The Application Of Evidence Based Practice

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

Health problems associated with teenage birth is low birth weight, which can lead to breathing problems, an increased risk of infection and low blood sugar. In 2010 the life expectancy of the Aboriginal population was estimated to be 10.6 years lower than the non-indigenous population for males and 9.5 for females. Statistics like these are examples of the problematic effects of a decreased access to health services and health theory in Aboriginal medical care. This is due to a cultural barrier that seems to have arisen with Indigenous people and health services that aren't explicitly Indigenous based, as well as a smaller amount of Indigenous-based health services available. As a representative of Randwick Childrens Hospital stated, ‘..For Aboriginal people the issue is about: do I trust the space I’m going into? Do I trust the doctor to rewet me? Do they understand cultural practices?’ HealthInfonet supported this; as in order for a health service to be effective they need to ‘provide culturally safe services…’ A service non-indigenous health services rarely

In the past few decades, many nursing practices were relied on state regulation, cost, or insurance policy. However, evidence based practice (EBP) are increasingly recognized and emphasized to change in nursing practice. For many clinical settings, there are thousands of resources available today. Not only most of nursing practice are made based on a pilot study but also implied to bring most benefits of the care.

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.

This essay demonstrates significant factors, a midwife and the women may face within Australian public hospitals. As a midwife the key skills are understanding of what supports and impacts the normal physiological process of labour and birth. This essay will discuss two influencing factors that have a negative effect on the normal progress of labour and birth. This will be seen, firstly by discussing the cultural and environmental impacts of labour and birth. Then, examining how the midwife may best support and facilitate the adverse effects of normal physiological process. This essay also discusses a positive labour and birth environment within the Australian standard model of care.

Within Victoria there are multiple models of maternity care available to women. An initial discussion with the woman’s treating GP during the early stages of her pregnancy is critical in her decision-making about which model of care she will choose and this key discussion is essential in allowing a woman to make the first of many informed decisions throughout her pregnancy. According to a survey conducted by Stevens et al. (2010) only 43% of women felt ‘they were not supported to maintain up-to-date knowledge on models of care, and most reported that model of care referrals were influenced by whether women had private health insurance coverage.’ Many elements of these models of care differ: from location of care, degree of caregiver continuity, rates of intervention and maternal and infant health, outcomes access to medical procedure, and philosophical orientation such as natural or medical (Stevens, Thompson, Kruske, Watson, & Miller, 2014). According to the World Health Organization (1985) and Commonwealth of Australia (2008) there is a recognition that ‘85% of pregnant women are capable of giving birth safely with minimal intervention with the remaining 15% at potential risk of medical complications’ (McIntyre & Francis, 2012).

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.

Childbirth is one of the greatest privileges on the earth anyone could have and we, as women, should feel proud to be major contributors for it. Thus, a mother has to play a key role in aiding the healthcare workers to mitigate the health crisis associated with childbirth by performing her duties faithfully. One such associated health crisis is “Premature (preterm) birth” which occurs when the baby is born too early, before 37 weeks of gestational period (CDC, 2015). The rate of preterm birth ranges from 5% to 18% of babies born across 184 countries (WHO, 2015).

According to Stevens (2013), the call to develop and implement evidence-based practice (EBP) within all healthcare disciplines is fueled by legislative demands for improvement in standard medical metrics such as mortality and morbidity. However, increasing demands by the public for evidence related to the metrics and outcomes of such concepts as quality of life illustrate what may be more important to the client (Stevens, 2013). This client-directed focus has resulted in patient-centered outcomes research (PCOR) (Stevens, 2013). "The Patient-Centered Outcomes Research Institute (PCORI) helps people make informed health care decisions, and improves health care delivery and outcomes, by producing and promoting high integrity, evidence-based information

Bernadette Ward RN, Midwife, Grad Cert Ed, MPHandTM, MHlth Sci Lecturer, Faculty of Health Sciences, La Trobe University, Bendigo, Australia. B.Ward@latrobe.edu.au Glenda Verrinder RN, Midwife, Grad Cert Higher Ed, Grad Dip Pub and Com Health, MHlth Sci Senior Lecturer, Faculty of Health Sciences, La Trobe University, Bendigo, Australia.

In 2006 to 2012 the Aboriginal infant mortality rate was eight infant deaths per 1,000 live births, the non-indigenous infant mortality rate of four infant deaths per 1,000 live births. Over the last ten years the aboriginal infant mortality rate has decreased from ten deaths in 2001 to seven deaths in 2010 per 1,000 live births and it continues to decrease. This could be due to better health care facilities and better knowledge of health and hygiene within aboriginal communities.

This study was based off the results that were found in planned home births versus planned hospital births with midwives in British Columbia or more commonly known as Canada. In 1998, Canada gave people the option to give birth at home with a registered midwife present. To receive the data in the best way possible the researchers decided to do a cohort study where the soon to be mothers and newborns who suppose to be born at home with a midwife present between the first of January 1998 to the 31st of December 1999. Along with this group there was a few other groups where the soon to be mother was planning on giving birth in a hospital with a physician or midwife. For the home births with a midwife the midwife was required to fill keep a record, a birth summary, and newborn record. Once this was all complete each was sent to a database. Next with the hospital births with an attending physician where the baby was delivered by a psysician in

Women living in rural and remote areas of Australia have less convenient access to maternity care than women living in regional and urban areas of Australia. These women, the majority of whom identify as Aboriginal or Torres Strait Islander, often have to travel to the nearest regional hospital to give birth. Unfortunately, for the majority of these women the closest regional hospital is hundreds of kilometers from their own community and they must make this trip without the accompaniment of a support person. The purpose of this essay is to discuss the above statement in further detail. Current inequalities in maternity care for women living in rural and remote areas will be discussed. An explanation will be given as to why the current model of care is inadequate and culturally unsafe. It will be recommended that a model of care which incorporates continuity of carer and birthing on country be implemented in rural and remote areas to provide a safer birthing environment and improve maternal and community satisfaction. The case load model of care will be viewed favorably as it can be adapted to each individual community and has been accredited with improving health outcomes for women and infants. Finally, midwives who work in rural and remote locations often struggle to gain the requirements necessary for midwifery registration due to limited exposure to the maternity setting compared with their regional and urban counterparts, therefore, recommendations will be made to

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