The Use of Evidence-Based Practice among Critical Nurses - Essay Example

?Evidence-based Practice Introduction Evidence-based practice in nursing refers to the utilisation of the best existing expert opinions, evidence, and preference of patients to determine the clinical decisions to be made. Even though the use of evidence-based practice in treating atrial fibrillation, among other conditions is encouraged among medical practitioners, it is not often implemented. This essay addresses the barriers that exist against using evidence-based practice in the treatment of atrial fibrillation. It will also evaluate different strategies that can be used to develop the use of evidence-based practice among critical nurses who tend to older patients suffering from atrial fibrillation. Evidence-Based Practice Evidence-based practice (EBP) is a development that can be utilised in nursing, psychology, social work, counseling, and public health, counselling, among other health service professions (Melnyk and Fineout-Overholt 2005). Evidence-based practice is a complicated process that uses study findings to ascertain the best methods according to research and then correlates the findings to create an body of knowledge that can be practically used. According to Sackett, evidence-based practice is descriptive of the judicious use of the best existing evidence to make decisions on how best to care for individual patients (as cited in Berwick 2003). According to Fawcett and Garity (2009) evidence-based practice is a way of solving problems regarding how best to deliver health care services. By using it, the medical practitioner can utilise patient preferences as well as clinician expertise to offer the type of individualized care that is required by different patients. The Australian Nursing and Midwives Council’s Code of Professional Conduct for Nurses states that nurses have a responsibility to uphold its stipulated codes in their personal as well as professional lives (Australian Nursing and Midwifery Council 2006). Some of its rules include expectations that enrolled nurses will give care to all patients under the supervision and guidance of a registered nurse. In addition, nurses, under the Code of Professional Conduct for Nurses have a responsibility to society, their patients, as well as each other, to conduct their services in the most professional manner. The Code of Professional Conduct for Nurses accepts evidence-based practice as a vital factor in professional nursing. According to the Australian Nursing and Midwifery Council (ANMC) all enrolled as well as registered midwives and nurses who are licensed to work in Australia have a duty to make sure that they use the recently discovered methods of treatment to treat their patients (Australian Nursing and Midwifery Council (ANMC) 2010). This is because evidence-based practice allows for a greater capacity to take care of many diverse health concerns. The Benefits and Barriers to Implementing EBP in Clinical Areas The main aim of evidence-based practice is to provide the most recently discovered treatments to patients while also ensuring that consumers benefit from treatments that are most likely to treat, manage, or cure their conditions. There are different benefits that come with the use of evidence-based practice. The quick access to information It has been suggested that evidence-based practice can easily be accessed by various medical authorities as well as the general public through elements of the mass media such as the internet (Nursing and Midwifery Council 2004). This allows patients to be able to select their preferred course of treatment or even evaluate whether a medical establishment has began to use the most recently discovered medical guidelines (Malloch and Porter-O’Grady 2010). According to Stanley (2011), the recent spike in the number of patients suffering from atrial fibrillation has spurred interest in this disorder, resulting in more research that is then posted online. This means that nurses are now able to access information easily about managing atrial fibrillation from various sources. Evidence-based practice allows for professional judgment Evidence-based practice, while availing the most suitable medical techniques in both medical and educational settings, also caters for the great amount of professional knowledge of medical personnel who are trained to provide services (Stanley 2011). This is important because there may be a need for certain changes to be made to the medical discoveries which will require the expertise of professional medical practitioners. According to Stanley (2011) information regarding whether to use appropriate rate control with treatment to prevent thromboembolism or engage in aggressive rhythm control is readily available online. Evidence-based practice ensures consistency Evidence-based practice in the medical setting is usually designed to promote the uniform use of medical techniques in specific fields. This allows all patients to be able to benefit from the same medical practices and methods. According to Stanley (2011) patients who suffer from atrial fibrillation can easily lean about the available methods that could be used in the treatment of their ailment. This is because there are numerous medical research papers that are readily available online and which are attributed to atrial fibrillation. Evidence-based practice keeps nursing methods current The fact that nurses have to constantly read about new nursing practices, or new medical treatment methods, means that they are always informed on the best ways through which to deliver care to their patients. Using evidence-based practice encourages nurses to read all written material that has to do with nursing research, consequently keeping their nursing practices up to date. According to Stanley (2011) using evidence-based practice in treating atrial fibrillation allows nurses to deliver the best care to patients. BARRIERS TO THE IMPLEMENTATION OF EVIDENCE-BASED PRACTICE Some of the barriers that prevent the use of evidence-based practice in clinical settings include the lack of time, the lack of resources to implementation, the lack of evidence necessary to engender changes, and the misunderstanding the research language (Fink, Thompson, and Bonnes 2005). 1. Time-consuming Clinical nurses are mainly tasked with providing patient care in a medical environment that is characterised by a rapid turnover of medical patients with broad care needs. In such settings, nurses are usually compelled to prioritise the demands for immediate patient care as well as associated workloads (Polit and Beck 2008). According to Stanley (2011) critical care nurses may not have the time to implement an individualized treatment approach which is standard in implementing evidence-based practice when caring older adults. 2. Not enough evidence to support the change National health care regulations tend to be based on cultural and ideological factors none of which are evidence-based factors. For medical procedures to be evidence-based as well as clinically useful, health policies must seek to balance the limitations and strengths of all research evidence with the healthcare settings realities. According to Stanley (2011) new developments being examined for the treatment of atrial fibrillation such as the use of suture lines in seeking to reduce the incidence of permanent AF, and catheter-based compartmentalization of the atria are still being tested. 3. The problem of research language Clinical nurses usually do not use research terms on their daily schedules and thus may need for certain terminologies to be further explained before they can understand what is being said. According to Stanley (2011) have limited skills in understanding evidence and literature searching. Even in cases where nurses can refer to literature for the meanings of words, this might further extend treatment periods for each of the patients. 4. Funding Many medical facilities do not have the finances to implement any radical changes that may be suggested by medical research findings as they may be working with extremely tight budgets and have to deal with other more urgent clinical management demands (DiCenso, Guyatt and Ciliska 2005). According to Stanley (2011) there have been researches done on atrial fibrillation but there is still not enough funding for finding treatment for the condition. For instance, any plan to advance the evidence-based treatment of non-valvular atrial fibrillation will have to address the excessive concerns that medical practitioners have about anticoagulation. 5. The low expectancy of favorable results among Hospital managers- Many doctors and other clinicians may say that they wish for evidence-based nursing to be implemented; but they will be reluctant to take practical steps to implement this because they may not yet trust the new processes in the way that they trust the old. According to Stanley (2011) cardiovascular surgeons or electrophysiologists may be particularly reluctant to implement procedures that may result in serious consequences even if applied in moderation. Many medics tend to favor the use of long established methods that guarantee recovery- even if at a slower rate. 6. Problems presented by Organizational Structure in Hospitals Making changes to organizational culture so as to implement new treatment methods is not an easy thing to accomplish. This is because medics are more acquainted and comfortable with the old procedures and may be doubtful about the new. According to Stanley (2011) factors such as the intersection among healthcare delivery, funding, and quality, as well as nuanced connections between medical and social dimensions in healthcare all have to be addressed before evidence-based care is accepted. Strategies for Promoting Evidence-based Nursing Practice 1. Education In the first place, medical facilities have to encourage the change of nursing education programs. It is important for nurses to be offered continuing education opportunities that assist them to understand evidence-based practices. This is because nurses who comprehend the significance of evidence-based nursing can even function as mentors for student nurses who are still oblivious of its potential effect on medical practice. According to the findings of Stanley (2011), educating nurses through training programs can result in the development of arrhythmia services in assorted primary care settings, and making sure that all the patients are risk stratified and treated in accordance with evidence-based guidelines. 2. Organizational Culture The organisational culture of medical centres also has to be focused on evidence-based practice so that the institutions’ norms, reflected values, and expectations contribute towards institutionalising evidence-based practice. Organisational characteristics such as location, size, and the centralisation of decision making, have in the past been linked with research deployment. According to Newhouse, Dearholt, Poe, Pugh and White (2005) evidence-based practice is also connected to quality assurance. This means that healthcare facilities have to have institutions in which they reward staff who often make use of research to deal with clinical problems or illnesses manifested by patients. From the findings in Stanley’s text, evidence-based practices such as are recommended by the Agency for Healthcare Research and Quality could greatly improve treatment options for patients suffering from atrial fibrillation (Stanley 2011). Restructuring medical facilities will allow patients to be able to benefit from quality improvement instruments that are developed with the support of AHRQ. 3. Leadership It is important for the leaders of medical institutions to support all operations aimed at espousing evidence-based practice. A hospital’s chief nursing officer, for instance, can form a vision that supports evidence-based practice, while other medical personnel like nurse managers come up with ways to promote as well as implement these EBP practices on a daily basis (Larrabee 2009). According to Stanley (2011) the leaders of medical centres can also collaborate with externally based individuals or groups that indirectly or directly support the use of evidence-based practice. Leaders can in medical settings can encourage or support the use of evidence-based practice by providing clinical supervision when implementing these practices while also supporting nurses to take advantage of professional learning opportunities that will acquaint them more with the evidence-based practices. Conclusion Essentially, if evidence-based practice is used effectively, it can, in combination with theory-based nursing practice, change the treatment of patients. Barriers such as the reluctance of nurses to implement evidence-based practices owing to inadequate knowledge and time constraints can be addressed by the restructuring of hospital operations and the introduction of continuous training courses that constantly upgrade the information for the nurses. It is also critical for hospital authorities to lead by example in supporting evidence-based practices by allocating time for the nurses to perfect their skills and by funding their implementation within hospitals. References Australian Nursing and Midwifery Council (ANMC). (2010) Codes of ethics and codes of professional conduct, Nursing and Midwifery Board of Australia. Australian Nursing and Midwifery Council. (2006) National competency standards for the midwife, 1st edition, ANMC, Canberra. Available at: www.midwives.org.au. Berwick, D. M. (2003) ‘Disseminating innovations in health care’, The Journal of the American Medical Association, vol. 289, no.15, pp.1969–1975. DiCenso, A., Guyatt, G. & Ciliska, D. (2005) Evidence-based nursing: a guide to clinical practice, Elsevier Health Sciences, New York. Fawcett, J. & Garity, J. (2009) Evaluating research for evidence-based nursing practice, FA Davis, Philadelphia. Fink, R., Thompson, C. J. & Bonnes, D. 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(2008) Nursing research: generating and assessing evidence for nursing practice, Lippincott Williams & Wilkins, Philadelphia. Stanley, J. (2011) ‘Pharmacological treatment of persistent atrial fibrillation in the older adult: Evidence-based practice’, Journal of the American Academy of Nurse Practitioners, vol. 23, no. 3, pp. 120-126. Read More