B1373 Nursing

Consider a recent clinical experience in which you were providing care for a patient.
Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?
What questions have you thought about in a particular area of care such as a  procedure or policy?
Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.
Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.

This clinical experience was about the care process which was conducted for a patient in the cardiac ward suffering from myocardial infarction (Melnyk et al., 2012). All the measures and interventions which were used in the process was related to the recent evidences such as while the diagnostic measures of the cardiac arrest, cardiac catheterization and electrocardiogram was used as per the research of Galiè et al. (2015), as these diagnostic measures are appropriate and useful in identifying the reason for cardiac arrest.

 In this aspect I looked for evidences using a PICOT questions, which was

Problem	Intervention	Comparative	Outcome	Time
Myocardial infarction diagnosis	cardiac catheterization and electrocardiogram as diagnosis method	Than other diagnostic methods	Does faster diagnosis	Within 24-hour

 “Can cardiac catheterization and electrocardiogram are able to diagnose the reason for myocardial infarction in the patients compared to other diagnostic methods within a day?” However, in this situation it should be mentioned that in there are few policies and procedure which can hinder the application of these evidence based practices within the healthcare facility (Majid et al., 2011). Such as, application of formatted diagnostic measures and medication for the benefit of patient and healthcare facility. Further there are several barriers in the application of this EBP in the care process of the patient. Such as rules and regulation of the hospital about the care interventions, less information about the recent EBPs within the care facility and so on (Melnyk et al., 2012). This could one of the major reason due to which the healthcare facility does not allow the application of EBP in care process. Hence, to overcome the barriers, all the core physician teams and senior management should be provided with evidences and supporting document about the recent and fast diagnostic process so that they can understand its effectiveness and apply in the process (Majid et al., 2011).

References

Galiè, N., Humbert, M., Vachiery, J. L., Gibbs, S., Lang, I., Torbicki, A., … & Ghofrani, A. (2015). 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the joint task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). European heart journal, 37(1), 67-119.

Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y. L., Chang, Y. K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association: JMLA, 99(3), 229.

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators. Journal of Nursing Administration, 42(9), 410-417.