For the better outcome of patients, consultation from an expert and experienced a professional is not new. Florence Nightingale started the concept of Evidence-Based Practices by publishing her work “Notes on Nursing” in 1860, which was based on cleanliness, nutrition, and fresh air. After that, thousands of researches provided the direction and trend to nurses and health care organizations to use “Evidence” in their clinical practices to provide the standard care to patients. American Nurses Association stress on the utilization of Evidence Based practices in “code of Ethics” and “scope and Standards of Practice”(Peterson, H, M, 2014). Healthcare clients always anticipated for the high quality of best care for them or for their loved ones. …show more content…
For any clinical decision related to any specific situation, only evidence alone never works. It also required good judgment, clinical expertise, awareness of patient’s preferences and needs (Kathleen M. Williamson et al.2015. Eizenberg , M,M . 2010). Complications in Critical Care areas to resolve need expert nurses who able to identify and manage the patient’s condition on time according to the situation. Health care provision in multifaceted circumstances, to reduce the patient’s length of stay in hospital, use of complicated machinery and client demand for quality care required smart significant decision making by nurses which result in better health care outcome and this critical thinking comes through EBP (Shoulders, B et al . …show more content…
In hospitals, 2% of deaths are just due to pressure ulcers and results showed that between January 2012 to December 2013 4% - 6% of patients in critical care units and 5% - 10% of general patients had pressure ulcers. 60 thousands of deaths occur worldwide just due to the complications of pressure ulcers. To prevent Pressure Ulcers (PU) and its complications, EBP is the best solution ( Abebe Dilie (2015). The effectiveness of EBP is that it decrease the cost of care by increased quality of care through utilization of appropriate resources which also results in decrease length of stay in hospital and clients satisfaction as well (Ali A. Ammouri ., 2014). According to the survey, 30%- 40% patients do not receive care based on Evidence Based Practices (Maaskant et al.
Evidence-based practice (EBP) entails the use of explicit, reliable, and judicious evidence to make effective decisions about the care of patients. This DNP student will introduce EBP with the IOWA model. The IOWA model applies to this DNP proposal. The IOWA model is an EBP applicable in healthcare setting and implemented to show the applicability of evidence in nursing to give the best outcome. Doody and Doody (2011) noted that the IOWA model focuses on problem-focused triggers and knowledge in undertaking quality improvement study. The steps involved include topic selection, team formation, evidence retrieval, grading evidence, developing an EBP evidence, implementation of EBP, and evaluation of the progress. These steps apply to this DNP proposal, showing best practices, guidelines, procedures, and policies
Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et al., 2014).
Clinical decision making involves the gathering of information, awareness, experience, and use of proper assessment tools. The term is often used when describing the critical role of nurses. The process is, therefore, continuous, contextual, and evolving. Authentic practices and experienced people are required to offer guidelines when needed. Effective decision making in clinical environment combines skills such as pattern recognition, excellent communication skills, ability to share, and working as a team, reflection, use of the available evidence and guidelines as well as application of critical thinking. A Clear understanding of this term contributes to consistency, broadening of the scope and improving the skills. However, this paper aims at providing an opinion on clinical decision making and how it is connected to nursing practices.
This paper will discuss three theories of decision-making that can be adopted in nursing practice, additionally how decision-making theories are able to be implemented and used. Decision-making in nursing is adopted through the critical thinking process that provides each nurse a model to make the best choices, solve problems and to meet goals in clinical practice (Berman & Kozier 2018, pp. 199-200; Levett-Jones & Hoffman 2013, pp. 4-5). Effective decision-making in nursing is a vital component and part of the role of a registered nurse; each year a substantial number of patients die due to medical errors and poor decision-making (Levett-Jones & Hoffman 2013, pp. 4-5; Nibbelink & Brewer 2017, p. 3). Through the use of effective decision making
230) in EBP. Clinical opinion, together with the best relevant research evidence, provides the framework to for the best patient outcome. The nurse’s clinical opinion is acquired through knowledge and skills developed from undergraduate, graduate, or continuing education, clinical experience, and clinical practice (Melnyk & Fineout-Overholt, 2010). Clinical opinion also includes internal evidence, which is generated within a clinical setting from quality improvement outcomes, management initiatives or EBP implementation projects (Melnyk & Fineout-Overholt, 2010). Nurses use their clinical opinion when they identify each patient’s condition, individual risks, personal values and expectations, benefits of possible interventions, and gather evidence for EBP. When searching for the best available evidence, there is a hierarchy in the strength of evidence. The highest level of evidence usually comes from a systematic review or an evidence-based clinical practice guideline based on a systematic review. Systematic reviews provide the strongest evidence through a summary combining the results from many relevant, unbiased studies, to answer a particular clinical question. Nurses critically assess the individual studies, to gather the best evidence available for patient care. Systematic
“Apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion. Remember he is face to face with his enemy all the time, internally wrestling with him” (Nightingale, 1992, p. 22). Fortunately, in the nineteenth century, Florence Nightingale recognized uncertainty could cause harm to her patients (Nightingale, 1992). Equally important to the nursing profession are the nursing theorists, their work, and the evolution of the theories that followed Florence Nightingale, the founder of modern nursing (Alligood, 2014).
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
The reduction of pressure ulcer prevalence rates is a national healthcare goal (Lahmann, Halfens, & Dassen, 2010). Pressure ulcer development causes increased costs to the medical facility and delayed healing in the affected patients (Thomas, 2001). Standards and guidelines developed for pressure ulcer prevention are not always followed by nursing staff. For example, nurses are expected to complete a full assessment on new patients within 24 hours at most acute-care hospitals and nursing homes (Lahmann et al., 2010). A recent study on the causes of pressure ulcer de...
Registered nurses work to contribute good health and prevent illness. They also treat patients and help go through there rehabilitation and also give support and advice to patients family. Registered nurses are general-duty nurses who focus in the achievement of caring for their patients. They are under the supervision of a doctor. As I researched this career It brought more questions to my life. It became a big interest that soon I would have an opportunity to answer my own questions obviously with the help of others.
Within this essay, evidence based practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored in the implementation of evidence based practice. Individuals need specific care tailored to them, it is vitally important to have the correct professional and appropriate personal care. In order to receive this, we need to get the patient involved in the decision process, listen to their views and opinions and receive the relevant, accurate, professional and medical information. Once all the information is collated, a personal care package can be put into practice. Evidence Based Nursing, An introduction (2008, p. 1).
One feature of evidence based practice is a problem-solving approach that draws on nurses’ experience to identify a problem or potential diagnosis. After a problem is identified, evidence based practice can be used to come up with interventions and possible risks involved with each intervention. Next, nurses will use the knowledge and theory to do clinical research and decide on the appropriate intervention. Lastly, evidence base practice allows the patients to have a voice in their own care. Each patient brings their own preferences and ideas on how their care should be handled and the expectations that they have (Fain, 2017, pg.
Evidence-based medicine (EBM) has been described as “the conscientious, explicit, and judicious use of current best evidence in making decision about the care of individual patients” . Evidence-Based Practice is a thoughtful integration of the best available evidence, coupled with clinical expertise. It enables one to address healthcare questions with an evaluative and qualitative approach. It is about applying the best available research evidence in provision of health, behavior and education services to enhance outcomes. Evidence-Based practice is about performing the best possible practice in order to provide the best possible care .
A theory I can relate to is Nightingales theory, I found her theory to be extremely interesting. A patient health is affected by the environment that they are in, whether it is at the hospital or at their house. Once a patient is discharged the nurse should be aware of the patient home environment, what they have access to, and what they don’t have.
The importance of Evidence-Based Practice is to ensure the best possible care is provided for patients. Evidence-Based Practice functions by measuring the effectiveness of a treatment and differentiating findings between high-quality and low-quality. It also helps with health development and improves the reliability and facilitates students to become reflecti...
Nursing began with the reformation by Florence Nightingale. Nursing philosophy, science and research all define the nursing profession. The profession of nursing has advanced because of the concepts of philosophy, science, knowledge, and research. These concepts continue to develop into advanced practice nursing. The nursing process implements critical thinking skills and applies accountability to nursing. Two important philosophical foundations of science are rationalism and empiricism. These strategies help create nursing theories. Philosophy is a set of ideas, beliefs or values. Our own personal values and beliefs must be clear in order to meet the healthcare needs to our patients (Masters, 2017, p. 112). My own personal nursing