Discuss About The Forefront In Implementing Clinical Setting?
EBP is currently a predominant care model which has gained global recognition in the facilitation of transferring research evidence into the best clinical practice. The uses of EBP involve the integration of best available information, clinical expertise and the values of a patient in order for them to attain optimal health outcomes (Brown, 2010). Therefore it is an important approach in strengthening the nursing practice. The Australian government has in this regard developed nursing standards which focus on nursing that nurses embrace EBP in their practice. This discussion presents the reasons why nurses should be at the forefront in implementing EBP, including a review on the importance of EBP to the improvement of patient outcomes. It also highlights the steps of EBP in a clinical setting and the reasons as to why there is need for support and training to enable nurses take the lead role in providing EBP
There are different benefits that EBP application in the clinical setting brings in regard to improving a patient’s health outcomes. First EBP enables the provision of a higher quality care for patients in the clinical setting (Cashin & Cook, 2011). This is because nurses in collaboration with other interdisciplinary team members incorporate the latest researched evidence which they use in provision of patient care. Secondly, evidence based practice platforms where health professionals interact through online networks enable nurses to as for latest recommendations on patient care. The nurses thus are able to find recommendations in regard to their questions so that they provide the patient with the best clinical care. EBP also enables the patient to receive care timely and efficiently within the best clinical environment. This is based on the understanding that EBP enhances a nurse’ confidence, their adaptability to patient situations, improves their nursing skills, their critical thinking and also informs their decision making processing (Cashin & Cook, 2011). This is because they will constantly be evaluating different materials to support their individual practice. It is also important to indicate that EBP practice improves the patient outcomes by enhancing cohesion within the clinical interdisciplinary teams as it helps in defining each other’s role in provision of quality care based on the latest evidence available(Brown, 2010). Also EBP is associated with lower costs and safer healthcare for patients as it emphasizes on the efficiency and effectiveness of the available limited resources as compared to traditional nursing care. Further, EBP reduces the length of hospital stay for patients who have been admitted. This is because care provision is instant and in line with the patient’s needs for quick recovery.
Theoretical and clinical application of EBP is done systematically. It involves the use of latest theories in research which have however been proven to inform the provision of the best patient care in the clinical setting (Cashin & Cook, 2011). The nurses and health care professionals study relevant research, various expert opinions and end up identifying the best approaches to provide patients with optimal healthcare. Theoretical and clinical application of EBP follows the process of; asking related question; searching any latest research; incorporating one’s clinical experience; accommodating the preferences of the patient and; applying the results of the research. This should be followed by an evaluation of the theoretical and clinical application and its effect on patient outcomes (Rebar & Gersch, 2015). In regard to raising the question, a nurse should use the format which captures the main aspects of the issue. The search for latest research involves the assembly of the evidence that is most appropriate in addressing the identified issue. The evidence needs critical evaluation in order to determine whether it is valid (Levin & Feldman, 2013). Relevant, applicable or not in the clinical setting. While some of the evidence might be theoretically applicable, a particular clinical setting may not allow its full implementation. It is thus up to the nurse to determine evidence applicability. Assimilation of the appropriate theory into clinical practice can then be done followed by continuous monitoring and evaluation for effectiveness.
The first reason as to why an RN needs to be at the forefront in the implementation of EBP in clinical setting is because they are required as standard of practice to think critically and analyze nursing practice. This is in line with Standard 1 of the NMBA (2016). In this regard the nurse should be able to employ different possible strategies including the best evidence available to inform their decisions on the provision of nursing care that is safe and of high quality. The registered nurse needs to be able to asses, analyze this particular evidence and incorporate it in the provision of care. (Standard 1 sub section 1.1 accesses, analyses, and uses the best available evidence, that includes research findings, for safe, quality practice). From the evaluation of successful evidence based decision, the nurse should reflect on their experiences to strengthen their professional expertise according to the nursing standards (Rebar & Gersch, 2015). Further, it is also a standard of practice aspect that Registered nurses in taking the lead role to implement EBP in the clinical setting; they also contribute to the improvement of quality of healthcare and on any further research( Standard 1 subsection 1.7 contributes to quality improvement and relevant research). Therefore since critical thinking and analysis is part of their standard of practice; nurses must lead in regard to the implementation of EBP.
Secondly, RNs have the responsibility to maintain their practice capability according to standard 3 of the NSRN of 2016. In this regard, it is up to the nurses to ensure that they are capable of fully practicing in the clinical setting. It is clear that they are responsible for their own individual professional development. They are in fact responsible in contributing to the professional development of themselves and fellow nurses within the clinical setting (Standard 3 Subsection 3.3 uses a lifelong learning approach for continuing professional development of self and others). More specifically, the standards of practices indicate that a RN should be at the forefront in seeking and responding to nursing practice reviews and feedback. This is the approach used in evidence practice where review and feedback are paramount in forming future practice on a similar clinical case (Standard 3 Subsection 3.5 seeks and responds to practice review and feedback). Standard 3 of the NMBA (2016) also emphasizes on the need for Registered Nurses to be actively engaging in their profession, identifying and promoting their nursing roles in influencing better health outcomes for their patients. Evidence based practice implementation requires that nurses participate actively in engaging fellow professionals to ensure that the information they have is at per with the latest requirement of clinical practice(Rebar & Gersch, 2015). These conditions are only possible and can be met when Registered Nurses take the front role of appreciating and engaging actively in evidence based practice.
Further, nurses must be at the forefront in the implementation of EBP as it helps them in the development of nursing plans for their patients in the clinical setting (Levin & Feldman, 2013). Evidence based practice emphasizes on the need for nurses to rely on the latest research in developing nursing plans for patients with specific health needs that are exactly similar to those of patients who have already been managed before(Hedges & Williams, 2015). It also include the need to seek for expert advice in coming up with the nursing plan. In line with Standard 5 of the NMBA (2016), Registered Nurses have the responsibility to plan and communicate nursing practice plans to their patients, family and the interdisciplinary teams in the clinical setting. The standard calls for need for partnership in structuring of nursing plans and this means; there is need for consultation including experts as advised in EBP. It is also indicated that the plan must be in line with the Nurse’s appraisal of any available evidence that is relevant and comprehensive. There is need to assess the most appropriate available data and/or evidence to construct nursing plans that are effective (Standard 5.1 uses assessment data and best available evidence to develop a plan). These include those that have contingencies, preferences, goals, and timeframes of specific interventions and actions that are evidence-based. The nurse should also be able to indicate the monitoring and evaluation process of the nursing plan and how they will be carried out (Standard 5.4 plans and negotiates how practice will be evaluated and the time frame of engagement). This is in line with the last step of EBP process which emphasizes on the need for monitoring, evaluation and appraisal of evidence based practice clinical application (Cashin & Cook, 2011). It is thus imperative that nurses be ahead in the implementation of EBP.
While it is a requirement for Registered Nurses to be front-runners in implementing EBP in the clinical setting, it is not feasible for them to do so without special training and support in EBP. The first importance of training and support in this particular filed is that it helps the nurse to have increased knowledge in the implementation of both evidence based practice and evidence based learning (Cashin & Cook, 2011). Knowledge in this particular field makes it easier for the nurse to raise questions, seek expert advice and incorporate it in nursing plans. Secondly, training and support on how to search for information from various clinical databases and on critical evaluation of obtained information is important (Rebar & Gersch, 2015). Registered Nurses are able to be precise in seeking for information which reduces the time spent as compared to a case when they are not trained. It is clear that EBP systems are dynamic and the technical knowhow needed around working with them call for updated information through training (Hedges & Williams, 2015). Further training and support from health facility management and ministry can increase the knowledge of nurses in the development and implementation of EBP and procedure that are effective and properly integrated within their clinical setting. Training and support are thus crucial requirements in enhancing the nurse’ role in EBP.
Registered Nurse practice in Australia is governed by the NMBA (2016). It is therefore the duty of nurses to take the forefront in implementing EBP within the clinical setting. Standard 1, 3 and 5 as discussed weigh in on the need for nurses to be actively involved in taking part in EBP. Even so, health institutions in the spirit of enabling a conducive environment should avail necessary training and support to RNs to improve the quality of care.
Conclusion
In conclusion therefore, nurses need to be at the forefront in implementing EBP in the clinical setting. This discussion presents the reasons for this as required by the NMBA (2016), including a review on the importance of EBP to the improvement of patient outcomes. It also highlights the steps of EBP in a clinical setting and the reasons as to why there is need for support and training to enable nurses take the lead role in providing EBP.
References
Brown, P. (2010). Health care of the older adult: an Australian and New Zealand nursing perspective. Warriewood, N.S.W.: Woodslane Press.
Cashin, A., & Cook, R. (2011). Evidence-based practice in nursing informatics: concepts and applications. Economics, PA: Medical Information Science Reference.
Hedges, C. and Williams, B. (2015). Anatomy of Research for Nurses. Indianapolis: Sigma Theta Tau International.
Levin, R. and Feldman, H. (2013). Teaching evidence-based practice in nursing. New York: Springer Pub.
McDaniel, J. (2009). Advances in information technology and communication in health. Amsterdam [etc.]: IOS Press.
Nursing and Midwifery Board of Australia (2016). Registered nurse standards for practice. Retrieved 19/9/201 at www.nursingmidwiferyboard.gov.au
Nursing professional development. (2010). Silver Spring, MD: Nursesbooks.operations.
Rebar, C. and Gersch, C. (2015). Understanding Research for Evidence-based Practice. Philadelphia: Wolters Kluwer.
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