Impact of Nursing Decisions on Financing of Healthcare

Impact of Nursing Decisions on Financing of Healthcare

Evidence based practice in Nursing

Nowadays for all health care professional including nurses Evidence-Based Practice (EBP) is an expected core competency irrespective of discipline. EBP is necessary to integrate the best research with clinical expertise and patient value to establish best health outcomes (Winters & Echeverri, 2012). This essay will describe concise outline of Evidence based practice. Further it will discuss necessity of EBP into nursing practice and how EBP will helpful to improve the quality of care. The possible role of EBP in nursing will be explored.

In addition it will identify some barriers of EBP which a nurse has to take in consideration during practice which need to be explored. However, there is still need to further research and evaluation of new technique to make the EBP more effective.
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Evidence Based Practice
EBP is the judicious and explicit use of best current evidence for making decisions for the care of individual patients (Sackett, 1997). Nurses are accountable for the holistic care of patients in providing care to the patients along with management of common symptoms.

Nurses must be confident and comfortable in their knowledge of basic principles so they can provide appropriate care to the patients and they must implement suitable interventions to deal with patients’ responses to this common treatment effectively (Chlan, Tracy, & Grossbach, 2011). All health care professionals should have access to up-to-date evidence in order to sustain best practices (Chlan, et al., 2011). As an alternative to practice that is based solely on the experience and knowledge of practitioners, EBP has been introduced in the field of nursing (Chlan, et al., 2011).

Structure of EBP is very systematic as it is based on seven scientific steps. Before putting evidence into practice nurse has to analyze this step so they can confirm it utility. For EBP first step for nurse is to do Community assessment. It contains information about existing socio-economic and physical environment conditions of the patients (Brownson, Baker, Left, Gillespie, & True, 2011).

Source: Brownson, Baker, Left, Gillespie & True (2011) In addition, currently used resource for the ongoing programs must be taken into consideration. Then nurses have to identify the issue which can suggest appropriate treatment for particular patient [Stating the Issue] (Brownson, et al., 2011). Further, descriptive data such should be used to quantify stated issue. Descriptive data can be selected by using sources such as special surveys, national studies and vital statistical data. This data can help in quantify diseases, understand behavior and characteristic of patient at particular time [Issue Quantification] (Brownson, et al., 2011).

Then nurses should search for the clarification of issue by discovering ongoing research and compare that with other available resources and literature research to find appropriate option for the patient [Evidence Based Intervention Search & Comparison and Critical Appraisal of Evidence based Interventions] Further step of nurse in EBP is to consider the resources required and the personnel who should be responsible for the achievement of the goal and objective before implementation of the intervention [Intervention Implementation] (Brownson, et al., 2011). Final step of the nurses is to evaluate that which intervention (treatment) will achieve stated objectives and goal and applied it [Evaluation] (Brownson, et al., 2011).

The approach of EBP will helpful for the nurses to use best available evidence and utilized it in the clinical practice according to individual patient’s preferences and circumstances (Melnyk & Fineout-Overholt, 2011). Research suggested that there is remarkable improvement in outcome of patient’s illness when best evidence is used in the delivery of the patient (Makic, Martin, Burns, Philbrick, & Rauen, 2013). Evidences are found very useful in implication of treatment and judgment of result of patients when they are collected from researches studies, experiences, clinical experiments and patient care data (Fisher & Happell, 2009). EBP will be helpful for the nurse to select appropriate option for the patients from variety of treatment for same type of illness (Fisher & Happell, 2009). So importance of patient’s characteristics and preferences can be will highlighted by EBP.

This will provide information about taking decisions about the individual care and treatment to be provided. So, it will strengthen clinical judgment about condition of patient on presented information (Fisher & Happell, 2009). American Association of critical care nurses recognize importance of evidence while providing care to patients and recommended beneficial use of EBP while dealing with patients (Winters & Echeverri, 2012).

Exclusion of EBP presents several challenges to effective implementation and dissemination as evidence is necessary to integrate interventions with the realities of varying practice contexts (Leeman & Sandelowski, 2012). There for it is difficult for the nurses to perceive outcome of the patient’s illness in the absence of EBP which will put more burdens of public and private health sectors in terms of cost and time to deal with patient’s condition. So EBP will helpful not only clinically but socially, economically and psychologically too.

However, there are still certain argument regarding introduction of EBP in nursing and improve care of patient as there is lack of more research in this area. Therefore, to make EBP more effective and useful certain areas are need to be explored well such as selection of framework model for EBP, identification of clinical question, efficacy of available evidence, evaluation of current practice (Makic, et al., 2013) More research in this area will allow nurses to practice more judiciously and continue to improve care of the patient by EBP.

To recapitulate, this essay has demonstrated that EBP is research base practice and patient should receive care based on optimal scientific knowledge. However patient’s preferences and resources should be considered. It is responsibility of nurse to provide high quality of care to patient. It is important to have evidence in practice to save time, money and unexpected complications in patients. Although there is still need for further research to improve quality and effect of EBP, EBP in nursing would be much more essential to achieve optimal health outcomes.

References:
Brownson, R. C., Baker, E. A., Left, T. L., Gillespie, K. N., & True, W. R. (2011). Evidence-based public health: OUP USA.

Chlan, L., Tracy, M. F., & Grossbach, I. (2011). Achieving quality patient-ventilator management: advancing evidence-based nursing care.
Critical Care Nurse, 31(6), 46-50.

Fisher, J. E., & Happell, B. (2009). Implications of evidence-based practice for mental health nursing. [Article]. International Journal of Mental Health Nursing, 18(3), 179-185. doi: 10.1111/j.1447-0349.2009.00607.x

Leeman, J., & Sandelowski, M. (2012). Practice‐Based Evidence and Qualitative Inquiry. Journal of Nursing Scholarship, 44(2), 171-179.
Makic, M. B. F., Martin, S. A., Burns, S., Philbrick, D., & Rauen, C. (2013). Putting Evidence Into Nursing Practice: Four Traditional Practices Not Supported by the Evidence. [Article]. Critical Care Nurse, 33(2), 28-44. doi: 10.4037/ccn2013787

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: Lippincott Williams & Wilkins.

Sackett, D. L. (1997). Evidence-based medicine. Paper presented at the Seminars in perinatology.

Winters, C. A., & Echeverri, R. (2012). Teaching Strategies to Support Evidence-Based Practice. Critical Care Nurse, 32(3), 49-54.

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