Evidence-based practice in health care refers to evaluation and implementing the scope of evidence in order to improve the care of the patient and their outcomes. Health care providers and professionals rely on the expertise and experience gained in evaluating the findings of the research which offer great benefits to the patients. Evidence-based care process respects the patient’s uniqueness, preferences, and individual preferences. Common recipe of this practice entails the integration of clinical knowledge and expertise, skills gained, experienced and level of education, which interacts with the patient personal preferences and uniqueness. Often sound evidence-based practice is sourced from concrete research which is conducted with sound methodological principles, (Burns & Grove, 2010). Evidence in itself cannot be beneficial, however, when used effectively supports the patient care process. Integrating clinical expertise, patient values and preferences and best research evidence enhance the best clinical outcomes for the patient and improve the overall quality of care offered, (Melynk & Finout-Overholt, 2011).
Evidence-based care has tremendous benefits towards patient outcomes, improving patient safety and overall improvement on quality of life. Currently, patients consume health care, thus the need for improved care, treatment safety standards. Usage of evidence-based practice goes a long way in improving and standardizing outcomes of care, (Reynolds, 2008).
This approach follows a systematic pattern which yields improved treatments and higher chances of success in health care practices. Thus this approach to evidence-based care is crucial in ensuring patient-centered philosophy is adhered to.
Other known benefits of evidence-based care include lowered cost of health and limited medical complications in various clinical expertise.
Evidence-based practice process follows 6 crucial steps in ensuring that an effective process is followed;
There is an increased value in the healthcare arena where treatment is consumer drive. Approaches have been implemented where patient preferences are solicited and used during the treatment protocol. Preference assessment is a form in which goes beyond measuring the patient preferences, (Tobiano et al., 2015).
The overall beneficiary of patient preferences aspects is the patient. The patients are the ones who eventually benefit greatly from patient preferences, as health care practitioners understand the patient unique circumstances in the best interest of the patient.
Patient preferences are elicited through the creation of rapport and good communication. An effective way of communication elicits patient preference and values, this is geared towards understanding the patient view of the socio-cultural situation he/she is involved. Research studies undertaken have shown that patient family setups influence patient decision-making process. At times the patients can need the assistance of family members to make decisions on their personal clinical care, hence the need to include in the process, (Hawley & Morris 2017).
Creation of good rapport with the patient is key in ensuring that appropriate information is offered to the patients. Engaging in conversation is key in ensuring that evidence offers dispassionate presentation, (Petrilli et al., 2015). Patients at times share the needed relevant information which is key to their treatment in this way, patient preferences are adhered to. Hence patient preferences offer nurses and other healthcare professionals with information which aid in making a personal choice and how to choose between two different options.
Strategies for implementing evidence-based practice
Over the recent past, there has been the focus on bridging the gap between research and practice. Many health-oriented agencies such as US National Institute of health and Agency institute of health care in the US have been advocating for narrowing the gap between nursing care and health care practice through evidence research, (Melnyk et al, 2014). However, despite the developments of interventions which are effective in the academic arena, challenges persist in the manner in which they are disseminated to nonacademic staff such as the healthcare organizations. The common problem with this fact is that there is a lack of effective framework which allows for effective implementation and intervention for such knowledge to be put into practice.
Thus an effective strategy of dissemination of evidence-based research is paramount. Majority of the interventions often fail to reach the threshold for achieving outcomes. This lack of clear follow-up may be linked to declining fidelity of the intervention to the implementation organization.
The wind of change in health care organizations in health care delivery with the professionals involved is geared towards providing maximum quality of care to its consumers who are the patients; hence the need of incorporating evidence-based research in the critical decision-making process of care delivery. Implementing evidence-based practice in, however, is a long process which needs multiple strategies which incorporate individuals and organizations.
A good number of such guiding strategies and guidelines have been put forward, majority which focus on the primary adaptations of interventions which include; determination of how organization is ready to make room for adaptation of such interventions, engaging front-line managers in enhancing and overcoming any perceived challenges and ensuring that there is an enabling framework to support such instances. However, despite these efforts, frameworks do not offer any suggestion on the fidelity adequacy of the intervention and incorporating differences across the organizations so as to maximize effectiveness.
One of the advanced and propagated frameworks for infusing evidence-based research in the healthcare setting is Replication Effective programs approach. This framework offers a roadmap for evidence-based practice to be implemented. Replicating effective programs tool provides the package which entails training, offering technical assistance and other effective strategies which maximize the chances of promoting the interventions. This framework has been evaluated through randomized controlled trials and its success has been noted.
Researches undertaken have shown that there are other various strategies which evidence-based practice can be incorporated successfully in healthcare practice. There is the need for the creation of a learning environment and designing of training programs such as evidence-based practice journal clubs so as to ease sharing of information. There is the need for close collaboration of healthcare practitioners with the implementers of evidence-based practice. Discussion meetings can be further be held across the professional’s network so as to bring the common goal of sharing evidence-based practice, (Brownson, 2017).
It is crucial to note that, for these effective strategies to work, health care managers and policy formulators need to put in place a strategic direction of the organization to incorporate evidence-based practice. This informs the adoption of the culture which promotes evidence-based practice and motivates the nurses and other healthcare professionals towards evidenced-based professional experience, (Guerrero et al, 2015).
Challenges in implementing evidence-based practice in healthcare
In the healthcare arena, it is often too difficult to incorporate evidence and recommendations into practice. This process often takes too long to be incorporated into practice. Transferring of knowledge is often viewed as a complex and difficult aspect of evidence-based practice. Various barriers have been highlighted which don’t necessitate adoption of evidence research into practice. These factors include lack of access to research, lack of adequate understanding of the research process, lack of adequate knowledge for critical analysis of information obtained, lack of time and minimal time and lack of effective support from the organization, (Melnyk et al, 2014). On the other hand, facilitators infuse positive attitude towards research, information levels, conferences attendance, the satisfaction of work, engaging in research activities and time need to read through professional journals.
Implementation of evidence-based practice in healthcare further involves personal attributes factors which are linked to an organizational framework, cultures, and environmental factors. Thus there is a need for a conducive culture and environment that support evidence-based research practice in healthcare practice.
Further, another key aspect is the development of a critical pool of professionals who are able to have an effective hand in evidence-based practices and undergone requisite training so as to ensure that there is a collaboration between the health care providers and the research network, (Harvey & Kitson, 2015).
Another key challenge in implementing evidence-based practice pertaining to nurses is the busy schedules of nurses and another allied healthcare team. This hampers the preparation of the challenge and limits the implementation of evidence-based practice. Thus as leadership is effective in ensuring the success of implementing evidence-based practice, the organizational culture and context play a crucial role in implementing evidence-based practice. This complexity is intrinsic factors linked to the reception of evidence-based practice, (Dang & Dearholt, 2017).
Conclusion
Evidence-based practice is a key clinical practice which is linked to current practice. Its implementation revolves around four basic steps that are framing the question based on clinical assessment, searching for relevant evidence, critical appraisal of evidence and application of findings to the clinical decision process. Hence when implemented, it offers critical assistance to health care in improving quality of care. Implementation has been regarded as a core competency in health care quality. Variations have been observed among different health care professionals, who depict various significant differences, nevertheless, the key is aspect is the overall improvement of health care among the consumers.
Hence in order to ensure effective utilization of evidence-based research in healthcare practice; factors such as positive perception, educational training, enabling environment and oriented organization leadership support usage of evidence-based practice in improving quality of care.
References
Brownson, R. C. (2017). Dissemination and implementation research in health: translating science into practice. Oxford University Press.
Burns, N., & Grove, S. K. (2010). Understanding Nursing Research-eBook: Building an Evidence-Based Practice. Elsevier Health Sciences.
Dang, D., & Dearholt, S. L. (2017). Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau.
Guerrero, E. G., Padwa, H., Fenwick, K., Harris, L. M., & Aarons, G. A. (2015). Identifying and ranking implicit leadership strategies to promote evidence-based practice implementation in addiction health services. Implementation Science, 11(1), 69.
Harvey, G., & Kitson, A. (2015). Implementing evidence-based practice in healthcare: a facilitation guide. Routledge.
Hawley, S. T., & Morris, A. M. (2017). Cultural challenges in engaging patients in shared decision making. Patient education and counseling, 100(1), 18-24.
Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
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.
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.
Petrilli, C. M., Mack, M., Petrilli, J. J., Hickner, A., Saint, S., & Chopra, V. (2015). Understanding the role of physician attire on patient perceptions: a systematic review of the literature—targeting attire to improve the likelihood of rapport (TAILOR) investigators. BMJ Open, 5(1), e006578.
Reynolds, S. (2008). Evidence-based practice: a critical appraisal. John Wiley & Sons.
Tobiano, G., Marshall, A., Bucknall, T., & Chaboyer, W. (2015). Patient participation in nursing care on medical wards: an integrative review. International Journal of Nursing Studies, 52(6), 1107-1120.
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