Over the last two decades, evidence-based practice has been developed in a gold standard for global healthcare planning and delivery. The aim of integrating EBP in healthcare system was to facilitate the provision of optimal care by offering care services that utilize the current best medical practices, cost-effectiveness, and meet patient preferences. Notably too, EBP was originally designed for clinicians, but the concept has been extended to adjacent fields such as allied health and public health professions. In German, there has been attempts to integrate evidence-based practice in patient counseling and advocacy. Unfortunately, there is limited knowledge about the success of this attempt within the German Healthcare system. The study by Altin, Passon, and Kautz-Freimuth (2015) seeks to identify the important determinants that influence the application of evidence-based practice in counseling and patient advocacy programs in Germany. Through a qualitative study, the authors performed a face-to-face expert interview with patient counselors and patient advocates. The interview manual was based on an existing literature review on barriers and facilitators of EBP in healthcare. The interview was analyzed using Grounded Theory Method and a paradigm adapted to present the relationship between barriers and facilitators of EBP and the attitude towards its utilization in patient counseling and patient advocacy. The results found that patient counselors and advocates did not recognize EBP as a tool to facilitate professionalization of patient counselors and advocates. The study found that various institutional barriers such as attitude, professional, cognitive-behavioral, and system barriers hindered the application of EBP in patient counseling and advocacy.
Within the healthcare setting, the evidence is defined as the availability of knowledge to decision makers and scientific reference to the assessment of performance. As a result, evidence-based practice has emerged as a marker for quality of care. According to Shafiei, Baratimarnani, & Goharinezhad (2014), EBP is critical to improving the quality of care delivered in a healthcare. The article recommends that nurses should use EBP in their practice to assess their skills, develop, and implement policies and procedures, as well as perform effective clinical interventions for improved and positive healthcare outcomes. Unfortunately, nursing faces challenges implementing EBP in their practice. A complex set of skills, information evaluation, critical appraisal of information, and implementation of the outcomes in patient care process is necessary to use EBP knowledge in nursing. Evidence indicates that only a small percentage apply EBP in their practice. Several factors are associated with the reasons why nurses do not apply EBP in their practice, and in response to this, the study focused on measuring the practice, attitude, and knowledge/skills of EBP practice in nursing in a teaching hospital in Iran. The cross-sectional study was quantitative research and used questionnaires to collect data. Descriptive analysis was used in data analysis and Pearson correlation coefficients used to evaluate the relationship between subscales.
Which type of research article did you find easier to understand? Explain
Quantitative research. Ideally, the difference between qualitative and quantitative research is that the latter uses statistics in data analysis and presentation of findings. Most people tend to fear statistics because they believe it is math and it is hard. However, in this case, the numerical data used in the study were relatively straightforward and posed no difficulty understanding the figures.
If you had to complete a research project which style would you choose and why?
Quantitative research. Quantitative research involves manipulation of pre-existing statistical data using computational techniques to generate results about a specific study. Although the method is complex and time-consuming, the coding involved in the study gives additional information makes it possible to do further analyses, which is otherwise absent in qualitative, which improves the reliability of the quantitative study.
Health Reform Letter
United States Senate
[State, & Address]
Re: Shortage of Nurses in the United States
The United States has been experiencing nurse shortages for decades. Unfortunately, an aging population, an aging nursing workforce, the limited capacity of nursing schools, and the rising incidence of chronic diseases is likely to escalate the issue to a crisis with worrying patient implications. Ideally, the country’s 3 million nurses make up the largest segment of the healthcare workforce. However, despite that growth, demand is outpacing supply and it is expected that by 2025, the demand for nurses will be significantly high.
The nursing shortage in the United States has affected every aspect of healthcare delivery. For the nurses, those who remain in the workforce will most likely find themselves in high demand but with significant costs. The nurses are also likely to experience heavy workloads that are physically and mentally exhausting. Due to the increased workloads, there will be increased job dissatisfaction, stress disorders among nurses, which will be reflected in their job performance. There may be a high demand for highly specialized nurses as hospital care attends to chronic patients. Nurses who are currently working may also be forced to go back to nursing school to gain more knowledge and training to be able to compete with trained new graduates.
Lack of adequate nurses has an inevitable negative impact on the quality of care delivered to the patients. Consequently, there is a direct relationship between patient mortality and nurse shortage. Nurse shortage also leads to the workload on the existing workforce, which can increase medical errors. Overall the nurse shortage affects the delivery of care and leads to increased medical errors, high mortality rates, which is reflected in the community that relies on the local healthcare facilities for delivery of quality care.
Altin, S., Passon, A., Kautz-Freimuth, S., Berger, B., & Stock, S. (2015). A qualitative study on barriers to evidence-based practice in patient counseling and advocacy in Germany. Bmc Health Services Research, 15(1), 1-9.
MacPhee, M., Dahinten, V., & Havaei, F. (2017). The Impact of Heavy Perceived Nurse Workloads on Patient and Nurse Outcomes. Administrative Sciences, 7(1) 1-17.
Olsen, L. A., Goolsby, W. A., McGinnis, J. M., & Institute of Medicine (U.S.). (2009). Leadership commitments to improve value in health care: Finding common ground: workshop summary. Washington, D.C: National Academies Press.
Patlak, M., Levit, L. A., & National Cancer Policy Forum (U.S.). (2009). Ensuring quality cancer care through the oncology workforce: Sustaining Care in the 21st century; workshop summary. Washington, D.C: National Academies Press.
Shafiei, E., Baratimarnani, A., Goharinezhad, S., Kalhor, R., & Azmal, M. (2014). Nurses’ perceptions of evidence-based practice: a quantitative study at a teaching hospital in Iran. Medical Journal of the Islamic Republic of Iran, 28(135), 1-7.
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