The nursing profession is indispensable for the provisions of services in the healthcare industry.Nurses are frontline healthcare workers who often have direct contact with patients, and consequently, they take many risks, especially in caring for patients with infectious diseases. Therefore, nurses have to abide by strict quality and safety protocols to keep their patients safe. Proper nursing policies have a lasting positive impact on the patient outcomes of a particular hospital.
The healthcare sector is wrought with many challenges that interfere with the ability of members of the healthcare workforce to provide optimal services to their clients. Many countries lack sound and efficient health policies to ensure that health systems run at their optimal capacity. Accordingly, nurses also face tremendous challenges in their careers. Most of these challenges affect the quality of services they deliver to their patients and, at worst, compromise the safety of both the nurses and their patients. One problem that has affected nurses, especially in their early years of practice, is difficulty in keeping up with new perspectives in healthcare to make justified clinical decisions and avoid medical errors (Ellis, 2019). Nurses should be open and transparent to scrutiny from both their peers and from members of the public. They should, accordingly, aim to utilize evidence-based practices to provide quality and safe care for their patients and to avoid unnecessary litigation for medical malpractice.
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The practice should be tailored towards a more justifiable outcome in a clinical setting. A clinician’s expertise, patient’s values, and preferences and studies that are well designed are all incorporated to provide the best evidence for clinical decisions. A number of methodologies rate the efficiency and effectiveness of evidence provided by a specific method of data collection, either a research study or a report. Currently, there are no strict guidelines on how all the factors should be weighed in the clinical decision-making process. Therefore, it is critical for nurses to have adequate skills and knowledge on evidence-based practices to choose with prudence, which study, report, or clinical practice guidelines to employ when making critical decisions about patient care.
Evidence-based information is divided into different categories based on input from nurse experts and other medical experts in the field. The categories range from the strongest to the weakest and guide the emphasis nurses should place on these sources of evidence. Randomized control trials offer a more vital evidence as compared to other sources. They also provide the best methods to collect evidence-based data about maternal hemorrhaging in the clinical setting. Randomized control trials are the gold standard for evidence in clinical practice. They can be replicated in different populations of mothers with hemorrhage, and this offers great credibility. In this type of research, pregnant mothers are aligned to various categories randomly and different tests are administered. The results obtained are thereby credible as bias is eliminated. Double-blind, randomized control studies provide better results than a yes or no survey conducted in a face to face interview. The face to face interview introduces bias from both the mothers and the researchers as the patient may say what they think the scientist will be happy to hear. The scientist may also incorporate their own bias in the data collection process.
Systematic reviews constitute the critical assessment of existing evidence that addresses the causes of maternal hemorrhage. Comprehensive literature research on the topic and the appraisal of the value of studies is done—a report of the results in a systematic manner to present all current knowledge. Statistical methods are then used to sum up and analyze information from many control experiments. Meta-analyses, therefore, have very strong credibility practice. The results reflect data from many studies on maternal hemorrhage and thus provide better estimates of the relation to the population than a single survey. Clinical practice guidelines are based on thorough reviews of existing evidence on specific topics (Leung, 2016).
Evidence from clinical cohort studies, case-controlled studies, epidemiological studies, as well as qualitative studies, also provide 2nd level evidence. Evidence from these research studies are good but not the strongest for making clinical decisions. Clinical cohort studies involve the study of a group of people who have common characteristics or exposure experiences. The outcome, in this case, maternal hemorrhage, is then compared between the exposed groups and the unexposed. The exposure status would be the complications that arise in pregnancy that may cause hemorrhage, for instance, eclampsia. The method is effective in establishing causal relationships. It can either be done prospectively or retrospectively to study the risk factors of maternal hemorrhage. An investigation form can be used as the data collection tool by medical staff who have received medical training. The maternal investigation form is monitored and filled from the day of admission. The data collected can be statistically analyzed and used to prepare the results. However, some pregnant women may decline to participate in the study, which would negatively impact the strength of the evidence.
Several EBP models can be used to make the process of translating research into clinical practice easier. The basic phases of the process include: Asking to identify a clinical problem, attaining relevant literature on the topic, and a critical appraisal of the evidence to determine the evidence hierarchy. The evidence obtained is then applied in the clinical setting, and the effect of the change is evaluated (Ellis, 2019). In the context of maternal hemorrhage, the feedback loop needs to be regularly evaluated because hemorrhage remains the highest cause of maternal mortality globally. The practice chosen should thereby be patient-centered and consultative with the different members of the team. The Iowa Model for Evidence-Based Practice to Promote quality care is fitting in this clinical setting as it addresses interprofessional change implementation is patient-centric and team-based. The method is very efficient for nurses working with mothers who experience hemorrhage as an interprofessional team is incorporated orated in all the phases from evidence collection to outcome dissemination (Farokhzadian, 2015). The multidisciplinary approach allows for a global approach to all problems that will result in the sustainability of change.
In conclusion, the ability to determine the credibility of evidence and resources to guide clinical practice is essential to all nurses. Nurses with the skills to critically evaluate evidence and make informed judgments provide a safer and higher quality of services to their patients. Competence in reviewing sources of evidence will also empower nurses to positively influence developments in care for their patients (Butler, 2016).
References
Butler, A. H. (2016). A qualitative systematic review on evidence‐based practice in nursing and health care. Worldviews on Evidence‐Based Nursing, 241-249.
Ellis, P. (2019). Evidence-based practice in nursing. Learning Matters.
Farokhzadian, J. K. (2015). Adoption of evidence‐based methods in nursing. Journal of research in clinical practice, 1107-1113.
Leung, K. T. (2016). Development of effective framework in the practice of nursing. Nurse Education Today, 189-196.
