According to the Registered Nurse Standards for Practice (2016), what is the role of evidence based practice in the nursing profession? (100 words±10% , 4 marks). Needs referencing.
Evidence based practice (EBP) holds the future of effective health care that support more probability of greater health and well being of the public(Mazurek Melnyk, 2016). EBP is crucial to the nursing profession because it bridges the gap between what nurses know and what they can do to do to provide effective care to the patients. Currently, a gulf of difference exists between the nursing practice and decision making that result the nursing care. EBP in nursing is aimed to empower the decision making which is supported by the best case practices in order to mitigate the fatalities that can be avoided. EBP brings a paradigm shift in improving healthcare effectiveness and creates a platform of knowledge sharing and learning in order to improve the quality of care given to patients.
How can the Evidence Based Practice Model enhance nurses’ clinical decision-makings? (100 words±10%, 4 marks). Needs referencing.
Evidence based practice model brings transparency and accountability in the nursing sector. The clinical decision-making process is complex and involves a high risk of patents safety and wellbeing as well as the professional career of the nursing practicians. EBP model aims at integrating the research evidence with that of clinical experience and pays attention to the individual care strategy of the patients. Clinical decision making based on evidential based practice also takes into account the patients preferences in terms of a right-based approach. Evidence-based practice model support culturally safe healthcare practices and promotes clinical decision making as per the safe cultural limits of Aboriginal and native peoples which are often the most vulnerable to receive the quality healthcare.
One of the components of Evidence Based Practice is consideration of the patient’s values and preferences. What does this mean? Using an example, explain the importance of this component (100 words±10%, 4 marks). Needs referencing.
EBP is a part of new nursing guidelines which demands a balance in decision making from healthcare concern as well as patients preferences in the care system. Understanding the patient’s values and preferences and integrating them in the clinical decision making means giving value to the patients viewpoint about the his health condition, understanding the circumstances from the patient and his family in order to do good with the care provided to the patient(Siminoff, 2013). Integrating the patient preferences in action-based care is the ideal process of creating a shared decision-making framework where information and awareness of the patient’s condition are crucial. EBP, when integrated with the patient preferences, results in improved understanding of the risks enhances the communication between nurses and patients and gives positive hope to the patient about the quality of the care received by patient(van der Weijden, et al., 2010).
Reflecting on your last clinical placement or clinical work experience, explain four barriers and four enablers to the implementation of evidence-based practice in the clinical settings? (100 words±10%, 4 marks).
EBP based practice in clinical settings is a challenging task. There are challenges and motivators to the EBP framework listed below from the personal experience:
- Lack of communication and trust-building between patient and nursing staff.
- Lack of desired change management in the clinical settings w.r.t EBP(Mathieson, Grande, & Luker, 2018)
- More focussing towards learning from research rather than evidence-based learning’s.
- EBP face challenges from the patient preferences, as well as the patient’sfamily and friends.
- Healthcare equality can be achieved using EBP.
- Enhanced patient-centric care.
- Foster individual development of clinical staff.
- EBP promotes international quality care
Why are randomised controlled trials considered to be ‘higher level evidence’? (50 words±10%, 1.5 marks). Needs referencing
Randomised controlled trials are assigned a higher value because of their credibility to be free from systematic errors. During a clinical trial, using the RCT, the participants can be randomly assigned to one or more than one clinical interventions(Mazurek Melnyk, 2016). It is one of the most scientific and rigorous methods of formulating the research hypothesis feasibility during the testing.
Can you trust the results of this study? What are the strengths and weaknesses of this paper? (Hint: refer to the CASP for randomised controlled trials to guide you in the critical appraisal of this study) (200 words±10%, 9 marks).
The result of this study clearly shows that music has a positive side which brings numerous changes in the emotional and anxiety level of the person suffering from the disorder. The Random control trails method was also an important part of ensuring scientifically valid results were achieved. Music therapy is considered to be a crucial part of standard care for the peoples with mild, moderate and severe depressive experiences. From the results, it shows that music therapy is a successful cost-effective standard care(Siminoff, 2013). Strong empirical research evidence was given by this study in favour of the depressive peoples.
The primary weakness of this research was the lack of defined clinical procedure to be used on the RCT’s who were given music therapies. The random control trials participants were not considered on the diversity of their age and gender. Thus, it is appropriate to say that the main weakness is the research methodology which further questions the results. Using the RCTs for the music therapy groups gives rather unique and rare results which are questionable from certain points such as it lacks the connection between the clinical methods for the control group and music therapy group. Also, the use of quantitative research methods does not ascertain the clinical methods conventionally used for the depression based research.
Was music therapy effective in treating the depression of the patients? (Hint: present and interpret the results for depression outcome- see Table 2 for the summary of the results- you need to consider the results for intervention and control groups, whether the difference between these groups is statistically significant, and if the estimation of the results for the wider population is precise (100 words±10%, 5 marks)
Table 2 is documenting the changes in primary and secondary outcomes within the music group and the control group for the baseline period of 3 to 6 months. The results of Table 2 clearly show that music therapy was successful in treating depressed patients. Table 2 signify that results outcomes for the music group were far greater and significant as compared to the control arm in the indicators of MADRS, HADS-A, and GAF scores.Also, the graphical analysis from Table 2 showsan odd ratio (OR) = 2.96 highlighting the greater results in the music group when 3-month period is analysed for all the psychiatric levels.
Would you recommend music therapy for patients with depression? (Justify your answer taking into consideration the benefits, harms, and the cost of the intervention) (100 words,±10% 3.5 marks)
Depression is one of the most common disorder creating wide-reaching impacts related to social disorder, degraded quality of life and increased mortality. The recommendation of the music therapy is beneficial to the peoples having the depressing disorder as the therapy involves the music which helps calm the emotional mood and expression as well as for the purpose of therapy personal communications needs to be established. The positive impacts of music therapy include reducing depressivesymptoms and controlling anxiety. The music therapy is also a skill-based activity which is available in cost-effective charges.
Mathieson, A., Grande, G., & Luker, K. (2018). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary health care research & development, 6(2), 34-67, doi.org/10.1017/S1463423618000488.
Mazurek Melnyk, B. (2016). The Doctor of Nursing Practice Degree= Evidence‐Based Practice Expert. Worldviews on Evidence‐Based Nursing, 13(3), 183-184, doi/abs/10.1111/wvn.12164.
Siminoff, L. (2013). December. Incorporating patient and family preferences into evidence-based medicine. . In BMC medical informatics and decision making, 53(13), 56.
van der Weijden, T., Légaré, F., Boivin, A., Burgers, J., van Veenendaal, H., Stiggelbout, A., . . . Elwyn, G. (2010). How to integrate individual patient values and preferences in clinical practice guidelines? A research protocol. Implementation Science, 5(1), 10, doi: 10.1186/1748-5908-5-10.
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