Because of the prevalence of lifestyle diseases and the rise in chronic disease rates among the elderly, there is a large number of older patients who rely on long-term care facilities. Health status deterioration among patients cared for in long-term facilities is widespread owing to a range of variables such as stress, depression, a lack of knowledge of one's current state, and other issues. As a result, nursing practice should embrace the use of evidence-based practice as a means of improving the care provided to patients in these long-term care facilities. According to study, the outcome of patients is determined by a variety of factors, with the nurse's practice being a primary influencer of the patients' outcome. Incorporation of evidence-based practice in nursing further improves the management of patients and their outcomes (Black, Balneaves, Garossino, Puvat, &Qian, 2015).
The use of evidence-based practice in hospitals has proven effective in improving patient safety and their clinical outcomes, reducing the costs used by patients in healthcare services and decrease the variations in the patients’ outcomes. Although the use of evidence-based practice has proven to be effective in improving the general outcome of the patients and nursing practice, it has been faced with numerous challenges such as lack of time for researching, lack of knowledge about the required research process for obtaining the evidence and lack of awareness when it comes to critically evaluating the evidence obtained (Black, Balneaves, Garossino, Puvat, &Qian, 2015). The purpose of this research is to investigate the influence of evidence-based practice in improving nursing practice in long term care facilities.
Literature Review
Evidence-Based Practice
Evidence-Based Practice (EBP) is defined as a problem-solving method used in clinical care that incorporates the thoughtful use of recent best practice from peer reviewed research, clinician’s proficiency, and patients’ beliefs, values and preferences (Black, Balneaves, Garossino, Puvat, &Qian, 2015). In nursing evidence-based practice is described as the use of recent best evidence in delivering nursing care to an individual or a group of people. It involves translating evidence obtained from research into practice while at the same time considering clinical guidelines and other sources of information.Evidence-based practice is a logical and philosophical approach to care which is in opposition to the traditional ways of caring for patients. The evidence used in EBP is obtained from a variety of sources such as randomized controlled trials, databases such as Cochrane and PubMed, and other scientific texts (Specht, 2013).
Significance of the Use of Evidence-Based Practice
The introduction of EBP in long-term care facilities is critical especially with the increasing numbers of the elderly in the country who require long-term care. These group of individuals is lively to be faced with health complications such as loss of memory, visual impairment, arthritis, among other age related conditions which may affect their abilities to care for themselves. As most of the elderly population is cared for in long-term care facilities, there is a lot of pressure that these facilities face as the resources used in these facilities continue to stretch to accommodate the growing population of the elderly. The use of evidence-based practice in these facilities can help in the utilization of these resources since, in EBP, methods implemented are more likely to work out and thus ensure that the available resources are used effectively. EBP also puts a lot of pressure on the quality of care given to patients and thus will improve the general outcomes of the patient in the facility (Specht, 2013).
Factors Affecting EBP
Research on the factors that influence the adoption of EBP among nursing practitioners was conducted on nurses working at Haukeland University Hospital in Norway, where 661 nurses from 20 different units of the hospital were used. The results obtained from the research showed that most nursing practitioners in the facility preferred the use of their own experience which they had obtained from years of practice and their own knowledge in managing patients rather than using evidence gained from research databases and journals. The younger nurses in the facility who had fewer years of experience experienced greater challenges in changing their ways of practice to EBP as most of them were used to basing the clinical decisions on the knowledge they had acquired from college. They thus faced higher levels of challenges in implementing EBP that older nurses (P< 0.001) (Dalheim, Harthug, Nilsen, &Nortvedt, 2012).
Based on the research, the commonest barriers to evidence-based practice in the facility were insufficient time for looking for research reports, insufficient time to find information that has been organized well such as guidelines and protocols, nurses lack confidence in assessing the quality of information found in the different research articles, difficulties in comprehending articles written in English (as this research was based in Norway), and the culture of the hospital team members. Insufficient time was reported as the greatest barrier (Dalheim, Harthug, Nilsen, &Nortvedt, 2012).
Research Questions
What is Evidence-Based Practice?
Can evidence-based practice be used in improving nursing practice in long-term care facilities?
What are the factors that affect the implementation of Evidence-Based Practice?
Research Design
This research will be a cross-sectional study. Cross-sectional studies are used to capture information at a specific period of time and can help to draw the relationship between the variables investigated in a research. The data will be collected from nursing practitioners within a short period of time. The research design used in the study will be quantitative research design as the study will make generalized conclusions about the benefits of using EBP to enhance nursing practice in long-term care facilities (LoBiondo-Wood & Haber, 2014).
Sample
Non-probability specifically convenience sampling will be used in this research as the participants are limited to long-term care facilities. Convenient sampling utilizes the available participants that are easily accessed during data collection. This sampling method is convenient as there are limited long-term care facilities in the country (LoBiondo-Wood &Haber, 2014). The sample that will be used in this research will comprise of registered advanced nursing practitioners working in long-term care facilities. Different long-term care facilities will be used to obtain the sample that will be used in the research in order to ensure thereliability of the results.
Inclusion Criteria
Nurses participating in the research must be registered nurses. Advanced nursing practitioners who will be available during data collection at the selected long-term care facilities.
Exclusion Criteria
Advanced nursing practitioners who are on leave during the time of data collection will not be included in the research.
Instruments
The instruments that will be used for data collection will include pretested questionnaires and in-depth interviews.
References
Black, A.T., Balneaves, L.G., Garossino, C., Puvat, J.H., &Qian, H. (2015).Promoting Evidence-Based Practice Through a Research Training Program for Point-of-Care Clinicians. The Journal of Nursing Administration, 45(1), 14–20. Retrieved 8thApril 2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263611/
Dalheim, A., Harthug, S., Nilsen, R.M., &Nortvedt, M.W. (2012).Factors Influencing the Development of Evidence-Based Practice Among Nurses: A Self-Report Survey. BioMed Central, 12, 367. Retrieved 8th April 2017 from https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-12-367
LoBiondo-Wood, G. & Judith Haber, J. (2014).Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice.Elsevier Health Sciences Publishers.
Specht, J.K. (2013). Evidence Based Practice in Long Term Care Settings. Journal of Korean Academy of Nursing, 43(2), 145-153. Retrieved 8th April 2017 from http://dx.doi.org/10.4040/jkan.2013.43.2.145
