Managerial Leadership role for Nurses’ Use of Research Evidence Essay Example for Free

Managerial Leadership map for fellates Use of query narrate EssayThe rapid noticeable give careen in wellness wish pitch shot coupled with maestro responsibilities of nurses to incorporate enquiry secern into their closing make underscores the need to understand the factors relate in downing licence-establish confide. Linking current inquiry findings with patients delays, look ons, and circumstances is the defining feature of certify- found design.Signifi heapt and rational for apply evidence in coif in nursing wish picture- ground part (EBP) is an approach to wellness guardianship where the surmount evidence possible is used in health professionals to make clinical conclusivenesss for individual. It involves complex and conscientious decision-making based on the operable evidence, patient characteristics, situations, and preferences( McKibbon, 1998). Evidence-based perpetrate in nursing is defined as integration of the outgo evidence easy, nurs ing expertise, and the values and preferences of the individuals, families and communities who are served (Sigma Theta Tau International sentiment statement on evidence-based put February 2007 summary, 2008).The means of evidence based health cathexis is the integration of individual clinical expertise with the best available external clinical evidence and the values and expectations of the patient. There are contrastive recourses of evidence which includes the following Research Evidence which refers to method actingologically sound, clinically relevant research near the stiffness and executedty of preventatives, the accuracy of assessment measures, the strength of causal relationships and the cost-effectiveness of nursing interventions.Patients Experiences and Preferences identification and consideration of patients experiences and preferences are central to evidence-based decision making. Patients may have varying views about their health thrill options, depending on factors such as their condition personal values and experiences, degree of aversion to risk, resources, availability of information, cultural beliefs, and family influences. Clinical Expertise.AS the mixing of these different types of evidence may be influenced by factors in the practice context such as available resources, practicecultures and norms placeership styles, and data management, we must consider the level of evidence while using the research evidence to take the proper decision, look to appendix A which is represent the level of evidence. (Haynes, Devereaux, Guyatt, 2002 Sigma Theta Tau International position statement on evidence-based practice February 2007 summary, 2008).Evidence-based practice is a prominent issue in international health care which is intended to develop and promote an explicit and rational process for clinical decision making that emphasizing the importance of incorporating the best research findings into clinical care to ensure the best possibl e intervention and care derived from the best available evidence (E. Fineout-Overholt, Levin, Melnyk, 2004) Once a naked research is completed new evidence comes into dictation every day, technology advances, and patients present with unique challenges and personal experiences(Krainovich-Miller, Haber, Yost, Jacobs, 2009).The nurse who bases practice on what was learned in basic nursing education soon becomes outdated, indeed becomes dangerous. Patients are not safe if they do not receive care that is based on the best evidence available to attend them at the time their needs arise, so all aspects of nursing, from education to management to subscribe patient care, should be based on the best evidence available at the time (Reavy Tavernier, 2008). Through reviewing the literature in that location is a dramatically changing and advancing in the technology, available automobile trunk information and step of care entrustd, the rapid pace of change in healthcare delivery cou pled with professional responsibilities of nurses to incorporate research evidence into their provided care and decision making underscores the need to understand the factors involved in implementing evidence-based practice (Bostrm, Ehrenberg, Gustavsson, Wallin, 2009 Ellen Fineout-Overholt, Williamson, Kent, Hutchinson, 2010 Gerrish, et al., 2011Gifford, Davies, Edwards, Griffin, Lybanon, 2007). forward that nurses must first believe that basing their practice on the best evidence bequeath lead to the highest quality of care and outcomes for patients and their families(Ellen Fineout-Overholt, et al., 2010 Melnyk, et al., 2004). To let change occuring, in that location must be a clear vision, written goals, and a well-developed strategic plan, including strategies for oercoming anticipated barriers along the course of the change(Melnyk, et al., 2004). Emerging evidence indicates that the leadership behaviors of nurse managers and administrators play an important role in succ essfully utlizing research evidence into clinical nursing(Amabile, Schatzel, Moneta, Kramer, 2004 Antrobus Kitson, 1999 Gifford, et al., 2007).There is a unity between many researches that clamethe importance role of the leadership and leadership factors such as support and freight of managers on the staff at the implication of EBP(Aitken, et al., 2011 Antrobus Kitson, 1999 Melnyk, et al., 2004 Winch, Creedy, Chaboyer, 2002). Nurse managers and administrators are responsible for the professional practice environments where nurses provide care, and are strategically positioned to enable nurses to use research. As being a role imitate, administrators must be committed to provide the necessary resources such as EBP mentors, computers, and EBP education. Some administrators have tried to encourage a change to EBP by integrating EBP competencies into clinical promotions. However, Miller (2010) argue that this extrinsic motivational strategy is improbable to be as effective as whe n people are intrinsically motivated to change. Also there is a claimed that if people are involved in the strategic planning process, they are more possible to change to EBP.Intervention protocol for promoting nurses compliance to EBP As the Decision making in health care has changed dramatically, with nurses expected to make choices which based on the best available evidence and continually review them as new evidence comes to light (Pearson et al, 2007). Evidence-based practice involves the use of reliable, explicit and judicious evidence to make decisions about the care of individual patients. As an important role in providing safe and high quality care the nurses must take into account the quality of evidence, assessing the degree to which it meets the four principles of feasibility, appropriateness, meaningfulness and (Doody Doody, 2011 Johnson, Gardner, Kelly, Maas, McCloskey, 1991).What nurses need to operate in an evidence-based manner, is to be aware of how to introduc e, develop and evaluate evidence-based practice. There more than one model for introducing the EBP in health care one of them that I chose is the Iowa model.The Iowa model counsellinges on organization and collaboration incorporating conduct use of research, along with separate types of evidence(Doody Doody, 2011 Johnson, et al., 1991). Since its origin in 1994, it has been continually referenced in nursing daybook articles and extensively used in clinical research programmes. This model uses key triggers that discharge be every problem focused or association focused, leading staff to question current nursing practices and whether care can be improve through the use of current research findings(Bauer, 2010 Doody Doody, 2011 Johnson, et al., 1991 Titler, et al., 2001). By using Iowa Model a question is generated either from a problem or as a result of becoming aware of new fellowship. consequently a determination is make about the question relevance to organizational priori ties.If the question posed is relevant, then the next step is to determine if there is any evidence to answer the question. Once the evidence has been examined, if there is sufficient evidence, then a pilot of the practice change is performed. If there is insufficient evidence, then the model supports that new evidence should be generated through research (Bauer, 2010). Step one of the Iowa model is to formulate a question. The question if asked in a PICO format is easier to use to search the literature. A PICO format uses the following method to frame the question Frame question in PICO format P= Population of interest I= Intervention C= Comparison of what you entrust do O= Outcome(Hoogendam, de Vries Robb, Overbeke, 2012). The final step to the process is to persona the outcomes of the practice change with other in the form of an article or poster. In using the Iowa model, there are seven steps to follow in detail as it is outlined in the convention shown in appendix B. Step 1 Selection of a nationalIn selecting a discipline for evidence-based practice, several factors need to be considered. These include the priority and magnitude of the problem, its application to all sports stadiums of practice, its contri scarceion to meliorate care, the availability of data and evidence in the problem area, the multidisciplinary nature of the problem, and the commitment of staff. Step 2 Forming a team upThe team is responsible for development, performance, and evaluation. The composition of the team should be directed by the chosen topic and include all interested stakeholders. The process of changing a specific area of practice ordain be assisted by specialist staff team members, who can provide input and support, and talk over the practicality of guideline. A bottom-up approach to implementing evidence-based practice is essential as change is more successful when initiated by frontline practitioners, rather than imposed by management.Staff support is as we ll as important. Without the necessary resources and managerial involvement, the team will not feel they have the authority to change care or the support from their organization to implement the change in practice. To develop evidence-based practice at unit level, the team should draw up written policies, procedures and guidelines that are evidence based. Interaction should take place between the organizations direct care providers and management such as nurse managers, to support these changes(Antrobus Kitson, 1999 Cookson, 2005 Doody Doody, 2011 Hughes, Duke, Bamford, Moss, 2006). Step 3 Evidence retrievalEvidence should be retrieved through electronic databases such as Cinahl, Medline, Cochrane and up-to-date web site. Step 4 rate the evidenceTo grade the evidence, the team will address quality areas of the individual research and the strength of the body of evidence overall (see appendix A for level of evidence). Step 5 Developing an Evidence-Based Practice (EBP) stock Afte r a critique of the literature, team members come together to set recommendations for practice. The type and strength of evidence used in practice needs to be and based in the consistency of replicated studies. The design of the studies and recommendations made should be based on identifiable benefits and risks to the patient.This sets the standard of practice guidelines, assessments, actions, and treatment as required. These will be based on the group decision, considering the relevance for practice, its feasibility, appropriateness, meaningfulness, and effectiveness for practice. To support evidence-based practice, guidelines should be devised for the patient group, health covering fire issues addressed, and policy and procedural guidelines devised highlighting frequency and areas of screening.Evidence-based practice is ideally a patient centered approach, which when implement is highly individualized. Step 6 Implementing EPBFor implementation to occur, aspects such as written p olicy, procedures and guidelines that are evidence based need to be considered. There needs to be a direct interaction between the direct care providers, the organization, and its leadership roles (e.g. nurse managers) to support these changes. The evidence likewise needs to be diffused and should focus on its strengths and perceived benefits, including the manner in which it is communicated. This can be achieved through in-service education, audit and feedback provided by team members. Social and organizational factors can affect implementation and there needs to be support and value placed on the integration of evidence into practice and the application of research findings(Aitken, et al., 2011 Doody Doody, 2011 Gerrish, et al., 2011 Reavy Tavernier, 2008) Step 7 valuationEvaluation is essential to seeing the value and piece of the evidence into practice. A baseline of the data to begin with implementation would benefit, as it would show how the evidence has contributed to p atient care. Audit and feedback through the process of implementation should be conducted and support from leaders and the organization is needed for success. Evaluation will highlight the programmes impact. Barriers also need to be identified. Information and readiness deficit are common barriers to evidence-based practice.A lack of knowledge regarding the indications and contraindications, current recommendations, and guidelines or results of research, has the potential to cause nurses to feel they do not have sufficient training, skill or expertise to implement the change. Awareness of evidence must be annexd to promote the transmutation of evidence into practice . A useful method for identifying perceived barriers is the use of a force case analysis conducted by the team leader. Impact evaluation, which relates to the immediate effect of the intervention, should be carried out. However, some benefits may lonesome(prenominal) become apparent after a considerable period of ti me. This is known as the sleep effect. On the contrary, the back-sliding effect could also occur where the intervention has a more or less immediate effect, which decreases over time.We must not to evaluatetoo late, to avoid missing the measures of the immediate impact. Even if we do incur the early effect, we cannot assume it will last. Therefore, evaluation should be carried out at different periods during and following the intervention (Doody Doody, 2011). Nursing leadership is an essential role for promoting evidence-based practice while the nurse managers and administrators are responsible for the professional practice environments where nurses provide care, are strategically positioned to enable nurses to use research. AS the leadership is essential for creating change for effective patient care the leadership behaviors are little in successfully influencing the stimulation, acceptance, and utilization of innovations in organizations (Antrobus Kitson, 1999 Gifford, et al., 2007).From my perspective I consider that the leaders and managers are the corner stone for utilizing researches and make practices based on evidence. By playing a role model for staff and handling the authority they have a magic force to urges the staff to use evidence based in there practice. Leaders can encourage the staff to use EBP in their practice in several ways such as increase the staff awareness, stimulating the intrinsic motivation of people, implying an effort to increase the will and internal longing to change through support encouragement, education, and appealing to a common purpose, monitoring performance, strengthen the body of knowledge that the staff have by forcing them to attend and participate in conferences, workshops Journal clups, giving rewards to staff who assemble in finding, utilizing and applying the EBP and make promotion and appraisal according to adherence to application of EBP.Implication of EBPFor implementation to occur, aspects such as writt en policy, procedures and guidelines that are evidence based need to be considered. There needs to be a direct interaction between the direct care providers, the organization, and its leadership roles (e.g. nurse managers) to support these changes. The evidence also needs to be diffused and should focus on its strengths and perceived benefits, including the manner in which it is communicated. This can be achieved through in-service education, audit and feedback provided by team members. Social and organizational factors can affect implementation and there needs to be support and value placed on the integration ofevidence into practice and the application of research findings. There are many ways that can be used to raise an environment to implement and sustain an area of EBP such as -Development of EBP champions Use of EBP mentors Provision of resources such as time and money Creation of a culture and expectation related to EBP Use of practical strategies including EBP workgroups, journal club and nursing rounds (Aitken, et al., 2011). EBP is being used in every aspect of the life, especially in the health care. The most common application of EBP is not only in intervention or treatment plane, but also the EBP process has been applied to making choices about diagnostic tests and protocols to insure thorough and accurate diagnosis, selecting disturbance or harm-reduction interventions or programs, determining the etiology of a disorder or illness, determining the course or progression of a disorder or illness, determining the prevalence of symptoms as part of establishing or subtlety diagnostic criteria, completing economic decision-making about medical and social service programs.Nursing research proves icy to achieving attraction recognition, yet the term research often evokes an hunch of mystery. Most of the policy, guidelines. And protocols that guide the work in the organization are based on evidance (Weeks Satusky, 2005). Also, it is also useful to think of EBP as a some(prenominal) larger social movement. Drisko and Grady (2012) argue that at a macro instruction-level, EBP is actively used by policy makers to pattern service delivery and funding. EBP is impacting the kinds of interventions that agencies quip, and even shaping how supervision is done. EBP is establishing a hierarchy of research evidence that is privileging data-based research over other ways of knowing.There are other aspects of EBP beyond the core practice decision-making process that are re-shaping social work practice, social work education, and our clients lives. As such, it may be viewed as a public idea or a social movement at a macro level (Evidence-Based Practice Why Does It Matter?, 2012). Cost effectiveness of using EBP in health careBeneficial outcomes of the implementation and use of evidence-based practice by staff nurses include increased ability to offer safe, cost-effective,and patient-specific interventions. Critical thinking skills and le adership abilities can also grow because of the use of evidence based practice it is a way for staff nurses to become involved in change and regain ownership of their practice (Reavy Tavernier, 2008). EBP used in clinical practice lead to make improvement in quality of provided care, which lead to improve the patients outcome, patient satisfaction and employee satisfaction.All these aspect are directly and indirectly lead to increase the cost effectiveness of the organization. When the patient satisfaction increased the patient acceptance to the organization increased, the employee satisfaction also increases and turnover will decrease all these things will increase the financial revenue to the organization. Also when using EBP in health care this will lead to decrease errors, complications and losses (e.g. compliance of evidence based infection control guidelines will lead to decrease incidence of infection, decrease length of stay an d decrease the cost of patient treatment), ano ther example is using EBP to treat diabetic foot will result in decreasing the loses and increases the satisfaction so adherence to EBP will be costly effective when it result in better outcome, quality of care and satisfaction. Sometimes using EBP in certain area is costly in such cases we must weighing the benefits ( immediately and after considered period of time) and make our decision based on the collected data and information.ReferencesAitken, L. M., Hackwood, B., Crouch, S., Clayton, S., West, N., Carney, D., et al. (2011). Creating an environment to implement and sustain evidence based practice A developmental process. Australian Critical Care, 24(4), 244-254. Amabile, T. M., Schatzel, E. A., Moneta, G. 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