Clinical expertise

please answer to each discussion within 100-150 words to each reply.

Chiamaka

Evidence-based practice (EBP) is the thorough and thoughtful use of current best evidence in combination with clinical expertise and patient values to guide health care decisions. Best evidence includes real evidence from randomized controlled trials; evidence from other scientific methods such as descriptive and qualitative research; as well as use of information from case reports, scientific principles, and expert opinion. When enough research evidence is available, the practice should be guided by research evidence in combination with clinical expertise and patient values.

Based on the input from my mentor and the research done, patient’s view of EBP would leave the decision about use of evidence-based endotracheal suctioning techniques to each nurse and respiratory therapist. Some individuals may be familiar with the research findings for endotracheal suctioning while others may not. This is likely to result in different and conflicting practices being used as people change shifts every 8 to 12 hours. From an organizational perspective, endotracheal suctioning policies and procedures based on research are written, the evidence-based information is integrated into the clinical information systems, and adoption of these practices by nurses and other practitioners is systematically promoted in the organization. This includes assuring that practitioners have the necessary knowledge, skills, and equipment to carry out the evidence-based endotracheal suctioning practice. The organizational governance supports use of these practices through various councils and committees such as the Practice Committee, Staff Education Committee, and interdisciplinary EBP work groups.

References

Gullen, L., Adams, S. (2012). Planning for implementation of evidence-based practice.

Titler MG. The Evidence for Evidence-Based Practice Implementation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 7.

Lanecie:

Understanding the health care system at the local level is important due to the health care system being supported by EBP and the need to constantly search for improvements in the way health is practiced (Warren Jl et. al., 2016). Understanding ones population group and identifying what is important and needed for them is essential and maybe different to what is needed for a different population group. Process improvement projects are an essential component of EBP and allow for opportunities of growth and increase patient outcomes.

After speaking with my mentor she mentioned several things, such as the resistance to change from nurses when implementing change, which is often caused by a feeling of lack of support or resources to implement the new change. Another suggestion she gave me was to talk with the nursing staff and ask them what they thought would work best for them and what they felt they needed to be able to implement the changes. As my mentor mentioned many of the nurses have decades of years of experience and can give stories on what has worked and what has not worked in the past.

References

Warren, J., McLaughlin, M., Bardsley, J., Eich, J., Esche, C., Kropkowski, L., & Rich, S. (2016, February 13). The Strengths and Challenges of Implementing EBP in Healthcare Systems. Worldviews Evidence Based Nursing13(1). doi:https://www.ncbi.nlm.nih.gov/pubmed/26873372