The current paper discusses the perspective of EBP implementation in the nursing practice. The positive aspects of EBP utilization usage from the point of nurses’ experience and professional qualities improvement are considered. The analysis of research methods knowledge presence among nursing staff allows determining the most significant areas of the EBP development in healthcare institutions. The paper also defines international experience on the issue of EBP utilization methods to describe the most promising ways of development of this field in the world.
The Importance of EBP Utilization
In recent decades, EBP proved to be the efficient tool for medical data collection and analysis. The accumulation of factual information about the course of treatment in each particular case provides a nurse with the resources which are necessary to perform qualitative medical services. Not relying only on a study of the previous experience and knowledge gained in the university, medical staff can collect and implement knowledge about their current practice and develop new approaches to the treatment process.
As for nurses, EBP utilization is the measure of significant importance due to the opportunities it provides. Nowadays, more informed customers have a demand for a high quality nursing care. To comply with this requirement, a nurse has to use not only knowledge, which she had achieved in the medical educational institution, but also accumulate, study and implement the most recent evidence from nursing practice into the work. In this case, EBP utilization is a unique tool that gives a nurse a possibility to improve nursing experience and professional qualification. As soon as EBP uses the best clinical data available to make decisions about nursing care, this method of information collection and analysis gives nurses access to the most valuable database.
The results of various studies have proved the practical effectiveness of EBP knowledge implementation in the nursing practice. Carol Boswell and Sharon Cannon consider the EBP utilization method to be one of the most useful ways to improve the qualifications of the medical staff. According to them, “overcoming obstacles to the use of research (EBP utilization) in practice can improve patient outcomes, decrease cost, and increase the body of knowledge for nursing profession” (Boswell & Cannon, 2014, p. 17).
According to the results of the recent researches in the sphere of EBP usage among nurses, one of the most valuable issues is the low level of nurses’ experience about how to use EBP tools to improve their knowledge. The absence of qualification on research methods employment determines limitations in the use of such a useful tool and reduces its popularity among medical staff. One of the reasons for this state of affairs is the limitations, which are present in the nursing educational process. According to Boswell and Cannon (2014), ”when you consider that the average age of nurses is 47, the fallacy of that line of thinking is that a nurse may have been taught 20 to 25 years ago” (p. 15). Another obstacle that determines a low interest to the study of research methods during education is te way the research methods are taught. Many students consider research methods studying to be similar to learning a foreign language. This circumstance is determined by the highly technical language of research methods presentation to students that can usually beat off interest in the study of the subject. As soon as future nurses do not achieve knowledge about research methods or get only a small amount of information, it is necessary for them to orientate in the EBP utilization process.
The absence of practice in EBP utilization, caused by high workload or lack of proper resources for the collection and analysis of information, leads to the creation of a gap in knowledge about the use of EBP. Institutions that do not understand the effectiveness of EBP utilization among nurses are not disposed to create the conditions for self-development for its staff. The lack of time or other opportunities to study reviewed literature in the sphere of nurse’s practice limits the knowledge of medics in the field of EBP research methods application. This circumstance defines an inadequate effectiveness of nurses’ activity in data collection and the analysis process. Thus, a nurse cannot implement results of EBP in practice and use all the above-mentioned benefits.
Since a nurse learns about the required research methods, the quality of his/her job increases significantly. A nurse can use technologies to search the information, needed for his/her work. In this way, the presence of knowledge about research methods gives medical staff a possibility to obtain the necessary certificates in a short period of time, which is especially important in the case of extreme or unique situations. Without such experience, a nurse will show the worst results of the work, which will ultimately affect the quality of treatment.
Another circumstance that determines the necessity of research methods knowledge presence among nurses is the need for promotion of EBP utilization practice among medical staff. As soon as nurses cannot imagine how they can examine the results of EBP, they do not have an interest in such activities, and, accordingly, to self-development through it. That is why educational and medical institutions should provide nurses with knowledge about research methods, which they can use in the work during EBP.
The study of the international experience of nursing EBP is extremely important because it provides an invaluable practical experience for nurses. Comparing approaches to EBP in different countries, specialists can highlight and learn for themselves the most successful methods of patient care. The next part of the paper discusses the experience of evidence-based nursing practice in the sphere of skin integrity maintenance in Australia. The process of EBP implementation in one of the private hospitals in the Western Australia will be considered.
The observed research took place in Peel Private Hospital in 2007. The idea of EBP principles implementation was to develop better tools and methods to perform healthcare for the patients with skin lesions. The project managers implemented several reforms in the health care facility to create conditions for nursing medical services quality inccrease. The researchers have identified risks in maintaining skin integrity practice and developed tools and principles of illness prevention, based on the EBP approach.
As one of the decisions, which served to EBP implementation in the clinic, was the organization of the medical staff educational process. The question of research methods knowledge for nurses was discussed earlier in this article. The consideration of this question showed that the education of staff in the sphere of EBP utilization plays a vital role in improving the quality of nursing services. At the same time, the project leaders have gathered the most relevant publications on the topic of interest to them. This data allowed them to establish the project in the most helpful way. According to the Gardiner et al. (2008), “Best practice data were collected from a literature search of MEDLINE, CINAHL and Joanna Briggs Institute databases” (p. 8).
The EBP implementation project also provided the trial of medical equipment for skin integrity. The researchers have chosen an audit tool as a method of EBP utilization. Having created audit data tool, the managers achieved a possibility to monitor and analyze the results of EBP introduction to the hospital. The Braden Scale was adapted to evaluate risks of skin injures. Gardiner et al. (2008) have identified the following means of achieved data analysis: SPSS, Descriptive statistics, two-tailed t-tests.
The results of the EBP implementation at the hospital were quite impressive. Due to the usage of data audit tool, medical staff had managed to distinguish the equipment that best met the requirements of nursing. Staff educational program had improved nurses’ knowledge in the question of EBP usage for their work. Thereby, nurses of the considered clinic had participated more actively in the course of the investigation that led to the best results. As the authors said, “the research team attracted interest from nursing staff in other areas of the hospital who realised that the study provided a context for sharing expertise” (Gardiner et al., 2008, p. 12).
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Nevertheless, the most important result of the EBP implementation was the increase of the knowledge of staff about possible risks in patient care. Thus, skin integrity risks identified increased from 16.5% to 44.6%. The subsequent in-hospital risk assessments increased by 19.6%. Dietary insufficiency identified changed from 3.4% to 10.6%. In this case, the emergence of new knowledge about the methods of treatment among the staff contributed not only to the development of the patient care practice but also improved the preventive treatment methods.
EBP utilization plays a vital role as a measure of nurses’ qualification development. Since a nurse achieves a possibility to study positive experience in the question of patient care, he/she can provide better medical services in her work. The presence of knowledge about research methods in very useful because it determines a nurse’s ability to search for and examine studies in the sphere of her professional activity. International experience shows that EBP can be very efficient measure of nursing services improvement when it is properly implemented and used in practice.
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