Introduction
Clinical practice guidelines are declarations with suggestions aimed at improving patient care. They are based on a comprehensive study of the available data and an evaluation of the advantages and disadvantages of various care alternatives. The evidence-based clinical practice guidelines are developed by the American Academy of Family Physicians (AAFP).
They serve as a foundation for clinical judgments and best practices support which should apply a sound, open process when converting the best available research into clinical practice for better patient outcomes. A crucial component of patient-centered treatment is evidence-based clinical practice guidelines. At the workplace, currently, as a home care registered nurse three guiding practices are provided to ensure that home care is the supportive service it is meant to be. Although the ideas are connected and overlap, three key points are deduced from this.
Impact of Clinical Practice Guidelines on Healthcare Professionals
Firstly, the nurse should consider the parent as the authority at home. It is simple to forget that parents have the final say in their kid’s care given the number of agencies, organizations, and healthcare specialists working with the child and family. Everyone else works as a consultant or a service provider. The parents are the ones who should be in charge of everything overall. Even though home health agencies may hire nurses and other payers may provide financing for in-home care, the parents are still ultimately the nurses’ employers (Zarowitz et al., 2018).
They have the power to choose and reject organizations and particular service providers, as well as to set precise rules for how services are supplied to their children at home. When dealing with issues in-home care, it is not advisable to fire specific providers or organizations as a first step but since the parents are the ones in charge of their own homes, they may choose to do so.
Secondly, establishing a personal and professional support network outside of the house they work in is crucial for nurses. They will be able to handle the intensity and stress of home care with the aid of this network. There are disadvantages to working with one patient in one home (Falzer, 2021).
For nurses who work full-time at home, it might become monotonous, stressful, or all-consuming. The nursing supervisor, home care colleagues, or their professional associations should all be able to provide professional help. Regular supervisory meetings, staff conferences, or even nursing support groups could be able to provide a nurse with some perspective on their behavior or unexpected family member behavior. It is equally crucial to have the social and emotional support of one’s own family and friends. The risk of being overly personally connected with the family exists for nurses who attempt to have their personal or social needs met in the client’s milieu. Due to this, maintaining a suitable professional connection may be impossible.
Lastly, the nurses in home care should always maintain a professional relationship with the attended families. To reduce the stress of having an outsider in the home, it is totally common for families to try to integrate the home care nurse into the family. They might do this voluntarily or involuntarily. It’s hard to resist this attraction because being regarded as a “family member” feels like acceptance and a declaration of affirmation (Dagens et al., 2020).
Although the nurse may find this charming, it may not accurately reflect the family’s opinion of the nurse as a person. Instead, it is an effort to lessen anxiety inside the family. Even when the family tries to incorporate nurses as family members, nurses must maintain an acceptable professional distance while both supporting and respecting the family’s naturally developed limits.
Clinical practice guidelines allow health practitioners to make informed decisions regarding patient care and problem-solving by utilizing the best available evidence. The core of pharmaceutical care is to improve a patient’s quality of life by directly and responsibly providing medication-related care to accomplish certain objectives. Therefore, pharmacy practitioners may be responsible for critically assessing CPGs that specifically focus on treatment choices involving medications (Falzer, 2021). An important tactic for lowering the likelihood of bias, whether the source of that bias is intellectual and professional preconceptions, financial interests, or something else, is the adoption of explicit, systematic methods for reviewing well-collected evidence and then developing practice guidelines.
The steps for evidence-based pharmacy practice can be summed up as follows: identifying the issue, assessing the evidence to determine the best course of action for the patient, personalizing the therapy for that patient in light of their experiences and preferences, and making the decision to start the treatment. Since pharmacists are drug experts who have received academic training for this purpose, they play a significant role in the health system in preserving the prudent use of medicine and offering pharmaceutical care to patients (Zarowitz et al., 2018). The “rational use of the pharmacist workforce” will result in the “rational use of medications,” enhancing the effectiveness of pharmacotherapy and lowering the cost of healthcare globally.
Nursing has also embraced the evidence-based practice, although there are many different definitions of it. Although all of the following are regarded as evidence, behaviors based on research findings are more likely to provide the intended patient outcomes across a range of settings and geographical locations. These practices include knowledge from basic science, clinical knowledge, and expert opinion (Dagens et al., 2020).
Evidence-based practice is encouraged by payers and healthcare institutions’ demand for cost control, more information accessibility, and increased consumer knowledge of available options for treatment and care. Evidence-based practice necessitates modifications to student education, more research that is applicable to practice, and tighter collaboration between clinicians and researchers. Evidence-based nursing care offers chances for greater individualization, efficiency, streamlining, and flexibility, as well as for maximizing the impact of clinical judgment (Zarowitz et al., 2018). Nursing care keeps up with the most recent technological improvements and makes use of new knowledge developments when evidence is utilized to determine best practices rather than to support current practices.
For nurse educators, evidence-based practice has an essential potential role to play by incorporating more practice-based evidence in teaching and learning implementation. To guarantee that student nurses obtain top-notch nursing education, nurse educators should employ EBP. Recent research suggests that nurses might not be well equipped to apply EBP, despite the recommendation of instructional tools to improve EBP knowledge and skills (Falzer, 2021). The demand for interactive clinical activities in EBP teaching methodologies is included in a three-level hierarchy for teaching and learning evidence-based medicine.
The teaching methods for EBP knowledge and abilities that are currently being used in undergraduate nursing education are identified in this research study. We also discuss the difficulties and learning results that students and teachers have encountered. Nurse educators must play a crucial role in guiding aspiring nurses as they acquire knowledge of evidence-based practice gain access to research resources, and take part in studies (Dagens et al., 2020). This calls for more creative teaching strategies, such as online teaching and learning, using electronic resources, video conferencing, and research-based teaching and learning, to encourage students’ active engagement, creativity, and critical thinking.
A hospital’s or hospital system’s chief financial officer is in charge of managing all financial risks for the company and ensuring that a hospital or hospital system operates as economically as possible. They are responsible for handling the majority of planning funds and record keeping. A CFO frequently updates the CEO and the board of directors on the hospital’s financial situation. The CFO is the organization’s primary financial spokesperson and oversees the finance department (Dagens et al., 2020). Typically, they will be in charge of handling the organization’s finances, negotiating new vendor contracts, finding ways to minimize costs, and selecting top executives for important hospital positions.
In a unit, the nurse manager is tasked with overseeing all matters of finance. The promotion of evidence-based practice (EBP) in clinical units in hospitals is a key responsibility of nurse managers (NMs). To support the objective of EBP in the clinical unit, there is a shortage of research that focuses on NM viewpoints about institutional contextual elements (Falzer, 2021). This article’s goal is to pinpoint the contextual elements that NMs have characterized as facilitating change and EBP at the unit level by contrasting and comparing these viewpoints from various nursing units.
Research Reference Used in the Guideline Adoption
Clinical practice guidelines (CPGs) present suggestions for cutting-edge care based on synthesized research findings. CPGs are created after a thorough examination of the available data, a determination of the suggestions’ possible advantages and disadvantages, and, if necessary, a cost-benefit analysis (Zarowitz et al., 2018). CPGs are made to summarize the scientific literature and offer recommendations for the delivery of clinical services rather than to give a one-size-fits-all approach to patient care.
CPGs should ideally give doctors the data they need to make clinical decisions about their patients. The guidelines were adopted in accordance with the World Health Organization guidelines in conjunction with AGREE II (Dagens et al., 2020). The AGREE II is a valid and reliable tool that can be applied to any practice guideline in any disease area and can be used by healthcare providers, guideline developers, researchers, policymakers, and educators. When creating a new practice guideline, AGREE II can also operate as the framework’s fundamental development plan.
Evidence Used in Guideline Definition
Evidence-Based Practice (EBP) refers to making decisions based on the best available evidence and offering patients effective, efficient care that is supported by science. EBP deployment can increase patient outcomes and improve healthcare safety when done consistently. During the adoption of these guidelines, randomized controlled trials (RCTs) were used to provide empirical data. However, there is also evidence from other scientific approaches including descriptive and qualitative research, as well as information from case studies, scientific theories, and professional judgment (Dagens et al., 2020).
The availability of sufficient research evidence informs practice, together with clinical knowledge and patient values. However, in some circumstances, there might not be enough research, and in those situations, the main sources of evidence used to make decisions about health care are things like expert opinion and scientific principles. The research evidence must be incorporated into the EBP as more research is conducted in a particular area.
Level of Evidence Used in Evidence-Based Practice
The implementation of the above-mentioned EPB was largely based on levels 1 and 3 of evidence. This was determined based on its methodological quality, validity, and suitability for use in patient treatment. Level 1 relies on evidence obtained from a systematic review or meta-analysis of all pertinent RCTs, evidence-based clinical practice recommendations based on systematic reviews of RCTs, or three or more high-quality RCTs with similar findings (Dagens et al., 2020). Level 3 on the other hand, relies on evidence derived from carefully planned, non-randomized controlled trials such as quasi-experimental.
Adherence of Evidence-Based Practice by Professionals
The adherence criteria by healthcare professionals was determined based on a systematic review conducted on 18 papers. In 7 out of the 18 evaluations, the professionals’ level of adherence was entirely maintained. Six evaluations did not fully sustain the adherence, and four evaluations had inconsistent sustainability outcomes when comparing the LATE POST measurement to the EARLY POST measurement.
In one study, the EARLY POST assessment was skipped, although the authors still noted long-lasting effects (Houghton et al., 2020). 9 out of 18 evaluations demonstrated sustained results by lowering the sustainability threshold of professionals’ adherence to 90% or greater, 3 evaluations showed no sustained results, and 4 evaluations showed mixed results. Whether the experts’ adherence had been maintained at a level of 90% or more was not obvious in the two evaluations (Houghton et al., 2020). Based on the findings a conclusion can be made that a greater number of professionals adhere to the set clinical practice guidelines and the remaining few are on the road to transformation.
Conclusion
The aforementioned guideline clearly states the best practices of a registered nurse in a home healthcare setting to provide guidance to nurses around the globe who seek to develop their professional home healthcare practice and performance. According to the guidelines, home health nurses are frequently the patient’s only access to healthcare at home. Patients receiving home care rely on nurses to identify every element that might have an impact on their health outcomes or goals. Nurses must do a comprehensive, continuing assessment of the patient’s health status and requirements. This thorough evaluation may involve tests for the patient’s physical, functional, nutritional, psychosocial, emotional, behavioral, cognitive, sexual, and spiritual well-being, depending on their particular circumstances.
Based on the patient’s medical diagnoses and other elements found during the evaluation that might have an impact on the patient’s health and well-being, the home health issues and requirements are determined. The nurse talks through issues and needs with the patient, family, and other caregivers after identifying them. They should decide together on objectives that respect the patient’s preferences, priorities, and wants. Every objective needs to be SMART that is, specific, measurable, achievable, relevant, and time-limited. The nurse conducts a continuing assessment of the patient’s progress toward the goals and anticipated outcomes in cooperation with the patient and the interdisciplinary team. Evaluation necessitates re-evaluation, and if the plan is failing, the nurse must update it with fresh, more likely-to-work tactics.
The nurse fosters an efficient transition of care for management following discharge once the patient’s home health goals for care are met. Home healthcare nurses are called to treat everyone equally regardless of the person’s race, ethnicity, religion, socioeconomic background, sexual orientation, gender identity, or any other diversity issue that tends to marginalize people. To tailor their care to their patients’ varied beliefs, attitudes, and practices, they analyze their patients’ cultural, religious, and other diverse needs and preferences before beginning any treatment. They offer compassionate care to everyone.
References
Dagens, A., Sigfrid, L., Cai, E., Lipworth, S., Cheng, V., Harris, E., Bannister, P., Rigby, I., & Horby, P. (2020). Scope, quality, and inclusivity of clinical guidelines produced early in the covid-19 pandemic: a rapid review. Bmj, 369. Web.
Falzer, P. R. (2021). Evidence‐based medicine’s curious path: From clinical epidemiology to patient‐centered care through decision analysis. Journal of Evaluation in Clinical Practice, 27(3), 631–637. Web.
Houghton, C., Meskell, P., Delaney, H., Smalle, M., Glenton, C., Booth, A., Chan, X. H. S., Devane, D., & Biesty, L. M. (2020). Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database of Systematic Reviews, 4. Web.
Zarowitz, B. J., Resnick, B., & Ouslander, J. G. (2018). Quality clinical care in nursing facilities. Journal of the American Medical Directors Association, 19(10), 833–839. Web.