Good Example Of Evidence Based Practice: Ideal Practice Vs. Reality Essay

Current healthcare models have been striving extremely hard to incorporate evidence-based practice into their health care approach. Some of the areas where efforts to utilize the evidence-based practice include health treatment and intervention, health policies and delivery decisions, healthcare funding, access to care among other areas. It is generally agreed that the standard of health care will be significantly improved if reliable and valid evidence is incorporated in all health care related decision-making.
However, in the real sense, decision makers in the healthcare sector are often unable to attain the goals and objectives of evidenced based practice. The standard of care idealized by an evidence-based approach is in most cases never realized practically.
Evidence-based care predicts an ideal standard of care but in reality, there is a huge gap between the idealized standard and the real quality of care (Ebben et al., 2013). This is largely because of various factors that include lack of necessary resources, lack of knowledge and skills by clinicians to incorporate evidence-based practically as well as unclear definitions of what constitutes real ‘evidence”.
There are several factors that impact the successful implementation of standards and protocols. These factors when available ensure that standards and protocols meant to improve the quality of care are fully implemented and there is visible improvement in the quality and outcomes of health care (Ebben et al., 2013). One of these factors is awareness and knowledge. Incorporation of health care standards and protocol is only possible if healthcare personnel are aware and knowledgeable about the evidence-based care guidelines and protocols. Another factor is motivation. Implementation of protocol and standards can only happen if the health care personnel is properly motivated to do so. The presence of incentive and punishments that are associated with standards and protocol implementation can go a long way in promoting motivation. Skilled staff are also important in the implementation of standards. The staff must not only possess theoretical knowledge on evidence-based care but must also possess the necessary skills that are needed to implement it. Health care institutions should avail training to staff in order to make sure that they have the skills to deliver the highest quality of care by implementing the provided standards and protocols. This may obviously take some time before it becomes a reality. The availability of relevant resource and equipment also favors the implementation of standards and protocol. A health care institution might be forced to buy new equipment in order to facilitate the implementation of the standards and protocols. Alternatively, the available equipment might have to be reconfigured in order to fit with new standards and protocols.
My unit implements evidence-based practice by first of all ensuring that evidence-based research is incorporated into the unit’s main guidelines. Each staff is supposed to abide strictly by these guidelines and policies. First of all, the nurse is required first to ask clinical questions in the PICOT form about the objectives of health intervention or care for the particular patient. This is followed by a search for the finest evidence. There is then an appraisal of the evidence. The next step involves integrating this appraised evidence with other aspects such as clinical expertise, patient values, preferences and beliefs. The final step is the evaluation of the outcomes of the clinical practice or the decisions that have been based in evidence.
The process of determining what must be done and what can be modified safely involves careful planning. This involves intensive analysis of the patient’s ailment or current condition, the nature of the available evidence and the availability of safe means of intervening using the available evidence. The results from the analysis of these aspects then assists in determining whether a certain step must be taken and whether it can be taken safely without harming the patient even farther.
In order for ideal care to be achieved, there is need to reconcile patient preferences, research, and clinical expertise. The nurse or health provider should be well acquainted with the patient preferences and if they conflict with research results, it is up to the nurse to explain to the patient and perhaps and attempt to make a compromise if he or she is unable to convince the patient to agree to the idealized intervention model. In cases where clinical expertise conflicts with research, it is advisable to seek the opinion of a second party.
There are few ethical concerns related to the integration of evidence-based care. The primary concern arises when evidence-based practice conflicts with patient preferences and no attempt are taken to reconcile the two.
If I had 5 minutes with a politician of my choice, perhaps a member of the National Congress., I would ask him to stage a bill in the Congress that proposes strict guidelines for evidenced based care implementation in all hospitals.
There are several people that I would want to include on PAC to advocate for change in health care policy. These would include health research experts, health sponsors and fund providers as well as fellow nurses and health care staff who have witnessed the deplorable condition of the current health system and who appreciate the need for immediate adjustment of policy.
If I had to propose a story to a journalist to highlight the nursing practice in my organization, it would have to be the case where a certain patient died of asthma because of exposure to inappropriate care. It was only after he died that it emerged that there was vast information and evidence on an appropriate type of care that could have saved the patient’s life. This story will highlight the need for evidence based care in all health institutions.

References

Ebben, R. H., Vloet, L. C., Verhofstad, M. H., Meijer, S., Mintjes-de Groot, J. A., & van Achterberg, T. (2013). Adherence to guidelines and protocols in the prehospital and emergency care setting: a systematic review. Scand J Trauma Resusc Emerg Med, 21(9).