Term Paper on "Health Care Policy Issue Analysis on Evidence-Based Practice"

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Health Care Policy Issue Analysis on Evidence-Based Practice

Health Policy Issue Analysis on Evidenced-Based Practice

Despite many efforts that are used to promote evidence-based practice (EBP), many patients are not receiving appropriate care. Evidenced-based practice implies that decisions about treatment options will depend largely on evidence of their clinical effectiveness. The major purpose of EBP is the elimination of the use of expensive, ineffective, or dangerous medical decision-making.

However, developing and using this evidence is not always straightforward. Making use of evidence in clinical practice is a major challenge for nurses. They face numerous gaps and barriers to EBP. The major barriers include a lack of time, poor access to literature, and a lack of ability to judge the quality of the research. To tackle the issue of EBP and barriers to effective and efficacious nursing care, it is imperative to address the individual confounding variables.

The goal of policy implementation is to facilitate EBP in ways to ensure that patients receive the most cost effective and efficacious care. To support this goal, the following objectives were formulated: to determine the level of understanding of EBP of nurses and provide necessary education, to identify the barriers and ways to integrate EBP effectively into clinical practice, to establish evidence-based guidelines and make it accessible, and to implement strategies to enhance the utilization and adherence to evidence-based practice.

This paper presents and analyzes the following alternatives that could potentially offer a solution to the issue of EBP gaps and barriers to effective health care: 1) Mandating curricula that stress EBP in order for college and university nursing programs to become accredited, 2) Concentrating more on improving education within healthcare institutions, 3) and doing nothing.

Problem Identification

Many patients today are not seeing the quality of care that they actually need, despite the fact that evidence-based practice (EBP) has been evolving (Claxton et al., 2005). Patients are too often receiving inconsistent, wasteful, and even harmful interventions when it comes to nursing (Helfand, 2005). There has been an increasing emphasis on the outcomes of patient care, and this is changing the focus of tasks, practices, and opinion-driven decisions to more of a focus on practices that are guided by evidence (Helfand, 2005).

There are, however, still some problems that remain unresolved, and these include the gap that is seen between evidence and practice, the unnecessary variations in practice, and the rising cost of healthcare, among others (Claxton et al., 2005). Evidence-based practice attempts to eliminate the wasteful and harmful practices that are seen through improving the standards of care. This could also help to provide healthcare that is more cost-effective for many patients (Claxton et al., 2005).

The Establishment of EBP is not an easy process. Nurses are confronted every day with challenges in providing both safe and effective care for their patients. According to Haines, et al. (2004), barriers may exist in the healthcare system such as a lack of financial resources, a lack of access to care, problems with the practice environment such as poor practice organization, problems with the educational environment such as failure of the curricula to reflect research evidence and inappropriate continuing education, and the patient demand for care that is not effective in the long run.

Barriers to the proper use of research in nursing practice exist at both the institutional level and at the individual level. The lack of time that these individuals have is generally seen to be the most significant of the barriers that they must address (Claxton et al., 2005). Very few nurses today have either the skills or the time to search for relevant evidence and appraise it properly (Claxton et al., 2005).

Quite often, these nurses rely mostly on the experimental knowledge that they have gained throughout the interactions that they have with their nursing colleagues, the medical staff, and the patients that they work with, and they use this knowledge in their practice (Pravikoff et al., 2005). Unfortunately, they receive very little to no education or any kind of training in information retrieval, they do not often understand or value research into the issues that they face, and therefore they are generally unprepared for a practice that is built on evidence instead of experimentation and 'common knowledge' that may be seriously out of date in many cases (Helfand, 2005).

Some of the problems that nurses are facing today in this area can be attributed to the rapid and significant technological changes that are being seen (Garber, 2005). However, certainly not all of the problems fit into that category, and some if it must be blamed on nursing education programs and their failure to prepare their students at all of the levels that they might work at, so that these future nurses could understand how very important it is to maintain a practice that is based on something more than tradition, experience, and intuition (Garber, 2005). There are many ways that people have dealt with healthcare in the past, but these may not be the best patient-care practices that are available today.

Evidence-based practice is very crucial when it comes to the care that is directed toward the improvement of patient outcomes (Helfand, 2005). This kind of practice allows for the basis behind the reduction of inappropriate variability within patterns of practice, and increased compliant in the patients that are seen. The measurements that are taken of patient outcomes in organizations that use EBP can help to further validate the importance of this practice and help to close the gap that is often seen between practice and research (Helfand, 2005). It is likely that EBP will become much more common as the cost of healthcare increases.

The contribution that nurses make when it comes to advanced practice roles, such as those that work as clinical nurse specialists and nurse consultants, can greatly help with assisting in the EBP process (Helfand, 2005). This contribution should be maximized. These specialists and consultants can then act as a very valuable resource for the collection of evidence-based information, and then they can assist in the supporting of an environment which is much more receptive to change (Helfand, 2005). This change will be highly important for patients and the quality of care that they receive.

Context of Issue

Social Factors

Evidence-based practice (EBP) has also been strongly driven by a need to deal with a large amount of scientific information overload, by the need for cost-control, and by a stronger public demand for a higher quality of care for all patients today (Eddy, 2005). The evidence-based practice idea has also been driven by both public and government pressure for more accountability regarding health care providers, as there is concern that individuals that enter the hospital are not receiving the highest quality of care that they could be, but yet the cost of healthcare continues to rise rapidly (Eddy, 2005).

More and more people are without health insurance, and they cannot afford to go to the doctor, so they put it off until something serious goes wrong. Policymakers are using scientific evidence in order to make the health care policies better for the public. Insurers then use scientific evidence in order to control costs by reimbursing for treatments that are more cost effective (Eddy, 2005).

Patients use the same kinds of scientific evidence in order to make better and more informed decisions regarding their health conditions and the treatments that might be available to them for those conditions. Information that is seen about the effectiveness of different interventions can provide a strong foundation for the making of rational decisions about the care that will be offered with the limited resources that many people have today (Eddy, 2005).

Economic Factors

The inappropriate variability that has been seen in practice patterns is a very costly problem within the healthcare system in the United States (Eddy, 2005). Health services are required by law to justify all of their expenditures, and therefore a detailed examination of all of the costs that are associated with any kind of treatment will become a more common practice in the future. The pressure of controlling costs is one of the many reasons that are seen to be behind EBP (Eddy, 2005).

It identifies the treatments that have been seen to be the most clinically effective and also identifies those that have not shown promise where cost effectiveness is seen in the past, so that the cost effectiveness of these particular treatments can be improved in the future if all possible (Gerrish & Clayton, 2004). Cost is a serious issue that cannot be ignored within the health care setting any longer. However, how this can be balanced with the local and the individual choices and values are not always that clear. Nonetheless, the awareness of such important issues is seen to be necessary for nurses, in order to help them facilitate more informed patient choices within the confines of a health care budget that is finite (Gerrish & Clayton, 2004).

Political and Legal Issues

Evidence-based practice is… READ MORE

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