Critical Reflection - Evidence Based on Nursing Practice - Essay Writing Assessment Answer

Nursing Critical Reflection Assignment

Assignment Task

ROLE OF CRITICAL REFLECTION IN EVIDENCE BASED NURSING PRACTICE

The field of medicine and health care forms one of the most dynamic and explored research areas. A huge amount of money is spent each year on high quality research which directly affects the life of millions of people world-wide. New and more effective medicines, biomedical devices and medicinal protocols are been discovered at an accelerated rate. This has led to accumulation of ample amount of research literature. The most important objective behind this research is to help and assist the health care professionals like doctors, nurses and technicians to deliver the best possible treatment and care to their patients. A considerable shift has been observed in recent years in medicinal practices, where along the traditional and well-used procedures and practices doctors and nurses are also incorporating the innovative interventions which are formed on the basis of best practices and extensive research literature available to them. Evidence-based practice (EBP) is one such technique which is popularly growing and has the potential to effectively handle many clinical situations and hence provides a better care for the patient (Majid et al., 2011).

Traditionally, the caring for the patient was more dependent upon the practical experience and opinion of the health care professionals involved in their treatment. EBP has marked a striking shift from historical perspective of authoritative estimations to more of a data driven approach where information is extracted from the various reported research experiments and studies (Jette et al., 2003). It has also been proved by a meta-analysis carried out by Heater et al. that evidence based nursing practice actually improves the patient care in comparison to the traditional practices (Heater, Becker, & Olson, 1988). Moreover, as nurses have started a significant role in making clinical decisions, there is a need for them to learn to utilize the best possible evidence while taking a decision to make it more effective and justifiable.

Implementation of EBP involves two major steps. The first task is to generate evidence and it strongly relies on the knowledge of science. Secondly, the more important thing is to utilize the evidences, which is the real art of nursing. Both these steps are based on logic and critical thinking. Finding a good evidence is not sufficient, rather using the knowledge to put it to best use is more crucial. Locating the best possible evidence from the research to carry out EBP sometimes becomes a challenge for the nurses. Thus, there is a need to train the professional nurses so that they can acquire the required skills. One learnt, maintenance of these skills also require serious and frequent effort in terms of time and stud. (Profetto-McGrath, 2005).

Nurses have an additional responsibility to their name to personalize the search for evidence depending upon the client and its present condition and then effectively applying them to the real situation using their clinical judgments, available resources and paying due respect to the values and beliefs of the client. In additional to the basic nursing skills, there are some more abilities that must be possessed by the nurses to successfully implement the EBP process. They have to (1) identify the gaps in the current knowledge, (2) formulate the relevant questions, (3) extensively search within the available literature, (4) apply the proper rules of evidence to be sure about the validity of the studies, (5) apply the extracted information in the patient’s case, and (6) involve the patient as well within the clinical decision making process (Majid et al., 2011).

Effectively identifying the gaps and framing the questions is the most important part of the complete process and can serve nurses well when they face with challenges. The skill of questioning can be learnt and helps to activate the process of critical thinking. Various questions can be used to challenge what has been observed, heard, read or experienced during the clinical practice. Well-developed questions facilitate the progress in EBP as it directs the nurses to explore various evidences, disclose gaps in the present settings, and gather information essential for solving the problem of the patient. Nurses need to be confident enough in their role to challenge whether the common practice is the best practice or not. Nurses have to be nurtured to be curious or inquisitive. Curiosity comes with critical thinking and thrives and fosters in a questioning culture (Profetto-McGrath, 2005).

Critical thinking thus integrates both knowledge and skills. These skills include the capability to analyze, evaluate, and draw inference. However, knowledge and skills alone do not suffice. To be effective, the critical thinkers also require specific temperament constituting their attributes, habits of mind and attitudes, which assists in using knowledge and complements the skills. It builds the ability to think beyond the daily routines and protocols and makes nurses confident to be prudent in discriminating between good and ineffective practice (Profetto-McGrath, 2005).

I personally feel that EBP is improving the way health care have been seen and practiced since years. I would like to quote an example were I utilized my skill of critical thinking to practice evidence based nursing. While nursing in a general unit for some time I notice an increase in the number of patients fall. This did not seem normal to be. I reported my observations to the senior authorities. I was given the permission to look into the matter with the help of some other staff. We analyzed the data available for the last six months. We considered various parameters like medications given, condition diagnosed, surgical status, use of oxygen, etc. We observed that 90% of the falls were reported for the patients who were administered with Lasix PO or IV in the evening. A look into the recent literature showed a research associated with Lasix administration, fall prevention and medication pharmacology. Some changes were made in the policy that Lasix will be given to the patients only during the day time. Continuation of the new policy for a few months gave remarkable outcomes. We observed a 70% decrease in the number of patient falls just because of a single implemented measure. This incident has encouraged me to practice EBP and think beyond what is being practiced since ages.

Thus I believe that student nurses with the ability to think critically can contribute a lot in the implementation of EBP process as they directly coordinate with the patients for the maximum number of hours. Critical thinking skills must be integrated in the course curriculum to be taught and supported in the educational programs.