Implementation of Evidence based Nursing-Free-Samples for Students

Question: How does evidence based practice improve patient outcomes? How evidence is based practice applied theoretically and clinically? Answer: Evidence-based research (EBP) in nursing involves collection, evaluation and implementation of medical data that would help improve the care service and outcome of the patient in a healthcare setting (DiCenso, Guyatt Ciliska, 2014).Clinicians and registered nurses rely on their own experience and expertise to analyze research findings that would benefit patients. EBP understands the patients requirements, preferences and values while respecting boundaries and provides a safe clinical service (LoBiondo-Wood Haber, 2017). It has to be kept in mind that registered nurses have a big responsibility when it comes to patient safety and care, even if doctors and perform first hand assessment of the patients situation before nurses. So, the Position Statement for this paper is: Registered Nurses are required to critically analyse a situation and formulate a strategy based on best available evidence- Standard 1 of Nursing and Midwifery Board of Australia. There are many benefits of implementing evidence based practice in nursing like, predicting better patient outcomes, improving the safety measures for patient as well as improving the quality of life (Cook, Tankersley Landrum, 2013). The recent development of the healthcare industry has made patient demand state of the art treatment which has to be provided with efficiency (Cook Odom, 2013). The whole basis of incorporating research in clinical practice is to ensure that the best possible treatment is provided to the patients with minimum damage in the shortest possible time. According to Standard 7 of standards of practice NMBA, nursing staffs are expected to critically evaluate the patient outcome of the patient and take responsibility in doing so as well as planning and assessing the situation which cannot be done without having a prior research based on evidences and develop nursing wisdom (Nursing and Midwifery Board of Australia - Registered nurse standards for practice, 2015 ). Certain medical conditions make it difficult for nurses to treat patients, for which they rely on traditional guidelines to avoid risk of mis-assessment (Kavalieratos et al., 2014). Treatment of critical care patients is such a situation, in such cases nurses only rely on the age old methods to help the patient recover. The common practices nurses follow in a critical care are as includes, helping the patient turns in a position where maximum air can be inhaled, Administering the patient with sedatives that help them sleep in critical care conditions so that the body can function without any tension, When dealing with infant or child, the critical care nurses always prefer feeding tubes, Critical care nurses always make sure to prevent the venous thromboembolism in the patient to avoid complications. Research helps to develop knowledge about current issues and how can that be dealt with. In nursing as well, importance of research cannot be denied (Gray et al., 2013). The practice of implementing research findings in clinical practice develops the analytical assessment abilities in a registered nurse. The clinical expertise like wisdom, reasoning, understanding patient history analyzing patient data, collection of those data and utilizing the resources available make influence the clinical decision making process of the nurses (Brownson, Colditz Proctor, 2017). Understanding the importance of patients preferences and values regarding the treatment also ensures the establishment of trust in the patient-care giver paradigm (Schneider Whitehead, 2013). It is the duty of the nursing staff to maintain the homeostasis of the patient-caregiver relationship transparent so as to ensure better care service (Dawson et al., 2014). All this affect the well being of the patient and ensures th e positive outcome of the patient care. It is generally preferred to perform EBP as it is known to reduce risk of rehospitalisation, progression of a chronic diseases, cost of treatment, reduce post operative complication, infection and spreading of diseases from an infected patient. Prevention of wrong medication administration and gap in patient handover is not possible without evidence based practice (Hoffmann, Montori Del Mar, 2014). According to Standard 6 of the NMBAs RN standards, an RN Provides safe, appropriate and responsive quality nursing practice, by meeting the goal of patient care and adhering to their own scope of practice to provide patient with safe and quality of service and minimize risk of assessment (Nursing and Midwifery Board of Australia - Registered nurse standards for practice, 2015). Theoretical knowledge helps develop am framework for nursing strategies that could be gathered from traditional knowledge, authoritative advice and current scientific data. The concepts and theoretical understanding create the basic knowledge needed for clinical assessment in care givers (Thomas Law, 2013). The development of reasoning skills of deduction, innovation of ideas and inductive reasoning develops from general assumptions is facilitated by theoretical knowledge (LoBiondo-Wood Haber, 2017). This helps to apply a direction for a common goal, leading to develop strategy for improved patient care and rationale to take clinical decisions. It is important to develop the EBP to promote change in the healthcare institution. The integration of EBP in the clinical practice can be done by formulating a framework of care plan. Incorporating scientific analysis into the care plan has become a necessity in todays day and age. The following step is to develop a set of questionnaire that will help both the nurse and patient cooperate and devise a clinical action. The main parameters of this questionnaire are as follows- P: type of patient and population which includes a patients ethnicity, race and problem, I: interventional procedure and treatment method, C: considering alternative methods of treatment in case the patient does not respond properly to the current regimen, O- deciding for the outcome of the treatment and T: stands for deciding the timing of the treatment (Melnyk et al., 2014). The similar practice is set by the standards of NMBA, Standard 5 when an RN Develops a plan for nursing practice, this plan of action requ ires understanding of the patient situation, formulate a contingency based of the available evidence that comes from prior research will only help in the betterment of patient outcome (Nursing and Midwifery Board of Australia - Registered nurse standards for practice, 2015). According to the standards of registered nurses set by the Nursing and midwifery board of Australia (NMBA), The standard statement 1, it is expected of a registered nurse to use a variety of clinical strategies from the best option available while making clinical decisions to provide safe, and quality care by using patient centric, assessments using frameworks of evidence based practice guidelines (Nursing and Midwifery Board of Australia - Registered nurse standards for practice, 2015). The International Council of Nurses (ICN) Australia, Clause 3 of also has a set of Code of Ethics for nursing staff, which states that evidence based practice is the root cause that defines the activity of a registered nurse and links clinical practice with patient care (The ICN code of ethics for nurses, 2012). There are many barriers when it comes to evidence based practice in nursing which are time management, access to evidence, knowledge and skill and patient preference. Time management: This is the most important aspect of evidence based practice. The growing rate of hospitalizations and illness all over the world has made it difficult for nurses to find time for research. The registered nurses has to check many patients dealing with different problem under one single ward which makes it difficult for them to appraises research data in the duty routine. Access to evidence: it is not possible for registered nurses to have access to peer reviewed journals and understand the level of all clinical research papers Knowledge and skill: the registered nurses do not have as much knowledge as a practitioner which would enable them to understand the scientific implications of clinical research, which makes it difficult to practise evidence inclusive clinical assessment (Gray et al., 2013). Patient preferences: it is important for a nurse to value the preference of patients when it comes to good clinical practice. Sometimes, that becomes a barrier to make clinical judgement, for which it is required to gain trust of the patient and make them understand the importance of the agreed upon intervention (Hoffmann, Montori Del Mar, 2014). The discussion above makes it clear that evidence based practice improves the outcome of patients and that evidence could be based on traditional knowledge or current scientific research. Nurses hold a responsible position in the healthcare industry which makes it difficult for them to assess the patient situation as good as the practitioner, similarly it is expected that registered nurses have the minimum skills and knowledge to perform procedures before the expert arrives in times of emergency. There are many barriers to practising evidence based clinical practice, one of which was appropriate skill and knowledge to assess the situation of application of research ideas, another important aspect is management of time which is less in case of nursing staff as they have to check multiple patients at the same time. Patients also have opinions and preferences in regards to their treatment which makes it difficult to apply new research based knowledge. The overall essay aims to address t he issue that it should be encouraged from the nursing training to correlated research evidence in clinical practice so that in times of professional decision making the issue can be surpassed to some extent. References: Brownson, R. C., Colditz, G. A., Proctor, E. K. (Eds.). (2017).Dissemination and implementation research in health: translating science to practice. Oxford University Press. Cook, B. G., Odom, S. L. (2013). Evidence-based practices and implementation science in special education.Exceptional children,79(2), 135-144. Cook, B. G., Tankersley, M., Landrum, T. J. (Eds.). (2013).Evidence-based practices(Vol. 26). Emerald Group Publishing. Dawson, A. J., Stasa, H., Roche, M. A., Homer, C. S., Duffield, C. (2014). Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies.BMC nursing,13(1), 11. Gray, M., Joy, E., Plath, D., Webb, S. A. (2013). Implementing evidence-based practice: A review of the empirical research literature.Research on Social Work Practice,23(2), 157-166. Hoffmann, T. C., Montori, V. M., Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making.Jama,312(13), 1295-1296. Kavalieratos, D., Mitchell, E. M., Carey, T. S., Dev, S., Biddle, A. K., Reeve, B. B., ... Weinberger, M. (2014). Not the grim reaper service: an assessment of provider knowledge, attitudes, and perceptions regarding palliative care referral barriers in heart failure.Journal of the American Heart Association,3(1), e000544. LoBiondo-Wood, G., Haber, J. (2017).Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences. Melnyk, B. M., Gallagher?Ford, L., Long, L. E., Fineout?Overholt, E. (2014). The establishment of evidence?based practice competencies for practicing registered nurses and advanced practice nurses in real?world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs.Worldviews on Evidence?Based Nursing,11(1), 5-15. Nursing and Midwifery Board of Australia - Registered nurse standards for practice. (2015).Nursingmidwiferyboard.gov.au. Retrieved 27 March 2018, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx Schneider, Z., Whitehead, D. (2013).Nursing and midwifery research: methods and appraisal for evidence-based practice. Elsevier Australia. The ICN code of ethics for nurses. (2012) (p. 3). Geneva. Thomas, A., Law, M. (2013). Research utilization and evidence-based practice in occupational therapy: A scoping study.American Journal of Occupational Therapy,67(4), e55-e65