HLT54115 Diploma Of Nursing

Introduction

Evidence based practice (EBP) as applicable to the nursing domain is denoted as the problem-solving approach for proper clinical decision-making in a healthcare setting. It considers integration of best available evidences within the research area for enhanced nursing practice. EBP takes into consideration external and internal influences on clinical practice and is in support of translation of evidences into practice (LoBiondo-Wood & Haber, 2017). The present paper aims to guide EBP on the basis of the research article titled “Implementing evidence-based practice: effectiveness of a structured multifaceted mentorship programme” by Wallen et al., (2010).

Summary of the article

The paper by Wallen et al., (2010) aimed at understanding the efficiency and usefulness of a structured multifaceted mentorship program whose designing was done for implementation of evidence-based practice in a clinical research intensive environment. The authors gave the background of the study as the known challenges in implementation of evidence-based practice. It was highlighted that a rich pool of literature point out the barriers faced while considering implementation of reformed practices. It is known that evidence-based practice leads to better patient health outcomes through improved quality of care. Nevertheless, the applicability of evidence based practice in real life clinical settings is incoherent. The researchers carried out a quasi-experimental mixed methods study. The study considered carrying out three focused discussions for collecting data from nursing leadership and shared governance staff. In addition, pre- and post-intervention questionnaires were used for data collection between the time frame of June 2006 and February 2007. These were distributed online and encompassed measures of evidence-based practice beliefs, organizational readiness, job satisfaction, group cohesion evidence-based practice implementation, and intent to leave nursing and the current job. Those who took part in the evidence-based practice mentorship program indicated that there was an increase in readiness to embrace evidence-based practice and perceive organizational culture in a more positive manner. Further, they indicated better scores for evidence based practice belief. Qualitative research analysis found out that engagement of staffs at all clinical levels need leadership for supporting evidence based practice culture. Leadership is also required for striving for sustainable resources. The findings of the study was in alignment with previous literature highlighting that there exists a correlation between beliefs of nurses regarding the applicability of evidence based practice and  implementation of evidence based practice. Mentors are required to strongly believe in evidence based practice and lead to more group cohesion between nurses.

Steps for development and implementation of an EBP

When evidence based practice is delivered in a supportive care organization by skilled workers, highest quality care provision is achieved. In addition, enhanced staff satisfaction and reduced healthcare costs can also be achieved. The seven steps of evidence based practice had been highlighted by (Nieswiadomy & Bailey, 2017). As a preparation of the process, healthcare professional needs to engage in the cultivation of a spirit of inquiry. The first step of the process would then be to come up with clinical questions in a PICOT format. This is followed by searching for evidences and consequently critically appraising the evidences gathered. Searching for relevant evidence for informing clinical practice needs to be streamlined and an extensive research is to be carried out with the help of diverse sources. Critical appraisal of the evidence is to be based on a robust framework that helps in the analysis of the validity and reliability of the evidence. The following step is the integration of the apprised evidence into care practices within the care settings. This has to be aligned with the patient values and preferences. The fifth step is the evaluation of the outcomes of the practice decisions. This is crucial since monitoring of the changes lead to understanding of the positive effects brought about. The final step is the dissemination of the results of the whole process. There lies a potential to achieve desirable outcomes for the service users in EBP is implemented. Nevertheless, when experiences are not communicated with other professionals in the care organization, there is a need of duplication of results. Therefore it is vital that successful EBP initiatives are shared with other stakeholders.

Application of the learned information to a practice setting

A practice problem that would benefit from EBP is infection control in clinical settings. The burden of healthcare associated infections in the present times across care settings is acknowledged. Nurses have a primitive responsibility of preventing illnesses across care settings. The aim is to promote maximal outcomes for the patient. Prevention of illness can be facilitated by changes in professional practice as per the available guidelines. Infections acquired in the setting can be reduced to a considerable extent with the suitable application of evidences.  Infection control is an evolving process and needs the coordination of information gathered through different sources (Zingg et al., 2015).

Evidence based information on infection control measures can aid in guiding practice change among professionals. Updated information can encompass areas such as use of barrier precautions, use of personal protective equipment, provisions of keeping the clinical environment clean and appropriate hand washing (Herzig et al., 2016). Evidence based practice can ensure that nurses are aware of the measures that can be taken for reforming setting policies and guidelines. When nurses consider positive changes in practice in relation to infection control, it is an explicit and conscientious approach aligned with the best interests of the patient population. Patient satisfaction level would be greater in such a case (DiCenso et al., 2014).

Conclusion

Evidence based practice aims at having a positive effect on patient care through development of practice. It is the way in which the best available evidence can be applied in clinical settings. Research indicates that evidence based practice has brought about significant changes in different care disciplines of nursing. The steps of engaging in EBP are distinct and each holds a significance of its own. Finding the appropriate evidence through a robust search and appraising the evidence forms the most crucial steps of the process. A number of nursing practice problems entails EBP, one of which is infection control and prevention. Through engagement in continual research nurses can augment their professional practice in future.

References

DiCenso, A., Guyatt, G., & Ciliska, D. (2014). Evidence-Based Nursing-E-Book: A Guide to Clinical Practice. Elsevier Health Sciences.

Herzig, C. T., Stone, P. W., Castle, N., Pogorzelska-Maziarz, M., Larson, E. L., & Dick, A. W. (2016). Infection prevention and control programs in US nursing homes: results of a national survey. Journal of the American Medical Directors Association, 17(1), 85-88.

LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.

Nieswiadomy, R. M., & Bailey, C. (2017). Foundations of nursing research. Pearson.

Wallen, G. R., Mitchell, S. A., Melnyk, B., Fineout?Overholt, E., Miller?Davis, C., Yates, J., & Hastings, C. (2010). Implementing evidence?based practice: effectiveness of a structured multifaceted mentorship programme. Journal of advanced nursing, 66(12), 2761-2771.

Zingg, W., Holmes, A., Dettenkofer, M., Goetting, T., Secci, F., Clack, L., … & Pittet, D. (2015). for the systematic review and evidence-based guidance on organization of hospital infection control programmes (SIGHT) study group. Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. Lancet Infect Dis, 15(2), 212-24.