Evidence-Based Practices in Nursing - Research Paper Example

? Evidence-Based Practices in Nursing of Evidence-Based Practices in Nursing Evidenced-based practices are important in any level of nursing but in primary care nursing is particularly important (De Pedro-Gomez, 2012). The purpose of this type of practice is to show that research creates a baseline of knowledge for the nurse who is pursuing the care of any patient or set of patients. Evidence-based practices provide an opportunity for the nurse to bring options to their clients that may not be known without the careful details of a research modality (De Pedro-Gomez, 2012). Taylor (2012) adds that because primary care nursing is rapidly changing, the need for evidenced-practice becomes more significant. Also, a primary care nurse is often the first person to working with clients who are dying, increasing the safety of patients, increasing patient outcomes and their overall experience in healthcare. In this paper, it is the intent of the student to show how evidence-based practice in primary care nursing correlates with the steps in the nursing practice for Neonatal Care (NICU) using the total patient care model. Care Delivery Model The team care delivery model seems to be the most relevant model for working in the Neonatal ICU to insure patient safety. When infants are in the intensive care unit they have different needs than infants who are in a regular nursery. In order to make sure that infants, parents, and family needs are met while the infant is in the ICU, a team provides around the clock care for each infant. According to our textbook, the RN is in charge of planning and providing the tasks to the other team members as to what is needed for each infant. The RN creates a collaborative environment with all of the team members and is responsible for scheduling each member of the team. As a primary care nurse, being a part of the team is essential because the primary care nurse is the first one to see the infants in the ICU on a daily basis. Working as part of a team makes sure that the infants are cared for during breaks, lunches, and other situations that may come up for individual nurses. How Steps in Nursing Process Relate to Evidence-Based Process (A) Assessment The assessment area for evidence-base nursing in the literature is largely based on assessing the overall NICU programs. In some of the literature, it is shown that nurses are not always knowledgeable about evidence-based practice which may inhibit their ability to use certain interventions (Smith, Donze, Cole, Johnston, & Giebe , 2009). Using evidence-based practices has been shown to increase the level of care for patients by about 30% (Smith, Donze, Cole, Johnston, & Giebe , 2009). Allen and Chubb (2010) add that using evidence-based assessment can help to redirect the needs of a Neonatal unit to improve care on every level. Russ, Dougherty, and Jagadish (2010) state that evidence-base practice can help nurses narrow the knowledge gap when they are working in the NICU which enhances their ability to o their jobs. (D) (Nursing) Diagnosis In diagnosis, evidence-based nursing provides an understanding of the interventions that have been used to assist in many conditions. D’Agostino (2010) suggests that the literature provides many cases of information about premature babies and how to diagnose their problems. The process of diagnosis was discovered through a series of evidence-based articles in electronic journals. The research provided a concrete foundation for working with premature babies and it provided the information that the nurses needed to proceed with a specific process. This is one of the roles that evidence-based processes have in diagnosis. Another role of evidence-based nursing is to provide the opportunity for nurses to discern the difference between quality studies and those that re not of good quality. As an example, Stapelkamp, Carter, Gordon and Watts (2011) studied the research on children and acute pain. They found that there were several articles that were not as good as others when looking for information in this area. P-Plan 1: Implementation Implementing evidence-based nursing is important because it provides a stronger understanding for nurses about what they are implementing and why. It gives them practical knowledge about what they are doing in the NICU and it can open dialogue between primary care nurses and RNS. Segal and Leach (2011) suggest that implementation can also have challenges. Although Segal and Leach reported on a specific model, the results of their study could be used for any model. As an example, Segal and Leach state that one challenge is explaining the needs of complex patients can be a problem. This can be eliminated when there is a team of people talking about the processes involved. Evaluation Evaluation can be done in many different ways. Nursing can evaluate specific programs or evaluate a specific procedure. Evidence-based nursing can provide insight into those programs and procedures that have been evaluated in the past and help current nurses define how their programs relate to these past evaluations. A good example of this is a study done by Latimer, Johnston, Ritchie, Clarke and Gilin (2009). The authors found that when observing pain in infants, a collaborative effort between nurses and doctors was important to understand the needs of the child. The study further showed that nurses often under medicate babies in ICU when doing certain procedures. By having the knowledge of how medication should be determined, nurses are able to better provide pain medication and evaluation for infants. Role of Nursing in Correlate to Planning and Providing Evidence Based Nursing Care A primary care nurse’s role in correlating and planning evidence based nursing care starts with their being able to adequately serve the patient (Howell, 2012). Nurses have to be included in conversations that work with flow of work and how care is ultimately delivered (Howell, 2012). Nurses must have a role in care coordination, implementation and cost reduction so that the healthcare facility will have a well-rounded idea of care (American Nursing Association, 2012). Primary care nurses are on the frontlines of care and they are involved with Neonatal care on a regular basis. Their role is often to carry out the plan that the RN has put into place and become vital aspects of the team when moving the processes forward. Communication Strategies Important to Creating a Culture of Evidence-Based Practice Schulman (2008) states that creating a culture of evidence-based practice begins with an understanding of what it is and what it is not. The individual creating this practice must be able to communicate the differences between evidence-based practice and other types of practice. There should be meetings where all participants are able to communicate what they are learning and provide information about the evidence they are gathering. Communication skills would include the ability to listen to parents and their needs for their child, interpersonal skills that would have them show compassion in their interaction with parental communication, information sharing with other members of the team, maintaining eye contact with the parents and observing body language. These are all essential for the nurse to be able to effectively communicate with the parents. Three Most Important Learning Aspects of Course The issue of communication is something that I have learned in this course. Communication is important because you have to be able to talk to the parents of the patient so they gain a real understanding of what is happening with their child. Also, we have to communicate the infant’s condition in a way that calms the parent’s fears as best we can. Next, I think that Maslow’s Hierarchy of Needs was very important. I can see how a patient can move through each of the different needs. As an example, if a family were attempting to deal with their infant’s needs in the ICU and they were homeless, they may not be able to really concentrate on the needs of their infant. The family will also need to feel safe about what is happening with their infant so they can move onto acceptance of the love from their family as they go through the crisis with their infant. Finally, the assessment, diagnosis, and plan for the evidence-based process was important for me because it put evidence-based procedures into perspective. I thought at first that we had to do a lot of research for people but I realize now that researching articles on different procedures an on different ways that other nurses have done certain procedures can enhance what we already know about procedures. Conclusion The use of evidence-based procedures for nursing is important to the growth of primary care nurses. When we are able to see what others have done and know that it is based on research, we can be sure that our procedures are sound. Evidence-based procedures provide a foundation for further research and for making sure that everyone is working in the most professional manner. By understanding what is being done in primary nursing, a nurse can become more skilled over time. Evidence-based procedures are a more scientific way of developing appropriate patient outcomes and assistance with parents and families. References Allen, M., & Chubb, S. (2010). Using an Evidence-Based practice model to expedite improvement of care for vulnerable infants. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 39(1), 111. doi: 10.1111/j.1552-6909.2010.01128.x/pdf American Nurses Association. (2012). The value of nursing care coordination: A white paper of the American Nurses Association. Retrieved from http://www.nursingworld.org/carecoordinationwhitepaper D’Agostino, J. (2010). An evidentiary review regarding the use of chronological and adjusted age in the assessment of preterm infants. Journal for Specialists in Pediatric Nursing: JSPN, 15(1), 26-32. doi:10.1111/j.1744-6155.2009.00215.x De Pedro-Gomez, J., Morales-Asencio, J. M., Bennasar-Veny, M., Artigues-Vives, G., Perello-Campaner, C., & Gomez-Picard, P. (2012). Determining factors in evidence-based clinical practice among hospital and primary care nursing staff. Journal of Advanced Nursing, 68(2), 452-459. doi: 10.1111/j.1365-2648.2011.05733.x Hansen, L. H. (2010). Sources of information about early childhood & family support practices sources of information about evidence-based practices. CaseMakers, 5(1), 1-6. Retrieved from http://www.fipp.org/Collateral/casemakers/casemakers_vol5_no1.pdf Howell, W. L. J. (2012). The changing role of nurses. Hospital and Health Networks. Retrieved from http://www.hhnmag.com/hhnmag/jsp/articledisplay.jsp?dcrpath=HHNMAG/ Article/data/03MAR2012/0312HHN_FEA_movingforward&domain=HHNMAG Latimer, M., Johnston, C., Ritchie, J., Clarke, S., & Gilin, D. (2009). Factors affecting delivery of evidence-based procedural pain care in hospitalized neonates. Journal Of Obstetric, Gynecologic & Neonatal Nursing, 38(2), 182-194. doi:http://dx.doi.org.dml.regis.edu/10.1111/j.1552-6909.2009.01007.x Russ, S. A, Dougherty, D., & Jagadish, P. (2010). Accelerating evidence into practice for the benefit of children with early hearing loss. Pediatrics, 126 (Supplement 1), S7-S18. doi: 10.1542/peds.2010-0354E Schulman, C. S. (2008). Strategies for starting a successful evidence-based practice program. AACN Advanced Critical Care, 19(3), 301-311. Retrieved from http://www.aacn.org/wd/cetests/media/ci1931.pdf Segal, L., & Leach, M. J. (2011). An evidence-based health workforce model for primary and community care. Implementation Science, 6(3). Retrieved from http://www.implementationscience.com/content/6/1/93 Smith, J. R., Donze, A., Cole, F. S., Johnston, J., & Giebe, J. M. (2009). Neonatal advanced practice nurses as key facilitators in implementing evidence-based practice. Neonatal Network, 28(3), 193-201. Retrieved from http://www.mc.vanderbilt.edu/documents/CAPNAH/files/Mentoring/Section%206/Neonatal%20advanced%20practice%20nurses%20as%20key%20facilitators%20in%20implementing%20EBP.pdf Smith-Strom, H., & Nortvedt, M. (2008). Evaluation of evidence-based methods used to teach nursing students to critically appraise evidence. Journal of Nursing Education, 47(8), 372-375. doi: http://dx.doi.org.dml.regis.edu/10.3928/01484834-20080801-08 Stapelkamp, C., Carter, B., Gordon, J., & Watts, C. (2011). Assessment of acute pain in children: development of evidence-based guidelines. International Journal of Evidence-Based Healthcare, 9(1), 39-50. doi:10.1111/j.1744-1609.2010.00199.x Taylor, R. (2012). Using and developing the evidence base in primary health care. Primary Health Care, 22(1), 31-36. Read More