Essay on Research In Clinical Practise

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.

Even though evidence informed practice helps improve healthcare, there are still a few limitations. One main limitation is lack of time and accessibility. The best quality evidence is usually very difficult to locate, a busy nurse may not have the time to delve deep to find reliable sources. (NICE 2007) However there are now

According to Provision seven the attitudes of Deborah and the other nurses on the unit do not advance the nursing profession. Nursing from the beginning of its existence with Florence Nightingale has fought to be considered not only an art but also a science. Scientific research was one of the governing factors of Nightingale’s principles of nursing. She used statistical data to help her keep records of success and failure rates of her nursing interventions. The use of this scientific research proved to be beneficial because it gave substantial scientific evidence that her nursing interventions significantly decreased mortality rates during the Crimean War. The support of her statistical data enabled nightingale to prove to her colleagues and peers that the art of nursing plays a significant role in patient outcome and mortality. This relates to the nurses in the NICU, because since the beginning of nursing evidence based practice has been implemented and deemed useful. For one to denounce future practice of evidence based practice in contemporary nursing will further remove nursing from its professional status. Nursing is one

To start the search for evidence within University Hospital, questions were asked in regards to pressure ulcers. Monthly updates are often sent out via email from the wound care team to keep everyone up to date on knowledge. While there was informative numbers within those updates, this information falls short according to Moore, Webster, & Samuriwo (2015). The main limitation of the study is the lack of a control group in pressure ulcer prevention and treatment. There is no clarity in the specific criterion that contributed to improved clinical outcomes. Teams used more than one method in the research project. Also, there is no study that meant the inclusion criteria in the random clinical trials. The lack of standardized

The primary goals for conducting nursing research are to generate new knowledge to promote positive outcomes for patients, enhance quality and cost-effectiveness of care, improve the healthcare delivery system, and validate the credibility of the nursing profession through evidence-based practice (Schmidt & Brown, 2012). The purpose of this paper is to explore the practice-related problem of pressure ulcers and the importance of the problem in the nursing profession.

Jane presented with a wound to her lower left leg which, following a holistic assessment (appendix 2), was diagnosed as a venous leg ulcer. The assessment was conducted in accordance with Local PCT Leg Ulcer Guidelines (appendix 3) as well as RCN Guidelines (RCN 2006) to rule out other possible aetiology such as arterial ulceration, diabetes or malignancy (Moloney and Grace 2004). Although traditionally considered uncommon, recent studies suggest that malignant ulcers are more prevalent than previously thought (Miller et al 2003, Taylor 1998) therefore even though initial assessment suggests an uncomplicated venous ulcer, if Jane’s wound fails to heal following appropriate treatment then specialist advice will be sought. Between 17% and 65% of people with a leg ulcer experience severe or continuous pain with a major impact on quality of life (Briggs and Nelson, 2003) and effective pain relief is important to maximise quality of life, to enable mobilisation and improve appetite to facilitate wound healing. Fortunately, Jane experienced no pain from the leg ulcer prior to or at the time of assessment. However, careful review and monitoring of any pain will be important throughout the treatment process as the first line of treatment for uncomplicated venous leg ulcers are compression systems (RCN 2006) and although compression counteracts the harmful effects of venous hypertension and

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.

Evidence-based practice is a decision making process in which you combine scientific data with clinical expertise, patient values and circumstances of the patient. (Hoffmann, Bennett 2017). The World Health Organisation (WHO) defines chronic diseases as those which are caused by non-reversible pathological changes in the body, are permanent and leave a lingering disability, those that require ongoing rehabilitation or care. Indigenous Australians experience very high prevalence, morbidity and mortality from chronic health conditions such as diabetes, cardiovascular, renal and chronic respiratory disease. Multi morbid and comorbid chronic diseases are increasingly placing a greater burden on individuals, communities and health care services

Dissemination of any project’s outcome discuss the intervention and statistics to that target clinical practice and the audience of public health. Any project is supported with an aim to change the community. Therefore it is imperative to aware the community regarding the research finding of that project (Harris, 2012). The occurrence of pressure ulcer has been a greater concern for the healthcare industry. In order to receive confidence and trust from leaders, hospitalist and management, the project team requires to collect evidences regarding the occurrence of pressure ulcers. Since the policies and protocols of the pressure ulcers incidence plan is established from evidence based practice so it is significant to understand the reliability and validity of the research. Disseminating strategies used to broadcast outcomes to stakeholder and the greater nursing community as well are mentioned below.

Utilizing evidence based practice in nursing is paramount today in the always evolving field of nursing. Having the clinical expertise and knowledge of a nurse is just the first step in making decisions for the treatment of a client. Adding the most recent and up to date evidence alongside with the client’s values and preferences is ideal to guiding the process of healthcare (Kelly & Tazbir, 2010). When evidence based guidelines are set forth in the plan of care for a client, the clinician has an abundant of amount of data to make sound decisions on. This allows the nurse to make the best decision or develop the best strategy to deliver care. Evidence based practice also allows

The purpose of this essay will be to discuss evidence based practise and its use in nursing, I will be discussing, the types of research and various forms of data, including the principles of evidence based practise and research. Evidence Based practice is finding the most effective, research proven, evidence to make decisions regarding the service users individual needs and the best decisions for them. As David Sackett quotes, "evidence based practise is the integration of best research evidence with clinical expertise and patient values." (Sackett D, et al 1996, p.71) Evidence based practice is good practice, assist practitioners, avoiding information overload and applying the most useful information.

Pertaining to the articles “Guidelines for the management of the venous ulcer: a gap analysis” It’s cited lots of the challenges for successful leg ulcer guidelines implementation. Few of the challenges are;

The purpose of this assignment is to critique two research studies that I have identified from my practice. I am currently working as a community staff nurse within a District Nursing team (DN). Leg ulcers have a huge impact on the DNs workload, Moffat; Franks & Oldroyd (1992) evidenced that time spent by DNs caring for people with leg ulcers ranged from 9-22% of the total workload. Douglas (2001) informs us that leg ulceration affects around 1% of the population. This evidence has provided the author with a rationale to review the literature regarding the contemporise issue of Doppler assessmenDts with an aim to measure the reliability and validity of this type of clinical procedure. Learning outcomes to be met will be indicated in bold

Donnelly, Winder, Kernohan and Stevenson used a Randomized control trial (RCT), to try and establish a difference between offloading and standard care in relation to the number and severity of pressure ulcers (PU’s) on the heel of patients who were admitted with fractured hips, while also examining the number and severity of PU’s that occurred in other areas of the body. This study took place in the fracture trauma unit of a major tertiary referral center in Belfast, with 119 patients being allocated the control group and 120 in the intervention group. The patients were aged 65 years and over and could not already have existing heel damage. The research design chosen, randomized control trail, allows for patients to be randomly allocated to

The effect and importance for evidence-based practice in nursing profession has reverberated across nursing practice, our educational institutions and in the field of science. The cry-out for improvement and the need to transform our healthcare industry calls for evidence-based practices to be inculcated into our health which would in turn usher in effectiveness, safety and efficiency into our health care. Therefore new practice approaches are those ideas with evidence-based practices that would help us move our healthcare in the desired direction. There is no doubt that we need evidence-based practices in tackling the issue of hospital acquired pressure ulcers (HAPUs). For some time now in the facility where I work, we perform thorough skin assessment upon admission, utilizing Braden scores, revised skin protocol, fluidized patient positioners, and silicone gel adhesive dressings. Most importantly, efforts were made to motivate the staff and also educate them to be more enterprising in discovering patients at risk of developing hospital acquired pressure ulcer. And since we started this, the result has been tremendous; the incidence of HAPUs in our facility has been reduced considerably. There is no doubt in my mind that by the end of 2018 our facility would have achieved a great deal in tackling the issue of HAPUs.