Roles And Values Within The Profession Of Nursing

Evidence-Base practice (EBP) is defined as: “based on problem identified from the practitioner’s area of practice; a combining of best evidence and professional expertise and an integration of this into current practice; about ensuring patients receive quality care, being part of quality improvement processes; about collaboration and requiring a team approach” (French, 1999). Scott and Mcsherry (2008) supported the French’s assertion, proposing the key elements of EBP are that it is a theory-driven process, which involves the use, evaluation and application of research; identification of best evidence; evaluation of care; problem solving; decision-making; clinical expertise; and requires patient involvement. Evidence-based practice is made of evidence, clinical expertise, patient preference, the context of care (Barker, 2013). In brief, evidence-based practice is the parameter in the nursing practice that it requires that the nurses gather and use clinical evidence to make decision for the patients so that in the nursing process they can deliver the quality of care for the patients (Ellis, 2013). In the other words, in the nursing practice all the nursing procedures performed by the clinical evidence supported.

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.

Evidence-based practice is the practice of making clinical decisions based off the best available research evidence coupled with the nurse’s own expertise, while also taking into account, the patient’s assessments and own personal preferences. This use of research has proven effective at providing better outcomes and lower healthcare costs, yet there are several barriers, such as time, education, and support, which prevent nurses from consistently using evidence-based practice (AJN, 2012). The top three barriers to the use of evidence-based practice are lack of time, education, and support in implementing new practices and using them consistently.

The State of Tennessee Board of Nursing’s Rules and Regulations of Registered Nurses, Rule # 1000-01-.13-1r states that unprofessional conduct is defined in part by "failing to take appropriate action in safeguarding the patient from incompetent health care practices" (State of Tennessee, 2011). There are a number of arguments in this case study that incompetent health care practices are being performed, from the decision to place a patient on a ventilator for an oxygen saturation of 88%, circumventing the patient’s written and verbal advanced directives, utilizing an unauthorized family member to get consent for

Through the manner in which the case scenario is presented, Mr. Y is not involved in Mr. E’s life decisions even though he is entrusted with Mr. E’s final life decisions.

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).

This scenario presents various ethical issues that could be argued several ways from HIPPA violations to whether or not this patient has/had the cognitive ability to understand the execution of an advanced directive and Power of Attorney. Advance Directives are put in place for this very reason. It eliminates the need for family members to make a choice in the heat of the moment and also respects the wishes of the person whom it affects directly. Although Mr. E’s hypoxia could affect his ability to think clearly one cannot assume that he has an altered level of consciousness nor the inability to execute an advance

Evidence based practice, “involves integrating the best available research evidence with professional expertise while also taking account of patient preferences the patients state setting and circumstance and health care resources” (Gerrish, K. Lathlean, J, 2015). As the health care profession constantly changes, then it is vital that all evidence based practice is kept up to date with current information and research, relating to nursing practice. Always assuring that the patients need are taken into consideration (Sackett et al, 1996).

Evidence based practices are important in nursing practice because It increases confidence in decision making, high quality patient care and achievement, it results in better patient outcomes, contributes

As a provider of care, the nurse has a more personal relationship with the patient and can get more information. The provider of care can identify barriers in nursing care and can use this as a foundation to develop a plan, or theory. Evidence-based practice is incorporated in everyday nursing care, because many policies and procedures are the result of this practice. Before a policy is implemented, there is research that is done to provide a positive result. Nursing research has helped in the improvement and prevention of diseases. “Nurses may play a variety of roles in research, including the following: informed consumer of research; participant in research-related activity; contributor to a systematic review process; data collector for a research project; and principal investigator for a research study” (Houser, 2015,p.9).

In nursing research is crucial for nurses in delivering care for patients. Today, nurses are accepting the requirements of evidenced based practice into their clinical areas and also for decision making. Researchers had argued that regardless what discipline the healthcare providers belongs too; it is an obligation for all of them to strive and extend the body of knowledge for better patients’ outcomes (Polit & Hungler, 2001). As for nursing, there is a lot of knowledge can be gained by nurses via research studies. Globally the ultimate goal in healthcare is to facilitate patients’ to reach the highest level of health status that would allow them to participate in the social and economic life of the community that lives in. To achieve these goals, the healthcare industries need to adapt the best practice approach for patients’ care. Best practice is adopted via research; the search scientific knowledge is indeed strongly supported by nationwide (Lea, Williams & Donahue, 2005).

Nursing is a unique profession which is built upon theories that guide everyday nursing practice. According to Taylor, Lillis, & Lynn (2015), “Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices” (p. 27). Many nurses may unknowingly apply a theory or a combination thereof, along with critical thinking to get the best outcome for a patient. Theories are used in practice today because they have been supported by research and help the profession uphold its boundaries. Most nursing theories consist of four concepts which are the patient, the environment, health, and nursing. Each patient is at the center of focus and they have the right to determine what care will be given to them using informed

“Nursing theory aims to describe, predict and explain the phenomenon of nursing” (Colley, 2003, p. 33); therefore, nursing theory is the scaffolding on which nurses stand to build and remodel nursing practice. This is a symbiotic relationship because nursing theory builds the nursing practice and as practice expands the scaffolding must, in turn, grow as well. As such, the investigation into practice and research keep informing the practice and profession of nursing. Ultimately this leads to more effective patient care utilizing evidenced-based

In nursing, evidence-based practice relates to the preferential usage of interventions for which qualitative and empiric research has rendered evidence of substantial efficacy for certain issues in nursing care. The collection, analysis, and integration of crucial, relevant, and pertinent research-driven, patient-reported, and nurse-observed evidences are promoted by evidence-based practice. Another instance or illustration of evidence-based practice is the systematic study of care theories and their implementation to patients. Hence, these attempts act upon against rationalizing of nursing practice on shaky knowledge—solely on the basis of other nurses’ experience—devoid of scientific evidence on which nursing practice can be established.

Evidence-based practice (EBP) in nursing means making decisions about patient care on the basis of best, current, standardized practice and guidelines. According to an article, written by Dr. Kathleen Stevens, the development of evidence-based practice (EBP) is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care (Stevens, 2013). The author also mentioned in her article that the intended effect of EBP is to standardize healthcare practices to science and best evidence and to reduce illogical variation in care,