To What Extent Can Nurses Deliver Evidence-Based Care Term Paper

  • Length: 20 pages
  • Subject: Healthcare
  • Type: Term Paper
  • Paper: #32324751

Excerpt from Term Paper :

nurses deliver evidence-Based care?

Define main ideas within the title supported from the literature

Nurse instructors confront many hurdles in the present healthcare environment. Educational methods, philosophies, and the content of curricula is required to reviewed to cater to the requirements of the professional nurses who would practice in the coming millennium. (Kessenich; Guyatt; DiCenso, 25) Evidence-based practice or EBP has currently emerged to be a remarkable attribute in nursing literature along with a key impetus in restructuring nursing practice. (Elizabeth; Pyle, 64) Evidence-Based Nursing or EBN is the strategy by which the nurses formulate clinical conclusions applying the best available research evidence, their clinical skill and patient prioritization. (Evidence-Based Nursing: University of Minnesota) It could be narrated as the meticulous, unequivocal and judicious application of the current best evidences in formulating decisions about the care of individual patients. When clinicians formulate health care conclusions for a population or group of patients applying research evidence, this definition can be stretched out to evidence-based health care. Formulating patient care conclusions applying prevailing information and the clinical skills improves the performance of health care providers to generate best practice. (Evidence-based Practice FAQs) Let us now understand some of the main issues relating to what extent can nurses deliver evidence-based care.

Advantages and Limitations of EBP:

In the present day health care environment, all clinicians must apparently understand and interpret the pertinent evidence prior to extending care. (Evidence-based Practice FAQs) In consequence to the present promotion of evidence-based practice, a number of information systems are prevailing that nurses should be aware of. While the extent of studies enhances, it is pertinent to assess the evidence generated in terms of its potential contribution to nursing practice. (Sullivan, 35) Evidence-based nursing is one strategy that may make the emerging healthcare providers possible to address the emergence of new literature and technology and finally may result in improved patient consequences. (Kessenich; Guyatt; DiCenso, 26) EBP has the prospects of enhancing the quality of nursing care based on the best evidence prevailing. Detecting the most suitable care can occur in the best possible consequences for the recipient. (Linda, 2)

Evidence-based practice necessitates variation in education of students, more practice-relevant research and closer working relationships between clinicians and researchers. Evidence-based practice also generates scopes for transforming the nursing care to become more focused, more successful, efficient and energetic, and to maximize impacts of clinical judgment. Unluckily, it is not reasonably so simple. Significant conceptual and practical concerns interfere as barrier in the path of extensive acceptance and safeguard of evidence-based-nursing. (Elizabeth; Pyle, 63) Sackett & Rosenberg during 1995 recognized that few health professionals have the time to search for, nor the skills to critically evaluate, evidence on which to base their practice. They acknowledged that the mode of inducing the doctors to make their practices based on evidences was to accumulate the evidence from them. (Street, 41)

Tools and practices of evidence-based practice:

Being aware of the tools and practices of evidence-based practice is required for offering the best qualitative patient care. (Guyatt; Haynes; Jaeschke; Cook; Green; Naylor; Wilson; Richardson, p. 1290) Hence we may look into the following sections:

Raising Questions:

Clinicians are required to find the answers to the more problematic questions associated with the concerns and advantages concerning costly interventions or treatments. Health care consumers and insurers require state-of-the-art treatment along with research revelations that demonstrate its efficacy. Every system and step associated with the procedure is required to be meticulously considered for their contribution to health outcomes. Clinicians can no longer depend upon the reasoning of finding out the mode that the things have been done always or the reasoning of finding out the mode of understanding to perform this. (Evidence-based Practice FAQs)

Finding the Evidence:

With enhanced interest in tracing prevailing valid evidence to safeguard clinical experience. As a result of the holistic feature of nursing, accumulated evidence necessitates searching a diversity of sources within many varied scientific disciplines. Thus we can mention here the views of Donna K. Ciliska, Janet Pinelli, Alba DiCenso and Nicky Cullum in this respect that evidence-based experience refer to coordinating the best available research evidence with information about patient preferences, clinician skill level, and prevailing resource to make conclusions about the patient care. Obstacles to the research-based evidence prevail when time access to journal articles, search skills, critical appraisal skills, and awareness of the language applied in research are deficient. Resources are prevailing to come across such barriers and safeguard an evidence-based nursing experience. (Linda, 3)

Clinical Guidelines, Evidence-Based Approach and Clinical Pathway:

Nurses require the tools to be competent to apply research in a sensible way. Reducing out the gap between theory and experience necessitates both a mode to transform the study revelations into the language and action of practice, and the scope to extract sustained variations relied on such findings. A number of mechanisms prevails that may enable this process to continue. The development of clinical guidelines based on sound evidence about best practice; The environment of clinical standards on the basis of such guidance; successful care planning to facilitate application of guidelines and the adhering to the standards in practice. Clinical guidelines are meticulously developed statements those help clinicians and patients in performing conclusions about suitable treatment for specific conditions'. (Sullivan, 36)

Real execution relies on the skills of nursing staff to include the details into the strategy of care planning, in a mode that generates a clear rationale for each intervention and assist staff to avoid ritual activity that is only a reflection of routine practice in the clinical area. Such kind of strategy makes possible for an evidence-based approach to be extended to everyday clinical problems and can be enhanced by the improvement of care pathways which include local best experience, national guidance and research evidence. (Sullivan, 36)

One other assistance that is worth mentioning is that it is common to many nurses the device where it is attempted to translate evidence reports or practice guidelines into something that directs best practice at the level of micro-system. And it is 'The clinical pathway'. (Cronenwett, 58)

Randomized controlled trial (RCT):

Evidence-based health care is regarded as deployment of the best prevailing evidence to a particular clinical problem. The randomized regulated trial or RCT is regarded as the most suitable design for assessing the successfulness of a nursing intervention. However, presently, there has been a considerable stress on systematic overviews and qualitative studies of the research literature. (DiCenso; Cullum; Ciliska, 38) The 1970s visualized the coming out of the book of Archie Cochran, Effectiveness and Efficiency: Random Reflections on Health Services. Cochran puts forth the view in the book that we are required to entail care that has been confirmed to occur in good consequences. This confirmation should come from appropriate study. Cochran was the first to clearly explain that random, regulated trials are the only things that offer valid information on the successfulness of the medical interventions. He urged for maintenance of an international register of random regulated trials and clear condition for assessing published research. (Kerry, 30) In spite of the advantages of RCT's, they have their limitations as well. In many fields of nursing care, studies in the desired form of random clinical trials do not exist.

Modeling Evidence-based research:

Thus understanding such limitations of the RCT's so as to have a body of current research; there must be sufficient people with sufficient time and sufficient expertise to conduct it. To utilize revelations of research studies there requires being structured and standardized modes to accumulate it and reach it that demands the requirement for modeling evidence-based research. (Kerry, 30)

Information Technology:

Since the Randomized Controlled trials have their limitations the answer to this is information technology. As per Marsha E. Fonteyn, in the previous decade, clinicians have radically enhanced their application of the Internet as a source of information to steer clinical practice. The quantity of evidence-based information on the World Wide Web is enhancing at a volatile rate. Advanced Practice Nurses or APNs are necessitated to be understood as to the way to trace evidence-based information effectively on the Internet, as to the way to assess the validity and relevance of the information and the way to apply the information to support their practice decisions. (Linda, 3)

II. Explore and attempt an analysis of main issues making case for and against

Advantages and Limitations of EBP:

Advantages:

The evidence-based practice for nurses is progressively enhancing practice above clinical hearsay and bringing experience certainty to an unsure Healthcare world. (Kerry, 31) Evidence-based nursing experience is an advantage to practitioners along with the patient care managers. It indicates and records quality nursing experience and then practitioners to make sure that the staff offers quality patient care based on evidence instead of custom. What variations does the EBN entail? Evidence-based nursing enhances the quality of patient care; extends nurses with new tools for cross-training and continuing educational programs; cuts down the length of reorganization; instills new skill, direction, and confidence to…

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