护理科研中的循证实践研究

Paper代写范文:“护理科研中的循证实践研究”,这篇论文主要描述的是在护理医学领域当中我们会接触到一个专业性的词汇,那就是循证实践,也有人称之为循证医学,循证实践主要讲述的就是针对不同的病人制定不同的实践方式,践行着以人为本的社会医疗保健体系理念,让医护人员能够为病人提供更加优质的医疗保健服务,循证实践所强调的步骤严谨,能够让病患们得到更加专业的治疗服务。

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引言——Introduction

The association of American Medical colleges and six other schools of health professions met in the year 2009. They formed what would be a collaboration to encourage meaningful professional education (Schmitt, et al., 2011). They all convened a team of experts from various fields. These were medicine, nursing, pharmacology, public health, dentistry and pharmacy. The main aim for the convention was to develop core competencies for professional collaborative practice. They developed five main competencies which would prepare health professionals to effectively and intentionally work together. This would help form a health care system that is safe, person-centred and community-oriented (Schmitt, et al., 2011). The five collaborative competencies are patient cantered care, Interdisciplinary teams/multidisciplinary teams, Evidenced-based practice, Quality improvement and Information technology. These five competencies form the foundation for health professional to work with patients, families and the community at large.

循证实践——Evidence based practice

Evidence based practice refers to applying the most excellent research evidence in the provision of health care, education services and behaviour for outcome enhancement. Evidence based practice has emerged from the medical field. Health care professionals have conducted numerous researches, and randomized control trials to find an effective way in enhancing medical care (Alspach 2006). This has however, been a challenge since nurses have found it to be a challenge in incorporating the findings into direct practice with patients. The institute of medicine IOM defines evidence based practice as the incorporation of excellent research evidence and clinical proficiency with patient values (Majid et al., 2011). Health care providers around the world are embracing evidence-based practice as a global effort to fabricate quality and accountability in the field of medicine.

Evidence based practices are the skills, strategies and techniques used by health practitioners to interact with their patients. This helps the medical practitioners to provide an effective treatment program that will enable the patient to get good health. Evidence based practice enhances program outcomes in the health sector (Majid et al., 2011). Through this evidence based practice, health practitioners will acquire the required skills and knowledge needed for them to work together to offer the best medical care. EBP also builds on mutual respect, shared values, responsibilities and effective communication between health practitioners and their patients (Majid et al., 2011). Evidence based practice improves team work and provides transformative directions for the improvement of the health care systems across the world.

循证实践与护理专业之间的关系——Relation of EBP to the nursing profession

Evidence based practice provides nurses with ways to use critically appraised, scientifically-proven evidences in the delivery of quality health care for the sick. Through evidence based practice, nurses are able to explore the empirical ways of understanding, appraising and applying data in treating their patients (Alspach, 2006). Evidence based practice helps nurses to understand their patients, which help them to improve their decision-making on how to handle their patients. Evidence based practice provides nurses with a way to address and frame questions that they direct to their patients (Alspach, 2006). This helps the nurses to understand the patients and their principles. The result of this is that the patients would receive the best possible medical care.

Historically, experiences and opinions of health care providers influence how they cared for their patients. Evidence based practice, however, changes this perspective. Decisions on how to treat patients now depends on the evidences gathered through data extracted from prior studies and research. Evidence based practice (EBP) prohibits nurses and other health practitioners making assumptions about their patients without solid evidences (Alspach, 2006). The danger in assuming details about the patients’ health is that this would lead the nurses to offer wrong treatments to patients. Nursing practice based on solid evidence gathered through (EBP) evidence based practice improves patient care (Alspach, 2006). Nurses should refrain from using traditional ways in caring for their patients. It is essential for nurses to conduct thorough research to ensure that the evidence they gather is solid and correct.

For effective implementation of evidence based practice, nurses need to apply plausible evidences to each client situation. They should do this through the use of clinical judgements, searching related evidences, using system resources and considering client values. There are certain abilities that a nurse need to posses in order to carry out effective evidence based practice. These abilities include identification of knowledge gaps, formulation of relevant questions and efficient literature research. Other vital skills needed are application of rules of evidence, appropriate application of literature findings to patients’ problems and capacity to allow the patient take part in the decision making.

A patient needs to know what the nurse decides and should be able to offer his own opinion on the decision (Alspach, 2006). Some barriers may limit nurses from conducting effective evidence based practice. These are not having the authority to amend patient care procedures. Doctors are the only people with the authority to change care procedures. Nurses are busy people and, therefore, may not have the sufficient time to implement new ideas. Other limiting factors are that nurses may lack access to information technology, limited information technology skills and lack of effective information searching skills.

循证实践实例与应用——Example of EBP and application

There are several examples of evidence based practice in nursing, psychology,medicine and other medical practices. They include use of patient centred approaches, such as bio-psychosocial illness model. Patient centred approaches (PCA) have recently gained high pReference from both the patients and medical providers. According to Langendoen (2004), patient centred approach enhances attainment of intended health outcomes in patients and improves efficiency of health care services since it minimises the use of various procedures such as diagnostic assessments and referrals. Empirical research findings show that patient centred approach offers an intuitive form of care, which influences the treatment outcome positively compared to other types that are characterised by   lack of empathy, such as model centred care (Langendoen, 2004).

Health care provider recommends patient centred approach for various reasons.  First, the health care provider is capable of exploring the reasons of the patient’s visit and the concerns of the client, which enables him or her, get an integrated understanding of the patient’ world. In this case, the health care provider is able to establish the emotional needs and life issues of the patient. This facilitates establishment of a common ground between the patient and the healthcare provider on management of the condition as well as in the identification of the underlying ailment. Patient based approach is also highly recommended because it enhances prevention of ailments in addition to health promotion.  It is lays the basis of establishing a continuous patient – nurse relationship, which greatly enhances the attainment treatment objectives, within a realistic timeframe and resources (Langendoen, 2004).

Use of family therapy in treatment of adolescent behavioural problems is another example of evidence based practice. The practice basically has proven to be effective in addressing adolescent behaviours such as character problems, substance abuse and delinquency among others (Hogue & Dauber, 2013). In addressing adolescent behaviour problems, family therapy basically focuses on two critical areas. The first is emphasis on the core family therapy intervention technique to address the adolescent behavioural problem. Some of the techniques include meeting different family members of the affected adolescent in the sessions, establishing a family oriented approach of addressing the problem and the specifying treatment objectives, which are family based. In addition, family therapy seeks to bring in-session change within the family interactions, with an objective of streamlining strained relationships, so as to promote interpersonal interactions, attachment and communication (Hogue & Dauber, 2013).

This approach is based on empirical findings which show that enhancing family interactions, enables the family to develop effective problem solving mechanisms, which in turn enhances parenting behaviours. The second focus of family therapy in addressing adolescent behaviour problems is an ecological orientation that entails active intervention of extra-familial systems that influence the behaviour and conduct of the youth. These systems include the community, school, and peers among other systems, through which the adolescents acquire and show clinical and behavioural problems. Application of family therapy, in addressing adolescent behavioural problems is formulated on empirical research findings which demonstrate profound influence offamilial and extra-familial environment on development of deviant behaviour in children and adolescents (Hogue, & Dauber 2013).

总结——Conclusion

Evidence based practice is a crucial process that medical practitioners such as nurses should undertake. Application of evidence based practice leads to affectivity in treatment of patients. This is because EBP enables medical practitioners to find out what exactly is troubling their patients. This knowledge enables them to come up with a treatment suitable for the patient concerning his or her medical situation.  Nurses should embrace the use of evidence based practice in their daily activities. This will enable them to offer the best treatment and care to their patients.

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