Nursing - Collaborative Care - Evidence-Based Practice Assessment Answer

Evidence-Based Practice

Nursing profession is an autonomous and collaborative care of the patients that promotes health and well being of the people. My area of interest is the provision of Patient centered care and the provision of proper care plans to the patient. Care plan has majorly three purposes which are first to ensure regardless of which member is on duty, the same kind of care is given to all the patients, second is to make sure that the care provided is recorded and third one is to support the patient to discover, direct and resolve the patients difficulty (Royal college of nursing, 2016). According to Natan, 2017, patient centered care ensures safety and quality of care provided to the patients. The challenges encountered in PCC are the implementing PCC based on patients preference nurse training, defining PCC with patients preferences, and family members doubting its efficacy and feasibility (Natan, 2017). These challenges could be mitigated by EBP. EBP is the judicious utilization of the current evidences in association with the patient and the clinical expertise (Thompson, 2019).

The first step of EBP is the spirit of enquiry which refers to the ongoing willingness to know of the best evidence and the existing practices. It is very important to cultivate an idea for all those issues that have been encountered by the nurses during the implementation of the effective PCC services. (Wyant, 2018). For PCC, the spirit of enquiry comes with its implementation. There are various challenges faced during its implementation because family members doubt for the nurses care and them understanding the patients needs.

The next step is to ask a clinical guiding question that is in the form of PICOT because it is the consistent structure used to generate focused clinical questions. PICOT refers to population which is our group of interest, interventions made, comparison intervention, outcome derived, and the timeframe in which it was completed (Stillwell et al., 2010). As PCC is complex process in which various challenges are faced, the clinical guiding question is to find out the measures to mitigate the challenges for its better implementation based on patients preferences. The PICOT question is what is the impact of nurses care and the family members care in reduction in falls on ALS patients

The next step is to search and collect all the relevant evidences that would help in answering the above asked PICOT questions. For this, the keywords from PICOT are chosen and the evidences are collected on the basis of most powerful level of evidence. Seven levels of evidence are present. Level 1 is the most powerful evidence and level 7 being the least powerful one. Level 1 is the evidence from the meta analysis or systematic reviews of unplanned control trials. Level 2 is the evidence from well structured unplanned control trials. Level 3 is the evidence from well structured control trials that are not unplanned. Level 4 is the evidence from case control or cohort studies. Level 5 is evidence from systematic reviews of illustrative or qualitative studies. Level 6 is evidence from a single illustrative or qualitative study. Level 7 is the evidence from expert opinions (Karkada, 2015). In PCC implementation, the nurses play the most vital role because they are available 247 beside the patient. The nurses are trained in such a way that they would be able to understand the patients needs and the gestures. The evidence shows that the patients receive more unprofessional and unskilled care by the family members (Khosravan et al., 2014). The evidences from a study shows that although there is a security and comfort in family members care but there was a lack of proper information and measures that are to be taken when a person falls.

Critical appraisal of the evidence is the step that determines the practice, find the flaws and mistakes and its worth in the study. Each study is reviewed to determine the evidence level, the manner in which it was conducted and how well it is to be practiced. The evidence should be reliable and worth the practice (Overholt et al., 2010). The results should be applicable to the good care of the patients. When ALS patients were left with family members, there were more falls because they lacked the manner in which a patient should be handled. The nurses are trained in such a way that there are proper care plans with nurses that they adopt to take care of such patients.

Integration of the evidences with the clinical expertise and the patients preference is the next step of the EBP. It is the adoption of the practice guidelines that are clinical in favor of both the care providers perspective and the patients inclinations are equally present in decision making (van der wijden, 2010). The relevant evidences are linked with the expertise and the patient preference of care he requires.

The next step is to evaluate the outcomes of EBP decision in such a way that it proved to be positive or negative for the patient. The outcomes should ideally be positive and be helpful in the patients care. By guiding and evaluating a patients progress and by comprehensively searching the literature a care provider analyzes whether the intervention is correct or not (Napa Valley College, 2018). The outcome derived was that through better communication, nurses proved to facilitate better care of the patients and they also documented the data for the patients falls. They can better train the caregivers for ALS patients (Jeffery, 2015).

The last step of the EBP is to disseminate the outcome. This refers to sharing of the results so that others can learn from it too. Various methods adopted for dissemination of an outcome that impact of nurses care is better for ALS patients are departmental services that are inter and intra departmental, posters, lectures, conferences, journal clubs, manuscripts, online media (University of Saint Mary, 2019).

From the above discussed EBP, it can be concluded that a tool for communication and decision making is necessary for the well being of the patient. The care plan is that tool which helps to ensure the quality of life. Nurses prove to be the better care taker for ALS patients and the reduction in falls is observed under the nurses care. It enables the care provider to generate new information and care plans with the help of the literature and the evidences that prove to have the positive outcome on the patient.

Reference

Karkada, S. (2015). EBP (EBP). International journal of nursing research and practice,2(2),1-2.

Napa valley college. (2018). Evidence-Based Medicine Evaluate the Outcomes of Practice Decisions. Retrieved from https//napavalleycollege.libguides.com/c.phpg527381ampp3608313Overholt, E., Melnyk, B. M., Stillwell, S. B., amp Williamson, K. M. (2010). Evidence-based practice step by step critical appraisal of the evidence part I.The American Journal of Nursing,110(7), 47-52.

Royal college of nursing. (2016). Care plans. Retrieved from https//rcni.com/hosted-content/rcn/first-steps/care-plansStillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., amp Williamson, K. M. (2010). Evidence-based practice, step by step asking the clinical question a key step in evidence-based practice.AJN The American Journal of Nursing,110(3), 58-61.

Thompson, C.J. (2019). Use the 6As to Remember the Evidence-Based Practice Process. Retrieved from https//nursingeducationexpert.com/evidence-based-practice-process/University of Saint Mary. (2019). 6 steps of the EBP process. Retrieved from https//online.stmary.edu/msn/resources/evidence-based-practice-for-the-busy-nurse-practitionerVan der Weijden, T., Lgar, F., Boivin, A., Burgers, J. S., van Veenendaal, H., Stiggelbout, A. M., ... amp Elwyn, G. (2010). How to integrate individual patient values and preferences in clinical practice guidelines A research protocol.Implementation Science,5(1), 1-9.

Wyant, T. (2018). A Spirit of Inquiry Leads to Evidence-Based Answers to Practice Questions. Retrieved from https//voice.ons.org/news-and-views/a-spirit-of-inquiry-leads-to-evidence-based-answers-to-practice-questions

Merav Ben Natan., Hochman, O. (2017). Patient-centered care in healthcare and its implementation in nursing.International Journal of Caring Sciences,10(1), 596.

Khosravan, S., Mazlom, B., Abdollahzade, N., Jamali, Z., amp Mansoorian, M. R. (2014). Family participation in the nursing care of the hospitalized patients.Iranian Red Crescent Medical Journal,16(1).

Jeffery, D., amp Fish, A. F. (2018). A Journey with Amyotrophic Lateral Sclerosis.Journal of Christian Nursing,35(3), 152-159.

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