The objective of this article is to develop nursing strategies to educate nurses about the importance of evidence-based practice in dealing with complex health patient issues and the importance of staffing to the delivery of high quality patient care in health care today. To address some of the possibilities, limitations and inconsistencies in existing studies today, current design and limitations of trending measures and methods will be presented. In addition to that, this research will conclude with a discussion of implications for management of patient care, future search and public policy which go hand in hand. I will explore reasons necessary to consider all the relevant clinical decisions that make the context while examining the various ways in which nurses engage with research-based information. In addition to that, key aspects will be included such as; the relationship between the usefulness and accessibility of information from various sources including decisions to which critical information is applied in the method.
Evidence-based practice is an imperative approach to provide preeminent quality care to both patients and their families. It is believed that nurses are the biggest determinants of treatment of patients because they spend more time with them in health centers taking care of them in all sorts of manner. As well, nurses are expected to appraise access and incorporate research evidence into their clinical decision making and judgment. Notably, evidence-based practice improves the outcome of patients as compared other health practice; traditional practice for instance. Collectively, it is important to note that evidence-based decision making is an authoritarian approach to making coherent choices that are based on various ideas of how theories could be used to improve real world decision making. Research shows that patients who receive care based on evidence particularly from well-designed studies have experienced close to 30% better outcomes (Keele, 2011, p. 122).
Defined as ‘a problem-solving approach to practice involving the diligent use of up to date best evidence in patient care decision making’, evidence practice is a systematic search for the best evidence and critical appraisals to answer clinical questions. It considers patient values, clinician’s expertise and preferences as well.
Key steps to Evidence-Based Practice;
Precisely, evidence-based decision making would involve the following strategies; combining knowledge arising from one’s patient preference, clinical expertise and research evidence within the available context.
- Formulation of a clinical question
- Gathering best evidences to answering clinical questions
- Critical appraisals for best evidences
- Integration of the evidence with the clinician’s assessment of the patient’s condition, own expertise, available health care resources and patients values and preferences to implementing clinical decisions
- Assessment of the practice change as a result of realizing the evidence
Like all other decision making concepts, evidence-based decision making involves choosing from a wide range of options that would include ‘wait and see’ or doing nothing strategy. Primarily, all these choices are informed by evaluating available information which basically entails the process of using clinical judgment. Making evidence-based decisions requires that research evidence be adhered to uncritically and not be taken face to face though it ought to be given an appropriate credence in decision depending on its external and internal validity. Seemingly, integrating of research evidence into decision making majorly involves framing a focused clinical question in response to recognizing, searching, appraising, incorporating and evaluating the effects of the actions and decisions taken. These are key components of the active process that is evidence-based decision making.
Evidence-based decision making is a critical prescriptive approach to making critical choices based on coherent ideas of how to improve real world decision making using theory. Ostensibly, before planning strategies to achieve this deal, it is of paramount importance to identify the starting point. That is; ‘how nurses are currently using and viewing research based information in decision making’ (Meleis, 2011, p. 47).
Information Need “Information Behavior” and Clinical Decision Making
One big challenge of researching how people literally respond to information discrepancy is that these discrepancies or information needs cannot be well observed. If an information need is to be transformed into action such as accessing evidence-based nursing, then the people ought to have a clear motive for doing so. Components of evidence based decision making require the basic motive for attracting research based information to minimize clinical uncertainty which assumes that finding the actual research would amplify one’s assurance that a certain course of action is likely to enhance desired outcomes. Quite often nurses report that their underlying principle for seeking research evidence is mainly to back their existing practice. These processes of integrating research, appraising and searching for information with existing knowledge with them, have been labeled by researchers in information science as “information behavior”. Subsequently, characteristics and the structure of the decisions faced by nurses is of paramount importance for understanding critical ways in which information is processed and accessed by nurses.
The Cognitive Continuum: the decision as Driver for Information Behavior
This model implies that the major determinants of whether an individual engages in rational decision making (more likely to engage to engage in evidence-based decision making) or intuitive decision making (unlikely to engage in evidence-based decision making) depends entirely on a judgment or decision such as identifying nursing interventions lies wholly in the continuum figure (cognitive) (Burton, 2011, p. 92).
At a practical level health care provider particularly nurses, must be aware that culture affects collective and individual experiences that are indirectly and directly related to health. Nurses therefore need specific skills and competencies to support, advocate for and safeguard patients against obliteration and devaluation of their cultural expressions, cultural histories and cultural experiences in a global community. Collectively, these skills should include self knowledge, self respect and self reflection, and facilitating patients’ language communication. These factors will therefore be influenced by a number of contextual variables and factors.
Creating a Culture
In order to critically deal with the complex health patient strategy, nurses and are expected to implement evidence-based practice by focusing more on patient needs which will in the long run facilitate implementation of evidence-based practice. Such as;
Decision Making and Models for the Implementation of Research Knowledge
Policy: Nurses provide direct patient care ought to be very much involved in evaluating and setting institutions, public policies that are related to technologies and also in organizations.
Quality and Safety: Nurses and other health care provide providing direct care should ensure that all the technologies they use on a daily basis to meet international safety and quality standards as well as technical all technical specifications needed to perform in the health care environment they are used to.
Access: Nurses who provide direct patient care ought to ensure that all institutional decisions with both their input and that of other key stakeholders.
Use: Nurses provide first-hand patient care should be involved in their intestinal processes and policies that are related to training, maintenance, monitoring and reporting difficult events that related to technology (Nursing research, 2013, p. 219).
Critically, outlining the various types of clinical decisions is just a starting point in realizing the agenda. Future works should attempt to explain and explore relevant patterns of information use in decision making where more detailed maps seem to exist. However, there is much need for standard evaluation and quality of interventions targeting evidence-based information provisions (Lloyd, 2010, p. 72).
Nurses who are key determinants of health care are regarded as major decision makers within the health care group. Subsequently, the potential model of evidence-based decision making, implementation process and search appraisal is an active process. Observation of nurses in health care practice suggests that seeking active information is among the few possible responses the numerous irreducible uncertainties. On the quality of care, research reveals a health care system that often fails short in its ability to apply modern and up to date technology appropriately and safely. Instruments, workplaces and equipments could possibly be developed according to human factors design criteria, though for the case of the end-user, nurses could possibly maximize safety through proactive risk-assessment methods, selection process and ongoing surveillance of equipment.
Keele, R. (2011). Nursing research and evidence-based practice: Ten steps to success. Sudbury, MA: Jones & Bartlett Learning.
Meleis, A. I. (2011). Theoretical nursing: Development and progress. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Nursing research: Methods and critical appraisal for evidence-based. (2013). S.l.: Elsevier Mosby.
Lloyd, M. (2010). A practical guide to care planning in health and social care. Maidenhead, England: Open University Press.
Burton, R., & Ormrod, G. (2011). Nursing: Transition to professional practice. Oxford: Oxford University Press.