The Registered Nurse Should Access And Analyse The Best Available Evidence Essay

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.

Ethical practice is another component of the social contract of nursing which is a reflection of the values, beliefs and moral principles of the nursing profession. The American Nurses Association (ANA) has established the “Code of Ethics for Nurses” which serves as a “guideline” for the nursing profession in which clinical judgements and

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.

Nurses are faced with ethical dilemmas on a daily basis, each situation being unique and requiring the nurse to set aside their own values and beliefs in order to properly care for their patients. Situations requiring nurses to make an ethical decision are diverse and dynamic; the values set out by the College of Nurses of Ontario code of ethics remains the same. Therefore, all decision based on these vales regardless of the setting and circumstances ensure consistent solutions. The scenario involves a woman who was admitted to the NICU due to complications during her sixth month of pregnancy. The patient indicated that no extraordinary measures should be made to save her baby; she became further detached when the baby developed a bleed

Bradley, S., & Mott, S. (2010). Handover: Faster and safer? Australian Journal of Advanced Nursing, 30(1), 23-32

Conrad, A., Grotejohann, B., Schmoor, C., Cosic, D., & Dettenkofer, M. (2015). Safety and tolerability of virucidal hand rubs: a randomized, double-blind, cross-over trial with healthy volunteers. Antimicrobial Resistance & Infection Control, 4(1), 1. doi:10.1186/s13756-015-0079-y

There are nine provisions included in the ANA code of ethics. The provisions can be broken into three categories. The first category is the nurse’s ethical responsibilities to her patient which is provisions one through three. Second is the nurse’s obligation to herself, provisions four through six. The third ethical requirement for nurses is related to their relationship to the nursing profession, community, nation, and world overall. This focus is summarized in provisions seven through nine [ (American Nurses Association, 2013) ].

Evidence based practice is an important priority in nursing because it ensures that the best quality and most effective care is being used. Restraint use is an intervention that is being minimized more and more. It can be an important intervention when necessary but there are specific circumstances and guidelines that must be followed. Evidence based practice is proving that restraint use may be eliminated due to safety concerns and more beneficial interventions being used.

Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored in the implementation of Evidence Based Practice.

Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice

Ethical issues in nursing will always be an ongoing learning process. Nurses are taught in nursing school what should be done and how. Scenarios are given on tests with one right answer. However, there are situations that nurses may encounter that may have multiple answers and it is hard to choose one. “Ethical directives are not always clearly evident and people sometimes disagree about what is right and wrong” (Butts & Rich, 2016). When an ethical decision is made by a nurse, there must be a logical justification and not just emotions.

The Code of Ethics for Nurses was created to be a guide for nurses to perform their duties in a way that is abiding with the ethical responsibilities of the nursing profession and quality in nursing care. The Code of Ethics has excellent guidelines for how nurses should behave, however; these parameters are not specific. They do not identify what is right and wrong, leaving nurses having to ultimately make that decision. Ethics in nursing involves individual interpretation based on personal morals and values. Nursing professionals have the ethical accountability to be altruistic, meaning a nurse who cares for patients without self-interest. This results in a nurse functioning as a patient advocate, making decisions that are in the best

As an individual’s ethics will play a large part in their practice, there are specific guidelines and legislation that exist to ensure that nurses, as well as other health professionals, practice in a way that is ethical (Avery, 2013). These laws further exists to attempt to simplify the ethical issues that sometimes present in nursing practice and to attempt to guide one’s actions. The Nursing and Midwifery Board of Australia (NMBA) provides guidance to nurses by providing a number of professional codes and guidelines (Avery, 2013). The NMBA has developed a code of ethics for nurses comprising of eight codes (Avery, 2013). These are as follows; 1) Nurses value quality nursing care for all people; 2) Nurses value respect and kindness for self and others;

Codes of ethics contain a coherent set of normative principles underlying a nurse’s purpose and associated values (Vanlaere and Gastmans, 2007). Two perspectives of ethics are the ethics of justice and the ethics of care (Botes, 2000). The ethics of justice constitutes an ethical perspective in terms of which ethical decisions are made on the basis of universal principles and rules, and in an impartial and verifiable manner with a view to ensuring the fair and equitable treatment of all people (Botes, 2000). The ethics of care, on the other hand, constitutes an ethical approach in terms of which involvement, harmonious relations and the needs of others play an important part in ethical decision making in each ethical situation (Botes, 2000).

Professional nurses encounter a variety of legal ethical and bioethical issues on a daily basis. For this reason, it is essential that all nurses are aware of current state and national legislation, acts and guidelines and the implications of these for nursing practices as well as legal processes, principles of open disclosure and the role of a coroner in the health sector. In this way, nurses can adhere to the overarching guidelines for practice as well as working within the code of conduct, competency standards and scope of practice. This paper will provide an overview of legal and ethical parameters of professional nursing practice.