evidence based nursing assignment help australia

evidence based nursing assignment help australia

Evidence-Based Nursing: Improving Patient Care in Australia

1. Introduction to Evidence-Based Nursing

As the writer says at the beginning of the book, “The aim of Evidence-Based Nursing: Improving Patient Care in Australia is to demonstrate how research, research methods, and other forms of evidence can be used in the practice of nursing.” Our first order is to think about “evidence” in the sense of “data” or “proof”. In everyday language, we would say things like “Do you have any evidence to back up your claim?” In this book, “evidence” has a broader meaning – the writer uses the definition from the old Scottish Legal Services which includes ‘anything by means of which an alleged matter of fact is established or disproved’ – and we want to look at why that is so important in nursing practice. We also can think about this term “Evidence-Based Practice” – in fact, the writer uses it as his main title instead of “Evidence-Based Nursing”. This is a phrase we are going to become very familiar with and we will be trying to work out what it means throughout our module. At its core, “evidence-based practice” means making decisions about patient care that are informed by “the conscientious, explicit and judicious use of” the best quality evidence that we can find. This means finding the right thing to do and doing it at the right time in the right order and then being able to evaluate the effects of the work that we have done. So far, so good – we all want to be doing the “right” thing for our patients, don’t we? But the writer says that “this definition places a practice at the heart problems whereas often the term is used in a highly theoretical way”. Well, that makes things a bit more complicated. He goes on to discuss what knowledge in nursing is and why a book about evidence-based practice in multi-professional care homes in England is relevant to Australia. This is a little bit different but we should come to understand that it makes good sense because even though nursing is different all over the world, the ambitions of using evidence to provide better care are the same.

2. Importance of Evidence-Based Practice in Nursing

In reality, many patients often have a variety of diagnosis-related problems, such as chronic pain and anxiety, which require satisfactory administrative input, and the case is special for the nursing workforce, where staffs use business and evidence-based practice. This is not just a theory; it is what happened in clinic every minute. Unfortunately, evidence-based practice helps to increase the importance of efficient training and self-development, but not everybody can understand the means of the evidence published. Indeed, EBP is something like the medical standards which require all medical professionals to rely on reliable medical equipment, not just depend on their impressions on the diagnosis and treatments. And maybe this is the reason why the Australian nursing board has set one of the legitimate principles named as: registered as a nurse and a midwife, the approved code of professional conduct, 3.3 – recognize and respect the use of research in practice and encourage research awareness and participation. That means, every nurse, no matter registered as a division 1 nurse, division 2 nurse, midwives, or enrolled nurses, all of them need to follow this legal standard and act according to the legitimate law. Actually, doing literature reviews and using evidence-based practice can help to develop clinical guidelines, so that nurses can understand what they are doing, why to do this and why not to do that. In fact, developing EBP is required to find out efficiencies and cost savings in the hierarchical system: individual nurses and doctors should rely on the modern medical findings, instead of experience and intuition. Ergo, more research funding may be needed by the government to facilitate the development of EBP in Australia, so that the large number of tendencies of technologists seek to produce knowledge. Every individual and organization that furnishes a health service must acknowledge the code. However, from the student nurses’ prospectus, the evidence may help them to further study about the medical findings and self-development, but in clinic, in actual fact, working under the best practice guidance would be safer and more effective, because many researches conclude that depending on experiences cannot provide a satisfied, consistent, and traceable health promotion and prophylaxis results. And most importantly, EBP is able to extend the modern and new methods onto the treatment patterns and displace the traditional ways in nursing, instead of being a belief.

3. Implementing Evidence-Based Nursing in Australia

Institutions that seek to transition to a more evidence-based approach need to develop a strategic plan. The first stage in this process is often an organisational audit that is designed to identify the character and extent of evidence-based practice currently operating within the institution. Johnston and colleagues highlight the importance of “a clear, unequivocal commitment from the highest levels of management in order to facilitate widespread adoption of evidence-based practice. Also critical to success is the establishment of a culture that nurtures and sustains evidence-based practice.” This includes committing resources such as funding for research and education, and developing systems for disseminating knowledge, facilitating communications and fostering multidisciplinary teamwork. The strategic plan needs to take account of the idiosyncratic features of the particular institution. For example, the evidence-based goals and outcomes for a small rural hospital will vary considerably from those of a large urban or metropolitan teaching hospital. Flexibility is needed to respond to changing clinical, organisational and data environments. However, “the need for a consistent, integrated approach to the acquisition, analysis and application of evidence in decision-making cannot be overemphasised.” Central to this strategic plan is the provision of education and training opportunities for staff at all levels, in order to develop a workforce capable of critical analysis and confident in the application of evidence-based practice. Owing to a history of traditional approaches to healthcare, adopting an evidence-based approach can be perceived as a significant cultural change for both individuals and organisations. Training can take a number of forms, from the development of basic computer and information literacy skills, to the ongoing strengthening of critical appraisal abilities through the use of specific educational interventions such as journal clubs or workshops. Staff in senior and management positions who may never have been exposed to an education relying on research evidence are also often targeted by evidence-based training programmes. This acknowledges the need for the active participation and leadership of key decision-makers in the implementation of evidence-based practice. By fostering an environment that enables staff at all levels to realise their potential, and by embedding clinical decision-making in a culture of critical evaluation of research evidence, the ultimate goal of “maximising safety and optimising quality of clinical and cost effective patient outcomes” can be realised. Finally, strategies of implementation need to be comprehensive so that they address the range of individual, interprofessional and organisational barriers that have been identified in the literature. By developing a strategic plan that encompasses these guiding principles, and by actively engaging stakeholders in processes of change, there is real potential for organisations to effectively acculturise evidence-based practice as the norm. However, it is also important to recognise that in response to a constantly changing evidence base and health service demands, the implementation strategies will need to be reviewed and revised on a regular basis. Creative thinking and a readiness to embrace new technologies and methodologies are also required. For example, communication and knowledge sharing through advances such as online “communities of practice” or decision-support tools will no doubt offer new and innovative ways to develop evidence-based knowledge, expertise and synergy among healthcare professionals. The realisation of such innovative solutions, and the continual development and expansion of the knowledge base, may lead to significant improvements in health outcomes for patients and communities as a direct result of the invigoration of evidence-based practice.

4. Challenges and Barriers to Evidence-Based Nursing

Many different barriers and challenges exist to the successful implementation of evidence-based nursing in Australia. Alsop and Anderson highlighted that the medical, nursing, and health literature is rich in information but poor in evidence. Before we consider these barriers, we should remind ourselves that healthcare is an information-rich environment. This previous statement also becomes significant in the light of increasing workloads and patient acuity. One of the barriers is that research findings are not extended into clinical practice as they should be. However, nurses are required to keep up to date with the latest research in their practice. It is argued, however, that because there is so much information and a great diversity in nursing, that nurses do not have the time to set aside and review all the available literature. This is compounded when it is recognized and stipulated in the literature – and in the Code of Professional Conduct (NMC, 2004) – that only research which has been critically appraised should form the basis of healthcare. This need to critically appraise research and evidence before using it in practice effectively raises the bar in terms of the level of academic and methodological prowess required by healthcare professionals. In order to master the skill of critically appraising research, nurses need to receive comprehensive training. However, McKenna et al found in their study of 282 nurses in the Republic of Ireland that 60% had not received any formal research training as part of their nurse education. This claim is supported by a recent audit of the numbers of nurses and midwives in Northern Ireland who have accessed research and development training. English et al reported that of the total number of nursing and midwifery registrants in Northern Division of the UKCC (United Kingdom Central Council for Nursing, Midwifery, and Health Visiting – now the NMC), only 1.4% had acquired some form of research training. The authors conclude that the current lack of training will contribute to the existing tiers of research culture in healthcare. Also, this criticism can also be applied to the wider multi-disciplinary team. O’Connor deployed a qualitative research study to explore the views of health professionals in relation to evidence-based practice. Consequently, O’Connor discovered that busy workloads, lack of time, and easy access to resources were the main barriers identified by the subjects in the study. O’Connor found that, although the term research was often interpreted as being concerned with scientific research rather than any formal inquiry, the word practice was commonly acknowledged as the application of professional experience. This suggests that a change in the pre-established link and the language used between research and practice could overcome the barriers. Noteworthy is that O’Connor pointed out in her findings that there was much variance in those clinicians and managers who were largely responsible for the development of evidence-based practice when compared to other professionals. This is suggestive that the unity between professionals can also act as a barrier in enabling successful transition to an evidence-based approach.

5. Future Directions for Evidence-Based Nursing in Australia

Right now most of the healthcare professionals in Australia are trained to provide patient care based on tradition and personal experience rather than clinical research. Although evidence-based nursing is gradually gaining its momentum in Australia, there is still a lack of effective strategies in place to ensure its continuous growth. So what can be done? Well, there are a number of future directions that have been suggested by nursing leaders, researchers and policy makers. First of all, it is important to establish research mentorship for both new and experienced clinical nurses to build up their research capacity. As one of the nursing leaders has pointed out that, for evidence-based nursing to move forward in Australia, we need to provide the clinical nurses with two supports – “time and skills”. This highlights the importance of not only releasing nurses from their usual clinical duties so that they can engage in research, but also providing necessary research skills for them to generate their own evidence in practice. Moreover, research collaborations between nursing schools and healthcare facilities should be an ongoing strategy. By consolidating the knowledge base and research skills of nurse academics, as well as tapping into the rich seam of clinical data available within healthcare facilities, we can genuinely improve the quality of patient care provided, and close the gap between research and practice. Another common proposed strategy is to develop nursing leaders in research and evidence implementation. It has been suggested that nurse leaders need to champion the cause of evidence-based practice and be on the front line of its implementation. Moreover, they should also take on the role of fostering a culture for continuous improvement in patient care through critical evaluation of existing practice and research engagement. This is also in line with one of the suggestions made in the ‘National Safety and Quality Health Service Standards’ in Australia, that is, nurses need to “use the best available evidence for safe and high quality patient care”. Last but not least, strategies to improve the quality and the influence of clinical evidence are also often discussed within the context of evidence-based nursing development in Australia. As discussed in the book, clinical research may involve different study designs and methodological approaches, but it is only through obtaining high quality evidence that nurses can truly influence and inform the way how patient care is delivered. In the future, it is important to not just build a solid research foundation, but also to have strategies that can ensure the implementation of high quality and clinically sound evidence in practice.