Clinical Case Review Essay

How would Ed’s blood help protect him from a foreign invader such as the one now in his system?

Slutsky, J. (2005). Using evidence-based guidelines: Tools for improving practice. In B. F.-O. Melnyk, Evidence-based practice in nursing & healthcare. A guide to best practice (pp. 221-236). Philadelphia, PA: Lippincott, Williams & Wilkins.

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

On the 24th February 2000, Victoria was taken semi-conscious and suffering from; hypothermia, multiple organ failure and malnutrition, to a local church. The taxi driver that collected them from the church was so horrified at her condition, that he took them straight to A and E. Victoria died the following day.

Evidence-Base practice (EBP) is defined as: “based on problem identified from the practitioner’s area of practice; a combining of best evidence and professional expertise and an integration of this into current practice; about ensuring patients receive quality care, being part of quality improvement processes; about collaboration and requiring a team approach” (French, 1999). Scott and Mcsherry (2008) supported the French’s assertion, proposing the key elements of EBP are that it is a theory-driven process, which involves the use, evaluation and application of research; identification of best evidence; evaluation of care; problem solving; decision-making; clinical expertise; and requires patient involvement. Evidence-based practice is made of evidence, clinical expertise, patient preference, the context of care (Barker, 2013). In brief, evidence-based practice is the parameter in the nursing practice that it requires that the nurses gather and use clinical evidence to make decision for the patients so that in the nursing process they can deliver the quality of care for the patients (Ellis, 2013). In the other words, in the nursing practice all the nursing procedures performed by the clinical evidence supported.

Evidenced Based Practice (EBP) is essential to enable all nurses to provide the most current up to date practises for their patients. This process involves research, systematic review of current practises, critical thinking skills, evaluation and application to the clinical setting. In addition to this, the nurse must take into account the patients’ preferences. For nurses to have professional autonomy they must be able to justify their actions and demonstrate an understanding of why they perform the tasks they do. This defines them as unique professionals judged by their knowledge and not simply by their hands on skills.

The call centre of the Eastern Medical Faculty Foundation, hereafter referred to as EMFF, provides a competitive advantage to the Internal Medicine Department of the Chicago School of Medicine through the delivery of efficient and high quality service to patients. Treating patients generates revenue the Internal Medicine Department and contributes to investments in research in the highly competitive healthcare sector. Unfortunately, declining customer satisfaction, as evidenced in a growing number of customer complaints, suggests the quality of service is deteriorating and threatens the very competitive advantage of the EMFF.

However the research study would have been better if they used qualitative methods to find out the nurse’s perceptions, knowledge and barriers towards evidence based practice in clinical decision making. Majid, et al. (2011) could have interviewed some of the participants to get detailed descriptions of how they feel about evidence based practice in clinical decision making. This would allow the researches to get an in-depth understanding making the study more valid (Saris and Gallhofer, 2007).

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

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.

Itroduction: Evidence-based practice is an approach to medicine that uses scientific evidence to determine the best practice (Beyea & Slattery, 2006). As nurses perform their daily tasks they must continually ask themselves, “What is the evidence for this intervention?”. Nurses are well positioned to question current nursing practices and use evidence to make care more effective. In order to improve patients’ outcomes it is the responsibility of the nurse to transition evidence-based practice into the norm, through application of daily practice (Flynn Makic, Rauen, Watson & Will Poteet, 2014). Continual evaluation of current practice must be performed to ensure the use of evidence-based practice opposed to practice based upon tradition. The implementation of evidence-based practice standardizes healthcare practices and diminishes groundless variations within care. These variations lead to the production of uncertain health outcomes (Stevens, 2013).

As a nurses I will rely on research findings to help in my practice decisions, I will use critical thinking to apply research directly to specific patient care situations. The research process allows me as a nurses to ask and answer questions systematically that will ensure that decisions are based on sound science and rigorous inquiry. Research will help me in a variety of settings answer questions about patient care, education, and administration. Research ensures that practices are based on evidence, rather than eloquence or tradition. The call for evidence-based quality improvement and healthcare transformation underscores the need for redesigning care that is effective, safe, and efficient. As a new nurse I believe that evidence contribute to effective care of the patient, I will use evidence to reduce the rate of morbidity and mortality. According to the textbook evidence can help healthcare professionals avoid making errors in decision making relative to patient care. Using research decreases the need for trial and error, which is time consuming and may prove counterproductive.

Clinical practice guidelines (CPG) are used to guide the healthcare providers for specific clinical decision making. Researchers had proven that by using CPG it helps in reducing inappropriate variations in healthcare practice. In healthcare service the use of CPG had shown improvement in promoting the delivery of high quality care. CPG had been long develop and evaluated in the medicine field however, in nursing profession, nurses had shown a great interest in developing and using CPG as a means to facilitate evidence based nursing practices. Hospitals that had adopted CPG had shown a great reduction on inappropriate variations in clinical practice and prometed high quality care with evidence based health

Today's nurses are expected to have critical thinking skills, be able to use research, and to continually seek out education to advance skills, knowledge and use of evidence-based nursing interventions. Evidence-based health care practices are available for a number of conditions such as asthma, heart failure, and diabetes. According to Sullivan (2013), “evidence based practice suggests that using research to decide on clinical treatments would improve quality of care, and that might be the case”. The book also mentions how there are obstacles that prevent nurses from following the evidence based practice procedure. These obstacles include lack of time, autonomy over their practice, ability to find and assess evidence and support from administration

Clinical practice guidelines (CPGs) are designed to improve the care and safety of patients in hospitals. This thesis explores the promoters and barriers for CPG adherence among nurses. The research is based on a combination of a systematic literature review, qualitative research and a quantitative study. The systematic literature review included searching three data bases, namely, the British Nursing Index (BNI), Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The qualitative research study included one-to-one interviews and focus groups. The quantitative study consisted of a questionnaire distributed to nurses to extend and check the findings of the qualitative studies. The systematic literature review revealed