HCA 699 Why should patient values and clinical judgment be included in applying the evidence in clinical decision making for an individual patient?
HCA 699 Why should patient values and clinical judgment be included in applying the evidence in clinical decision making for an individual patient?
HCA 699 Why should patient values and clinical judgment be included in applying the evidence in clinical decision making for an individual patient?
Evidence-based practice is important in improving the overall quality of patient care. Hourly nursing rounds is an EBP used to reduce patient falls at a medical-surgical unit (Flowers et al., 2016). However, implementing the evidence-based practice (EBP) is associated with many challenges acting as barriers (Patel, 2019). Lack of support from the stakeholders such as leaders and nurses, which could enhance the implementation of the project is a major barrier. Nurses have not taken hourly rounds with the seriousness it deserves. Sometimes staff perceives hourly rounds as an option or extra work imposed on them rather than as a daily care activity (Flowers et al., 2016). Staff should change their perception and beliefs regarding hourly rounds to ensure its effectiveness in preventing falls.
In addition, hospital leadership lack support for the hourly rounds. For instance, some leaders view hourly rounds as luxury and encourage it only when the staff has time and not short-staffed (Toole, Meluskey, & Hall, 2016). Furthermore, leaders do not recognize staff members who excel with hourly rounding. Also, leaders in most cases are not involved in the rounding. They should change their perception and hold the mirror for themselves. It is unfair for leaders to expect staff to round every hour when they themselves do not. Nurse participation in organizational activities and quality improvement measures is very important. According to Toole, Meluskey and Hall (2016), nurses are the most significant agents of change in a healthcare setting. However, they cannot succeed without leadership support. These two groups of stakeholders need to work in collaboration to support hourly rounds to reduce falls in the surgical unit.
References
Flowers, K., Wright, K., Langdon, R., McIlwrath, M., Wainwright, C., & Johnson, M. (2016). Intentional rounding: Facilitators, benefits and barriers. Journal of clinical nursing, 25(9-10), 1346-1355. doi: 10.1111/jocn.13217
Patel, N. (2019). Breaking barriers: Implementing evidence‐based practice. Oral Surgery, 12(4), 286-292. https://doi.org/10.1111/ors.12435
Toole, N., Meluskey, T., & Hall, N. (2016). A systematic review: Barriers to hourly rounding. Journal of nursing management, 24(3), 283-290. doi: 10.1111/jonm.12332.
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The patient values and judgement are critical in the treatment processes. With the modern practices in healthcare systems, medical professionals need to respect the values of the patients; this may enhance the treatment processes as well as the recovery of the patients (Nielsen, Lasater, & Stock, 2016). Before engaging patients in the treatment processes, it is necessary to consider their what they believe in and the medical processes that they are likely to prefer. Therefore, patient’s values and clinical judgement need to be included while applying the evidence in the clinical decision making. Applying evidence is essential in knowing the treatment preference of the patients and the kinds of medications that they are likely to react well to. When it comes to the evidence-based practices, all the advanced practices need to incorporate patient values and the clinical judgement.
References
Nielsen, A., Lasater, K., & Stock, M. (2016). A framework to support preceptors’ evaluation and development of new nurses’ clinical judgment. Nurse education in practice, 19, 84-90.