Abstract
The nursing profession is considered to be one of the most dynamic professions in the health care system. As a front line health care provider, nurses are expected to deliver the quality of care that their patients need. Their role as professional deliverer of care in the healthcare settings has evolved into decision making that entails a critical analysis on how to improve their patient outcomes. Their learning experiences evolve from formal education to one of clinical practice that requires them to exercise sound judgment and quality health services that can be improved through evidence based practices. Like other disciplines, the nursing practice involves dynamic changes in order to adapt to the research and evidence based practice outcomes that require nurses to embrace these changes in order to become effective health care professionals who can respond to the unique needs of their patient, their patient’s family, fellow health care providers and the community to improve patient health outcomes and better response to treatment. This paper will provide some insights on how essential and relevant is an evidence based practice in nursing in improving nursing efficiency and competence in clinical practice and how learning the research methods could improve their skills in implementing evidence based practices in the clinical settings. A peer reviewed study will also be included in the discussion to show how evidence based practice is being practiced in clinical nursing in other countries.
Evidence based practice in nursing has become a solid foundation in the clinical practice of nurses, allowing them to exercise quality decision making in the delivery of their health services based on critically appraised evidence that is scientifically supported based on research studies. Nurses have the positive perception about the application of evidence based practice in nursing because it makes them competent in exercising critical decision making according to the applicable nursing care needed by their patients of a specific population. Understanding the research methods for the effective implementation of evidence based practices in the nursing field of patient care is necessary in order to optimally prepare nurses to become more skilled and highly competent health professionals.
According to the research study conducted by Majid, Foo and Mokhtar (2011), there is a need to adopt evidenced based practice in nursing because nurses are becoming more engaged in the practice of decision making for their patients. Owing to this shift of responsibilities of nurses from merely carrying out doctor’s orders to one of being capable of exercising a decision making process on how to improve patient condition and response to treatment, I believe that evidence based practice will help provide nurses the ability to adapt to particular clinical situations that would allow them to independently carry out decisions on the kind of nursing care to provide to a specific patient population. Because the main objective of evidence based practice is to integrate research based evidence in order to arrive to the best clinical treatment possible according to the relevant external data with high regard to clinical experience in consideration of patient needs (Malloch and O’Grady, 2010), nurses will find evidence based practice useful in enabling them to respond to the specific needs of their patients. Because the learning process in the nursing profession is one obtained from both the formal education and clinical experiences, it can be drawn out that evidence based practice supports to expand and widen a nurse’s clinical experience by improving their ability to respond to the individual needs of patients with the ability to address their special concerns, expectations and requirements to help them respond to their treatment better. The adoption of evidence based practice in the field of nursing care allows nurses to become more competent in achieving better patient outcomes, it contributes to the improvement of nursing practice, improves a nurse’s ability in decision making and makes the nursing health services current and relevant to the changing needs of patients.
Research method is an important phase of learning among nurses in order to implement effective evidence based practices in their health care services. Nursing research involves the scientific process that validate and improve the existing knowledge as well as generating new knowledge to influence directly or indirectly the practice of nursing (Burns and Grove, 2011). Nursing research is an important component of evidence based practice in order to determine the best quality of treatment outcomes for the patient, their family and the health service providers according to relevant experiences as evidence. With nursing research, a nurse is able to understand the important factors that affect the patients' response to their treatment including the understanding of their patient’s values and specific needs. With the use of the nursing research process, nurses learn to identify the key concepts of clinical practices needed in a particular health care setting. The data gathered from research can contribute in improving the analysis of the treatment needs of patients, the quality of the delivery of nursing services and in measuring the effectiveness of nursing care and to determine whether there is a need to re-design their treatment approach to patients to improve treatment outcomes. The research methods allow nurses to examine thoroughly the specific problems that are unique to a specific group of patients, their families and the community. Because it uses a scientific approach of study, it involves stringent methodological processes that ensure quality conclusions of a research study. In many instances, evidence based practices can also help enhance the research outcome in the nursing practice in order to essentially improve quality health care services and improve patient response to treatment based on evidences gathered from clinical practices in the nursing care setting.
The Best Practice for the Care of Patients With Tuberculosis in the low income countries provides the guidelines on the good collaborative clinical practice among nurses in the delivery of care among tuberculosis patients (Williams, et al., 2007). Countries in Asia and Africa has the highest incidence of TB in the global community (World Health Organization, 2012) and improvement in these countries in terms of the quality in the delivery of nursing care is essential. Nurses are often placed in the position as the focal person or unit coordinator in the management of tuberculosis patient in low income countries and nurses routinely collect patient data relating to the case findings and treatment outcomes. According to the peer reviewed study, nurses who are able to show compassion and listen to their patient’s concern while maintaining a non-judgmental attitude, thoroughly monitoring patient compliance to medication, educating the TB patient on what to expect from their treatment and how to accomplish better treatment outcomes by frequently returning to clinics for a follow-up checkup, checking whether the patients with positive sputum smear based on the TB patient register already started treatment and providing relevant health educational not only to the patient but to their support group like family and friends have improved the efficient diagnosis of TB and improved the trust and confidence of these patients among nurses and in the healthcare services they receive in general. Moreover, nurses who are able to collect specimens according to the standards provided in the study showed that good quality sputum specimens are collected for laboratory examination through the best practice guide implemented in the labeling, sputum collection method, proper sputum storage, prevention of contamination and transmission and proper documentation, improve the efficiency of nurses in the monitoring and diagnosis of TB patients. In this study, nurses are able to observe the standard guidelines on the best practices based on evidence based practices on the proper management of TB patients in certain clinical settings that is prevalent in low income countries. Education and proper approach to patients with TB has improved compliance to treatment and efficient diagnosis is conducted through the standard practice in delivering nursing care for them.
In conclusion, evidence based practice has become a valuable management tool that nurses can use in order to guide them in terms of decision making and in understanding the best practices and guidelines to follow in the delivery of their health care services to a specific clinical setting. It is easier for nurses to improve their competence and skills in addressing the specific needs of patients under a specific clinical condition when evidence based practice has already provided more specific clinical practice guidelines. This makes them more skilled in the conduct of a more systemic decision making process regarding the most appropriate care intervention to certain groups of patients. Learning the research method in order to effectively carry out evidence based practice in the field of nursing is essential as it involves a scientific and systematic method of gathering evidence that will help nurses to exercise better judgement under certain clinical conditions with better competence in addressing their patient needs and improving their patient treatment outcomes.
References:
Burns, N. and Grove, S.K. (2011). Understanding Nursing Research: Building an Evidence Based Practice. Maryland, USA: Elsevier Saunders.
Majid, S., Foo, S. and Mokhtar, I. (2011). Adopting Evidence Based Practice in Clinical Decision Making: Nurses’ Perceptions, Knowledge and Barriers. Journal of the Medical Library Association. 99 (3). 229-236.
Malloch K. and O’Grady, T. (2010). Introduction to Evidence Based Practice in Nursing and Health Care. London, UK: Jones and Bartlett Publishers.
Williams, et. al. (2007). The Best Practice for the Care of Patients with Tuberculosis. A Guide for Low Income Countries. Retrieved from http://www.ghdonline.org/uploads/Best_Practice_Guide_V6_-_eng.pdf
World Health Organization (2012). Global Tuberculosis Report 2012. France: World Health Organization.
