Challenges and Opportunities for Evidence Based Practice

take exceptions and Opportunities for Evidence root word PracticeIntroductionIn recent years Evidence-based class period (EBP) has been advocating in treat profession, however until now there all the same encounter umpteen a(prenominal) difficulties, conflict impact on evidence-based practice provement. In this essay willing be discussed the con head for the hillss and opportunities of future direction of evidence-based practice in breast feeding.EBP is a conclusion make approach introduction in 1992. Sackett et al. (1996) state that EBP is a stovepipe evidence method of health care decision make which gist to ruffle sources from look into findings, clinical expertise and consideration of client preferences, clinical setting and a nonher(prenominal) external factors much(prenominal) as cost. (as cited in Hewitt-Taylor, 2002). EBP is a scientific and systematic process rather than handed-down approach such as customs, rituals and authority from transmission to mitigate quality and efficiency of tolerant outcome (Shaneyfelt et al. 2006). disputes sewer be defined as barriers, difficulty during deem the evidence-based practice in nursing. Actually, there are many disputes of EBP development, in the denomination will try to divide into four geeks to discuss altercate of the contain, Challenge of the clinical environment, Challenge of the look into and Challenge of the fundamental law. The power of opportunities is to analysis how to improve or diminish the gap between research evidence and clinical practice, and discuss the factors that jock for the future direction of EBP in nursing.ChallengesChallenge of the concur,Challenge of the nurse relate to the nurses beliefs or attitude to EBP, lack of understanding, companionship and skills of EBP. A recent study (Oranta, Routasalo Hupli, 2002) indicated nurses have divergence the jimmy between research and practice some nurses have conservative ideas that do not delicious change the nursing practice. The result reflect nurses have misunderstanding or negative attitude about evidence based care which whitethorn create wrong belief i.e. indifference or ignore the value of EBP. Nurse unawareness of research, are not familiar with EBP, and no spirit improve the knowledge, not to mention to fulfil it in clinical care. (Hutchinson Johnston, 2004 Wang, Jiang, Wang, Wang Bai, 2013). Attitudes ask behavior, if nurse attitude remain unchanged, would increase degree of difficulty to dribble out EBP in the future.Lack of skills implementation of EBP alike a large challenge facing by nursing (Majid et al. 2010 Hutchinson Johnston, 2004). There are nine-fold components of EBP complicate asking suitable questions, selecting the best pertinent entropy, evaluating the evidence and integrating of patient preference, research evidence etc.in clinical decision making (Shaneyfelt et al. 2006). Nurse requests ability of desegregation and critical appraisal resea rch skills i.e. information seeking, understand statistical terms, implementation to run through the EBP process. Provide grooming and training for EBP should be an important concern in the future for nurse.Challenge of the researchNext challenge point related to research. Nurses always opine articles from journal are not readily available (Chau, Lopez Thompson, 2008 Gale Schaffer 2009 Wang et al. 2013). Actually findings from different research may not always have high take aim of reliability and validly, methodologies and presentation inadequacies or misconception may exist. Nurses probably feel upturned and difficult to appraisal quality of findings, research reports are lengthy, include many academic, jargon terms and statistical analyses ca consumption difficult to comprehension (Oranta, Routasalo Hupli, 2002).Further more than, research finding usually not publishes fast enough and lack of rule of thumb to implement in the clinical practice. Develop the research disse minate type to improve clinical utilization is a main direction in future, otherwise presentation of researches increase barrier to use finding in patient care, eventually obstruct EBP implementation.Challenge of the clinical environmentclinical environment seem to be a liberal challenge which supreme restrict nurse implementing EBP (Lee, 2003). Most studies (Hutchinson Johnston, 2004 Gale Schaffer 2009 Wang et al. 2013) stated that nurses have lack of clock and heavy workload influences on utilization of research in practice setting. Take Hong Kong as an example, according to the survey conducted by Association of Hong Kong nurse Staff at 2013, the average of nurse-patient ratio117 (normal 14-6) in globe hospitals, the bed occupancy rate is 92.9%. Nurses not only have day-to-day heavy workload, also facing a serious shortage problem. judgment of conviction and labour restrict and clinical safety concerns, nurse tend to use traditional practices and cannot keep frequently f ollow update journals during functional (Hutchinson Johnston, 2004). The working environment resistant changing tried and definitely threats EBP utilization in future.Challenge of the organizationEBP is a complex and multifaceted process, cannot apply by individual, administrative support is very important. However lack of organization support is the common complaint by nurses. According to Chau et al. (2008) and Hutchinson Johnston, (2004) the most important challenge of research utilization are lack of authority and no cartridge clip to implement new ideas or involve research activity. These concerns related to the organization which include the setting barriers and limitations e.g. quantify, resources, support and mentoring.Besides, conservative attitude of organization such as lack of intention in changes or welcome new ideas must influences EBP utilization (Gale Schaffer, 2009). It would limit the development of clinical practice to implement EBP and take the health ca re qualities.In addition, nurse indicated that corporation with other originals also a barrier of EBP implementation (Oranta, Routasalo Hupli, 2002). Health care is a team working which involve many different professionals, such as physician, physiotherapist etc. during co-operation may cause differences of decision making. In traditional doctor has the most authority in clinical decision making, nurse advice may cause conflict or challenges by doctor. Therefore birth between medical and nursing is also an organization related challenge of EBP utilization.Although there are many challenges of EBP in clinical utilization, challenges creates opportunities, the following plowshare would analysis how to overcome some barriers between research evidence and clinical practice, and talk about the factors that relate to the future direction of EBP in nursing.OpportunitiesFirstly, upgrading of nursing education curriculum improve nurses professional status and research knowledge. breast f eeding students learn of EBP show more potential of ability on clinical decision making (Brown et al. 2010). Although the nursing programme in universities already include research skills teaching to implement evidence-based practice, transferring finding into clinical practice still a big problem for novice nurses. The curriculum should be include how to connect the EBP to the utilization, not just think the part of research skills training.Besides, base on shortage of nurse, there are different potpourri of organizations domiciliate nursing training such as nursing school, hospital nurse training courses, these courses more focus on clinical practice, but not include teaching EBP. At least the basic concept and skills of EBP should be educated in those courses which to improve knowledge of apply EBP into clinical practice.Second, solidarity and cooperation is also an opportunity to future direction of EBP. No matter clusters, hospitals or hospital ward in Hong Kong tend to wor king independently and lack of co-ordinate with other. To propose EBP should include cooperate and sharing. The hospitals or clusters can form some research groups from different hospitals or wards include senior and junior nurses to conduct research-related work. This kind of workshop would improve the stuffs ability to identify the clinical issues, review researches, analysis, uphold to implement research finding or conduct research etc. eventually improve the quality of nursing care.Third relate to organization, the inferiors heed the superiors if the organization have positive attitude to motivate and reward EBP can raise the awareness to the staffs pay attention to EBP (Gale Schaffer, 2009). To improve future develop of EBP, organizational should be modified the nurse ratios. Provide more time and facilities to encourage nurse for discussing and applying research finding in clinical (Lee, 2003).Fourth, facing of decreasing birth rate, the elderly increasing inevitable, agin g population already became a international problem, elderly care must pay more attention in nursing. Community services would be a big tendency and increase outreach services and day care services nursing care. Communities services for example community nurse and Nursing Clinic also help to relive the treatment cost, reduce stress and workload of front pull out nurse and bed occupancy rate. This situation closely relate to EBP because the reference of nurses become more arduous and specialization, the case nurse reserve professional health care services with integration, multifunction should have both evidence and knowledge to support the practice and patient outcome. The phenomenon nominates opportunity to EBP to walk out the hospitals and integrate into the communities.Fifth, in the future nurses implement EBP may not just focus on Western medicine, also include Chinese medicine. In topical years, popularity of Chinese medicine increasing in Hong Kong, most elderly tend to u se Chinese treatment such as acupuncture, qigong diet regimen. Chinese medicine research and the utilization on clinical should be part of concern in EBP when making decision. As favorable condition of geographics and culture in Hong Kong, combine Chinese and Western medicine would be a tendency, as a nurse should have the knowledge integration and application in clinical care.In conclude EBP utilization show a more scientific method to the clinical decision making lead to improve and maintain health care quality, it is definitely the planetary direction in nursing future development. Base on the repressive of policies and environment, working environment and organization seems to be two bigger challenges of EBP utilization. Although there are many challenges of EBP, different limitations from nursing and the external environment such as aging population, Chinese medication become more popularity etc provide some opportunities to indicate the future direction of EBP. Nursing prof ession requisite to sensitive to those factors, then appropriate to develop or improve, probably reduce the gap between clinical practice and EBP, also may provide a new direction for EBP in nursing utilization.