Free «Position Paper: Evidence-Based Practice» Essay Sample
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In the recent years, the daily activities of a nurse have taken a certain evolutionary path and have undergone significant changes. For decades, a nurse has been perceived as a healthcare specialist with the respective education, working under the guidance of a physician and performing the assigned tasks and some of the manipulations (e.g. bandaging, stitches removal, etc.). Thus, her primary duties were the provision of a specific care and monitoring of the patients. However, the transformations in the global healthcare system, which began in the late 20th century, have led to the introduction of professional terminology to the concept of nursing and rethinking of the role of the nurse in the professional community. As a result, a new model of a nurse has been formed, according to which she became a partner of both the physician and the patient, with a possibility to work independently. Naturally, such changes have resulted in the emergence of new requirements to her skills and abilities, making her rely not only on the knowledge and competence of her superiors, but also utilize her personal professional experience. In other words, they have to resort to the evidence-based practice (EBP). At the same time, the significance of such approach is yet to be realized. The following work focuses on emphasizing the importance of EBP for nurses, as well as the analysis of the process of its implementation in the different healthcare systems, namely the Spanish one.
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The Importance of EBP in Nursing
The EBP has become an integral component of the modern nursing, since the decisions taken by the nurses are not always based on the results of scientific research. In particular, nursing practice is considered evidence-based in case the decision-making process involves the integration of the individual experience of a nurse with the best results obtained in the course of systematic studies. At the same time, it must take into account the patient’s needs (Melnyk et al., 2014). The importance of such approach to nursing is determined by several factors. First of all, the contemporary healthcare professionals have to operate with many different types of data, including the ones that emerged recently. For example, there is the information that is obtained in the course of clinical trials, as well as the systematic review of the studies focused on therapeutic manipulation, including the prognostic ones that involve the use of such methods as observation and survey. Naturally, such data can lead to significant changes in the provision of medical care, specifically after its comprehension. Moreover, the use of EBP provides for the decrease in the amount of differences in medical practice, which occur in case the opinions of the experts involved in the studies do not coincide. For example, sometimes the cheaper drugs may be more efficient than the new ones, with EBP providing the means to justify their use. On the other hand, the commonly used methods of treatment can be harmful to patients due to the fact that their effect is not studied well enough (Melnyk & Fineat-Overholt, 2011). In turn, the use of the EBP results, as well as their correct interpretation benefits both the patients and the healthcare system as a whole.
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Another factor justifying the importance of EBP for nurses is the fact that the new data on treatment (i.e. the results of the research and trials conducted by the healthcare specialists) can be rather difficult to obtain, especially for nurse. However, in the course of her activities, she requires it on a daily basis (Melnyk et al., 2014). For example, nowadays, the scientific articles on nursing can be found in a variety of specialized magazines and journals, though not all of the published materials contain valid data due to the reasons mentioned above. At the same time, even in case a nurse has access to all data she requires, there is no guarantee that she will be able to analyze and evaluate it without disrupting her working schedule. Therefore, to perform her duties, she will have to rely on her individual experience, combining it with the relevant data on treatment. As a result, the nurse’s field of search will be narrowed significantly, allowing her to study the required materials more thoroughly and use the obtained knowledge more efficiently.
The next factor that contributes to the importance of EBP in nursing is the fact that contemporary methods of treatment, as well as the respective healthcare information, eventually lose their relevance due to the effects of the scientific and technological progress (Melnyk et al., 2014). In other words, the more years have passed since the nurse’s graduation from the educational institution, the less her knowledge meets the requirements regarding the provision of medical care. As a result, she must study on the constant basis, namely in the course of her work, learning from her individual experience. Moreover, the traditional curriculum and especially the continuing education that consists of lectures are not quite efficient in the modern conditions. The primary reason for that is the ever-changing mode of operation of healthcare providers, which requires the presence of new knowledge and skills relevant to newly obtained scientific data (Melnyk & Fineat-Overholt, 2011). On the other hand, EBP with a special emphasis on skepticism, uncertainties, and inquisitive attitude encourages nurses to use their critical thinking, which is an efficient way to maintain their knowledge and skills at the relevant level. In this case, EBP serves as a means of improvement of nurses’ professional qualification.
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Understanding of the Research Methods
Nowadays, the system of training of highly qualified nurses is directed at the formation of their ability to make self-decisions within their competence (i.e. the EBP-based approach). As a result, the understanding of the research methods by the nursing staff and their use in the course of innovation activities, as well as the conduction of the complex scientific projects aimed at improving the quality of the provided services, has become of particular importance for them (Schmidt & Brown, 2015). Thus, nurses engaged in the modern system of medical care must perform entirely new functions related to the process of their professional activity, namely the applied research.
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It should be noted that the work of a nurse involves the formulation of a nursing diagnosis. As a result, she has to gather specific information about the patient, which, in other words, means conducting of an examination. During this process, the primary data sources include the patient himself, his relatives, personnel of the healthcare facility, medical records, and special literature. Naturally, to collect the required information efficiently, the nurse must use such research methods as survey and observation. After the data has been gathered, the nursing specialist must analyze it and identify the problems of the patient. They may include the issues preventing him from maintaining the optimal health level (e.g. pain, anxiety, shortness of breath, etc.). This stage involves the use of such research methods as analysis, synthesis, and comparison, in case the nurse had to deal with similar symptoms before (Schmidt & Brown, 2015). The results of the analysis are used to formulate the nursing diagnosis, i.e. a description of the patient’s response to illness, as well as his condition (e.g. physiological, psychological, and social one).
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As a result, it is possible to say that the professional nurse examines not a disease but the patient’s reaction to it, which distinguishes nursing diagnosis from the one made by a physician. By using the survey methodology, nursing specialist finds the causes of the patient’s discomfort. Moreover, she has to define all the existing or potential deviations from the comfortable, harmonious state, ease the patient's condition within the boundaries of her competence, and, if necessary, teach him to live with a chronic disease (Schmidt & Brown, 2015). Naturally, the completion of such task requires the understanding of the research methods, namely the ability to combine one’s personal knowledge and professional experience with the results of the clinical studies, meaning the synthesis of information. Having identified the problem of the patient and formulating a nursing diagnosis, the nurse must decide which of healthcare professionals will be able to help the patient (surgeon, psychologist, speech therapist, etc.). As a result, it is possible to say that currently, nurses require research competence, namely the ability to independently find and use the information necessary to perform their tasks, as well as the one important for their professional and personal development. At the same time, the understanding of the research methods is required to consciously plan and implement the measures aimed at improving one’s nursing skills, conducting research on the analysis and evaluating the quality of the provided care, facilitating the introduction of modern medical technologies, and improving professional skills, as well as introducing the new forms of work (Schmidt & Brown, 2015). In the conditions of the continuous improvement of the healthcare system as a whole, as well as the growing popularity of EBP, the research competence of a nurse becomes a necessity.
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The EBP and Nursing in Spain
Since its introduction, EBP has been used on the global scale. However, the nurses’ attitude towards it differs depending on the country. For example, in the healthcare system of Spain, which was subject to the study involving the survey of the different groups of nurses, EBP is more popular among specialists who do not have a significant working experience, i.e. no more than ten years (Pericas-Beltran et al., 2014). It is possible to assume that due to the lack of the long-term professional practice their mind is still quite flexible, making it easier for them to adjust to the requirements presented by EBP (i.e. the ability to collect and use the data independently, as well as apply a wide array of research methods). Moreover, this group of respondents considered the challenges accompanying the implementation of EBP to be motivating, which can be explained by their relatively young age. The people that have more significant working experience also perceive the EBP to be a positive phenomenon (Pericas-Beltran et al., 2014) as it provides more opportunities for the professional growth.
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The nurses with managerial responsibilities also supported EBP, preferring to recollect their previous professional experience and analyze the problem prior to starting the work on its solution. Such algorithm of actions is common for evidence-based approach, which involves the synthesis of evidence and knowledge. Moreover, according to nursing leaders, the EBP provides a back-up for the nurses, making their work more reassuring (Pericas-Beltran et al., 2014). On the other hand, the managerial staff of the Spanish healthcare facilities is yet to find the efficient way to switch to the EBP. In particular, many nurses, especially the ones that worked long enough, may resist the changes. Moreover, there is a lack of motivation, with the activities aimed at maintaining it on a sufficient level being considered a prerogative of managers rather than the nursing staff (Pericas-Beltran et al., 2014). In this regard, it is possible to say that the experienced nurses (i.e. the ones that have worked for more than twenty years) are rather passive in terms of EBP implementation. As a result, it is clear that currently, the Spanish nurses perceive EBP quite positively, but are not ready to abandon the traditional ways of work.
In conclusion, it is possible to say that in the contemporary conditions, EBP has become a necessity for nurses. In particular, the emergence of the new types of data, the ever-changing environment, and the unavailability of all the required information on a certain topic provide for the rapid aging of the knowledge obtained by a nurse in the course of her education. In turn, there is a need to study on a constant basis, creating the plans for personal and professional development on the basis of both individual experience and the results of clinical studies. Such tasks cannot be accomplished without the nurse resorting to EBP, as well as possessing research competence. Nevertheless, the effect they provide is quite significant, namely in the terms of the quality and efficiency of the healthcare services. At the same time, it is clear that despite the benefits provided by EBP, the nurses’ attitude towards it is not always positive. In particular, the study conducted in Spain has demonstrated that many people find it difficult to accept the new ways of work, primarily due to the fact that they are quite different from the traditional ones. In combination with the low motivation of the Spanish nurses, especially the experienced ones, this fact may prove to be a significant obstacle. As a result, in order to implement EBP successfully, the managerial staff of the healthcare facilities must primarily pay attention to the needs and competency of the personnel, to ensure their readiness to the changes.