Evidence-Based Practice is defined as the conscientious, judicious, and explicit utilization of most recent best evidence in coming up health care decisions for each patient. EBP is the integration of clinical expertise, client values, and the best research evidence in the process decision-making process concerning a health care delivery to an individual patient. This means that it is the use of systemic decision-making processes or delivery of services that have been proven through scientific evidence, to improve measurable patient outcomes continuously. EBP eliminates single observations as the basis for making care delivery decisions. It greatly relies on information that has been gathered through experimental research taking into accounts the characteristics of a patient and clinician expertise. Clinician expertise is the knowledge that is accrued through life experience and professional practice. This kind of evidence is known as practical knowledge or professional craft knowledge. It is a kind of knowledge that is embedded and expressed in practice, and it is usually tacit and intuitive. According to the recent study, care providers do not act on their own knowledge, but they also draw on the expertise of their colleagues to inform their practice. In most cases, the knowledge borrowed from the skilled practitioners is research-based. This paper will address my personal experience and how well I utilize my personal experience in quality health care delivery. Moreover, the paper will address, how IOM core competencies and how they are applied to fit current health needs.
In the health care center, I spend most of the time directly with the client, offering routine observations and care. I also implement orders from the physicians such as changing dressings, giving medications, and assessing the response of the patient to the treatment plan. I critically interpret client information and assess available data to come up with decisions about the actions that are required (Tiffin, 2013). I always focus on assisting patients to attain their needs including emotional, social, physical, cognitive, and spiritual needs. Nurses can only accomplish these outcomes by working in collaboration with health care team together and execute the best-personalized and evidenced-based plan of health care for the clients. Nurses are client advocates and facilitate optimal health, wellness, and function in the care of a person, communities, families, and populace. Moreover, am supposed to carry out as a nurse is educating and coaching the patient. Nurses assist patients in managing their health by addressing various topics like coping with a diagnosis, making the right healthy lifestyle, and being able to understand signs and symptoms of emerging disease or problem.
The Ways of Knowing
I am a professional nurse who defines herself in terms of the knowledge I possess and goal I should acquire. I use three essential patterns of knowing that make the syntactical and conceptual structure of nursing knowledge.
It refers to the knowledge that I possess myself, and what have seen and experienced throughout my life. I have acquired this knowledge through the process of reflection, observation, and self-actualization. This knowledge is the one that I have gained in my personal life, in school, and in the process of practice. According to Brugger and Madison (2015), our knowledge helps us to establish authentic and therapeutic relationships that propel us towards integrity and wholeness.
This knowledge has helped me to develop a moral code, a sense of differentiating what is wrong and right. My personal ethics is mainly based on obligations of protecting and respecting human life. Ethical knowing is the one that guides my deliberate actions. The Code of Ethics for Nurses guides me to develop and refine my moral code. (Yanulavich, 2015) One of the greatest difficult decisions that I had to make based on my ethical knowledge was to decide whether I should provide euthanasia to a patient who had requested while his family was against such an action.
This is the knowledge that I have acquired from my research and goal facts. The knowledge is organized systematically into theories and general laws. This way of gaining knowledge is normally known as the science of nursing (Yanulavich, 2015). I employ this form of knowledge every day in my EBP to ensure being able to deliver customized care to every client.
Decision Making and Assessment process
On my duties of making a decision or assessing my clients am faced with a dilemma of how to manage various cognitive measures. Reflective thinking, intuition, critical thinking, and judgment are some of the things I have to control to come up an informed decision and assess the patient well.
I manage critical reflection through examining the underlying assumptions and radically doubt the validity of assertions, arguments, and facts of the case. Having proper critical reflective skills is crucial for nurses `to know how to act in given situations and avoid causing injury to the patient. For example, when dealing with the circulatory system, use of critical reflection can assist in generating new and scientifically based ideas on to deal with an individual client (Benner, Hughes, & Sutphen, n.d). Current research lacks clear difference between the circulatory system of men and women and the basic pathophysiology that is related to heart attack. In such situations, I have to apply critical reflection to know what to do although it might not be enough to make such a critical decision.
This is a problem-solving technique that heavily relies on my inner sense as a nurse. It helps me to understand and learn things without the conscious use of reasoning. When making a decision, intuition has to be applied carefully to avoid guessing that can lead to devastating results. In most cases, intuition is an important and legitimate aspect of clinical judgment gained through knowledge as well as experience (Benner, Hughes, & Sutphen., n.d.).
When a nurse applies an intentional thinking, a relationship develops among the attitudes, knowledge, and skills that are attributed to the nursing process, critical thinking, and problem-solving process. Implementing the nursing process offers me a creative approach to thinking and doing things to obtain, categorize, and analyze the data of a client (Benner, Hughes, & Sutphen., n.d). This helps me to take the best plan actions that will attain the needs of the client.
This is a decision-making process that helps nurses to develop the right nursing action. It helps me to know the best action to be implemented at the right time in the patients care. I use my clinical experience enable me to recognize patterns and cues that help to arrive at the best conclusions.
Five Competencies of IOM
The Institute of Medicine (IOM) was started in 1972 with obligation and responsibility of training all medical personnel needed in the country. IOM established 12 campuses that would assist it to delivery health care skills to all physicians across the country. According to IOM, there are many challenges facing health care sector, and they can only be addressed by changing various health care systems. The primary system that needs to change is the health care professionals who require having a common vision to provide customized individual patients. This strategy will facilitate the process of delivering quality care to the patients to cure chronic diseases that affect everybody differently. IOM established five major competencies that are intended to improve quality health care delivery across the countries.
Provide patient-centered care
As a nurse am supposed to identify, care, and respect the differences, preferences, values, and the expressed needs of the patient. I should also educate the patient on matters of his or her health. I should share the process of making a decision with my colleagues and management to make an informed decision (Greiner & Knebel, 2003). Moreover, I have responsibility advocating for disease prevention, promoting healthy lifestyles among the U.S populace.
Employ evidence-based practice
`I should participate in learning and research duties to ensure the continuation of research-based knowledge in the health care sector. I should educate patient to be able to manage herself and incorporate self-care behaviors in her life.
Work in the interdisciplinary teams
Nurses should work in close collaboration with their colleague to realize efficient care delivery. I have to collaborate, communicate, cooperate and integrate care in teams to make sure that care is delivered continuously and reliable. I should work in collaboration with other care providers such as laboratory personnel, doctors, pharmacist, and dieticians to provide reliable outcomes for patients with chronic ailments (Greiner & Knebel, 2003).
Apply quality improvement
I should identify hazards and errors in the health care; understand and execute basic safety design principles like simplification and standardization. Health care is evolving and needs to cater for emerging cases increase, and therefore, I should comprehend and measure the quality of care regarding process, structure, and outcomes depending on client and community needs. Lastly, to advance the quality of health care system, I should design and test interventions to fit the current requirements of the healthcare sector. The outcomes of a patient with chronic diseases such as diabetes depend greatly on how well a care provider remembers to update information every time a patient visits.
I should manage knowledge, mitigate error, and support decision-making by use of current and efficient information technology. For example, it is my responsibility of monitoring data entry and distributes outcome reports of a patient with a chronic disease such as diabetes. In case, I fail to fill such information every time a patient visit, it will be very hard to realize the expected outcomes (Greiner & Knebel, 2003).
The current research is tailored to ensure health care keeps on improving across the whole nation. Due to the increasing number of patients who need customized health care, the nursing role is evolving at a high rate and nurses are being given wide health care responsibilities. Caring for patients is becoming more complicated while many hospitals are becoming understaffed. As the society is becoming aged and rate of chronic diseases such as obesity, diabetes, and other conditions are increasing. Nurses should be ready to embrace these changes by looking for new knowledge through advancing their education to be deal with the current health need in the most efficient ways.
Benner, P., Hughes, R. G., & Sutphen., M. (n.d.). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville Pike, Bethesda MD.
Greiner, A., & Knebel, E. (2003). Health Professions Education: A Bridge to Quality (1st ed.). National Academies Press.
Tiffin, C. (2013). The Changing Role of Today's Nurses. HuffPost. Retrieved from http://www.huffingtonpost.com/charles-tiffin-phd/nursing-school_b_1384285.html
Yanulavich, D. (2015). Nursing: The Ways of Knowing. The Pulse. Retrieved from http://nurses.excelsior.edu/nursing-the-ways-of-knowing/
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