Discuss About The Methods Appraisal Evidence Based Practice?
Evident based practice in the field of nursing is the utilization of the best evidences available currently, in planning and giving care to a patient. It is an approach to systematically administrate clinical practices (Hoffmann, Bennett & Del Mar, 2013). It needs the practitioner and the caregiver to evaluate the present research works, guidelines and other available resources to give a patient the best personalized management (Hall & Roussel, 2016). The process integrates the experience of a clinical expert, researches of the relevant updated evidence available for a particular type of illness.
The report discusses about the importance of evidence based practice in the field of nursing. The requirements that a patient has is also taken under consideration during the practice of the model.
The necessity of the caregiver to execute the rule and regulations drawn on the basis of the current evidence is elaborated in the report. The implementation of the evident based practice and its impact on the patient is also being discussed.
The practice of treatment and care giving on the basis of evidences, came to existence in the 1980’s. The practitioners faced many problem during the time when there was no methodology added to the process (Rubin, 2012). This made the process complex as there was no insight available for approaching the problem. The process is not just the utilization of researches, it also requires the inclusion of one’s personal intuitions and knowledge.
The process assists the nurses to ensure high-quality of care to the patient because it combines the research materials in addition to personal knowledge of a nurse. It increases the caregiver’s confidence for making a decision by providing the outlines of the procedure (Greenhalgh, Howick & Maskrey, 2014). The process is crucial to be followed by the nurses because it provides them the current procedures and policies that is being implemented across the globe.
The impact of evidence based practice till date has given positive patient outcomes. The process has successfully helped the caregivers and practitioners to yield positive outcomes in minimum duration. The method has transformed the healthcare industry by redesigning the process of caregiving. This process is safe, highly effective and can be practiced efficiently (DiCenso, Guyatt & Ciliska, 2014). The difficulty that the nurses faced in contributing their valuable knowledge has been minimized and they get a clear idea about the case they are dealing with, as an outcome of the process. The practice also reduces the period taken for treatment and has a major role in lowering the charges of treatment, as it reduces the patient’s time of stay. Reduction in the span of stay also minimizes the risk of infection, which are acquired from hospitals.
The nurses in the making in the present scenario, need to study the different ways in which the practice can be processed practically. The practitioners and the senior registered nurses have reported the need of making the students learn the practice, at least in the areas of their specialization. The Australian colleges of nursing, therefore, have added the subject in the syllabus to commemorate the process. The theories help them to have an understanding of the practice process, it decreases the problems faced by the interns during practical approaches, as, they already have an insight of the scenario. The process has been in strict implementation from the last two decades. The process of caregiving has been reported to have immensely bettered since then.
The first and the most crucial part to execute the evidence based practice process is to create a culture for incorporation of the process in the healthcare centers or organizations. Implementation of evident based practice in the clinical setups is a difficult scenario to find. It is found to be either partially successful or fail to exist (Royse, Thyer & Padgett, 2015). The outlines that the practice recommends the nurses to follow has a number of restrictions and amendments added to it, these rules and regulations need the nurse to learn certain theories and implement it. The process of learning is considered as a burden by some of the caregivers, which makes the process of implementation difficult (Melnyk et al, 2014).
The nurses handling the patients of the critical care units, play a vital role in the recovery process of the sufferer. The knowledge of the evidence based practice is crucial for such caregivers because the critical patients do not have the time required to assess the information in a reluctant manner (Francis et al, 2012). If the nurses do not have the understanding of the situation, the consequences can be inimical (Dearholt & Dang, 2012). The nurses who supervise the outdoor patients have to have the experience of handling a large number of patients at the same time, this practice helps to comprehend and reduce the time of examination.
There have been many cases of nurses who provide care without proper training to the patients in several parts of Australia. There are many nurses who are in this profession without any formal training, for a long time at many hospitals in the country (Schneider & Whitehead, 2013). The scenario was acceptable in the earlier days as the population was not so high then. The caregivers had ample amount of time to dedicate to a certain patient. In the present scenario, the caregivers do not have the time to explore and then react, they have to retaliate in a restricted period of time, which needs the knowledge of the ailment, the patient is suffering from and work accordingly in fraction of moments.
Registered nurses are the ones, who practice caregiving by implementing their knowledge about illness and give personalized care to the patients. They are supposed to work by building a professional as well as therapeutic relationship with the patients individually. The nurses who are registered in Australia have to deal with a diverse number of cultures and respond accordingly (Hamric et al, 2013). The need for them to have the knowledge of the rule of practice is pivotal as they do not have the luxury of spending time to analyze a patient’s situation. They have to manage many cases at the same time, they have to have the expertise of handling various patients suffering from different ailments, the knowledge assists them to commemorate about each case in a rapid manner. The Nursing and Midwifery Board of Australia (NMBA) has also set several standards for the registered nurses to practice. According to the NMBA standard 2016, there are seven basic standards that should be followed. First standard being, thinking and analyzing the practice to be implied, second standard being, marketing professional and therapeutic relationships with the case, third being maintenance of their capability for practicing by being updated. Fourth standard is to conduct assessments comprehensively. Fifth is, to develop personalized plans for practicing nursing. Sixth standard deals with providing appropriate safe and quality caregiving. Seventh and the final standards deals with the evaluation of the outcomes that the nursing practice results in (Hockenberry, Marilyn & Wilson, 2014).
The presence of untrained registered nurses in Australia is common. The nurses who are untrained are mostly above forty years of age. They have been in the profession, before the strict implementation of the evidence based practice. The administrations of various hospitals have reported that the efficiency of the trained and the untrained nurses vary. The nurses lacking the knowledge of theoretical evidence based practice, take longer time to determine the approach they have to give to a certain case than the trained ones. The feasibility of untrained nurse in the clinical settings is the least. The need of highly professional caregivers is in the rise with the increase in diversity and number of people in the population (Lewenson, 2014). The lack of expertise increases the chances of discrepancy in the process of nursing. The risk factors exponentially increase, when the patients are subjected to such caregivers.
The scenario cannot be changed abruptly, although the situation of the untrained nurses in critical care units can be strengthened and developed by imposing compulsory attendance of nurses in the caregiving programs (Stanhope & Lancaster, 2013). This will create an understanding among the nurses and help them to tackle the complex situations in a better way.
According to the set ups that are found to inculcate evidence based caregiving, three standards are important to be implemented for significant improvement in the set ups. The standard 1.1 (the registered nurse accesses, analyses and uses the best available evidence, that include research findings for safe quality practice) is significant for implementation, it deals with assessment of the presently available evidences, then analyzing and using it as per the needs of the patient. Evidence based nursing also requires the caregivers to practice by reflecting on the knowledge and experience they have inculcated since the beginning of their career, this requires the incorporation of the standard 1.2 (develops practice through reflection on the experience, knowledge, actions, feelings and beliefs to identify how these shape practice) in the working environment of the clinicians. The practices based on evidence as discussed in the previous sections requires a caregiver to assess the cultural background of the patient and evaluate the behavioral aspect and give care accordingly, this requires the inculcation of the standard 4.1 according to the NMBA standards 2016, it emphasizes on the assessments of the cultural aspect and give them holistic approach (the registered nurse conducts assessments that are holistic as well as culturally appropriate). Holistic approach helps to build a relationship with the patient, it enlightens the sufferers to approach the caregivers without any hesitation (Karna, et al., 2012).
Conclusion:
Therefore, from the above report, it can be concluded that, the nursing based on evidences raises the understanding between the caregiver and the patient. It highly increases patient outcome and helps in creating a professional relationship with the patient. The need of commemorating the practice process is on the rise because of increase in the diversity of the population, so, the issue should be given the attention it needs. The professional and theoretical implementation together enhances the process of care giving, it eases the task of the nurse as well as the practitioner. Inculcation of the NMBA standards enhances the conditions of the set ups. Untrained nurses present should be given crash courses to increase their efficiency, it minimizes the ambiguity that the nurses previously dealt with. Clinical manifestation of the practice is on the rise across the globe. The practice based on evidences gives an insight of the present scenario of the nursing profession, it has not only minimized the care giving process but also helped the professionals to work in a systematic way. Further development of the process should be taken care of, for advancement of the process.
References:
Dearholt, S., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Models and guidelines. Sigma Theta Tau.
DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based Nursing-E-Book: A Guide to Clinical Practice. Elsevier Health Sciences.
Francis, J. J., O’Connor, D., & Curran, J. (2012). Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework. Implementation Science, 7(1), 35.
Greenhalgh, T., Howick, J., & Maskrey, N. (2014). Evidence based medicine: a management in crisis?. Bmj, 348, g3725.
Hall, H. R., & Roussel, L. A. (2016). Evidence-based practice. Jones & Bartlett Publishers.
Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2013). Advanced Practice Nursing-E-Book: An Integrative Approach. Elsevier Health Sciences.
Hockenberry, M. J., & Wilson, D. (2014). Wong’s Nursing Care of Infants and Children-E-Book. Elsevier Health Sciences.
Hoffmann, T., Bennett, S., & Del Mar, C. (2013). Evidence-Based Practice Across the Health Professions-E-Book. Elsevier Health Sciences.
Karna, K., Sharma, S., Inamdar, S.., & Bhandari, A. (2012). Study and evaluation of medication errors in a tertiary care teaching hospital–a baseline study. Int J Pharm Sci, 4(5), 587-593.
Lewenson, S. B. (2014). Taking charge: Nursing, suffrage, and feminism in America, 1873-1920. Routledge.
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.
Royse, D., Thyer, B. A., & Padgett, D. K. (2015). Program evaluation: An introduction to an evidence-based approach. Cengage Learning.
Rubin, A. (2012). Statistics for evidence-based practice and evaluation. Cengage Learning.
Schneider, Z., & Whitehead, D. (2013). Nursing and midwifery research: methods and appraisal for evidence-based practice. Elsevier Australia.
Stanhope, M., & Lancaster, J. (2013). Foundations of nursing in the community: Community-oriented practice. Elsevier Health Sciences.
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