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Evidence-Based Practice in Emergency Care

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Evidence Based Practice in Emergency Care
15.03.2021
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The purpose of the research paper is to investigate how emergency care departments use Evidence-Based Practice (EBP). This aim will be achieved by explaining the importance of EBP in nursing, the importance for nurses to understand research methods while implementing research evidence, and revealing how nurses use EBP globally. The research shows that EBP enhances the standards and quality of care that nurses give their clients significantly. It also improves the nurse’s compliance to protocols, while reducing the time they spend administering drugs to the patients. Since the patients in the emergency units suffer from acute conditions, nurses should make speedy but careful decisions. Understanding research methods empowers nurses to choose evidence for practice that is most reliable and valid. The study concludes that nurses in the emergency care departments should use EBP. It is caused by the fact that the evidence reveals that it has promoted the quality of care, reduced hospital stay and costs in Canada, and resulted in better treatment of end-of-life patients in Hong Kong.

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Emergency care, which is the area of interest for the research paper, entails nurses handling high-risk patients who suffer from conditions or diseases that are potentially life-threatening (Dobrasz et al., 2013). According to Dobrasz et al. (2013), the clients who are under emergency care face consequences that can expose them to hospitalization, staying under care for an extremely long duration, and high chances of death. Dobrasz et al. (2013) discuss that through research, it became obvious that prompt assessment of the patients under emergency care and early intervention are some of the best practices for nurses and other healthcare staff members. Moreover, evidence indicates that it is imperative for nurses and the interdisciplinary leaders within the emergency departments to collaborate and use other stakeholders’ buy-ins as strategies for achieving safe processes with better patient outcomes (Dobrasz et al., 2013). Evidence-based-practice (EBP) is important for nurses because it yields the best practices that they can use to improve outcomes, minimize the length of stay for the patients, and reduce the mortality rates within the emergency departments.

Part A- Importance of Utilizing EBP in Nursing

Nurses should use EBP because it enables them to set the standards for assessing the patients using knowledge from research as evidence (Brown, 2013). While discussing the significance of using evidence-based practice in nursing, Brown (2013) explains how EBP enhances the quality of care for patients. The book discusses that EBP raises the quality of care that the patients receive from nurses by promoting the effectiveness and safety of the care through the incorporation of scientific evidence into the nurse’s protocols and standards (Brown, 2013). The crucial component of EBP is evidence, as nurses select the methods, standards, and protocols that they apply to their patients on the basis of the existing evidence on how they have worked in other settings.

EBP affects the quality of care delivery in specific ways (Brown, 2013). The area of emergency care requires EBP because nurses require reliable methods they are certain about. In addition, they should be sure of the specific ways, in which the approaches determine the outcomes. The unique aspect of emergency care is that nurses lack adequate time to consider different options of treatment. Dobrasz et al. (2013) study focuses on children within two emergency cancer departments of different hospitals. The main interest of the research was to evaluate the impact of EBP on the average time that nurses spend while administering drugs to cancer patients. The study revealed that incorporation of EBP in both settings reduces the time spent administering drugs to young cancer patients. The study lasted between 2008 and 2012 and during its duration, the time that nurses spent to administer the drugs in the first setting reduced from 103 minutes to 44 minutes (Dobrasz et al., 2013). Similarly, the time that the nurses spent in the second set of the study reduced from 141 to 66 minutes (Dobrasz et al., 2013). The nurses in both emergency departments improved their protocol compliance. In the first emergency department, the rate of complying with protocols increased from 24% to 78%, while the same rate changed from 30% to 84% in the second setting (Dobrasz et al., 2013). EBP benefits nurses because it improves their protocol compliance and reduces the time for administering drugs to patients.

Research has found that EBP improves positive outcomes and safety of children who receive treatment for traumatic brain injuries. According to Bridget et al. (2014), nurses who evaluate and manage children who present symptoms of acute brain injuries should follow the best practice guidelines in the process of identifying the intracranial injuries that require surgeries. They should also use the best practice guidelines when observing the potential damages that the injuries have caused, and provide handwritten advice concerning the management of the injuries (Bridget et al., 2014). The best practice guidelines come from evidence-based research studies. Brown (2013) discusses that nurses can achieve a high quality of care if they incorporate EBP into their work.

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Part B- Why Understanding Research Methods is Necessary for EBP Implementation

Nurses should understand research methods when implementing evidence-based practices because the approaches or methodologies that researchers use determine the accuracy of the findings. AHRQ is an example of an accredited national agency in the United States, which applies the best methods to find its evidence. Brown (2013) states that A great deal of ongoing data collection, analysis, and reporting is mandated by the certifying agencies (p.357). Such agencies include the Center for Medicare and Medicaid Services (CMS) and the Agency for Health Research and Quality, AHRQ (Brown, 2013). Brown’s emphasis on the need for nurses to receive their best practice guidelines from the accredited agencies follows the fact that they use highly objective research methods that yield evidence with high reliability.

The study by Boatright, Holcombe, and Replogle (2015) is typical research that demonstrates the significance of considering research methods during EBP implementation. Firstly, the research’s methods section explains that the study happened after receiving its approval from the Institutional Review Board (Boatright, Holcombe, & Replogle, 2015). Secondly, the section explains how the researchers collected their data. They used electronic medical records (Boatright, Holcombe, & Replogle, 2015). The study also used inclusion criteria to select 100 participants from 288 patients that they identified using the inclusion search strategy. The study systematically explains the procedure or methods that the researchers used to locate the respondents, obtaining the data, and analyzing and translating it (Boatright, Holcombe, & Replogle, 2015). By considering the methods of the study, nurses can determine the reliability and validity of the findings, which are core components that they should consider when choosing the kind of evidence to use in EBP. It is unlikely that all the findings from studies are reliable and valid, but it is impossible for nurses to understand these aspects without appreciating the methods that the studies employed.

Part C- How Nurses are Utilizing Evidence-Based Practice around the World

The application of EBP has become popular globally, as different non-USA countries use it to improve patient safety and outcomes. Black et al. (2015) researched evidence surrounding Canada’s promotion of EBP among its clinicians by training them using a research program. Tse, Hung, and Pang (2016) explain how EBP is transforming the provision of end-of-life care in Hong Kong. Both studies focus on the emergency departments where nurses use research evidence to improve the quality of their care for patients.

Canadian nurses have improved the results for their patients, increased their safety, and reduced their stay in the emergency departments by tailoring their practices in an evidence-based manner (Black et al., 2015). Other benefits that the nurses in Canada have achieved from using EBP in their emergency care units are reduced healthcare costs and lowering the differences in patients’ outcomes (Black et al., 2015). As part of promoting the effective use of EBP in the emergency departments, nurses have conducted researches that have identified the barriers to proper utilization of evidence at individual and organizational levels (Black et al., 2015). Some of the drawbacks that hinder nurses from using EBP appropriately within the Canadian emergency care departments include inadequate competence about the research process and the methods of critiquing scientific studies (Black et al., 2015). At the organizational level, the barriers are a lack of hospitals’ dedication to implementing new knowledge, low accessibility to research findings, and lack of information about the educational tools that are related to research (Black et al., 2015). The challenges undermine the effective use of EBP.

Despite the existing challenges in the use of EBP in Canadian emergency units, Black et al. (2015) survey report that the application of evidence-based practice in the acute care settings. One of the perceptions from participant notes shows that EBP encourages the clinicians to seek solutions to how they can promote the quality of care using research evidence (Black et al., 2015). Another participant in the study observed that EBP promotes consciousness about the methods that nurses select and how they affect the patients (Black et al., 2015). It is apparent that EBP has transformed the ability of Canadian nurses to care for their patients in new and better ways.

EBP has improved the way emergency nurses in Hong Kong provide their care services to end-of-life patients. EBP has empowered the nurses around four major areas that include doing what is ethical to the dying patients, engaging the family of the end-of-life patients while caring for them, facilitating the nurse’s personal development and professionalism around caring for the dying patients, and communicating ambiguity towards the available resources for handling the acutely sick people (Tse, Hung, & Pang, 2016). The study evaluates evidence surrounding the four areas to determine the impact of EBP in the emergency departments with terminally sick people.

However, the use of EBP in the acute care settings with end-of-life patients is different from the ones where recovery is expected. According to Tse, Hung, and Pang (2016), the motive behind promoting the quality of care for EOL patients is to give them friendly experiences at the dying stages. For example, the participants in the study, who were the emergency nurses, stated that it was difficult to determine the duration of stay for such patients (Tse, Hung, & Pang, 2016). It was also challenging to meet the exact needs of the patients because the quality of their services to the patients varied and changed according to the duration of stay, which remained indefinite (Tse, Hung, & Pang, 2016). Nevertheless, the researchers concluded that the emergency departments in Hong Kong and globally should incorporate end-of-life care into their emergency departments and use research evidence to tackle the challenges.

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Part D- Conclusion

Nurses in emergency care should inculcate EBP because it reduces the length of patients’ stay in the hospital, promotes the safety of the patients, and reduces the rate of mortality. EBP is important for nurses because it greatly improves the quality of care for the sick, while nurses also use it to set the standards for assessing the patients on the basis of evidence. Using EBP guidelines, emergency care nurses can immensely reduce the time for administering drugs to their clients. It also promotes their compliance with protocols.

Nurses should understand research methods as part of implementing the findings of EBP. The knowledge enables them to critique, evaluate, and select reliable and valid evidence. EBP’s popularity has grown worldwide, though with some challenges. In Canada, EBP has enabled nurses to promote patient safety. It has also reduced their hospital stay and costs, among others. However, nurses face some challenges, e.g. inadequate competence about research methods. EBP has helped Hong Kong’s emergency departments to improve the quality of care for end-of-life patients. Therefore, EBP transforms the abilities of nurses in the emergency care units positively.

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