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Essentials of Evidence-Based Practice
Reflection on evidence based practice
Essentials of Evidence-Based Practice
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1. Client will understand the need for the new regimen by 11/18/15. 2. Client will be able to identify resources that may be used if assistance or support is needed following discharge by 11/20/15. 3.
In the Franciscan program change team used evidence based practice by doing the following: Identifying a problem, the problem being that physicians and systems do not reliably address the needs of people approaching death. The team researched the evidence and found that unlike most other population management programs, that addressing the needs of people approaching death does not depend on laboratory values, medications, or strict service utilization algorithms to target individuals and Instead it relies on physician perceptions. When physicians were ask to refer patients that were gravely ill who would benefit from it supportive services the evidence showed that the request was to vague and to difficult to incorporate into practice and
I like the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, because it is a powerful problem-solving approach to clinical decision-making, and it has user-friendly tools to guide. According to Zaccagnini & White, “it is designed specifically to meet the needs of the practicing nurse and uses a three-step process called PET: practice question, evidence, and translation” (2015). The goal of this model is to ensure that the latest research findings and best practices are quickly and appropriately incorporated into patient care. Great choice!
My objectives R5 (TICU): 1- Be familiar with different conditions encountered at the TICU (Pathophysiology and pharmacotherapy. This objective will be assessed with every new condition encountered during my rotation and with my preceptor. 2- Develop an evidence based recommendation based on literature and clinical picture of my patients.
NUR-342 written assignment Need for Change meets the criteria of Outcome 2, because the interventions developed focused on how to meet the patient’s treatment goals. As well as strategies to incorporate multiple healthcare disciplines in the development of a treatment plan. This assignment addressed the need to consider the long-term impact of treatment interventions. NUR 443 PLEET form meets the outcome for knowledge of human diversity because it is a summary of my experiences in the practice-learning environment (PLE). The PLE highlighted the creation and implementation of education strategies for a diverse population.
to provide high quality evidence-based practice care; this is considered the new norm. As we continue to familiar ourselves with advance technologies, we must integrate our clients and teach them how to use information technologies such as the internet, smart phones and other technical tools. We must take advantage of the resources so that we can continue to use cutting edge to reduce wasteful spending. According to himss.org (2015), nurses are an integral part of successfully achieving improved outcomes, optimal wellness and overall population health management. With this in mind, telenurses consistently monitors patients who are homebound or because of their geographical regions.
H. & Green, J. (2013). What the evidence shows on patient activation: Better outcomes and patient experiences; Fewer data on costs. Health Affairs, 32, 207-21. Retrieved from http://eds.b.ebscohost.com.ezproxy.net.ucf.edu/ehost/pdfviewer/pdfviewer?sid=ee039bcf-590b-4eb5-89a5-12b10ac27a54%40sessionmgr107&vid=1&hid=121 Hibbard, J. H., Stockard, J., Mahoney, E. R., & Tusler, M. (2004).
The need for standardized quality measures has been evolving as insurances companies, patients and employers want more data driven health outcomes that improve patient health while reducing cost. The National Committee for Quality Assurance and the federal Agency for Health Care Research and Quality (AHRQ) along with CMS have been a leaders in utilizing evidence based methodologies and measuring quality outcomes to improvement health. The Healthcare Effectiveness Data and Information Set (HEDIS) is the most widely set of quality measures in the U.S incorporating quality measures across many domains of treatment identification strategy in the Initiation and Engagement measures, based on procedure, diagnosis codes and chart audits that is feasible
The Impacts of Evidence-Based Practice on Service Provision for Children Placed in Foster Care Children in the United States who have been abused or neglected by their parents or caregivers are commonly put into the foster care system, a system designed, at its best, to provide a safe alternative to the child’s home while legal decisions or made or during attempts at family reunification. In many cases, children in the foster care system have come from homes in which child abuse and neglect are prevalent and may have experienced significant adverse events, including substance abuse, childhood sexual abuse, domestic violence, and physical violence. Unfortunately, the foster care system is an imperfect arrangement.
The concept clinical judgment is a very important role for nurses to have. Clinical judgment is an interpretation that helps to influence clinical decision making in nursing practice. Nurses use clinical judgment to make appropriate nursing diagnoses based on their findings in order to come up with interventions related to the patient’s problem. Clinical judgment requires deep knowledge of various concepts and the ability of nurses to apply their knowledge to recognize the situation. Evidence based practice plays a role in clinical judgment because the nurse applies the best evidence to make the situation safe and effective.
First and second step in developing a guideline is establishing transparency and avoiding conflicts of interest. Establishing transparency is imperative because it shows guideline users how the guidelines were formed and easily can show any conflict of interest (Hollon, et al., 2014). The third step in the development should display a round group of individuals that include clinical and research expertise (Hollon, et al., 2014). This helps guideline users gain even more trust in a guideline because it was conducted by a panel of experts in the field. Next, interaction between the expert multidisciplinary panel and system review team is debated and then the rating strength of recommendations (Hollon, et al., 2014).
Over the last decade, there has been a noteworthy change in the way that healthcare professionals use evidence from scientific research in their clinical practice. There has been plenty of evidence that a gap existed between research and practice. The concept of evidence-based health care has become part of the language of clinicians, managers, policy makers, and researchers in health services throughout the world. Though the notion of evidence-based health care is far from the new and the extent of its uptake in clinical practice is uneven, the diffusion and adoption of the ideas associated with evidence-based health care during the 1990s provide a remarkable testament to their power and their relevance to the current problems and challenges
Over the years, the evaluation criteria have evolved into a hierarchy. Importance to measure and report reflects the greatest potential of driving improvement and resides at the top of the hierarchy. If a measure is not important, the other criterion are less important. This must-pass criterion focuses the evidence for the measure focus and gaps in care, with demonstrated considerable variation or less-than-optimal performance across providers and populations. The evidence criterion requires a systematic review or an assessment of the quality, quantity and consistency of the body of evidence for the measure focus.
Throughout clinical practice this semester I have been able to address difference in nursing care, work alongside other heath care workers. During one of my shifts there were many times during the day where the RN on my team challenged my skills. For example, I was hanging an IV line for a client and had labeled the tubing to ensure that it was changed every 24 hrs. The RN went on to challenge this as she felt it was unnecessary and I should have labeled it to be changed every 72 hrs. I explained that I had done it because the IV wasn’t being run all day.
105). Effectual clinical judgement enables a nurse to clearly identify changes in patients and assessments through past experiences and knowledge; through analysing and evaluating objective and subjective data allows for a judgment to be made that will help prevent or reverse a deteriorating patient (Alfaro-LeFevre 2016, p. 105). Each nurse has a different level of expertise and knowledge that makes clinical judgement very individual and unique (Cappelletti, Engel & Prentice 2014, p. 4). When making a clinical judgment a nurse must ensure they stay within their scope of practice, maintain professionalism, are aware of their legal obligations and understand their workplace policies (Alfaro-LeFevre 2016, pp. 105-6).
