Discussion On The Nursing Practice Standards Of NMBA And The Importance Of Evidence-Based Practice

Practice Standards of NMBA

Discuss about the Nursing Practice Standards of NMBA.

According to the practice standards of NMBA, the practice protocol for a registered nurse has to be person centred and evidence based to begin with, and along with that a registered nurse must incorporate elements of preventative, curative, formative, restorative and supportive aspects of the care provided to the patient (Nursingmidwiferyboard.gov.au. 2017). Although evidence based practice has developed into a revolutionary concept in health care, it has to be understood in this context, that the concept of evidence based care is still very new to the health care industry. And there are many sectors within the health care industry that is neither accustoms with the concept of evidence based practice nor how it is supposed to be incorporated to the care provided. One of the most influential contributing factors to this scenario can be the conspicuous lack of knowledge in the nursing workforce regarding the evidence based practice and how it is integrated into health care practice. However, the benefits of evidence based practice cannot be denied either; hence a consensus regarding the rightful and optimal utilization of evidence based practice into the health care scenario (Chang, Russell & Jones, 2010). This paper will attempt to represent a position statement on the evidence based practice and the issues prevalent in the optimal implementation of this practice standard into the health care scenario.

It has to be mentioned in this context that evidence based practice has been recognized as a key requirement in the practice standards for a registered nurse curated by the Nursing & Midwifery Board of Australia or NMBA, hence there are a set of key benefits that are facilitated by the use of evidence based practice into the nursing practice. First and foremost, evidence based practice can be explained as the research practice, that facilitates the collection, evaluation and implementation of the clinical evidence in the care planning and execution procedure to improve the patient outcome along with the quality and safety of the care provided to the patients. According to DiCenso, Guyatt & Ciliska, (2014), health care industry has incorporated consumerism in a massive proportion in the past decade and in the face of extreme consumerism, incorporating evidence based practice serves the purpose of standardizing the health care practices so that better pati9ent outcomes and improved patient safety can be provided. It has to be mentioned in this context that evidence based practice incorporates the systematic and scientifically reasonable protocol of linking research with practice, where each and every step of the practice is based on extensive and critical research, which inevitably increases the success scope of the treatment of choice. According to Heiwe et al., (2011), the very foundation on which the evidence based practice is based on the research that provides authentic, reliable and transferable information regarding treatment choices and possible outcomes to the health care professional, which enables the health care professional to compare the available information about treatments with the possibility of the intervention or care action having a positive outcome. Johansson et al., (2010) have indicated this to be a primary reason behind the drastic improvement evidence based practice has brought forward into the health care industry, the main philosophy of evidence based practice is patient centred, hence, implementing evidence based practice helps in gaining maximum patient satisfaction and maximum patient safety.

Importance of Evidence-Based Practice in Healthcare Industry

Now, despite of there being a lot of advantages to evidence based practice, there are a number of challenges or issues prevalent in the implementation process. It has to be understood that there is a significant difference between the theory of evidence based practice and how is practically applied to a clinical setting. Considering the theory of evidence based practice, the principles of evidence based practice questions each and every step of the care plan so that each step can be based on core structural research of clinical evidences. In theory, there can be three distinct steps to follow in order to implement evidence based practice into the clinical care practice (Kirmayer, 2012). The first step is knowledge creation and distillation, in which the evidence based research, is conducted from relevant and reliable medical databases and then based on the research the information gathered and packaged into specific practice recommendations. The second step to evidence based practice is the diffusion and dissemination of the information collected, which links the researchers with the health care intermediaries so that the collected data can be screened and co-aligned to fit the specific requirement of the patient optimally. The last step is end user adoption and implementation, where the best fit practice recommendation is adopted and implemented in the clinical setting for the patient under consideration (Lyons et al., 2011).

Now, the practical implementation procedure of this is far from the systematic three-step framework which enforces a significant limitation of the theoretical framework, as there are a multitude of external and internal factors associated with the nursing practice that continue to influence the care practice and in turn modifying both the stages of evidence based search and its outcomes (Majid et al., 2011). As per the RN standards for practice by the NMBA, there are 7 core principles of nursing practice and each of those incorporate the concept of evidence based practice. Considering the Australian context, there is a vast cultural influence on the patient demands and patient satisfaction; hence, incorporation of core research based practice a significant number of challenges which complicates the path for successful clinical implementation of the theoretical standards. Another key challenge that widens the gap between theoretical and clinical implementation of evidence based practice into care scenario. Solomons & Spross, (2011) have opined on the fact that evidence based practice is still a very novel concept to health care and despite its implementation into practice standards like NMBA, there is limited effort to train the existing and new staff regarding how to implement the theoretical understanding of evidence based practice into clinical settings overcoming the challenges that are prevalent in this scenario. Most of the existing nursing workforce with considerable experience is much more comfortable with traditional method of nursing; they neither understands what evidence-based practice entails nor they are adapt with the steps of this practice standards. On the other hand, the new generation of nursing workforce despite having theoretical knowledge of evidence based practice; do not have any idea of how to implement their knowledge into clinical practice with the conspicuous challenges. On the contrary, Stichler et al., (2011) have argued, that the level of understanding of evidence based practice in the nursing workforce is incomplete, regardless of the years of practice, and the incomplete knowledge has created negative point of view regarding the effectiveness of evidence based practice into clinical practice. Hence, until and unless robust training and skill improvement programs are executed to enhance the knowledge and understanding of evidence based practice and how to blend it with cultural safety and patient centred care the nursing workforce cannot be expected to be at the forefront of this practice standard.

From the above discussion, the position statement can be clearly stated that evidence based practice is undoubtedly one of revolutionary steps which can change the health care industry for the better. However, the challenges cannot be overlooked as well, and these challenges can only be overcome with proper training to the nursing workforce which will enable them to understand the elements of evidence based practice critically and will help in incorporating this scientific research based technique into everyday practice. It has to be understood that as registered nurses, the majority of the responsibility of care planning and implementation is carried by RNs, without proper training about evidence based practice and support from the rest of staff with adequate understanding of this concept, RNs cannot be expected to implement EBP flawlessly into clinical setting.

References:

Chang, H. C., Russell, C., & Jones, M. K. (2010). Implementing evidence-based practice in Taiwanese nursing homes: attitudes and perceived barriers and facilitators. Journal of gerontological nursing, 36(1), 41-48.

DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based Nursing-E-Book: A Guide to Clinical Practice. Elsevier Health Sciences.

Heiwe, S., Kajermo, K. N., Tyni-Lenné, R., Guidetti, S., Samuelsson, M., Andersson, I. L., & Wengström, Y. (2011). Evidence-based practice: attitudes, knowledge and behaviour among allied health care professionals. International Journal for Quality in Health Care, 23(2), 198-209.

Johansson, B., FOGELBERG?DAHM, M. A. R. I. E., & Wadensten, B. (2010). Evidence?based practice: the importance of education and leadership. Journal of nursing management, 18(1), 70-77.

Kirmayer, L. J. (2012). Cultural competence and evidence-based practice in mental health: Epistemic communities and the politics of pluralism. Social science & medicine, 75(2), 249-256.

Lyons, C., Brown, T., Tseng, M. H., Casey, J., & McDonald, R. (2011). Evidence?based practice and research utilisation: Perceived research knowledge, attitudes, practices and barriers among Australian paediatric occupational therapists. Australian Occupational Therapy Journal, 58(3), 178-186.

Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y. L., Chang, Y. K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association: JMLA, 99(3), 229.

Nursing and Midwifery Board of Australia – Registered nurse standards for practice. (2017). Nursingmidwiferyboard.gov.au. Retrieved 29 October 2017, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

Solomons, N. M., & Spross, J. A. (2011). Evidence?based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review. Journal of nursing management, 19(1), 109-120.

Stichler, J. F., Fields, W., Kim, S. C., & Brown, C. E. (2011). Faculty knowledge, attitudes, and perceived barriers to teaching evidence-based nursing. Journal of Professional Nursing, 27(2), 92-100.