Benefits of Evidence Based Healthcare Practice

Benefits of Evidence Based healthcare makeEvidence found practice refers to clinical practices that include better in stock(predicate) scientific severalize (Levin and Feldman, 2006) based from expert opinion, clinical signposts and findings from enquiryes, feature with good clinician judgement and clients p references (Kim and Mallory, 2011) on issues relating to healthcare. The whole shopping mall is to ensure the topper care for patients and to be able to explain wherefore certain clinical discussions are applied. This piece of work will concisely outline the importance of evidence based practice before analysing quartette pieces of evidence in the care of a blow patient, Omar Banerjee, and its reclaimableness former(a) users.Oman et al (2003) states that evidence based practice started to be appreciated and recommended by the National Health Services (NHS) in the UK in the early 1990s. The priming coat was to rich person effective and less costly interpolations while providing naughty carapace healthcare system. The intervention should be based on best available evidence and provided in the best interest of the patient such as Omar in this analysis.In addition, when a particular intervention is apply on a client, evidence is submitd to back up that particular process (Kim and Mallory, 2011). In the UK this support can come from the NICE guidelines, Care lumber Commission and the codes and practices of professional bodies like breast feeding and Midwifery Council.Evidence based practice ensures accountability. Aveyard and Sharp (2013) n oned that professional health carers who belong to unlike professional organisations are expected to comply with their standards, codes and policies. This will be modify them to justify their actions if required to do so.The first analysis of Omars set apart is based on Cross (2008)s evidence on snapshot care. This evidence was obtained from the UWE blackboard website. I have chosen this name b ecause it has statistical reading abetful to Omar and his carers. It identifies important areas of his care brings and why lash investigate should continue to be an on-going process.Sander (2013) defined slash as a disease caused by the disturbance of the flow of agate line in blood vessels in the brain which could have been necessitated by a bursting blood vessel or blood clot. Omars crack was caused by a blood clot in the brain. slice has become a banging problem and the morsel main cause of death and disability in developed economies after heart related diseases (Cross, 2008). Sander (2013) emphasises out that snap is affecting about 150, 000 heap in the UK yearly.However, the article reports a free fall in deaths because of improvements in blastoff care, management and awareness. More resources have been displace towards short to long term care of stroke patients such as admission charge to nifty stroke units and to rehabilitation areas (Cross, 2008). The repo rt says this evidence, among others, is being used to develop new stroke treatments and guidelines in the UK. NICE (2008) which provides tools and quick reference guide to stroke related cases could have emerged as a resultant of this. These developments whitethorn give hope to Omar and his distressed family.The article cited two evidence of good practice from two infirmarys. It is reported that the stroke management team up at Aintree University Hospitals NHS Foundation impudence assess stroke patients on admission to the AE, take brain scans and admit relevant patients to a stroke unit within 24 hours. The other evidence is from Salford Royal NHS Foundation Trust where patients have brain scans, steep screens and initial dose of aspirin stipulation to relevant patients. These practices are recommended by NICE (2008) guidelines and whitethorn reduce win risks to patients. Omar received these interventions. This shows the strength of this article to Omars case and how early i ntervention whitethorn result in positive outcome.Although the article stressed the need for nurses to continuously monitor patients during the early stages of stroke on certain variables, it did not provide guidelines to back up the checks. Locally agreed hospital policies suggested may not meet NICE standards.Despite the improvements noted in the research, caveat should be taken when making decisions based on the findings. These are 2008 findings and a lot has happened since then. Omar may be interested in hearing new-fashioned studies such as that of Sander (2013) who points out that in addition to the swallow screen stroke patients should further be screened for malnutrition using Malnutrition Universal covert Tool (MUST) in line with the NICE (2008) guidelines.The second analysis of Omars care is based on a qualitative shoot of Tutton et al (2012) on ten staff and ten patients views on the concept of hope on a British stroke unit. The evidence was obtained from EBSCO via CI NAHL database and UWE library section. I chose this evidence because CINAHL is considered as one the good sources of evidence (Levin and Feldman, 2006) and the concept may be useful to Omar to learn other patients experiences in a alike hospital setting.The aim and list search terms in the article relate well to Omars case. forecast is defined as get better from illness and being able to do things as before (Tutton et al, 2011). This was echoed by any(prenominal) of the patients in the have. An in depth analysis of key terms and the codes used in qualitative flying field (Aveyard and Sharp, 2013) may help carers to understand how it feel to have a stroke. Omar and his family may share the uniform thoughts as they are finding it hard to come to terms with fulminant change of things in their family.Despite taking long magazine on data collection and variations in stroke severity Omar may be encouraged to learn that some patients took less than a week in hospital. This result is echoed by Arnaert et al (2006) in a similar study based on ten patients in Canada. They reported that some clients were hoping for a quick recovery and self-healing.The article is good evidence as it give tongue to what is already known about this topic and breast feeding implications. These aspects are echoed by Arnaert et al (2006) but Tutton et al (2011) further identify what the paper has added such as the multidisciplinary team involvement in caring for stroke patients to give hope a realistic thing.Although the article mentioned that consent was obtained from both participants, there are still some ethical issues in the article. Some of patients label are mentioned in the article. This is confidential information and Omar may find himself in a similar situation.Furthermore, relatives and carers of patients were not interviewed in the study. It may be infallible to hear their views as well especially after learning from Preeti how she was attempt to come to terms with Omars condition. Her understanding of hope would improve our knowledge on this aspect.It is generally accepted that qualitative evidence is ranked second from the bottom in the hierarch of evidence (Polit and Beck, 2012) and uses a small sample size for the purpose of in-depth analysis of topic under consideration (Aveyard and Sharp, 2013). Although a crowing sample size may be costly and time consuming, caution must be taken when making inferences on large population size like 150, 000 patients mentioned earlier.A third analysis of Omars care considers service size up and evaluation evidence from Sentinel Stroke National Audit curriculum (SSNAP) (2013). It is a national audit on stroke patients admitted to hospital in the first three months of 2013. The research looks at the processes of care at early stages of stroke (72 hours) from hospital arrival. I have chosen this evidence because SSNAP is a nationally recognised organisation and full treatment with other organisations in stroke related cases. Its recent results obtainable finished Google, SSNAP Audit Report (2012) and Royal College of Physicians links have strong implications on Omars condition.SSNAP (2013) results show the importance of using guidelines in any intervention involving stroke cases. There is strong evidence in the article that stroke patients were immediately taken for brain scans and admitted to the stroke units, as in the case of Omar, upon arriving hospital. This is in line with NICE (2008) guidelines. Most of the trusts were able to meet this standard. However, it is badgering to learn that there is a lower chance of having scan during the spend and night times, the time of the week when Omar experienced the stroke.NICE (2012) guidelines stipulate that people who have had TIA should have first dose aspirin upon initial assessment. Although Omar received one, the outcome in the report is not very pleasing. It is befool from the research that this standard was not met by all t rust as there are huge variations.The research was only focused on 72 hours upon hospital arrival. It may benefit the public and give presumption to Omar if the care he received from the ambulance crew were up to standards. NICE (2012) guidelines require people suspected to have had stroke to be screened using a FAST tool. There are no statistics regarding this in the article as the research excluded time before hospital arrival and the rehabilitation. This information may enlighten the public the importance of early intervention in stroke care.This evidence is not peer reviewed and the way data was collected is of concern. Because the SSNAP is a single source of data nationally (Paley et al, 2013) and an online web-tool was used to gather information one may wonder whether variations in results may appear if a different organisation undertakes the same research. Caution should be applied when rendition this data.The audit results stress the importance of early intervention by mul tidisciplinary stroke team in the care of stroke patients. However, there are some areas that require attention if the all standards are to be fully met.The last(a) analysis of Omars care is based on quantitative study by Beavan et al (2010) on whether looped nasogastric vacuum tube (NGT) feeding improves nutritionary manner of speaking to acute stoke patients with dysphagia. The evidence was obtained from UWE blackboard website. I chose this evidence because the intervention, tube feeding, helps to resolve Omars swallowing difficulties and improve nutritional needs. The research helps in respond questions on whether there are other alternatives and any effects associated with the intervention.The research was necessitated by the poor nutrition on patients on admission to hospital and the dislodgement associated with adhesive nasal stickers. Findings from the research reported more benefits in using the loop system than the other method. Some of the benefits include fewer check s for NGT position, less supplementary feeds required, more volume of fluids and feeds and less dislodgement of NGTs. This is brisk information to Omar as it highlights why the intervention is used. However, the costs were seen to be high for the two week period.It is important to explain to Omar that studies of this nature are useful and commonly used in clinical interventions. It is a view dual-lane by many authors like Polit and Beck (2012) and Aveyard and Sharp (2013). They rank randomised controlled trials as second best on the hierarch of evidence after regular reviews and meta-analysis.There are some ethical issues regarding the funding for the research. Procare Ltd supplied the loops. The researchers stressed that it was not involved in any logistics or interpretation of the results, but one may wonder why the loops were sold at a book price. Could this have resulted in a discount? If the answer is yes then it is likely that the costs could be higher than the reported o ne.In addition, the aspect of tolerability was mainly based on the views of nurses and family members. Although it is understandable that most of the patients were having communication problems, the number of patients ineffective to communicate is alarming to the extent that caution is required when using this evidence.The study was done some years ago and the results published in 2010. A number of changes may have happened since then. Omar will be susceptible on why using such an old piece of evidence. Recent research results may be easier to convince Omar and his family than old results.To sum up, stroke is a major disease affecting many people and causing disabilities among survivors. every nursing intervention will require evidence to back up. quatern sources of evidence have been analysed in relation to Omar, a stroke patient. The strengths and weaknesses associated with from each one of this evidence will enable any intervention in Omars care to be made in rationale way an d to his best interest.WORDS 2 089ReferenceAveyard, H. and Sharp, P. (2013) A Beginners pass by to Evidence-Based Practice in Health and Social Care, 2nd ed. Berkshire Open University Press.Kim, M. and Mallory, C. (2011) Statistics for Evidence-Based Practice in Nursing, Burlington Jones and Bartlett Learning.Oman, K.S., Krugman, M.E. and Fink, R. M. (2003) Nursing enquiry Secrets, Philadelphia, Pennsylvania Hanley and Belfus.Pilot, D. F. and Beck, C.T. (2012) Nursing Research Generating and Assessing Evidence for Nursing Practice, 9th ed. Philadelphia Wolters Kluwer Health/Lippincott Williams Wilkins.Levin, R. F. and Feldman, H. R. (2006) Teaching Evidence-Based Practice in Nursing A Guide for Academic and Clinical Settings, New York Springer print Company.Arnaert, A., Filteau, N. and Sourial, R. (2006) Stroke Patients in the chills and fever Care Phase Role of Hope in Self-healing online. 20 (3), pp137-146. Accessed 14 November 2013Beavan, J., Conroy, S.P., Harwood, R., Gladman , J.R.F., Leonardi-Bee, J., Sach, T., Bowling, T., Sunman, W. and Gaynor, C. (2010) Does looped nasogastric tube feeding improve nutritional delivery for patients with dysphagia after acute stroke? A randomised controlled trial. in stock(predicate) from https//blackboard.uwe.ac.uk/bbcswebdav/pid-3425495-dt-content-rid-4569416_2/courses/UZWSN3-15-1_13oct_gl_feb14_1/Tube%20feeding%20after%20stroke%20RCT.pdf Accessed on 19 November 2013Cross, S. (2008) Stroke care a nursing perspective. Nursing Standard. 22 (23), pp 47-56. unattached from https//blackboard.uwe.ac.uk/bbcswebdav/pid-3473085-dt-content-rid-4709333_2/xid-4709333-2 Accessed on 29 October 2013National engraft for Health and Clinical Excellence (NICE) (2008) Audit support (NICE clinical guideline 68 Stroke) Available from https//blackboard.uwe.ac.uk/bbcwebdav/pid-3461610-dt-content-rid-4659555_2/xid-4659555_2 Accessed 12 November 2013NICE (2008) Understanding NICE management Early assessment and treatment of people who ha ve had a stroke or transient ischaemic attack (TIA) Available from www.nice.org.uk/nicemedia/pdf/cg68publicinfo.pdf Accessed on 01 declination 2013Paley, L., Campbell, J., Hoffman, A. and Rudd, (2013) Sentinel Stroke National Audit Programme (SSNAP) Clinical audit first pilot public report, National results. Available from www.rcplondon.ac.uk/sites/ default on/files/ssnap_pilot_national_report_january_-_march_2013_admissions_with_appendices_.pdf Accessed on 11 December 2013Pale, L., Campbell, J., Hoffman, A. and Rudd, (2013) Sentinel Stroke National Audit Programme (SSNAP) Clinical audit first pilot public report, National results. Available from www.rcplondon.ac.uk/sites/default/files/ssnap_pilot_national_report_january_-_march_2013_admissions_with_appendices_.pdf Accessed on 11 December 2013Sander, R. (2013) Prevention and treatment of acute ischaemic stroke. Nursing Older People online. 25 (8), pp 34-38. Accessed on 4 December 2013.Sentinel Stroke National Audit Programme (SSNAP ) (2012) Acute organisational audit report Public Report for England, Wales and Northern Ireland. Available from http//www.rcplondon.ac.uk/sites/default/files/ssnap_acute_organisational_audit_-_public_report_2012_0.pdf Accessed 12 November 2013Tutton, E., Seers, K., Langstaff, D. and Westwood, M. (2011) Staff and patient views of the concept of hope on a stroke unit a qualitative study online. 68 (9), pp 2061-2069. Accessed 14 November 20131