Nursing And The Midwifery Board Of Australia: Standards For Evidence-Based Practice

Evidence-based practice

Discuss about the Nursing and the Midwifery Board of Australia.

Evidence-based practice provides the nurses with a method through which they can improve their decision-making process. The nurses are expected to deliver the care as well as interventions of the highest quality. However, in some cases, it is noticed that the nurses fail to deliver the quality healthcare. This can be a result of incomplete knowledge about the applications of the EBP. The nursing institutions fail to make proper inclusions of the standards provided by the Nursing and the Midwifery board of Australia (NMBA). Furthermore, the nurses remain untrained, which procures negative aspects on the health of the patients. Thus, in the following paragraphs, the discussion would focus on the various factors that affect the evidence-based practice in accordance with the latest standards of NMBA.

This practice has redefined the health care in their recent times. This method helps the nurses to critically appraise the literature in order to deliver the highest quality healthcare to the patients.  However, in some cases, the researchers have noticed that barriers such as not getting proper training can become a hindrance to the overall health care.

Evidence-based practice has echoed across the education, science and practice of nursing. This method assists the nurses in implementing the next big step in the quality of the health care. Such practices are mostly implemented in some medical conditions such as asthma, diabetes and heart failure. According to Andre & Heartfield (2011), the history of nursing is intertwined with research practices. However, Blackwell Willis, Reynolds & Keleher (2012) have pointed out that though this is the safest procedure, nonetheless, it requires the application of a few strategies to address the complexities of the systems regarding the care facilities. EBP, therefore, can be cited as judicious use of the best practices with patient values as well as the clinical expertise to provide a guide in the decision-making process of the nurses.

Chang & Daly (2012) have argued that significant failures to deliver proper care and interventions have raised the concerns of EBP. According to the nursing standards set by NMBA 2016, section 3.1.7, and the nurses should deliver proper care of improved quality. For this, the nurse requires to have relevant research.  This method has thereafter introduced strategies, which aim to hard write the current knowledge gained. This method furthermore has targeted research evidence and interventions. The Australian Government has introduced guidelines to standardise the healthcare protocols after noticing the differences in the different hospitals and districts.

Barriers to evidence-based practice for nurses

Nonetheless, Andre & Heartfield (2011) have suggested that in some cases, there in the unavailability of satisfactory scientific evidence. The nurses should in such cases, may adhere to the nursing standards provided by the NMBA 2016, section 5.1 where it is clearly stated that the nurses should acquire assessment data as well as the available evidence in order to develop the plan to provide the best treatment to the patient. Thus in such cases, the nurses require to drive the decision from the non-research sources like scientific principles as well as expert opinion. The nurse should be able to incorporate these evidences in providing the quality health care and interventions. This is a clinical decision-making process, in which expertise and consistent training, both are required. Therefore, it would be hard for the nurses to practice these standards without proper training.

As opined by Forrester& Griffiths (2010), two elements play significant roles in providing the best practices. The nurses should be able to get the right evidence for the medical condition thereby implementing it in the right way. The patient outcome can only have positive views if only the nurse acquires the updated version of the research articles., thereby following the 5.1 section of the NMBA 2016 laws. However, Smailes & Street (2011) have pointed out that only 10% of the randomised trials made their incorporations into the Cochrane systematic reviews. a On contrary, Conrick (2006) have highlighted that this method has been introduced to standardised practice in the healthcare systems in accordance with the standards set by the NMBA, 2016. This has been implemented after reports of illogical versions started circulating the healthcare systems. The authors have pressed that EBP has introduced the healthcare units with new roles, new teams including interprofessional, new cultures as well as new fields.

Evidence-based practices have been hailed as a cost effective way to provide interventions of the utmost quality procuring health promotions. Chang & Daly (2012) have proposed a theoretical framework that would help the nurse in implementing the strategies based on the upgraded theoretical knowledge. According to the NMBA 2016, section 1.1, the nurses require analysing, accessing and use the data available from the best evidences, which includes quality practice, research findings as well as safety measurements to provide the quality treatment to the patients. The nurse may further needs to implement the evidences acquired in order to treat the individual (Fedoruk & Hofmeyer, 2012). Therefore, this tool inserts motivation to make a clinically approachable decision based upon the theories or construction models.

Addressing the barriers to evidence-based practice for nurses

Duckett &Willcox (2011) have argued that education is different than applying it clinically. The laws do not bind education however; they are the effect of human interactions.  Theories may procure hypotheses that can lead to the guidance to action. The Heuristic models provide the nurses with the guidance to treat the patients accordingly. As for example, this model presents with a set of principles related to the patients such as gender, age, marital status or even health status. The provider set consists of the factors related to the carer as such their gender, years of practice, or even their type. This results in easing the conversational and building of relationship between the carer and the care service user. Borbasi & Jackson (2012) have presented with another theory called Principal-agent theory, which helps in predicting the similarities between the care provider and the service user. This model depicts that if the two parties have many similarities then the patients would listen to the carer thereby procuring high patient outcomes. Thus, theoretical knowledge as well as the models helps in overall increase in the patient outcome results. 

Evidence-based practice has its primary implementation clinically. The nurses require to follow the framework provided by the NMBA in order to practice in the country (Nursingmidwiferyboard.gov.au, 2016). This can assure that the nurses are competent enough to provide a proper decision that may procure a quality intervention.  When implementing the EBP clinically, the nurses are to follow the nursing ethics or the Ethical principles governed by NMBA so that they deliver the intervention methods clear of their ethical dilemmas. The NMBA expects the practitioners to abide by the codes as well as the standards provided. Furthermore, the NMBA has provided some basic principles for the context of practice, which includes the type, setting, degree of autonomic and the resources. NMBA can enact the section laws of 156 (1) and 157 of National law to provide protection to the public thereby implementing immediate action plans.

The nurse should ask the probable questions to implement the process in the clinical setting. At first, the nurse requires to identify the clinical problem. Then the nurse should build a question around it so that it would assist in selecting the appropriate resources to conduct the study.  The nurses require to critically appraising the resources so that usefulness of the resource can be determined. The nurse should acquire the information favoured by the patient and finally implement it to medical intervention. The nurses should ensure to have self-evaluation process so that they can gain expertise in the clinical practice. This would further assist them in the future implementation procedures. They can follow the principles and sections such as 5.1, 1.1 and 3.1.7 to deliver proper care by abiding the laws for evidence and research.

Theoretical knowledge and models for evidence-based practice

Fedoruk & Hofmeyer (2012) have suggested that evidence-based nursing heavily depends upon the training of the nurses in this field.  As discussed earlier that this method provides a scope for the nurses to work on their decision-making process in order to deliver quality health to the specific population. However, the nurses around the world are unaware of the proper training methods as well as the implementation of the method. This has often resulted the in poor delivery of intervention methods and highlighted their indigent decision making process. Such factors create hindrance in the adoption of the EBP process further adding to the poor delivery process. Borbasi & Jackson (2012) have recorded that nurses have very limited skills in regards to the area of scientific literature which serves as a basis for Evidence-based practice. They have also uphold their poor understanding of the evidence which adds to their lack of training in the most sought after method in today’s clinical processes. Chang & Daly (2012) have argued that only a small number of nurses in the country could recognise the appropriate strategy required for the intervention of the medical condition.

This has highlighted the lack of basic knowledge that is prevalent among the nurses. In most cases, the authors have cited that the nurses lack the traini8ng and that evidence-based practice can procure negative effects on the patients as well. If the authors further argue that if the nurse fails to come to a solution and thereby chooses the incorrect treatment, this may have ill effects on the patient’s health. Thus, the hospitals should ne aware only to allow the registered nurses with proper training to implement EBP to provide better care and quality (Borbasi & Jackson, 2012). Thereby, it can be cited that it is not feasible to expect RNs to provide EBP based implementation without proper training.

Daly, Speedy& Jackson (2010) have suggested that the nurses should acquire searching knowledge for sufficient literature base which is an essential criterion to retrieve the relevant as well as accurate evidence. As opined by Courtney & McCutcheon (2010), this method has fostered a belief regarding research practices and evidences. However, the authors have highlighted that though EBP allows the nurses to understand the subject more clearly as well as ask questions more on the implementations of the nursing practices to provide better care; nonetheless, any nurse with better understanding and strategy implementation can  provide the same amount of care. Borbasi & Jackson (2012) have argued that trained nurses can procure better patient outcome. According to the section 5.1 of the NMBA, the nurses should utilise the best practice to provide the utmost care to the patient’s based on the available evidence and procuring a plan out of it. (Nursingmidwiferyboard.gov.au, 2016).

Conclusion

The nurses require adopting the Evidence-based practice to deliver the highest quality of care and intervention by influencing their own choices and decision-making process. The nurses here should consider the principles of evidence-based assessment provided by NMBA in order to procure intervention methods based on the literature bases. Conclusion can be drawn on the fact that only through proper training the EBP can be achieved.

References

Andre, K., &Heartfield, M. (2011). Nursing and midwifery portfolios: Evidence of continuing competence. (2nd ed.) Sydney: Elsevier Australia. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=wzszbvGH52QC&oi=fnd&pg=PT20&dq=++Andre,+K.,+%26Heartfield,+M.+(2011).+Nursing+and+midwifery+portfolios:+Evidence+of+continuing+competence.+(2nd+ed.)+Sydney:+Elsevier+Australia.&ots=_IKqX0QeaY&sig=tqg3_u5OJOEYZZqMXgsnPxi0M6w#v=onepage&q&f=false

Blackwell Willis, E., Reynolds, L., &Keleher, H. (Eds.) (2012). Understanding the Australian health care system.(2nd ed.)  Chatswood: Elsevier Australia. Retrieved from: https://trove.nla.gov.au/work/25525985

Borbasi, S., & Jackson, D. (2012). Navigating the maze of research: Enhancing nursing and midwifery practice.  (3rd ed.). Sydney: Elsevier Australia. Retreived from:  https://books.google.co.in/books?id=Pa_RAQAAQBAJ&printsec=frontcover&dq=Borbasi,+S.,+%26+Jackson,+D.+(2012).+Navigating+the+maze+of+research:+Enhancing+nursing+and+midwifery+practice.++(3rd+ed.).+Sydney:+Elsevier+Australia.&hl=en&sa=X&redir_esc=y#v=onepage&q&f=false

Chang, E., & Daly, J. (Eds.) (2012). Transitions in nursing: Preparing for professional practice. (3rd ed.). Marrickville, NSW:  Churchill Livingstone/Elsevier. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=B_hwCgAAQBAJ&oi=fnd&pg=PP1&dq=Transitions+in+nursing:+Preparing+for+professional+practice.+(3rd+ed.).&ots=N2SxAEJHsZ&sig=LSyLRsm3JLVilL2rGAAZk7lucaU#v=onepage&q=Transitions%20in%20nursing%3A%20Preparing%20for%20professional%20practice.%20(3rd%20ed.).&f=false

Conrick, M. (2006). Health informatics: Transforming healthcare with technology. Melbourne: Sth Melbourne: Oxford University Press. Retrieved from: https://trove.nla.gov.au/work/157569282?q&versionId=171755428

Courtney, M., & McCutcheon, H. (2010). Using evidence to guide nursing practice.(2nd ed.) Chatswood: Churchill Livingstone/Elsevier. Retrieved from: https://www.us.elsevierhealth.com/using-evidence-to-guide-nursing-practice-9780729539500.html

Daly, J., Speedy, S., & Jackson, D. (Eds) (2010). Contexts of nursing: An introduction. (3rd. ed.). Sydney: Churchill Livingstone /Elsevier. Retrieved from: https://books.google.co.in/books?id=x5rQAgAAQBAJ&printsec=frontcover&dq=Daly,+J.,+Speedy,+S.,+%26+Jackson,+D.+(Eds)+(2010).+Contexts+of+nursing:+An+introduction.+(3rd.+ed.).+Sydney:+Churchill+Livingstone+/Elsevier.&hl=en&sa=X&redir_esc=y#v=onepage&q=Daly%2C%20J.%2C%20Speedy%2C%20S.%2C%20%26%20Jackson%2C%20D.%20(Eds)%20(2010).%20Contexts%20of%20nursing%3A%20An%20introduction.%20(3rd.%20ed.).%20Sydney%3A%20Churchill%20Livingstone%20%2FElsevier.&f=false

Duckett, S., &Willcox, S. (2011). The Australian health care system. (4th ed.). South Melbourne Vic.: Oxford University Press. Retrieved from: https://books.google.co.in/books?id=6AGSrgEACAAJ&dq=Duckett,+S.,+%26+Wilcox,+S.+(2011).+The+Australian+healthcare+system.+(4th+ed.).+South+Melbourne+Vic.:+Oxford+University+Press.&hl=en&sa=X&redir_esc=y

Fedoruk, M., &Hofmeyer, A. (2012). Becoming a nurse: Making the transition to practice. Thomson Learning Australia. Retrieved from: https://acquire.cqu.edu.au:8080/vital/access/manager/Repository/cqu:4790

Forrester, K., & Griffiths, D. (2010). Essentials of law for health professionals. (3rd ed.) Chatswood NSW: Mosby Elsevier. Retrieved from: https://www.elsevierhealth.com.au/essentials-of-law-for-health-professionals-9780729541664.html

Nursingmidwiferyboard.gov.au, (2016).Principles for assessment. Retrieved on September 10, 2016 from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Frameworks/Framework-for-assessing-national-competency-standards.aspx

Smailes, S.,& Street, C. (2011). The Health Studies Companion. Basingstoke: Palgrave Macmillian. Retrieved from: https://he.palgrave.com/page/detail/the-health-studies-companion-sophie-smailes/?sf1=barcode&st1=9781403941879.