Delivery in day(s): 4
NRSG367 Transition to professional Nursing OZ Assignments
Evidence-based practice is a systematic search and involves the diligent use of current valuable evidence while making decisions for the patient. It integrates the nurse’s clinical expertise, appraises the most implacable evidence to meet the patient needs and simultaneously respects patient’s requirements. Additionally, it values patient preferences and choices and considers their necessities while providing the health care services to improve the overall patient experience. It also offers the registered nurses an opportunity to transform patient care and expand their knowledge by providing patient-centric care (Hoffmann, et al. 2013). The below assignment analyzes the importance of evidence-based practice while nursing the patient to achieve better final results and then understands whether it is feasible for the registered nurses to implement evidence-based care into clinical settings without optimum training and support.
Evidence-based practice and its implementation in nursing care
The evidence-based practice embraces collection, evaluation, implementation, and analysis of evidence to improve the final patient outcome and majorly relies on those research findings which have the potential to benefit maximum patients. As it recognizes patients’ choices, this is not a static model but rather gets continuously transformed with recent and better research (Schneider and Whitehead, 2013).The advantages of evidence-based practice are multifold and in the past, the patient was a healthcare receiver but nowadays the patient is a healthcare consumer who needs improved and prompt services with the best standards of safety in a competitive market. Therefore, evidence-based practice strives to achieve excellence by strengthening the knowledge of the healthcare provider with superior and predictable outcomes. Such systematic guidelines and approach towards healthcare amplify the chances of success and quality of prognosis. Evidence-based practice thrives its success through the reliable information that is backed by research and proven patient outcomes (Kitson, et al. 2013).Apart from improved patient care and a better prognosis, there are significant chances of faster healing or patient recovery along with revamped patient self-management. It ameliorates the coping potential of the patient by working upon the visible results and thus boosts patient’s confidence towards comprehensive health. It also cuts the healthcare costs and thereby makes it feasible, both, for the patient as well as for the administration to foster enhanced healthcare practices. Evidence-based practice has out-reached its realm and is applicable for all the specialties of medicine, therefore, it reduces the possible medical complications.
Research has proved that the percentage of the total population which receives appropriate healthcare is not significant and in such cases, the remaining population is at a higher risk of being affected due to either human errors, medication hazards, knowledge deficit or lack of advanced technology (Masters, 2015). Evidence-based research helps to minimize those errors which are either caused due to lack of knowledge (lack of information about the clinical procedures, disease, diagnosis, drug name, dose, administration, frequency, etc.) and human errors which can occur due to unavoidable and unintentional reasons by employing already available research backed evidences into practice for the ultimate benefit of the patient.
Although the benefits of evidence-based practice are numerous, it is utmost essential for the registered nurse to analyze the available information and utilize it to benefit the existing patient situation. Evidence-based practice is based on the philosophy to address the patient’s needs with a goal to achieve effective and efficient treatment and therefore expects the nurses to efficiently comprehend the research conducted and comprehend its utilization and relevance for an individual patient (Hoare, et al. 2012).As the demand for evidence-based practice increases, so does the requirement of skilled nurses takes a hike who can exhibit critical thinking, implicit rationale, and profound decision-making abilities. This, in turn, demands educated and well trained professional nurses with intellectual skills to study the available evidence and utilize it in a customized situation for the benefit of the patient. There are several models proposed to utilize the evidence-based care however it employs the following 4 critical steps, both, in theoretical and practical aspects:
This includes inculcating a stem of inquiry which helps the nurses to acquire the best of knowledge at the holistic level. Nurses must be inclined to ask questions regarding the clinical diagnosis or the burning question to improve their expertise and focus on reducing the gap by commanding better risk management strategies, improvised regulations, nursing standards of care and quality improvement techniques (Nursing and Council, 2012).
Finding the relevant evidence
The most relevant evidence can be found by either conducting a primary or secondary research and the nurses have the role to study the literature review on the conducted studies. Nurses must understand that reviews and evidence from the meta-analysis or a systematic review are considered as the strongest and the primary level of evidence followed by randomized controlled trials, expert opinions, etc.
This is a crucial step to judge whether the existing study will be helpful in the existing case or not and after gathering the required evidence, the nurse should implement this step by answering the basic questions such as the positive evidence obtained, how trustworthy are the evidence and if they can be transferred to other patients.
The final initiative would be to integrate and utilize the most relevant evidence in clinical practice along with applying one’s own clinical expertise while taking into consideration patient’s choices. It also includes evaluation of the final outcome achieved to scale the dependency of the evidence (Florin, et al. 2012).
The implementation of evidence-based practice in nurses requires the nurse to seek through the quantitative and qualitative research with intricate skills and channel their knowledge to reckon those strategies which can be suitable for the individual patient. Such advanced level of nursing care requires knowledge to be revolutionized into clinically beneficial forms that can be made in action throughout the healthcare teams to achieve meaningful, visible and faster positive outcome. It necessitates the development of new competencies which must be centered to apply knowledge in clinical practice and achieve better decision-making abilities (DiCenso, et al. 2014).For the evidence-based practice to be adopted and successfully sustained, the policy must be adopted by the leaders, individual care providers, policymakers, and the micro-system so that the change is brought to the federal, state and local level. Studies have also proven that while nurses are keen towards learning new skills and capabilities to enhance their vision towards evidence-based care, yet, they face concrete barriers while bringing this effect into practice. This occurs as its acceptance and generalization require effective learning materials to transform graduate nursing health care into highly trained ones who are qualified with impeccable clinical practice.
Thus the registered nurse must promote evidence-based care to obtain an enhanced patient outcome in accordance with the patient values and preferences by formulating questions, assessing critical practice, evaluating research, and observing the outcome through a guided path. This requires implementation of a schematic learning regimen which is supported by the organizational culture. Although developmental systems are in place to integrate evidence-based nursing practice in regular care there are many barriers which are faced by the nursing staff while employing this practice. The barriers can either be due to individual characteristics such as lack of interest, confidence or knowledge to analyse the available research, negative attitude, values and beliefs, and lack of ability to change the patient care strategies or due to organizational limitations such as heavy patient flow and workload, inadequate staffing, lack of research time, inappropriate and inadequate resources, lack of support provided by the organization towards implementation of evidence-based care (Cullum, et al. 2013).
Therefore although the nurses are expected to implement research findings into their practice, many are not trained on how to do this. Rather than the graduating nurses, it is the duty of the academic institutions and the hospitals to broaden the focus on quality healthcare and implementing redesigned health care systems for ensuring patient-centered, safe, effective, timely and equitable care. There are records to prove that evidence-based care has been promoted in the last decade, however, there are several practicing registered nurses who either lack sufficient resources or complete knowledge required for implementing it in their daily practice or are deprived of organizational support. Although there are considerate advancements yet translation of clinical research into practice guidelines and schematically changing hospital or institutional culture still remains a huge public issue which hinders the daily use of evidence-based nursing care (Runciman, et al. 2012).Therefore, with such unresolved surrounding issues, it should not be expected that nurses are at the forefront of evidence-based practice implementation in the clinical setting.
Evidence-based clinical practice reduces the fatal attempts made towards patient care and aims to achieve a better clinical outcome by incorporating research backed and evidence proved studies while designing the healthcare plan for the patient (Broom and Adams, 2012). Incorporating evidence-based nursing care requires systematic amendments in the education structure, improved research-related clinical practice and nurses to be more streamlined so as to maximize the clinical outcome. It also necessitates the organizational facilities such as latest technological equipment and advancements to work with an immediate access to recent research. The above assignment reflects how nursing care can be evidence-based and patient-centric in nature so as to maximize the benefits and understands the necessary training amendments an institute or working organization requires to implement it. By acknowledging these requirements, the assignment reckons that without sufficient support and training a registered nurse cannot be expected to employ evidence-based care into clinical practice.
1. Broom, A., & Adams, J. (Eds.). (2012). Evidence-based healthcare in context: Critical social science perspectives. Ashgate Publishing, Ltd.
2. Cullum, N., Ciliska, D., Haynes, B., & Marks, S. (Eds.). (2013). Evidence-based nursing: an introduction. John Wiley & Sons.
3. DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based Nursing-E-Book: A Guide to Clinical Practice. Elsevier Health Sciences.
4. Florin, J., Ehrenberg, A., Wallin, L., & Gustavsson, P. (2012). Educational support for research utilization and capability beliefs regarding evidence?based practice skills: a national survey of senior nursing students. Journal of advanced nursing, 68(4), 888-897.
5. Hoare, K. J., Mills, J., & Francis, K. (2012). The role of Government policy in supporting nurse?led care in general practice in the United Kingdom, New Zealand and Australia: an adapted realist review. Journal of advanced Nursing, 68(5), 963-980.
6. Hoffmann, T., Bennett, S., & Del Mar, C. (2013). Evidence-Based Practice Across the Health Professions-E-Book. Elsevier Health Sciences.
7. Kitson, A., Marshall, A., Bassett, K., & Zeitz, K. (2013). What are the core elements of patient?centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of advanced nursing, 69(1), 4-15.
8. Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett Publishers.
9. Nursing, A., & Council, M. A. (2012). Registered nursing health care accreditation standards. Canberra, Australia: Australian Nursing & Midwifery Accreditation Council.
10. Runciman, W. B., Hunt, T. D., Hannaford, N. A., Hibbert, P. D., Westbrook, J. I., Coiera, E. W., ... & Braithwaite, J. (2012). CareTrack: assessing the appropriateness of health care delivery in Australia. The Medical Journal of Australia, 197(2), 100-105.