Nurse Leaders : A Medical Organization 's Patient Care Practices

Evidence-Base practice (EBP) is defined as: “based on problem identified from the practitioner’s area of practice; a combining of best evidence and professional expertise and an integration of this into current practice; about ensuring patients receive quality care, being part of quality improvement processes; about collaboration and requiring a team approach” (French, 1999). Scott and Mcsherry (2008) supported the French’s assertion, proposing the key elements of EBP are that it is a theory-driven process, which involves the use, evaluation and application of research; identification of best evidence; evaluation of care; problem solving; decision-making; clinical expertise; and requires patient involvement. Evidence-based practice is made of evidence, clinical expertise, patient preference, the context of care (Barker, 2013). In brief, evidence-based practice is the parameter in the nursing practice that it requires that the nurses gather and use clinical evidence to make decision for the patients so that in the nursing process they can deliver the quality of care for the patients (Ellis, 2013). In the other words, in the nursing practice all the nursing procedures performed by the clinical evidence supported.

As a provider of care, professional nurses depend on research, theories, and evidence based practice to guide the care they provide to patients. Nurses deliver care to their patients based on information they have learned through many years of school and training. Training for nurses and other providers of care is founded on theories, research, and evidence based practice in the healthcare field. Theories, research, and evidence based practice are all important for providing care to patients and each can be used in a different manner depending on the situation. Clinicians often use research based evidence to design and implement care that is high-quality and cost effective for patients. Evidence based practice can be used to provide care to patients in a steadily changing clinical environment. (PDF page 8-9). Nursing theories are frequently used as frameworks for establishing nursing care interventions and assessing

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

According to Warren et al. (2016), numerous barriers exist for implementation of evidence-based practice (EBP) within hospitals. In a study conducted evaluating the strengths and opportunities for implementing EBP in hospitals, lack of autonomy, lack of leadership support, and lack of inclusion in clinical practice decisions, were noted as the top barriers to the implementation of EBP (Warren, et al., 2016). The study revealed that while the majority of respondents’ beliefs

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).

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

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).

For decades, something was missing in patient care. Crucial quality and safety-improvement professionals involved in healthcare delivery were formerly not located in the places where care was actually provided. This often resulted in a disconnect that fragmented healthcare quality, safety, and improvement. According to Reid and Dennison, in their article The Clinical Nurse Leader (CNL)®: Point-of-Care Safety Clinician, “The role of the Clinical Nurse Leader (CNL)® restores this vital connection. The CNL is a clinician who brings the locus of control for safe and quality care from the administrative areas straight to the unit’s providers who deliver the services. “

Nurses are responsible in providing holistic, quality care to their clients. In order to effectively provide such care Boswell and Cannon (2009, p. 2 & 7) states that nurses must base their provision of care on the most current, up-to-date health information available and sound nursing knowledge. This is where evidence-based practice (EBP) comes in. Polit and Beck (2010, p. 4) defined EBP as "the use of the best clinical evidence in making patient care desicions". This usually comes from research conducted by nurses and other healthcare professionals. Thus it is pertinent that research reports are critically analyzed.

The incorporation of evidenced-based practice (EBP) into nursing practice is supported by research to positively improve the quality of care and improve patient outcomes. EBP is important to the nursing profession because it also leads to increased job satisfaction, teamwork, and levels of engagement in clinicians (Melnyk, et al., 2017). Miniature research projects such as quality improvement projects, surveys, and clinical research studies are frameworks used to get feedback and data from patients during their time spent in health care systems. EBP is not the standard of care in many health care systems (Melnyk, et al., 2017). This due to many factors, including lack of EBP mentors, nursing programs that do not incorporate EBP into the curriculum,

Evidence - Based Nursing, An introduction (2008, p. 285 ) “ The rapidity of change and the reorganization of nursing services within the health care sector presents challenges for the advancement of EBP. Managers and administrators should facilitate the uptake of practice based on current, high-quality research by formalizing the expectation that nurses care be Evidence Based”.

In medicine today it is becoming essential to remain on the journey to best possible practice, which “involves implementing available evidence into practice” (Dogherty, et al., 2013, p. 129). Dogherty, et al. (2013) researched the facilitation of evidence based practice by selecting 20 nurses “to attend an interactive knowledge translation symposium to examine what has worked and what has not in implementing evidence in practice.” Results from the study showed both many positive and negative facilitation experiences. “Successful implementation (of evidence based practice) is associated with focus on a priority issue, relevant and easy to use evidence, development of strategic partnerships and a multidisciplinary project team including

There are many skills, traits, and behaviors one must possess in order to be an effective leader. The American Organization of Nurse Executives (AONE) has compiled a list of competencies and skills that nurse leaders should be proficient in. The five competency domains identified by AONE (2011) are “communication and relationship building, knowledge of health care environment, leadership skills, professionalism, and business skills” (p. 3). The competency domain I believe is essential for one to possess in order to be an effective executive nurse leader is communication and relationship building. The competencies AONE (2011) listed under the domain communication and relationship building are “effective communication, relationship management, influence of behavior, ability to work with diversity, shared decision-making, community involvement, medical staff relationship, and academic relationships” (p.3). I will discuss how Tom (nurse manager of a psychiatric unit) did not meet these specific characteristics under that domain.

Evidence-based practice (EBP) in nursing means making decisions about patient care on the basis of best, current, standardized practice and guidelines. According to an article, written by Dr. Kathleen Stevens, the development of evidence-based practice (EBP) is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care (Stevens, 2013). The author also mentioned in her article that the intended effect of EBP is to standardize healthcare practices to science and best evidence and to reduce illogical variation in care,

According to Warren et al. (2016), numerous barriers exist for the implementation of evidence-based practice (EBP) within hospitals. In a study conducted evaluating the strengths and opportunities for implementing EBP in hospitals, lack of autonomy, lack of leadership support, and lack of inclusion in clinical practice decisions, were noted as the top barriers to the implementation of EBP (Warren et al., 2016). The study revealed that while the majority of respondents’