Evidence-Informed Practice: an Evaluation of the David Bennett Inquiry Report

Proper collection of blood cultures are necessary and the most direct method of determining whether or not a patient is septic. The purpose of obtaining blood cultures is to identify and isolate the bacteria that are causing an illness and then determine the best course of treatment based on the sensitivity of the bacteria to particular antibiotics. One of the most frustrating problems plaguing hospitals is the increased rate at which blood culture results are being returned as contaminated specimens. These results can lead to a significant increase in cost to the hospital and patient as well as an increased length in hospital

In this essay, I am going to consider how evidence-based practice can be used to support, justify, legitimate and/or improve clinical practice. I am also going to explore and discuss primary and secondary research evidences about how nursing interventions can potentially improve the quality of life of patients in the community suffering from heart failure. I will gather these evidences using a literature search which I will include an account of. Using a critiquing framework for support, I will appraise both primary and secondary evidences that I have chosen. I will also look at potential non-evidential factors that can influence evidence utilisation in practice. Finally, a conclusion will be drawn.

Explain when and why inquiries and serious case reviews are required and how the sharing of the findings informs practice?

Part 3(P3): Describes the potential effects of discriminatory practice can have on staff and individuals using health and social care.

An explanation of when and why the inquiries and serious case reviews processes are required, issues of how to share findings and implications for the workers practice

The government responds to The Francis Report in 2014 accepting all but 9 of the 290 recommendations issued in their initial response named ‘The Hard Truths’. They introduced a new legislation with an immidiete effect implimenting the toughest inspection regime covering all care services. Chief nursing officer Jane Cummings and Director of Nursing Viv Bennett introduced a 3 year strategy and vision that aims to promote values known as the NHS’s 6C’s. These 6 areas of action focuses on improving care for all patients which connects to the ‘WE CARE’ campaign. In brief, both state that competence; to have the ability to sucessfully enhance and improve lives. Compassion; to see through someone elses eyes and have an intent to act to change things for the better. Commitment; to be fully devoted to provide quailty care at the highest standard. Care; ensuring that every person counts whether it’s the service user, their families or the wider community. Communication; being open and honest with a mutual trust whilst working with others to take care of the patients physical and mental health as a whole. Courage; to have the ability to speak up if unethical practice is discovered whilst keeping in mind the respect and dignity of the patient. The government responds to The Francis Report in 2014 accepting

Over the last 15 years or so a number of cases concerning patient care and safety have come to light prompting investigations and inquiries that have led to changes in the way care is delivered. These include inquiries at Winterbourne View hospital, Mid-Staffordshire hospital(Mid staffs) and Harold shipman to name a few.

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).

Pressure ulcers occur over bony prominences when skin is compressed for long periods of time, affecting the blood supply to certain areas, leading to ischaemia development (Waugh and Grant, 2001). Compression of skin is caused by pressure, shearing and friction, but can also occur due to pressure exerted by medical equipment (Randle, Coffey and Bradbury, 2009). NICE (2014) states that the prevalence of pressure ulcers in different healthcare settings in December 2013 was 4.7%, taken from data available for 186,000 patients. The cost of treating ulcers can vary depending on severity from £43 up to £374 (NICE, 2014). Evidence based practice skills are essential in nursing as it allows the best available evidence to be used to improve practice and patient care, while improving decision-making (Holland and Rees, 2010). I will be critiquing two research papers; qualitative and quantitative, using a framework set out by Holland and Rees (2010), and will explore the impact on practice. Using a framework provides a standardised method of assessing quality and reduces subjectivity.

Measures used to evaluate the outcome of the evidence-based practice (EBP) change will be reviewing quarterly dashboard data. To ensure inter-rater reliability, the infection control nurse, and only the infection control nurse, will monitor ongoing efforts of data collection of CAUTI, and be an integral part of the feedback loop responsible of giving on-sight feedback to clinicians and team members. Also, the infection control nurse along with other team members will revisit the literature to see if any new knowledge focused triggers will be considered. The quarterly dashboard will inform of outcome indicators which may, or may not, affect the process indicators. Process and outcome indicators will be used for improvement purposes within the unit. The quarterly dashboard report also allows questions to be asked by team members and stakeholders, which stimulates more discussion and advanced thought toward quality improvement of the EBP change. The dashboard will assist in

Explain when and why inquiries and serious case reviews are required and how the sharing of the findings informs practice.

The report said “The enquiry believes institutional racism is present throughout the NHS and greater effort is needed to combat it. Until that problem is addressed, people from black and minority ethnic communities will not be treated fairly. The cultural, social and spiritual needs of the patients must be taken into account.

The heart-breaking case of Victoria Climbie [2000] led to the ‘Laming Report’ . In this case, two hospitals and two child protection teams were involved, twelve different services saw her before her death and no one took the steps to protect her. Lord Laming said ignorance is not an excuse and the blame could not be passed on junior staff.

In this essay I will discuss what learning from K216 materials has been useful to me whilst working with vulnerable and/or disadvantaged service users in my student placement, and what learning I have applied to my practice. Throughout I will look at how my learning informed what I decided to do, how I went about doing this and my understanding of the practice. I will discuss learning in respect of two areas of social work, which are ‘Communication’ and ‘Working collaboratively’. For ‘Communication’ I will focus on communication with service users with disabilities and/ or additional needs and I will explore a case of a mother who I had a telephone call with who was in crisis and in a highly emotional state. With ‘Working collaboratively’,

Evidence-based practice (EBP) offers a framework utilization of systematic high-quality research, an analysis which consistently enhances measurable client outcome and clinical decision-making grounded in rationality; EBP depends on data collected through experimental research and accounts for individual client characteristics and clinician expertise. The potential benefits of EBP comprise of increased service delivery and quality of care, heightened accountability, and a bridging of the research-practice gap (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000). It is imperative that research scholars are cognizant of research outcome dependability and validity prior to implementing results