Informed Decision Making In Nursing

Evidence Based Practise. There are many definitions of Evidence-Based Practice (EBP) and has been described as the integration of research evidence, Clinical expertise and patient values which all inform best practice (Sackett et al, 2000) What does EBP mean

Evidence based practice (EBP) is a process of integrating high quality evidence into practice or care provided by health professionals and decision makers in health care. This discussion will explore the meaning of the term Evidence Based Practice further and discuss its origins. EBP requires finding the best available evidence to inform practice, its greatest benefit being the best possible care for a client. Other benefits and limitations will be further discussed below. EBP demands the client be seen as an individual and their unique circumstances be considered in the application of evidence

The two Evidence Based Practice models that I decided to compare are the Johns Hopkins Nursing model and the ACE Star model. The Johns Hopkins Nursing model “helps bedside nurses translate evidence to clinical, administrative, and educational nursing practice” ( p. 302). The Johns Hopkins Nursing model focuses on nursing and nursing practice. The model helps nurses translate evidence-based practice into practice and enhances nursing autonomy, leadership, and engagement with interdisciplinary colleagues (). While on the other hand the ACE Star model focuses taking several forms of knowledge and turning it into evidence-based practice.

For this week’s discussion post I will identify a situation where evidence-based practice has been applied in my workplace. Evidence-based guidelines are put in place and into practice after research has been completed. This helps with intertwining practice and research and are established by professional organizations, government agencies, institutions, or expert panels (LoBiondo-Wood & Haber, 2014). These clinical guidelines give clinicians findings to help in the decision making process of diseases or treatments. In developing evidence-based practice, a clinical question must first be put into place.

Evidence based practice (EBP) is to demonstrate the best practice, which has been supported, with a clear rationale to back it up, while acknowledging the patient/clients best interest. In this professional outline it will be discussed why EBP is so important to start with student nurses career and continuing throughout the nursing career and the second main point will be on the impact it has on patient outcomes regardless of discipline. I believe if this mind set is instilled early in the nurses career the practice will evolve it a more proactive

Evidence-based practice is defined as “the integration of best research evidence with clinical expertise and patient values” (American Psychological Association [APA], 2006, p. 284). The term had originated from the Institute of Medicine, but is

Reflecting on the past seven weeks I have acquired countless knowledge, which I will use to further strengthen my profession as an Advanced Practice Nurse. The course allowed me to think beyond my current practice knowledge and acquired innovative ways to evaluate the situation at hand. The learning objective in program outcome four helps set standards that I will use to guide my clinical practice to meet various healthcare needs. Using the case studies has helped to further enhance my knowledge on disease physiological state, using differential diagnosis, disease manifestations, and clinical presentation. It has also taught me the skills on how to differentiate between similar diagnoses to properly identify the problem and treat the patients.

Evidence-based nursing practice help to improve individual bedside practice because nurses work in the ward based on knowledge they obtained from previous research. It can also answer problematic clinical practice issue since it aim at solving problem, it improves nurse’s quality and reduces variations in care. Nurses are also confident in their decisions due to the fact that they know what they’re doing and can as well prove it because every patient deserves care that is based on the best scientific knowledge and ensures high quality and are cost-

In the clinical setting, the nurses’ expertise can be used to make clinical assessments and recommendations for routine care at a lower cost than a physician visit. This would increase the number of patients seen and increase the quality of the care provided. The advance practice nurse would be able to hone in on preventative measures and increase patient education. The advance practice nurse can also make recommendations about practice changes needed to facilitate better health outcomes through the use of evidence-based practice. Nursing leaders are aware of how important nursing science is to provide needed evidence to transform practice, even though, finding the time and resources to support any research activity is often challenging (Stone, 2017).

The practice of nursing evolves daily from theories and philosophies that are proven by researchers, resulting in growth of the medical profession and advanced evidence based knowledge. Philosophies According to Alligood (2014b), philosophies are specific theories that focus on one or more metaparadigm concepts in a wide spectrum philosophical way (p. 43). For a person to understand philosophies it is required to understand the knowledge type, metaparadigms. Metaparadigm Metaparadigm is the vast perspective of a discipline and a way to describe a concern specifically to a profession or department (Alligood, 2014b, p.42).

It’s important to use evidence based practices in nursing because it creates solutions to the patient’s needs, it improves the overall care of the patients, reduces harm and helps support nurse’s actions and clinical judgments. Sackett (2000) says that evidence based practice is looking at the best evidence along with using your clinic expertise in helping you to make a decision about the patient’s individuals care. Outline the process undertaken when searching for credible and relevant evidence to support Part 2 of the workbook. (Justify and support answers with credible and relevant evidence whilst adhering to UWS referencing guidance). The first element of finding credible and relevant evidence would be to research journals and articles, as

Before EBP was imbedded into healthcare, nurses relied in the advice of senior nurses and what they learned through education and trial and error. Floranc enightengal ……. However, it wasn’t until the mid-1800s that evidence-based medicine had its beginnings, but did not come into play until the year of 1972. Through many years different modifications, various groups of nurses have drafted their own versions of evidence-based practice guidelines into play.

Giving care to a patient is not a straightforward process because a patient is made up of advanced systems. Symptoms and the severity of a disease process are dependent on a particular patient, and it may not always be uniform from patient to patient. Because of this, nurses must be able to use their knowledge appropriately to help a patient. Nurses use techniques, such as Evidence Based Practice, in order to integrate new and advanced knowledge into their patient care (Canada, 2016). By exercising evidence based practice, nurses effectively seek knowledge, take experience from past situations, and apply this intelligence to best give patient care (Canada, 2016).

A second legal and ethical issue questioned is whether the patient has decisional capacity and has the ability to participate in autonomous decisions. Decisional capacity is not defined strictly by chronologic age. Many authors agree that children under age 13 years do not have the capacity to make decisions regarding serious intervention such as bariatric surgery (Inge et al., 2004a). Assent for surgery must be taken from the child/adolescent patient, and informed permission must be reported from the parents/guardians before surgery. Most of experts generally consider the age range of 8-14 years to be candidate for assent, with younger children unable to give meaningful participation in medical decisions and older individuals capable of giving

CLINICAL SCENARIO AND IDENTIFICATION OF DECISION CHOSEN As part of my exploration to fulfill the requirement of the clinical decision- making analyses, I have identified a scenario in my working environment, which is Penang Hospital in Psychiatric Department. A female patient has been admitted into the female psychiatric ward, which was diagnosed to suffer bipolar mood disorder. In brief, the patient, who is 38-years old, has been further analyzed to undergo auditory hallucination and it could not be controlled due to allergic of anti-psychotic medication (Haloperidol and Clopixol Acuphase). Describing further on her condition due to bipolar mood disorder, she was irritable and restless most of the time.