CPG Adherence Among Nurses: A Qualitative Study

This is the fifth article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare

Mulloy, D. F., & Hughes, R. G. (2008). Patient safety & quality: an evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from http://www.nlm.nih.gov/books/NBK2678/

Another barrier is that organization does not provide the encouragement and acknowledgment to nurses who implement Evidence Based Practice (Cathy L. O’Nan, 2012). Major factors which prevent nurses from the implementation of Evidence Based Practices (EBP) are a lack of time to read articles, poor coordination with other members of health team and unavailability of nursing research articles. It was also concluded that nurses perceived the lack of managerial and organizational support to implement EBP (Ay, F., 2014).

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 Principles of Nursing Practice were introduced by the Royal college of Nursing (RCN) with the input from the Department of Health, the Nursing Midwifery Council, service users and user organisations. They indicate to the public what they should expect from nursing practice, no matter if they are a colleague, service user, or the relatives or carers of the service users. The Principles explain what makes up the safe and effective nursing care, and encounter the aspects of behaviour, attitude and approach that underlie good quality care. They are important to health professionals, in delivering safe care because they indicate how to follow the principles, to be able to assist you in reflecting on your practice and development as a

In conclusion, “Nurses in every setting demonstrate their commitment to continually improving their nursing practice by engaging in practice reflection, and by setting and achieving learning goals” (CNO, 2015). The use of standards and guidelines set by the CNO and RNAO are great references

From early on, nurses learn to use their better judgment when providing care. Thinking critically can aid nurses greatly. Considering this, standard precautions are viewed as a systematic approach at preserving the well being of themselves and others. But if all of this is true, then what prevents nurses from implementing standards of precautions in their daily practice with each patient they care for? The purpose of this paper is to explore what factors may influence nurses to become noncompliant. For varying reasons, data shows that nurses have the lowest reports of compliance. Therefore, it is especially necessary to analyze these factors and educate nurses on the importance of adherence. Factors such as lack of knowledge, time pressure, and poor practice and/or qualifications contribute greatly to nurses not adhering to their standards of precautions when proving patient

Fry’s extensive literature search comparison provides current evidence that positive clinical trends are demonstrated with the use of nurse practitioners in the hospital setting. Margaret Fry is an associate professor for Higher Research Degree Coordinator at the University of Technology in Australia and identified 1048 articles referencing the impact nurse practitioners with 47 studies considered relevant. This article is well written and researched, including a long list of pertinent references.

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).

The CNO outlined professional standards for nurses to comply with. The seven that are outlined are accountability, continuing competence, ethics, knowledge, knowledge application, leadership, and relationships. “A standard is an authoritative statement that sets out the legal and professional basis of nursing practice” (College of Nurses of Ontario, 2009, p. 3). Although each standard has different meaning, they all work together in order to provide the best possible patient care.

The nursing and midwifery council code (NMC) 2015 is a code of conduct that contains professional standards of practice and behavior mannerisms that registered nurses and midwifes must adhere too when in practice. It is deemed to be a voice for the public in order to protect them and therefore enlightens the main aim of the NMC which is to ensure nurses meet these standards in order for them to promote effective practice and safe surroundings for their service users. (NMC, 2015). The Royal College of Nursing (2015) believe that the latest report of the NMC code 2015 has been portrayed as being much more effective now, rather than beforehand because they

Evidence Based Practice is a principle that is centered on the improvement of patient care and outcomes, by introducing and researching current based evidence when making decisions for that patient. According to Johnston (2016), “Health-care practitioners are increasingly being encouraged to implement research evidence into practice in order to ensure optimal patient outcomes and provide safe, high-quality care”. Throughout the course of this class, whether it be from researching about Evidence Based Practice, or the implementation of nursing care delivery models, patient care and the way we treat our patients is at the forefront of change. We know that change is necessary, now it is just a matter of how to implement that change into the healthcare

In this assignment we will be discussing how the Nursing and Midwifery Council NMC (2015) guides nurses in the direction of good practice. Why we have the code? Who the code is for? How to implement the code in our daily lives as practitioners. The NMC (2015) is a set of guidelines which nurses and midwives must adhere to in order to provide the best care possible to their patients. The NMC (2015) is split into four main sections:

This pathway gives staff structure, support and professional integrity. Additionally, The Royal College of nursing, SCIE, and primary care trusts are all involved in the development of protocols and guidelines. This does however indicate that no service users are involved in the creation process, possibly resulting in service and organisational focused guidelines. Successfully implementing protocols has its barriers. The Open University, (K101 Introduction to Health and Social Care, Resources, 2014) highlights several problematic factors including, limited resources, staff shortages and equipment and medical supply problems. However, once implemented successfully these policies may help to manage risk, control budgets and reduce litigation.

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