Did the Expatriate Nurses Training Program Enhance Staff Satisfaction and Reduce Burnout - Essay Example

Evidence Base Practice Introduction Evidence Base Practice Introduction Many questions have been raised concerning the use of evidence based practices in hospitals. This lead to a research which was carried out to show that a large number of patients who are hospitalized acquire infections while they are being treated other ailments. the justification that was given to this is due to the nurses having burnouts making it possible for them not to able to curb hospitalized acquired infections. It is for this reason that medical practitioners have decided to embark on using Evidence Based Practice (Beyea & Slattery, 2006). It is important to not the reason why the evidence based practice is applicable in hospitals in order to improve the quality of enhancing and care for the satisfaction of nurses in the reduction of burnout. Research Question Did the educational preparation program for expatriates nursing staff enhance satisfaction and reduce burnout? Search Process There is a time when the University of Pennsylvania embarked on a research titled Maslach Burnout Inventory where the nurses were analyzed in relation to job related issues such as attitude. A comparison was done on the percentages found on burnout nurses in relation to catheter associated urinary tract infections and surgical site infections. Selection criteria They results showed that there was an increase in the number of burnout nurses in every additional CAUTI while there was an addition of nurse in every two SSIs in relation to 1000 patients. Looking at the numbers from one angle it would be said that it is not a big deal (Beyea & Slattery, 2006). However, reports indicate that the cost of dealing with these cases include $749 to $832 for each case involving CAUTIs. At the same time, it would cost $11,087 to $29,443 for each case involving SSIs. This number can be reduced. In case the number is reduced by 30 percent, it is discovered that there will be prevention of 4,160 cases of infections making it possible for the institution to save $41 million. Search outcome Evidence based practice otherwise known as EBP is a practice, which is recommended by the medical practitioners in improving the working conditions of the nurses. The main determining factor that makes the practice to be applicable is through integration of various aspects. The first issue involves the opinions indicated by the clinical expertise. This also involves evidence from external scientists (Kim & Mallory, 2014). These aspects are also applicable to caregivers, patients and clients who are on the verger of ensuring that the quality of services being delivered is of high quality. These services are expected to reflect the interest of the entire stakeholders involved in the medical practice. These can be in the form of needs, values, choices and interests, which drive them to giving proper care. It has been noticed that the nurses have a tendency of being tired after taking a heavier load of patients than normal, which makes them want to rest. This makes them cut corners or give shady works in order to complete their work. At the same time, they tend to forget the manner in which the nursing care can be carried out properly. The nursing care may involve emptying of the drainage bags, changing the dressing and paying attention to petty issues such handling the containment articles and washing of the hands (Malloch & Porter, 2006). These are the issues, which are related to the major hospital acquired infections. Nurse burnout is referred to emotional disillusionment and exhaustion that the nurses undergo in their current jobs, which makes them deal with heavy loads of patients, and in a stressful environment. These issues interfere with the lives of the nurses both professionally and personally which sometimes is reflected in the patients. Impact on the Environment The relationship between the patient and the nurses is vividly reflected on the outcome of the treatment. This relationship might be connected to the ratios of the patients attached to the nurses. The clear picture translated from the work ethics of nurses can be initialized in the standard of care delivered by them (Levin & Feldman, 2012). It is seen that there are a few cases whereby nurses are seen to drop in their standards of operations. It is important to note that one should not deal with the number nurses in the institution but rather the quality of work they are providing. There are instances when the nurses might detach themselves from work due to stress related issues. These issues might include conflicting values on the management and the nurses, lack of teamwork and prioritizing financial issues instead of the safety of the patients (Kim & Mallory, 2014). Hospitals and institutions have decided to embark on strategies of handling the unseen events related to infectious diseases. It is important to reduce the burnout by nurses while at the same time improving the care of the patients. This makes the nurses work towards seeing the wellbeing of the patient instead of focusing on completing their duties. The best way that has been recommended by majority of medical practitioners is to give enough rest periods for the staff (Malloch & Porter, 2006). This can easily be implemented by ensuring that the nurses are given their day off and additional working hours are scrapped from their schedules. At the same time, giving nurses regular break during their workdays can do the trick of making them feel fresh and free to work. Implementation of evidence based practice makes it possible for the hospital to organize their staff and avoid nurses burnout. It is explained that this process requires commitment from qualified nurses who would initiate a proper impact to the hospital. There are complaints, which are normally raised against poor staffing. This might be a wrong approach since it would not be capable of alleviating the situation (Beyea & Slattery, 2006). The health care environment witnesses different and complex needs of the patients everyday. The nurses are required to be equipped with the best education and knowledge for them to be able to handle many patients with different needs. This will always improve the outcome of the patient. Steps Involved in Evidence Based Practice Training The nurses are recommended to have proper knowledge of their career and the issues it entails. This would make them have an interest in implementing, planning and evaluation of infection control and prevention measures. They are then required to make certain of steps involved in the implementation of EBP throughout their working experiences. The steps involve framing the clinical question, finding the evidence, assessing the evidence and making the clinical decisions. These steps have been illustrated through the recommendations initiated by a research carried out to obtain and identify clinical practice guidelines in the nursing departments. These departments are associated to speech language pathology or in other words audiology (Kim & Mallory, 2014). This was initialized by the introduction of maps, which are essential for clinicians, clients, researchers, and caregivers in engaging in evidence based practice especially in decision-making. The maps that were highlighted, indicated the importance of the components used in evidence based practices. These components include current best evidence, clinical expertise and patient or client perspective. Framing the Clinical Question This first step involves coming up with the suitable question for the situation and the evidence that can be applicable. One of the universal strategy that has always been applied in coming up with the right question is referred to as PICO. This is an indication of Population, Intervention, Comparison and outcome of the situation (Beyea & Slattery, 2006). Using this type of formulation of questions, ensures that the relevant evidence is applied and the clinicians face the right situation. An example of its use can be seen below: Population Intervention Comparison Outcome Stroke patients Early initiation of aphasia treatment Aphasia treatment after initial/spontaneous recovery time Functional communication abilities Kindergarteners with articulation disorders Individual pull-out treatment Group pull-out treatment Ability to consistently produce /s/ 17-year-old male with a severe head injury Cognitive rehab No cognitive rehab Return to work/school From the representation given, the first question that can be formulation is associated with patients having aphasia who at the same receive SLP after having stroke would be in a position of having abilities of functional communications (Malloch & Porter, 2006). It has been noted that people experience difficulties in framing the appropriate questions associated with clinical designs. These queries are supposed to be specifically associated with all the categories. The difficulties are associated with it being an art rather than a science and there should be numerous errors before the exact question can be established. When it is a question of formulating a question associated with population, the clinician is expected to look at the specific circumstance that might have prompted the situation. This would involve evidences that make the caseload of the patient. This will be associated with the disease and the people who are involved in the entire concept. The questions are also formulated on the basis of intervention and comparison. This would mean that the clinician comes up with the questions on the alternative treatments, which can be given to the patients. This would be built on specific information and the actual events that take place. This sometimes focuses on the real issues which should be addressed through a pull-out model. The questions formulated on the outcomes usually involves the aftermath of the practice applied (Beyea & Slattery, 2006). This would be used in knowing if the method applied is a success or it would replaced by another strategy. After all the issues have been tackled, it would be time for the implementation of the second factor, which is the availability of evidence. This makes it possible for the clinicians to establish sufficient evidence, which is used in addressing the question implemented (Levin & Feldman, 2012). In most cases, the issues that are dealt with are dearth evidences, which the clinicians are, always involved making decisions based on their expertise and experiences on the manner of making the criteria to be relaxed. Finding the Evidence This implementation is usually involved with the decision-making. This makes evidence based practice to be implemented easily. The clinicians are sometimes forced to ask for other scientific evidences in order to come up with the best treatment decisions. There are two studies which are related to finding evidences. These essential studies fall in the category of systematic reviews and individual studies. Systematic review is all about clinical practices and guidelines, which are related to evidence, based practices. The scientific evidences can be established in a formal assessment, which give a clinical question used in the description of various diagnostics and approaches of treatment. These treatments must be established through scientifically proven evidences, which are based on the recommendations of clinical practices (Kim & Mallory, 2014). They are seen to be useful in assisting the clinicians make decisions related to treatment, which are properly done. This systematic establishment is used in the formation of a clinical question, which later helps in decision making related to the best treatment. Individual studies are related to the clinical practices and guidelines, which are systematically not available, not trustworthy, not current and not relevant. This is all about an individual carrying out his studies in order to come up with the best treatment decision. They usually use bibliographical data that can be found online or even in books (Malloch & Porter, 2006). These studies sometimes do not work properly as some of them might be unique and there are no issues indicated online or even in books which are related to the cases. Assessing the Evidence The issues related to the assessment of evidences are broken down to two important aspects of individual and systematic approach. Systematic approach is established on relevance of the review and the individual who published and wrote the review. The relevance of the specific clinical question is based on the personal perception on the ideology. This is usually carried out by looking at the connection of the patient to a certain group or practice. This requires the experiences and the expertise of the nurses in order to come up with a positive outlook of the ideology. If it is a question of looking at the works of person, the essential thing to follow is the credibility of the idea (Beyea & Slattery, 2006). This should be looked at from the aspect of findings which are positive or negative. The nurses are expected to use trusted sources since they guarantee positive outcomes as compared to the less objective sources. In understanding the individual studies, people would trust scientific journals, which are peer reviewed since they offer credible information. Nurses are required to establish two learning approaches the quality of the evidence and the level of evidence. Critical Appraisal of Paper Part Two: Article Review The being criticized is titled Adopting Evidence-Based Practice in Clinical Decision Making: Nurses’ Perceptions, Knowledge, and Barriers. The take on the article on the adaptation of Evidence based practice indicates that the nurses should have an initiative for them to be order to give the best services. This might be true, however, if the nurses are rewarded before their work is seen, it might be problematic to the patients. the most essential way in which the nurses can be able to implement the best works in regards to evidence based practices is through ensuring that their relationship with the patients are good. Good performances will be seen if the patience leave the wards better than they were brought in to the hospital. The article also insists that individuals should be able to give a critical appraisal towards the practice (Cashin & Cook, 2011). This method is expected to involve certain policy makers in health institutions and hospitals. This would mean that the practice would be established in certain regions while others are left to continue with their old practices. This will be like making other patients not to receive the same treatment. On the other hand, the individuals in the rural set up will not be treated with the same attitude. This might increase their chances of acquiring communicable diseases while they are at the hospital since the nurses will not be able to give them the best care that they need. The article indicated the importance of understanding evidence based practice in which the appropriate attitude should be applicable. This is essential to the initiative since it is associated with curbing the barriers, which would arise during its establishment. This might be true since majority of the nurses have been seen to always neglect their duties or even take for granted the issues they are supposed to put into practice (Cashin & Cook, 2011). This case makes it possible for them to concentrate on the provision of better care to the patients. The initiation of evidence based practice might not take place if the nurses are not committed in ensuring that it is implemented. This makes it possible to curb the barriers associated with attaining better results by the nurses. The article indicates that it is essential for nurses to carryout proper researches in order to know the right methods to be implemented. This is an issue that all the nurses should always put into consideration as good research will result to the best performances by the nurses, as they will be committed to the course. Conflicts of interest The nurses should also know the important literatures, which would enable them, act in accordance to the rules and regulations given by the authorities. The article stipulates that the research they carried out included questionnaires, which were, distribute to all the nurses. The results they attained indicated different understandings and the nature of knowledge that the nurses possessed. This is an indication that the attitude of the nurses towards the implementation of the ideology differs. It is important for them to have a universal understanding of the entire concept of evidence-based practice (Cashin & Cook, 2011). From the responds got from the research, it was realized that 64% of the respondents were positive which implied that majority of the people were aware of what is required from them. There are those who were unable to deal with the new evidences exhibited by the patients. There are those that found it impossible to deal with the heavy workload of patients they deal with in hospitals. The nurses required a lot of motivation for them to be able to deal with the workload they deal with. This meant that they could not do their work efficiently. At the same time, they did not exhibit the best work ethics towards their patients. This is the type of experience, which does not require moderate levels of experience but rather good work experience. This was a representation of the research showing that they had to undergo a self-test in order to know the type of work they were capable of handling. This test should be carried out whenever a nurse is practicing to start work. This will enable the institution know the work they are capable of handling in order to avoid burnouts by the nurses. The nurses were encouraged to have positivity whenever they were carrying out their duties. They carried out evidence based practices so as to avoid a lot of issues such as burnouts. They had no choice but to follow what the practice entailed (Cashin & Cook, 2011). This practice enables them to create time, train and participate in mentoring the other nurses. There are those nurses who are always carried away with the events taking place in hospitals whenever they are new. It is the work of the senior nurses to ensure that they work instead of being confused. Conclusion According to the article, there are some barriers that are related to the implementation of EBP. One of the issues indicated by the research was lack of time. This is seen to be the biggest issue that hospitals are on the verge of reducing. Nurses are always on the move and it might be difficult for them to start studying new aspects. They might not be able to work on their duties on time during the time they are trying to cope up (Cashin & Cook, 2011). The second barrier involves in the statistical language that the practice uses during the implementation. The language that the professionals use in the clinical field might be difficult for some nurses to understand. This sometimes leads to misunderstandings and misconception by the nurses. There are those nurses who are used to simple terms and nonprofessional English. This is also related to the misconception of the jargons used in the implementation of evidence-based practices. Bibliography BEYEA, S. C., & SLATTERY, M. J. (2006). Evidence-based practice in nursing: a guide to successful implementation. Marblehead, MA, HCPro. CASHIN, A., & COOK, R. (2011). Evidence-based practice in nursing informatics concepts and applications. Hershey, PA, Medical Information Science Reference. http://site.ebrary.com/id/10438667. COWEN, P. S., & MOORHEAD, S. (2011). Current issues in nursing. St. Louis, Mo, Mosby Elsevier. DART, M. A. (2011). 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