Grove, S. (2003). Understanding Nursing Research .Philadelphia: Elsevier Health Sciences.

Hamlin, L. et al. (2008). Preoperative Nursing: An Introductory Text. Chatswood: Elsevier Australia.

Keele, R. (2010). Nursing Research and Evidence-Based Practice. Sudbury: Jones & Bartlett Learning

Melnyk, B. and Overholt E. (2010).Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice. New York: Lippincott Williams & Wilkins.

Pravikoff, S, Tanner, B. and Pierce, T. (2005). Readiness of U. S. Nurses for Evidence-Based Practice. American Journal of Nursing, 105 (9), 40–51.