Impacts Patient Outcomes

Electronic records can be accessed from anywhere in a hospital setting, and all the information that was added, such patient visits and diagnosis along with relevant information such allergies and medication can be lifesaving to patients with comorbidities. Big data is described as a process of using software to sort through data to discover patterns and ascertain or establish relationship (Mcgonigle & Mastrian, 2018). Electronic records can create algorithms that can be used for data and can be used to predicting illness in populations. Big data can also be helpful to find cause and analysis, such as SSIs in hospitals. The data can generate people who are more at risk of getting infections post-surgery from the data they have from patient history and physical.Impacts Patient Outcomes And Diagnosis Essay

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Nurses can retrieve information from old records that are recorded in the electronic document. Big Data has its challenges such as security, HIPPA, data subjects where the data is going to be pulled to be analyzed, finally where it will be stored (Big Data in HealthInformatics[ Video File], 2014). The ability to implement all this information will deliver excellent care to patients in the future. Along with all the technology available and all the questions that are asked such social demographics, we can understand many things from the patient’s habits and where the nursing teaching can be done for the patient to have a better outcome for their disease process. An example, the data can demonstrate that the patient continues to come to be seen for high blood pressure. The doctor can see that he is on certain medications. They can be changed or discontinued that leads to the health care team to address what other things might be an issue for further evaluation, such as new tests or labs for the patient. Big Data gives health care provides so much information in a short time by accessing patient records.Impacts Patient Outcomes And Diagnosis Essay

References

Big Data in HealthInformatics[ Video file] [Video]. (2014). https://www.youtube.com/watch?v=4W6zGmH_pOw

Guest editorial: Basing practice on the best available evidence: A new inclusion in nursing & health sciences: Best practice information sheets. (2010). Nursing & Health Sciences, 12(3), 287–287. Retrieved June 19, 2020, from https://doi.org/10.1111/j.1442-2018.2010.00547.x

Macieira, T. G., Smith, M. B., Davis, N., Yao, Y., Wilkie, D. J., Dunn Lopez, K., & Keenan, G. (2018, April 16). Evidence of Progress in Making Nursing Practice Visible Using Standardized Nursing Data: a Systematic Review. AMIA Annu Symp Proc. 2017; 2017: 1205–1214.. Retrieved June 19, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977718/

Mcgonigle, D., & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

Silvia Bonilla RE: Discussion – Week 4COLLAPSE

Main Question Post

According to McGonigle and Mastrian (2018), “Hospitals and medical centers have more to gain from big data analytics than perhaps any other industry” (p. 197). Sensmeier (2015) writes that The McKinsey Global Institute defines big data as “datasets whose sizes are beyond the ability of typical database software tools to capture, store, manage, and analyze” (p.24). The problem that hospitals are currently facing is not on how to analyze the data but how to store it (McGonigle & Mastrian, 2018). As with any technology, big data has its benefits and challenges. One of the most important benefits of using big data as part of a clinical system is the ability to enter data once and reuse that data multiple times. It is essential for a clinical system to be able to share and compare data to inform outcomes; this allows nurses as knowledge workers to leverage that clinical data (Sensmeier, 2015).Impacts Patient Outcomes And Diagnosis Essay

One challenge of using big data as part of a clinical system is the lack of data standardization, making it challenging to make decisions about changes when different units use different standards and terminology (Thew, 2016). Through research, I have found that to mitigate this challenge, nurses must promote standards and interoperability. One way to do this is to promote “the use of standardized and accepted terminologies that address the documentation needs of the entire care team regardless of care setting” (Sensmeier, 2015, p. 26). Nurses must also recommend “consistent use of research-based assessment scales and instruments that are standardized through an international consensus body” (Sensmeier, 2015, p.26). Until we are all on the same page, we cannot bring about the full potential that big data offers our profession and our patients.

References

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.

Sensmeier, J. (2015). Big data and the future of nursing knowledge. Nursing Management, 46(4), 22-27. doi: 10.1097/01.NUMA.0000462365.53035.7d

Throughout this essay I am going to look at how team communication and collaboration are key factors in patient safety. I shall look at the factors that lead to communication failure. I am going to critically analyse how communication tools can impact on patient safety and look at the benefits and barriers and the challenges that arise from the implementation of these tools can be overcome. I shall look at the challenges I’ve discussed and with reference to experiences from my own clinical practice discuss how the communication tools I have used in practice affected patient safety.Impacts Patient Outcomes And Diagnosis Essay

Providing safe patient care is a challenge in today’s health care environment. Even with the many advances in technology basic, effective, interpersonal communicationInterpersonal communication is the process of sending and receiving information between two or more people. Types of Interpersonal Communication

This kind of communication is subdivided into dyadic communication, Public speaking, and small-group communication.Impacts Patient Outcomes And Diagnosis Essay

Communication failures have been cited as the leading cause of inadvertent patient harm. Communication failures include issues such as insufficient information, faulty exchanges of existing information, ambiguous and unclear information and lack of timely and effective exchange of patient information. Increasing recognition of these issues has made improving teamwork and communication a priority for advancing patient safety and quality of care. Effective interaction between team members has been associated with greater efficiency and decreased workloads, improved clinical outcomes, reduced adverse drug events, reduced patient morbidity, improved job satisfaction and improved patient satisfaction, (Velji & Baker, 2008).

It is well recognised that the increased perception and complexity of patients’ needs in a busy surgical or medical ward presents challenges for both nursing and medical staff. The National Patient Safety Agency (2007) suggested that effective communication is a key factor in improving clinical practice and patient outcome. Hospitals consist of multiple complex systems that rely on rules, contingencies, expectations and multiple inter-professional communications for patient care. Within these complex care delivery systems, nursing plays a primary role in ensuring patient safety. Effective communication amongst healthcare providers is crucial for ensuring that patients receive safe, high-quality care. However, within most healthcare settings, effective communication is hampered by a number of barriers Discussions about patients are often conducted within a busy work environment in which providers are dealing with many patients and numerous tasks. Instructions are sometimes communicated over the phone, rather than in person. In emergency situations, information has to be presented quickly, and in an attempt to present information in a concise way, information can be missed, which can lead to inappropriate interventions that directly affect patient outcomes. Rosenstein & O’Daniel, (2006) state that efforts to improve health care safety and quality are often jeopardised by the communication and collaboration barriers that exist between clinical staff. It is critically important that clinicians have standardised communication tools and create an environment in which individuals can speak up and express concerns.Impacts Patient Outcomes And Diagnosis Essay

“When a team needs to communicate complex information in a short period of time, it is helpful to use structured communication techniques to ensure accuracy.” (Lingard & Espin, 2005)

Many factors can contribute to communication failures. When implementing communication tools into practice there will be benefits as well as barriers and challenges to overcome. Efforts to improve health care safety and quality are often jeopardised by the communication and collaboration barriers that exist between clinical staff. There can be many barriers between different clinical groups as well as differences within the professional hierarchy. Doctors and nurses often have different communication styles in part due to differences in training. Nurses are taught to be more descriptive of clinical situations, whereas physicians learn to be very concise. Rosenstein (2007) expresses that even though doctors and nurses interact numerous times a day, they often have different perceptions of their roles and responsibilities to patient needs, and thus different goals for patient care. Standardised communication tools are very effective in bridging these differences in communication styles. A further common barrier to effective communication and collaboration could be hierarchies. Sutcliff’s research in (2000) shows us that communication failures in the medical settings arise from hierarchical differences, concerns with upward influence, role conflict, ambiguity and struggles with interpersonal power and conflict. Communication is likely to be inaccurate or withheld in situations where there are hierarchical differences between two communicators, particularly where one person is concerned about appearing incompetent or inexperienced, does not want to offend the other, or perceives that the other is not open to communication. In health care environments characterised by a hierarchical culture, physicians are often at the top of that hierarchy.Impacts Patient Outcomes And Diagnosis Essay Consequently, they may feel that the environment is collaborative and that communication is open while nurses and other direct care staff perceive communication problems. Haig, Sutton & Whittington, (2006) state that hierarchal differences can often come into play and weaken the collaborative interactions required, to ensure that the proper treatments and care are delivered appropriately. When hierarchy differences exist, people on the lower end of the hierarchy could feel distressed or uneasy at speaking up about problems or concerns. Intimidating behaviour by individuals at the top of a hierarchy can hinder communication and give the impression that the individual is unapproachable. Effective leadership flattens the hierarchy, creates familiarity makes it feel safe and encourages staff to speak up and participate. Teaching the skills of how to speak up and creating the dynamic where teams will express their concerns is a key factor in maintaining patient safety. In all interactions, cultural differences can also exacerbate communication problems. For example, in some cultures, individuals may refrain from being assertive or challenging opinions openly. As a result, it is very difficult for nurses from such cultures to speak up if they see something wrong. In cultures such as these, nurses may communicate their concern in very indirect ways. Cultural barriers can also hinder nonverbal communication. For example, some cultures ascribe specific meaning to eye contact, certain facial expressions, touch, tone of voice, and nods of the head which others may not be able to interpret correctly.Impacts Patient Outcomes And Diagnosis Essay

Communication methods and tools are potential sources of innovation for healthcare teams, enhancing teamwork and reducing risk. Leonard and Permanente (2004) developed a communication tool that has proven to be one of the most valuable, collectively known as SBAR; Situation, Background, Assessment and Recognition. The SBAR technique organizes communication into four types of information. First, the provider briefly describes the situation; for example, who the patient is, where the patient is located and a description of the problem. Secondly, relevant background information is communicated, diagnosis at admission, recent vital signs, and other clinical information. The final two pieces are the provider’s assessment of the situation, such as how severe the problem is, and an initial recommendation of what should be done and the plan of care needed.

The SBAR tool provides a framework for communication between members of the health care team about a patient’s condition. It is used to help create mechanisms useful for framing any conversation, especially critical ones, requiring a clinician’s immediate attention and action. It allows for an easy and focused way to set expectations between members of the team for what will be communicated and how, which is essential for information transfer and cohesive teamwork. It can also be used effectively to enhance handovers between shifts or between staff in the same or different clinical areas. The SBAR tool provides a standardised means for communicating in patient care situations; it is effective in bridging differences in communication styles and helps to get all team members using the same approach, providing a common structure for communication and it can be used and applied in any clinical area, (Denham, 2008). SBAR also presents guidelines for organising relevant information when preparing to contact another team member, as well as the framework for presenting the information, appropriate assessments, and recommendations.Impacts Patient Outcomes And Diagnosis Essay

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The tool can be used to shape communication at any stage of the patient’s journey, from the content of a GP’s referral letter, consultant to consultant referrals through to communicating discharge back to a GP. When clinical staff use the tool in a clinical setting they can make a recommendation which ensures that the reason for the communication is clear. This is particularly important in situations where staff may be uncomfortable about making a recommendation i.e. those who are inexperienced or who need to communicate up the hierarchy.

As well as SBAR there are a variety of other communication tools devised to help promote and ensure patient safety. Some tools were designed to be used in any clinical area while others were developed for a specific purpose. Surgical procedures are undertaken in many healthcare settings, these procedures are undertaken in day surgery units and on an outpatient basis as well as during inpatient care. Adverse events occur in approximately 10% of hospital admissions. Approximately 40% of these events are associated with surgery. The National Patient Safety Agency found that between October 2006 and September 2007, over 128,000 reports of patient safety incidents from surgical specialties were reported to its National Reporting and Learning System. In November 2008 the NPSA also released a warning over wrong site neurosurgery, with 15 cases occurring between January 2005 and September 2008, (Peyton & Soar, 2009). These incidents varied from incorrect treatment or procedure to misplaced patient notes. Not all incidents were serious, but some led to patient harm or death and most could have been prevented. Impacts Patient Outcomes And Diagnosis Essay Problems in communication and information flow, as well as workload and competing tasks have a measurable negative impact on team performance and patient safety. Clinical staff have frequent interruptions, usually multi-task and often work with incomplete information about the tasks they are expected to undertake. Clinical uncertainty and occasional surprise add to this complex situation. It is also often assumed that safety checks have been completed by others without confirming they have actually taken place. Increased team working and the implementation of fail-safe systems are therefore necessary to help prevent human error. Hospitals are under ever increasing pressure to develop sound hospital systems that are put in place to prevent catastrophic, harmful events. This is where surgical communication tools can play a vital role in ensuring no harm, or avoidable mistakes, take place during surgical procedures.Impacts Patient Outcomes And Diagnosis Essay

The WHO Surgical Safety Checklist is an important development, which may help to prevent a number of these surgical errors. The World Health Organisation (WHO) Surgical Safety Checklist launched June 2008, and was adapted by the National Patient Safety Agency (NPSA). One of the key error prone areas that the surgical checklist can help is that of wrong site surgery. Panesear and Cleary (2009) state that wrong site or wrong patient incidents are rare, but the consequences can result in considerable harm and psychological damage to the patient. Research by Haynes (2009) indicates that the use of a simple checklist can substantially and significantly reduce risk of morbidity and mortality associated with surgery. The Checklist is a tool to improve preoperative safety for patients and improve communication and teamwork. The checklist has five steps of; Briefing, Sign In, Surgical Pause, Sign Out and De-brief which improve patient safety through enhanced team performance. Having more than one step and a whole team present at each step, increases the reliability of the tool. Adding briefings before the lists starts and de-briefings at the end of the list, in addition to the Checklist, further improves communication between the team. The better the team communication, the better the chance of highlighting any errors or inaccuracies.Impacts Patient Outcomes And Diagnosis Essay

The WHO Safety Checklist incorporates the surgical pause as well as the surgical safety briefs. Incorporating more than one communication tool with another should help improve patient safety by repeating the safety checks at different stages throughout the procedure. The surgical pause rule provides that, except in life-threatening emergencies requiring immediate resuscitative measures, once the patient has been prepared for the elective surgical procedure, and immediately prior to the initiation of any procedure, the team will pause and the physician performing the procedure will verbally confirm the patient’s identity, the intended procedure and the correct surgical/procedure site. The physician’s operative report or procedural notes must reflect that the pause and the confirmation took place. This Surgical Pause tool was issued by the Board of Medicine in 2006 and seeks to prevent wrong site, wrong side and wrong patient surgeries.Impacts Patient Outcomes And Diagnosis Essay

Another strategy to help improve patient safety in surgery is the use of theatre briefings and debriefings. These discussions, initiated and led by the surgeon, are intended to prevent and alleviate adverse events by promoting communication through improved teamwork. Specifically, they encourage any team member to speak up if they perceive a problem that could result in patient harm. The briefing consists of introductions by name and role of each theatre team member, a surgical pause, and discussion of expectations for the operative plan, paying special attention to potential problems that could be encountered. The team leader also conducts debriefings at the end of the case to note lessons learned for future patients and procedures. Peyton and Soar (2008) state that preliminary evidence suggests that preoperative theatre briefings are associated with an improved safety culture, reductions in wrong-site/wrong procedure surgeries, early reporting of equipment issues, and reduced operational costs. Although briefings and debriefings are not end all solutions to the problem of errors or inefficiencies in theatres, they help to minimise errors by allowing personnel to discuss potential problems before they lead to potential or actual harm. Safety briefings are a straightforward tool designed to help multidisciplinary teams communicate safety problems and concerns. They increase staff awareness of safety, encourage more open communication about safety issues, and over time assist in creating a culture of safety while helping to reduce errors, (The Health Foundation, 2009). Safety briefs can also be used on the ward as well as the operating theatre. Patient safety briefings are an easy, efficient tool to share information. The purposes of these briefings are to keep members of the clinical unit informed, anticipate needs, and make appropriate plans. Any member of the team can institute unit-based patient safety briefings, but often the charge nurse orchestrates them. Briefings are conducted at a designated place at predetermined times and should last no more than 5 minutes. They give the team a chance to communicate and discuss any problems, thoughts or put ideas forward. It also gives the team a chance to discuss previous problems brought up and how they can overcome them; with a view to use the briefings to bring a more effective and efficient way of managing patient safety concerns.Impacts Patient Outcomes And Diagnosis Essay

NOW

During the clinical placements I have experienced whether it be on a hospital ward or in the community I know that nothing is as crucial as the safety of the patients in your care. Safety precautions and tools are used on a daily basis, numerous times a day by a variety of clinical staff. As I am now a third year student nurse with many different clinical experiences, it is important that I not only understand the vital importance of using these communication tools properly and precisely but also gain the confidence to communicate information verbally as well as non-verbally. During my placements I have come across most of the communication tools that I have discussed previously. The SBAR Tool is one I have come across most frequently. In every clinical area I have been in SBAR was used on a daily basis; in handovers, transfers, discharges, updates, safety briefs and referrals. It seems to be adopted through clinical practice and staff then go on to use it subconsciously after a period of time. It is a very effective tool if used correctly, but only if implemented by all members of staff on the ward. I have had some experience using SBAR and find it a very easy tool to implement and an extremely beneficial skill to have. I can adopt it to different situations and I find it a good base for starting handovers and transfers. On my current clinical placement I work in our triage area with a number of emergency admissions every day. With every admission into triage, SBAR is used several times; when receiving the emergency handover over the phone, handing over to the medical team, writing in the patient’s notes, handing over to the nurse on the ward once the patient is transferred and recording the handover onto the dictaphone for the nurse next on shift. In my opinion it definitely encourages communication between staff and as a student has increased my confidence in participating in handovers. It is a useful tool for both verbal and non-verbal types of communication due to the fact it can be used for a variety of different situations in numerous clinical settings. In my opinion it helps break the actual and perceived barriers between clinical staff and allows the understanding that communication between staff from different areas should be of a high standard and easily exchanged due to the use of this common model. While observing staff at work in a busy ward environment, and how the passing of information between for instance the doctor and nurse can be difficult at times and even miscommunicated, it makes it clear to me that structured use of communication tools can lead to improved patient health and safety and should be common practice in all clinical situations.Impacts Patient Outcomes And Diagnosis Essay

My experience with the surgical safety tools has been more limited but I am still aware of the importance they are to patient safety and how necessary it is to have frequent checks from the beginning to the end of the operation or procedure as well as having a variety of staff present at each check. I have had experience with completing pre-operative charts which is the beginning of these surgical safety checks. That would be the first time you check the patient identity, procedure, pre-op checklist and consent form. Without having the WHO surgical safety checklist and the other surgical safety tools in place, communication between staff would be less efficient and would probably take more staff time. In my opinion all the communication tools I have discussed are extremely significant and all have their own place within healthcare. From my experience I have observed that is critical that staff use these communication tools to help play their own part in maintaining patient safety and encourage others to do too. On a busy medical or surgical ward, where there are lots of admissions and emergencies and staff have to carry out numerous tasks, I have learnt that effective communication is essential as when staff are extremely busy, information can be missed, forgotten and wrongly communicated. The communication tools that I have discussed can and do all play a part in ensuring and assisting patient safety if used correctly and if applied appropriately and correctly by staff throughout healthcare.Impacts Patient Outcomes And Diagnosis Essay

Each representative of the medical profession certainly at least once in life thought about the essence of healing art. The traditional answer to this question is something like this: “healing art consists of the knowledge needed to understand the causes and pathophysiological mechanisms of diseases, from clinical experience, intuition and a set of qualities that together constitute the so-called “clinical thinking”.Impacts Patient Outcomes And Diagnosis Essay

Cultivated in the traditional medical education concept “clinical thinking” does not have clear meaning and holistic vision of healing and is based on analogies. At the turn of 80-90-ies the new fild of knowledge was formed in medicine – clinical epidemiology. The most popular became the works of the group of Canadian scientists – D. Sackett, B. Haynes, G. Guyatt and P. Tugwell from the McMaster University, Ontario. They were the first who tried to study the medical skill in terms of rigorous scientific principles. These scientific principles have a great impact on the style of medical practice and ideology of doctors.

Clinical epidemiology is developing the scientific basis of medical practice – a set of rules for clinical decision-making. The central tenet of clinical epidemiology is that: every clinical decision should be based strictly on proven scientific facts. This postulate is called “evidence-based medicine”.

Evidence-based medicine is an approach to medical practice in which decisions on the use of preventive, diagnostic and therapeutic measures are taken based on the available evidence of their efficacy and safety, and such evidence undergoes search, comparison, compilation, and wide dissemination to be used in the interest of patients (Evidence Based Medicine Working Group, 1993).Impacts Patient Outcomes And Diagnosis Essay

Evidence-Based Medicine is a conscientious, explicit and judicious use of current best evidence for making decisions about care of individual patients. The practice of evidence-based medicine involves the union of individual expertise with the best available external evidence obtained from systematic research. By individual clinical expertise experts mean the professionalism and clinical thinking, acquired through the accumulation of clinical experience in clinical practice. Increasing professionalism is manifested in many ways, but most pronounced it is in the more efficient and effective diagnosis, the more thoughtful identification and compassionate attitude to the difficulties of patients, their rights and preferences in making clinical decisions regarding the provision of medical care. Under the best available external proof, specialists mean clinically relevant research. External clinical justified evidence not only invalidates the previous diagnostic tests and treatments, but also replaces them with new, more powerful, precise, effective and safe. (Sackett, DL et al. (1996) Evidence based medicine: what it is and what it isn’t. BMJ 312 (7023), 13 January, 71-72).Impacts Patient Outcomes And Diagnosis Essay

Principles of evidence-based medicine include the testing of the efficacy and safety methods of diagnosis, prevention and treatment in clinical trials. The practice of evidence-based medicine is the use of data from clinical trials in daily clinical work of a doctor or a nurse.

In most countries there were recognized some of the rules for conducting clinical studies outlined in the standard GCP (Good Clinical Practice) as well as the rules of production of drugs (standard GMP) and perform laboratory tests (standard GLP).

The International System of evidence-based medicine evolves exponentially: since its establishment in the early 90’s to the present time the number of centers, books, publications and forums on the problem is huge. The U.S. Agency of Health Policy and Research subsidized in 1997 12 such centers established at leading universities and research institutions of different states, a growing number of centers on individual issues (child health, primary care, general practice, mental health, etc.). The common thing for all directions is the use of the principle of evidence at any level of decision-making – from the state program till the appointment of individual therapy.Impacts Patient Outcomes And Diagnosis Essay

Nowadays evidence-based practice is widely implemented in professional nursing practice. The idea of evidence-based practice for nursing was developed from the evidence based medicine movement.

Currently, nursing is an integral part of the health system. It is a multifaceted health discipline that has a social health importance, as it is meant to maintain and protect public health. Nursing is a science and art, aimed at solving existing problems related to human health in a changing environment.

Thus, evidence-based nursing is the kind of evidence based medicine. It involves identifying the necessary research and implementation of them into practice care in order to improve the quality of patient care. The aim of EBN is to provide high quality and most cost-effective care ever possible. EBN is a process based on the collection, interpretation and integration of important research results. Some experts define the EBN narrowly, considering only the use of randomized clinical trials, while others also include the use of case reports and expert opinions. In order to apply the practice in the right way, a nurse must understand the concept of research and know how to properly evaluate the study. These skills are taught in modern institutions of nursing education, as well as at training.Impacts Patient Outcomes And Diagnosis Essay

Nurses serve instrumental roles in ensuring and providing evidence-based practice. They must continually ask the questions, “What is the evidence for this intervention?” Or “How do we provide best practice?” And “Are these the highest achievable outcomes for the patient, family, and nurse?” Nurses are also well positioned to work with other members of the healthcare team to identify clinical problems and use existing evidence to improve practice. Numerous opportunities exist for nurses to question current nursing practices and use evidence to make care more effective.

For example, a recently published evidence-based project describes the potential benefits of discontinuing the routine practice of listening to the bowel sounds of patients who have undergone elective abdominal surgery. The authors reviewed the literature and conducted an assessment of current practice, and they subsequently developed and evaluated a new practice guideline. These authors reported that clinical parameters such as the return of flatus and first postoperative bowel movement were more helpful than bowel sounds in determining the return of gastrointestinal mobility after abdominal surgery. The authors found that this evidence-based project resulted in saving nursing time without having negative patient outcomes (Madsen et al., 2005).Impacts Patient Outcomes And Diagnosis Essay

To understand what Evidence-based practice in nursing is better while defining the process it describes. In every day activity of clinical nursing, EBP provides nurses with a tool with the help of which they can provide the best and safest health care ever possible. The new emphasis of the EBP nursing comes from the problems that have emerged in recent years regarding the safety of the health system.Impacts Patient Outcomes And Diagnosis Essay

Formulating Questions

As it is written on the Yale University Nursing Library website and the website of University of Minnesota, the first step in EPP is to formulate right, necessary questions. Such questions consist of background questions such as “what causes some particular disease?” Such kind of questions has a practical application – the need to solve an exact clinical problem. The clinical questions should include foreground questions also. These pertain to how the disease or condition in question is usually treated.Impacts Patient Outcomes And Diagnosis Essay

Finding the Answers

As soon the right questions have been formulated, the nurse can then look for possible solutions to the problem by making some necessary research. The aim of the research is to find sources that tall about the possible treatments and outcomes of the disease. Nurses in clinics often use databases such as CINAHL and MEDLINE for performing their searches.

Evaluation

The next step is to evaluate the evidence as soon as it is found. Not all clinical treatments are the same, and not all sources that pretend to provide evidence of a possible clinical treatment are the same. Implementing the evidence-based practice in nursing process there is a need to understand that there not only various levels of possible treatment, but also various levels of quality in terms of research sources. The research quality is based on the quality of the research design and its applicability to the exact clinical case.Impacts Patient Outcomes And Diagnosis Essay

Application

Having evaluated the evidence, the nurse can start its application in her practice. One of the main questions that appear at this stage is how the evidence can be applied in order to meet nurse’s specific need or situation. Concerns of nurses include the validity of the diagnosis, how possible therapeutic techniques can affect the patient, whether there is any adverse risk to the patient and the prognosis of the treatment. As soon as the decision is made about the provision of a certain treatment, application of the treatment is usually made.Impacts Patient Outcomes And Diagnosis Essay

Re-evaluation of the result

As soon as the treatment has been made, the clinical nurse should reevaluate if the implemented evidence was adequate and useful for the particular patient and situation. Clinical nurse should assess whether or not the intervention was successful. Nurses ought to know whether their findings might contribute new knowledge to the nursing field. They also should know how they will apply these findings throughout their future nursing practice. (Http://www.ehow.com/about_6728914_define-evidence_based-practice-nursing.html)

Conclusion

“Evidence based clinical practice is an approach to decision making in which the clinician uses the best available evidence, in consultation with the patient, to decide upon the option which suits that patient best”. (Muir Gray JA. (1997) Evidence-based healthcare: how to make health policy and management decisions. London: Churchill Livingstone).Impacts Patient Outcomes And Diagnosis Essay

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So evidence-based practice helps nurses to provide high-quality patient care based on research and knowledge rather than because “this is the way we have always done it,” or based on traditions, myths, hunches, advice of colleagues, or outdated textbooks.

For example, when clinical questions arise, should one look to a nursing textbook for the answers? Remember that books are not published every year, and new information may not be included in the edition you have. Also, when using textbooks, consider whether you have the most current edition.Impacts Patient Outcomes And Diagnosis Essay

There are also issues to consider when asking colleagues for advice-specifically, be mindful that their responses may be based on their personal experiences, their observations, what they learned in school, what was reviewed during nursing orientation, or myths and traditions learned in clinical practice.

A recent study provided evidence that most nurses provide care in accordance with what they learned in nursing school and rarely used journal articles, research reports, and hospital libraries for reference (Pravikoff, Tanner, & Pierce, 2005). That finding, combined with the fact that the average nurse is more than 40 years of age, makes it apparent that many nurses’ knowledge is probably outdated. Practice based on such knowledge does not translate into quality patient care or health outcomes. Evidence-based practice provides a critical strategy to ensure that care is up to date and that it reflects the latest research evidence.Impacts Patient Outcomes And Diagnosis Essay

So, EBP important to nursing practice because it results in better patient outcomes; it contributes to the science of nursing; it keeps practice current and relevant; it increases confidence in decision-making; policies and procedures are current and include the latest research; integration of EBP into nursing practice is essential for high-quality patient care. Thus, evidence-based practice is very important for modern professional nursing practice. Impacts Patient Outcomes And Diagnosis Essay

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