Application of Evidence-Based Practice Attending to Patients - Term Paper Example

Application of Evidence Based Practice Students Name Institutional Affiliation Executive Summary The effectiveness’ and application of evidence-based practice has been controversial among health professionals and stakeholders. On the other hand, pressure ulcers have been on high increases in the recent past (In Veenema, 2013). The following paper will seek to apply evidence based practiced in the healing of wounds from patients suffering from pressure ulcers. The objective is to show how EBP is instrumental in enhancing service delivery. In order to meet this objective, the researcher will collect data from two different heath institutions where one applies EBP while the other does not. The methods of data collection include interviews, observation, and questionnaires. The collected data will be complied, analyzed, before making conclusion and providing a recommendation. Table of Contents Executive Summary 2 Introduction 4 References 12 Application of Evidence Based Practice Introduction Evidence-Based Practice of the EBP refers to an approach that is focused on the use of scientific studies as well as research as the foundation for finding the most efficient and suitable practices in particular fields (Bridges & TriService Nursing Research Program, 2009). According to Sackett, EBP is the conscientious, explicit as well as judicious utilization of current best practices and evidence in coming up with decisions about the care of the individual patient. On the other hand, pressure ulcers, which are also known as decubitus ulcers, comprise a significant portion of wounds that require specialized care as well as presenting more expenses to patients and their families (Couig & Kelley, 2012). The study indicates that any patients who are suffering from pressure ulcers are finding it difficult to recover from agonizing wounds due to the failure of applying evidence based practicing in attending to such patients (Nygaard, 2007). The following paper seeks to show the importance of using evidence based practices when attending to patients suffering from pressure ulcers, especially those with wounds. Data Collection Methods In carrying out this study, both qualitative and quantitative methods of data collection will be applied. The survey will be carried out at two health facilities that have different experiences with patients suffering from pressure ulcers. In one of the facilities, patients are with chronic and acute wounds are treated just like normal wounds without providing specialized care. In The other health service, patients with pressure ulcers are offered specialized services through evidence based practices (Veenema, 2009). In collecting the data, questionnaires will be formulated and distributed to the two institutions for the patients who can fill them without help. The aim of the surveys will be to know the impact of evidence based practices in enhancing service delivery when caring for people with wounds. On the other side, face-to-face interviews with the patients from two institutions will be carried out to offer insights on their progress based on the times they reported for medical attention. In addition, observation method will as well be used in the collection of data. The data will then be compiled, and a systematic analysis will then be conducted for final inferences. Project Objective As noted above the aim of this project is to show the important role played by evidence-based practice, in delivering the solution to health issues in the society. The project will demonstrate the effectiveness of evidenced based practices in wound management among patients with pressure ulcers. To achieve this, the research will be conducted in two different health facilities that Project Scope Project scope highlights the extent to which the project will cover. In other words, project scope is the area that the research intends to cover as well as the areas that can be affected by the results of the findings. In this project, the research will be conducted on patients with pressure ulcers from two different health facilities. In one of the scenarios, the researcher will collect data from a health facility where practitioners took the time to understand the problem of pressure ulcers to determine why patients’ wounds were taking too long to heal. In this scenario, the researcher will be interested to know if the application of evidence-based practices has led to enhanced service delivery in the facility. On the other hand, the second facility will be where patients of this problem are still struggling with their wounds and the health practitioners and stakeholders continue to offer them normal services without understanding that they need special attention. The results of the project are expected to influence actions at the second health facility and other health institutions that are not making use of evidenced based practices to improve their service delivery in different areas. The project is also expected to ensure that health practitioners become more innovative and try to solve health issues based on credible evidence and understanding of the causes of problems that they are encountering. Background Evidence based practice of the EBP is an approach focusing on the use of scientific studies as well as research as the foundation for finding the most effective and suitable practices in specific fields (Ewes & Humphreys, 2015). EBP was initially started with more emphasis on medicine but later was developed into other areas such as nursing, education, and psychology. The main aim of EBP is to provide transparency as well as assuring clients that the techniques and procedures used provide the best interventions and techniques available. The common definition of EBP comes from Dr. David Sackett, who observers that EBP is “the conscientious, explicit as well as judicious utilization of current best evidence in making decisions regarding the care of the individual patient (Ewens & Humphreys, 2015). Therefore, EBP means incorporating individual clinical knowledge with the best external clinical evidence based on systematic research. Based on this observation, it is clear that EBP the incorporation of patient values, clinical expertise, and the best research evidence into the process of decision making for the sake of efficient patient care (Howard et al., 2010). As the patient comes to the encounter with his or her personal preferences as well as unique expectations, concerns, and values, the available and best research evidence is usually found and used for clinically relevant application to solve the problem that the patient is having (Ewens & Humphreys, 2015). However, it is important to note that the evidence does not, of itself, make the decision, but it can assist in supporting the patient care process (Veenema, 2009). The application of the components of EBP into the actual clinical decisions helps in promoting opportunity for the optimal clinical outcomes as well as enhancing quality of life, especially for the patients. The EBP practice is usually triggered by patient encounters that generate questions regarding the utility of diagnostic tests, the effectiveness therapy, the prognosis of diseases, as well as the etiology of disorders. In order to successfully conduct the EBP, medical practitioners such as clinicians need to have skills including efficient literature searching as well as the application of formal rules of evidence when evaluating the clinical literature (Ewens & Humphreys, 2015). The process of EBP involves six main steps which include assessing the patient or the problem at hand, formulating a clinical question from the case to be answered , acquiring the evidence, appraising the evidence, applying the methods of solving the problems and finally conducting self-evaluation process to assess the effectiveness and suitability of the solution (Kim, 2015). The Need to Apply EBP for Pressure Ulcers The study has shown that there has been an increase of pressure ulcers in the society due to life’s stresses, poor eating habits, among other related lifestyle issues (Adelman, 2015). Pressure ulcers, which are also known as decubitus ulcers, has considerable portion of wounds that need a special care as well as presenting more expenses. In this way, the occurrence of wounds for someone with ulcers should be prevented as much as possible. A pressure ulcer refers to any lesion brought about by unrelieved pressure, which leads to damage to the underlying body tissue (Adelman, 2015). Notably, pressure ulcers often occur over bony prominences and are staged or graded in order to determine the scope of damages done on tissue that has been observed. The Stage 1 of pressure ulcers is defined as nonbankable erythema of intact skin, referring to the heralding lesion of skin ulceration. Further, the Stage 2 of this problem is defined as partial thickness skin loss that involves dermis and epidermis (Adelman, 2015). In addition, Stage 3 is considered as a full thickness skin loss that consists of necrosis or damage of subcutaneous tissue, which could extend down to the underlying fascia. Finally, the Stage 4 is the full thickness skin loss with extensive destruction, tissue damage to bone, muscle, or supporting structures. According to The Wound, Ostomy and Continence Nurses Society (WOCN) the prevention of pressure ulcer is best attended to by ensuring that patients that are at risk are identified in developing of pressure ulcers to start initiating new measures of prevention (Adelman, 2015). WOCN contends that this process needs an understanding of risk factors, the use of evidence-based risk assessment tools, knowing of relevant preventive measures as well as accessing the important medical facilities such as surfaces of therapeutic support. The WOCN argue that many hospitals and health facilities have not appropriately allied evidence based practices and approaches in dealing with pressure ulcers patients (Adelman, 2015). Further those who have pressure ulcers need assessment as well as interventions in identifying and correcting the causative factor(s) and application of modalities in the treatment that would assure optimal wound healing (Adelman, 2015). At the same time, regular follow-up assessment, as well as modifications of the treatment plan when indicated, is also instrumental in assuring optimal wound repair and suitable and efficient utilization of resources, including supplies (Veenema, 2009). Critical to note is that the difference existing on infection and colonization of wounds is decided by the number of organisms found in the specified wound since an infected wound has a larger number of microorganisms compared to a contaminated wound. Stage 2, 3 and 4 pressure ulcers According to the clinical guidelines from the Agency for Healthcare Research and Quality (AHRQ), must all be taken as colonized with bacteria (Adelman, 2015). Accordingly, proper and effective cleansing of wound, as well as debridement, should be able to prevent the colonization of bacteria from extending to the stage of clinical infection. Strategies to ensure pressure ulcers are managed including facilitating healing include proper management of tissue load (which involves proper positioning and the utilization of support surfaces) as well as the relevant ulcer care and infection management. Notably, initial ulcer care for the patients who have developed wounds involves wound cleansing, debridement, dressing application as well as possible adjunctive therapy (Adelman, 2015). The objective of performing debridement is to ensure that moist and devitalized tissue is removed. If a patient has small wounds, they can be debrided at the bedside. However, if one has extensive wounds, debridement can be done in an operating room or a special procedure room. About wound cleans, experts observe that the advantages of cleaning need to be weighed against the risk posed by potential trauma to the tissue be that the process of cleaning is causing. Understandably, solutions such as iodophor, povidone iodine, acetic acid, sodium hypochlorite solution, and hydrogen peroxide should not be used since they are potentially cytotoxic. Additionally, normal saline should be applied at a pressure between 4 and 15 pounds per square inch (psi). Concerning ulcer dressings, ideals dressing need to be able to ensure the protection of the wound, make it biocompatible, and offer excellent hydration (Adelman, 2015). The common rule is to ensure that the ulcer tissue is moist, and the intact skin surrounding the area is dry. On the other hand, When one is caring for wounds, clean dressings and sterile instruments should be used (Adelman, 2015). Further, it is prudent to ensure that treatment of the ulcer that is most contaminated is done last for those who have a number wounds. In order to ensure that cross-contamination is prevented as well as the spread of materials that are infectious, it is advisable that clinicians should wear the suitable personal protective equipment (PPE) and changing the gloves as well as performing proper and thorough cleaning of hand hygiene among the patients. Based on the above observation, research has shown that most of the pressure ulcer patients who suffer from acute to chronic wounds are not provided with the necessary care by the health professionals due to failure to apply evidence-based practice when serving such patients (Finkelman & Kenner, 2010). This project seeks to illustrate the importance of evidence-based practice in treating patients with pressure ulcers in health facilities. Analysis of Data In analyzing the data, the researcher wishes to use Triangulation, which is the process of utilizing data from multiple sources (Grouch, 2006). Triangulation helps in examining existing data quickly to ensure strengthening of interpretations and improving programs based and policies on the available evidence. By analyzing information that is collected by different methods through different groups and in varied populations, one can find corroborated across sets of data, reducing the possible influence of potential biases that may be existing in a single study.’ To ensure that the triangulation process is in place concerning this particular project, questionnaires, interviews and observation methods will be used in the collection of the data as explained above. Conclusion and Recommendation Hypothetically, the collected data will be expected to show that patients from the health facility, which applied evidence based practice, will have experienced quick recovery unlike those of the second facility who will have taken long to recover from their wounds or may not have recovered yet. Conclusively, evidence based practice is instrumental in improving service delivery in the health sector. EBP helps in facilitating professional judgment in service provision among health practitioners. Consequently, patients experience increased the cost of health services while at the same time they are not getting better. Therefore, this paper recommends that evidence based practice should be integrated into health institutions to help not only the patients but also assist nurses and health professionals in making well-informed decisions. References Adelman, D. S. (2015). Pressure ulcers and challenges. Sudbury, Mass: Jones and Bartlett Publishers. Bridges, E. J., & TriService Nursing Research Program. (2009). Battlefield and disaster nursing pocket guide. Sudbury, Mass: Jones and Bartlett Publishers. Couig, M. P., & Kelley, P. W. (2012). Annual review of nursing research: Volume 30, 2012. New York: Springer Pub. Co. Finkelman, A. W., & Kenner, C. (2010). Professional nursing concepts: Competencies for Quality services. Sudbury, Mass: Jones and Bartlett Publishers. Howard, P. K., Steinmann, R. A., Sheehy, S. B., & Emergency Nurses Association. (2010). Sheehy's emergency nursing Principles and practice. St. Louis, Mo: Mosby Elsevier. Ewens, B., & Humphreys, M. (2015). Evidence Based Practice. Oxford: Wiley-Blackwell Pub. Grouch, R. (2006). Research Methods London: Greenwich Media. In Veenema, T. G. (2013). Nursing and emergency preparedness for chemical, biological and radiological terrorism and other hazards. Kim, H. S. (2015). The essence of nursing practice: Philosophy and perspective. McSherry, W., McSherry, R., & Watson, R. (2012). Care in nursing: Principles, values and skills. Oxford: Oxford University Press. Nygaard, G. G. (2007). Nursing the primary care challenge. Veenema, T. G. (2009). ReadyRN: Handbook for disaster nursing and emergency preparedness. Read More