Evidence-Based Nursing Practice

Evidence-Based Nursing Practice

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Evidence-Based Nursing Practice

Evidence-based nursing practice mainly constitutes the incorporation of an issue resolution measure within the setting of patient care while pondering on the best possible evidence from research, the patient’s values and preferences, patient medical data, and clinical expertise as well as experience. The importance of evidence-based nursing practice involves the provision of high-standard quality care, which optimizes the outcomes of patients. Research continues to highlight improved results when best proof is utilized in relation to the presentation of patient medical care. Regardless of the awareness regarding the significance of practicing through the application of the best possible evidence, attaining and maintaining evidence-based practicum within the respective practice setting is challenging. In fact, studies show that the incorporation of the said practice within routine clinical practice is inconsistent. Practically, the issue of methicilin-resistant Staphylococcus aureus (MRSA) contamination is presented in this particular case. This is a rather recurrent problem in the nursing context and if modified may actually boost patient care. 

Irrespective of the awareness of the essence of practice founded on evidence, maintaining evidence-based measures within the nursing and medical context is difficult. The obstacles as well as the facilitators involved in practicing while applying evidence have been documented. The results can actually be classed into various subjects. The first of these comprises peer stress on perceived status quo. Accordingly, most medical contexts refuse to implement evidence-oriented practice in order to restrict change. Such practices normally doused in tradition instead of the best possible proof are known to be ‘sacred cows’ (Mellinger & McCanless, 2010). Hence, to transition proof to practice, many basic dimensions are required. These involve a critical review of the present evidence, assessment of present practice, creation of a tactic aimed at incorporating evidence-based change, and the appraisal of the conversion of proof into practice and results.

In order to attain excellence in practice, nurses in the critical care setting should embrace evidence-based practice as the accepted model. It is impossible to go on with clinical practice intercessions that fail to be facilitated by present optimal evidence, specifically if the said actions are ineffective and potentially dangerous. The practice problem identified in this case involves the ease of contamination associated with methicilin-resistant Staphylococcus aureus (MRSA). Foremost, this area is within the setting of nursing. Hence, a modification in the respective concern can lead to a considerable improvement in the realm of patient care. Secondly, the identified problem comprises an area whereby the proof and the tradition fail to agree and as such, practice persists with the setting’s tradition. Based on the grounds outlined above, the unchanged practices addressed are particularly the infection control measures that are applied in order to restrict or avert infections associated with MRSA contamination.

Generally, medical-care attained infections distress an approximated 4.5 out of each 1000 admissions to the hospital (Scott, 2009). The prevention of contagions that take place during the process of hospitalization – for instance, infections associated with surgical sites – is imperative in the provision of high-quality patient care. Furthermore, limiting the dissemination of organisms that are resistant to multi drugs is significant as well. The prevention of infection and applications aimed at controlling them is normally implemented by healthcare personnel. Additionally, the suspected sacred cow is associated with the regularity in which workers such as nurses carry out or fail to operate preventative measures, including failure to wear protective gear when entering isolation rooms or hand hygiene. Over the last thirty years, the increasing occurrence of multidrug resistant organisms (MDROs) such as MRSA in hospitals based in the United States has negatively posed an impact on patient safety (Gaspard et al. 2009).

Accordingly, MDROs such as MRSA are connected to increased lengthy stays for patients, mortality, as well as hospital costs. The consistent application of preventative approaches towards the related infections is significant in safeguarding the patients and managing the dissemination of infections within the practice contexts associated with critical care. Nonetheless, regardless of long-term research and proof facilitating interventions aimed at averting infection, the translation of evidence among medical care personnel into routine practice is minimal. One basic aim in healthcare involves the prevention of Health-Care Acquired Infections (HCAI). In the event that an infection takes place, a sequence of actions is implemented in order to handle the dissemination of infection towards other patients. Additionally, certain interventions have to be applied constantly by medical care personnel for purposes of preventing infections. If the infections have already spread, the obligation of the workers should involve controlling the dissemination from taking place further.

Evidence-based concepts involving the deterrence of infection comprise four specific tenets. These comprise hand hygiene, boundary precautions, the sanitization of the environment, objects, and paraphernalia, and lastly, antibiotic stewardship. However, in the case of MRSA, the main tenet involves decontamination of paraphernalia, items, and the setting associated with the respective MDROs. Combating MRSA continues to be an integral facet for most healthcare services, especially long-term medical care facilities (Gaspard et al. 2009). Once identified, the dissemination of these organisms should be thwarted. Presently, the movement and placement of patients within geriatric facilities and critical-care environments is monitored rarely on a systematic basis. Moreover, in events involving asymptomatic carriers, the application of quality preventative measures is normally the only alternative form of control for regulating the spread of MDROS on a wide level (Gaspard et al. 2009). In this specific setting, the contamination of clothing worn by faculty constitutes an imperative aspect in medical care facilities that support recurrent contact between the patient and the nurse.   

In most cases, the contamination of clothing via MRSA exposure is common. Accordingly, uniforms worn by medical staff, especially attending nurses, acts as a significant vector for disseminating these MDROs. Possible considerations assert that the effects are even more considerable since the respectve clothjing may act as a viable source for hand contamination via onward transmission. The settings of patients colonized or affected by MDROs such as MRSA recurrently become contaminated. Certain studies specifically concentrated on the clothing worn by the staff in order to indicate this occurrence (Gaspard et al. 2009). Care in healthcare environments, such as long-term medical care facilities involve numerous instances of high close contact between the patients, the staff, as well as their respective environments. This further explains the considerable levels of contamination noted in various practice studies. Additionally, such high levels of contamination can operate as a source since the pockets on the clothing and the contents can contaminate the hands of the caregivers (Gaspard et al. 2009).

In conclusion, information regarding and conformity to barrier preventative measures as well as interventions by care workers to lessen environmental contamination via MRSA are imperative in preventing the dissemination of infection. Every thing that the nurses encounter, including the uniforms in the event of a work period, acts as a possible contaminated surface. In order to lessen the reach of MDROs, nurses need to practice preventative measures such as washing uniforms disjointedly from normal clothing, submersion of uniform in washing, tumbling, and even ironing in order to prevent the respective infections from disseminating among the nurses and the patients as well.

References

Gaspard, P., Eschbach, E., Gunther, D., Gayet, S., Bertrand, X., & Talon, D. (2009). Meticillin-resistant Staphylococcus aureus contamination of healthcare workers’ uniforms in long-term care facilities. Journal of Hospital Infection, 71(2), 170-175.

Mellinger, E., & McCanless, L. (2010). Evidence-based nursing practice in the perioperative setting: A magnet journey to eliminate sacred cows. AORN Journal, 92(5), 572-578.

Scott, R. D. (2009). The direct medical costs of healthcare-assisted infections in US hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/hicpac/HAI/pdfs/hai/Scott_CostPaper.pdf

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