The Use of Evidence Based Practice in Nursing - Essay Example

? The Use of Evidence Based Practice in Nursing The Use of Evidence Based Practice in Nursing Introduction In nursing the utilisation of evidence- based practice is founded on the notion that medical practices have to be generated and tailored according to a constant succession of research findings such as theories and evidence. Due to the fact that adjustments in health practice stimulate the incidence of further research, any theories that are obtained from research function as data to turn out more changes in health practice (McGonigal & Mastrian, 2011). In nursing, evidence-based practice calls for the re-evaluation of research for the purpose of improving inadequate practice. In clinical settings, the use of evidence based practice takes into account factor such as the consideration of the need for change, where the research question’s formulation is based on the shortfalls of current health practices (McGonigal & Mastrian, 2011). The use of evidence based practice also takes into account the best existing evidence, understanding it, and integrating it after making the necessary improvement. Models for implementing evidence based practice in clinical settings Some models for implementing evidence based practice in clinical settings include the Ottawa model of research use, the Stetler model, and the IOWA model of evidence-based practice. The Ottawa Model of Evidence Based Research in Nursing The Ottawa Model of Research Use (OMRU) was first created as an interactive model (Kirchhoff, 2004). The Ottawa Model of Research Use is quite effective in practice contexts and holds that research is a dynamic process that involves interconnected actions as well as decisions being made by different people in relation to each of the theory’s elements. The Ottawa Model of Research has undergone different evaluations, with the most recent including factors such as evidence based innovation, the practice environment, potential adopters, the adoption of innovators, the implementation of interventions, and the results of the execution of innovations. The Stetler-Model The Stetler Model of Research Utilisation is a model that is practice-oriented, and is used mainly as a conceptual and procedural guide for the execution of research outcomes in practice. The theory’s first part consists of the five stages of research utilisation (Stetler, 2003). The theory’s second part has to do with clarifying the existing data as well as options for each stage. The Iowa Model of Research is basically used to enhance the general quality of healthcare, and is a creation of the Quality Assurance Model Using Research (Stetler, 2003). Research utilisation is perceived to be an organisational procedure through which different factors are used to unite the practical implementation of research theories. The IOWA Model The Iowa Model can be used for the purposes of implementing quality healthcare as it provides a framework for medical practitioners to make decisions about the daily practices that impact patient care outcomes (Larrabee, 2009). The Iowa Model encourages health practitioners to generate practice questions, whether as a means to solve an existing concern, or simply to acquire new knowledge. These three models allow for medical practitioners to be able to share important data with others within as well as without a medical organisation; thereby increasing nursing knowledge and encouraging other medical organisations to take on evidence based practices. Three information technology applications in quality management Three information technology applications that are very important in quality management processes in healthcare sectors include electronic health records, bar coding, and the use of the clinical decision support system. Electronic health records were first created to serve as a type of electronically based file cabinet holding various types of information about a medical facility’s patients. Its continued improvement meant that it would further benefit by integrating text, handwritten prescriptions and notes, and text messages. Today, electronic health records are perceived to be a part of patient tracking systems as well as the computerised order-entry. This does not just mean that it allows for the keeping of longitudinal records; it also means that medical practitioners are able to easily access patient data. In bar-coding, the healthcare environment becomes identical with the bar-coding that is done in other areas such as the supermarket industry. Essentially, an optical scanner is utilised to acquire all the data that is encoded on the commodity in question. In the healthcare sector it can be used for medicine in that medical practitioners can march prescriptions to patients by means of bar codes on patient bracelets or even medications. Bar codes could also be used on laboratories, medical devices, and radiology. The Clinical decision support system (CDSS) allows medical practitioners the opportunity to be able to offer real-time diagnostic as well as treatment recommendations. Some of the areas that could be included in the Clinical decision support system (CDSS) include drug interactions as well as simple alerts. How the applications may be used to improve performance areas of focus With the different procedures availed by information technology such as the electronic prescribing, medical practitioners can be able to record data concerning drugs (Fawcett & Garity, 2009). Due to the use of safe and secure networks, using information technology discoveries can assist medical practitioners to generate a sustainable medical practice. Becoming a practical user of developments in the field of information technology, factors such as the electronic health records permit providers who are creating their practices to employ and hold on to talented young medical practitioners (Shojania & Grimshaw, 2005). The use of information technology in as far as storing patient information is concerned also allows for the patient’s medically related information to remain secret. In general, both the medical institution as well as medical practitioners will benefit from the existence of high quality as well as safer care. Bar-code technology actually helps in reducing the incidence of medication administration errors, transcription, and adverse happenings that have to do with the misrepresentation of information concerning drugs. The most mistakes usually take place during medication administration as well as transcription. According to Estabrooks (2004) medication errors are a very real result of fatigue among other factors, within medical institutions. Employing bar-code technology will go further to effect medication safety by avoiding such incidents. In as far as clinical decision support systems are concerned; they can be used to integrate patient data as well as statistics, the base of medical knowledge, and an inference engine to create case specific advice. In general, four functions of information technology forums can be administrative, cost-control, administration duties, and the support of decisions. Information technology has been deeply involved in ensuring that clinical coding as well as the utilisation of procedures as well as documentation (Fawcett & Garity, 2009). It is also responsible for keeping patients’ records on the different functions that they undergo such as chemotherapy, referrals, preventive care, and follow-up. The function of factors such as bar coding ensures that there is no extra duplication of relegated tasks (McGonigal & Mastrian, 2011). The use of information technology also provides invaluable support for treatment plan procedures, and clinical diagnoses. Three potential benchmarks and milestones from quality indicators that could be used for the QI plan By measuring aspects such as quality indicators, medical practitioners are able to determine their organisation’s or division’s level of observance of national standards (Berwick, 2003). Quality monitoring can be benchmarked to such a standard by medically–related organisations such as Medicaid Services (Fawcett & Garity, 2009). Another benchmark could be the development of service standards. For instance, since bed flow may be understood to be a serious concern for emergency departments, using service standards as a benchmark would result in the initiation of telemetry, and a faster response time to complications that the patients may periodically experience (Fawcett & Garity, 2009). It would also be beneficial for the developments of evidence based practices to be monitored as often as possible; probably on a quarterly basis, in order to ensure that all functions are progressing on time. The alignment of performance and quality measures with the mission, vision, and strategic plan One of the most important factors which ensure the alignment of performance, mission, and quality is to ensure that the clinical setting is prepared for partnerships in terms of academic practice research (Larrabee, 2009). This allows for access to clinical settings as well as clinical populations, which will generate a desire to implement research results. Medical practitioners such as nurses also have to be empowered as they are the main factors that will execute true change. True alignment of performance, strategic plan and mission will require the revaluation of healthcare systems. It may also require the persistence of all stakeholders as the process begins to be implemented. This is because implementing the program will force health practitioners out of their comfort zones while forcing them to confront unfamiliar territory (Larrabee, 2009). It is also necessary for medical practitioners involved to embrace multiple perspectives on different issues so as to allow room for the new policies to be adequately implemented. References Berwick, D. M. (2003). Disseminating innovations in health care. JAMA, 289(15), 1969–75. Estabrooks, C. A. (2004). Thoughts on evidence-based nursing and its science: a Canadian perspective. Worldviews Evid Based Nurs., 1(2), 88–91. Fawcett, J., & Garity, J. (2009). Evaluating research for evidence-based nursing practice. Philadelphia: F.A. Davis. Kirchhoff, K. T. (2004). State of the science of translational research: from demonstration projects to intervention testing. Worldviews Evid Based Nurs., 1(S1), S6–12. Larrabee, J. H. (2009). Nurse to nurse: Evidence-based practice. New York: McGraw-Hill. McGonigal, D., & Mastrian, K. (2011). Nursing Informatics And The Foundation Of Knowledge. New York: Jones & Bartlett Learning. Shojania, K. G., & Grimshaw, J. M. (2005). Evidence-based quality improvement: the state of the science. Health Aff. 24(1), 138–50. Stetler, C. B. (2003). Role of the organisation in translating research into evidence-based practice. Outcomes Manag., 7(3), 97–105. Read More