Evidence-Based Practice Application

EBP stands for evidence-based practice which is essential within the healthcare field to ensure patient care is supported by evidence gained from research and clinical trials (Griffiths et al., 2019).  This strategy blends scientific evidence and research advanced about the approaches employed with expert practice and patient preferences to enhance outcomes and set higher standards of care. To enhance patient management and quality of care, the integration of EBP requires a precise understanding of relevant clinical matters and patient care tools (Ekvall et al., 2021). In this study, we will focus on how evidence-based practice is implemented when it comes to a certain patient care technology and analyze how it is done about patient care as well as evaluating how well it answers some of the significant clinical questions. We intend to show the importance of EBP in enhancing patients’ status and healthcare delivery systems through examining this process.

Analyzing Criteria and Process for Evidence-Based Nursing Practice

Evidence-based nursing practice (EBP) is a systematic approach to making the best possible clinical decisions using the best available evidence, such as research findings, and patient preferences  (Kumah et al., 2022). This would usually lead to the development of a well-structured clinical question based around certain aspects or elements, such as (PICO(T)) i.e., Patient/Population, Intervention, Comparison, Outcome, and Time with formulating Evidence-Based Clinical Question. This is important for developing the research question so that you know what to ask and it keeps within a certain parameter.

Searching for the Best Available Evidence

After diagnosis of the clinical question, it is now time to look for the best evidence that is available. To do this, one must have access to resources that include peer-reviewed research papers, systematic reviews, and or clinical guidelines which are available in national databases like PubMed, CINAHL, and the Cochrane Library (Ekvall et al., 2021). It is recommended that the most relevant research must be attained by using an optimum and systematic search technique

While using appropriate search words and restricting the search results by applying appropriate limitations (Griffiths et al., 2019). Next, other well-known tools and frameworks for assessing the quality of the evidence include the GRADE system (Grading of Recommendations Assessment, Development, and Evaluation) (Meng et al., 2022). To determine the robustness of the evidence generated by this approach, the strength of recommendations considers factors including the study method, symmetry of points, focus of evidence, and risk of prejudice.

Synthesizing and applying the evidence

The next important phase that comes after analyzing data would be to integrate this data and use it in practice. This means that patient preferences or choices have to be incorporated while integrating the findings with evidence-based knowledge (Gómez et al., 2022).  Staff divided into the healthcare team often have to collaborate in a multidisciplinary manner to ensure that the evidence is applied to practice appropriately. Developing standard operating procedures, or treatment plans that are feasible in a clinical setting and others based on the existing empirical evidence may form part of this step.

The last step in the EBP process is to assess the outcomes of the implemented practices. The results of the practices should be measured in terms of the improvements achieved after implementation of the practices (Ekvall et al., 2021). This involves ascertaining whether the EBP has achieved the objective of enhancing the positive results of care—fewer complications, increased satisfaction, or better quality of life for the patient. It could be necessary to carry out its assessment and changes at regular intervals depending on the feedback received from patients, new research, or changes in clinical practice guidelines.

Difficulties in Developing EBPs

However, several limitations could hinder EBPs from being developed and implemented despite their clear benefits. One is the lack of sufficient high-quality evidence to guide the development of the guidelines (Griffiths et al., 2019). This is because studies can be difficult to carry out specifically to come up with solid and concrete results on many domains that concern nursing, especially in complicated or rare diseases where there are either inadequate research studies conducted or there is conflict (Kumah et al., 2022). In addition, time constraints are another major concern of the nurse, for whom there is often hardly any time to locate, appraise, and apply research findings in the course of their work.

Lack of access to resources

Another is lack of resources especially where there are few subscriptions to databases or scholarly publications. This situation can be problematic for nurses because when they do not have the current research, it is difficult for them to know the latest evidence (Pitsillidou et al., 2021). In addition to this, the implementation of EBPs might be a challenge since practitioners might resist change. Usually, new practices affect the old habits which can be a problem because there will be new practices without seeing the benefits over the old ones, especially when it is changing the habit people have.

Ethical considerations

It is worthy of note that ethical considerations may pose challenges to the development and deployment of EBPs. Issues may include sometimes the patient’s preference may not be consistent with the evidence or given cultural or individual differences the evidence cannot be implemented fully (Ekvall et al., 2021). In these cases, nurses need to navigate between the need to provide care based on evidence, and the patient’s rights and conditions. Thus, while EBP development and deployment is vital to boost patient care, it also involves conscious consideration of the data in question, the clinical context, and any potential barriers to implementation. Thus, nurses can ensure that patient treatment is evidence-based, and by addressing these challenges and contributing to the development of EBP, they will be able to do it with the latest and most reliable evidence.

Importance of Effective Scholarship and Information for Evidence-Based Nursing Practice

Research and accuracy when collecting data play a crucial role in the implementation of EBP in nursing practice (Gómez et al., 2022). In the field of nursing, scholarship means the systematic and systematic acquisition, critical analysis, and application of information derived from studies. Research conducted to support EBP ensures the credibility and relevance of identifying information employed to support clinical decisions, enhancing the results achieved in the treatment of patients.

Scholarship is important for enhancing the pragmatic utility of gained knowledge because it may bridge the gap between learning and practice (Kumah et al., 2022). The scholarship enables nurses to adopt good practices and maintain contemporary knowledge and development in the health sector and also plays a crucial role in the formulation of better policies to advance patient care (Griffiths et al., 2019). Moreover, good scholarship promotes a culture of learning and reasoning which is crucial in nurses’ practice. Therefore, the implementation of research-based practice allows for flexibility in the thinking of nurses; their ability to challenge and voice concerns regarding the continuation of procedural activities that have become routine but may not reflect the most effective or evidence-based practices for patients; the opportunity to incorporate their creativity for the care of their clients, and the freedom to make decisions based on research.

Criteria to Evaluate Scholarship and Information

Credibility of Sources

The sources which information will be collected from should be considered as credible sources (Meng et al., 2022).  Sources to gather information from include articles from academic journals and books, CINAHL, PubMed, and policymaker sources, including the CDC and WHO. One has to critically assess the author or researcher in terms of their achievement or professional qualifications and affiliations.

Relevance

The data has to be relevant to the legal practice area or the clinical problem under consideration. They should include the patients to be targeted, the therapy or treatment to be offered, and the expected outcome (Gómez et al., 2022). Although it is to some extent of truth sometimes the clinician does not have relevant know-how regarding the patient and thus, negligence in patient care or performing the wrong procedure can occur.

Rigor and Methodology

Another important factor that should be taken into consideration is the level of rigor of research. These include the sample size, methods of data collection, analysis of the data, and the design of the study like in a randomized controlled trial, and systematic review (Ekvall et al., 2021). It is expected that only good techniques that minimize bias, ensure reliability, and enable replication should be used in research of the highest caliber.

Recency 

It is necessary to use up-to-date information in industries, which evolve, such as healthcare, for instance (Griffiths et al., 2019).  It should be comprehensive where necessary, but the information used should be recent and in line with the new developments in the medical field and current scientific advice. Inaccurate knowledge can be negative or less effective since it is not current.

Objectivity 

The research should include the data in a manner that is devoid of bias and prejudice. This is not allowed to be influenced by conflicts of interest for instance receipt of funds from institutions that have interests in the outcomes of the research (Nantsupawat et al., 2023). Reporting techniques as well as any conflicts of interest must also be reported to ensure that the entire process is bias-free.

Influence and Applicability

Lastly, there is an aspect that talks of the scholarship’s impact which is an essential factor in any reliable scholarship (Opsahl et al., 2020). This includes the ability to influence practice, improve patient care, and the development of the body of nursing knowledge. Especially useful is the knowledge that can be applied immediately to patient encounters and has been found effective.

Describing a Clinical Question Addressed by Evidence-Based Patient Care Technology

“How does telemonitoring of heart failure patients for follow-up care affect the hospital readmission rates as compared to usual face-to-face visits?” is a noteworthy clinical question, around which, patient care technologies-based solutions may be found (GómezSánchez et al., 2022).  This is a crucial question given that heart failure, as noted earlier, is a chronic condition that results in frequent hospital readmissions, which tends to push up costs among patients and healthcare facilities (Meng et al., 2022). Through the use of telehealth technology patients’ health status, symptoms, and patient adherence to prescribed medication can be easily assessed by the clinicians. This makes it possible to have early intervention and may even reduce cases of hospital readmission.

Identifying Knowledge, Gaps, Missing Information, or Areas of Uncertainty

Telehealth Technology Knowledge

Telehealth technologies are numerous, and many of them are already in use in various capacities to capture different data including weight, blood pressure, and heart rate among others; nurses must understand the various systems available, how they work, and how they can enter the data captured by the telehealth system into the patient’s electronic health record (Nantsupawat et al., 2023). However, it is as important to understand the technological aspects and to be able to solve the usual issues.

Current Research on Telehealth Efficacy

As useful as telehealth has been within chronic illnesses such as heart failure, there may still be questions about some of the long-term outcomes of its use, particularly if the variation in patients is taken into consideration (Ekvall et al., 2021). Nurses should be informed regarding the newest evidence, which embraces systematic reviews and meta-analyses considering the impact of telehealth technologies on the outputs of patient care, including hospital readmissions, and quality of life.

Patient Adherence and Engagement

Another essentially unknown area involves how the patients adhere to the telehealth guidelines and engage with the technology (Griffiths et al., 2019).  They recognize the importance of understanding social determinants that affect adherence, including the socio-economic circumstances and comfort and technological skills of the patients. Figuring out how telehealth practitioners can involve patients more and eliminate barriers is a critical factor in the effective utilization of the technology.

Gaps in Data Integration and Interoperability

One of the problems that is related to telehealth is how to ensure that the telehealth data integrates with other healthcare systems  (Kumah et al., 2022). Some questions remain unanswered, for instance, whether, by incorporating telehealth data with existing EHR systems, the processes of fast and efficient clinical decision-making are possible.

Patient Privacy and Data Security

Telehealth introduces concerns as to how the privacy and security of patients ‘information will be addressed. It is not entirely clear whether current security measures can safeguard the patient data that is transmitted through the adopted telehealth solutions (GómezSánchez et al., 2022).  Nurses should be required to learn effective ways through which they can protect the confidentiality of patients’ information and secure the communication that happens through telemedicine.

Cultural and Ethical Considerations

Further research is needed to know whether this model is beneficial for a great number of people and how the usage of telehealth is seen in different cultures (Meng et al., 2022).  Further research and more recommendations are needed in the direction of ethical issues, for example, ensuring the subjects’ voluntary and equal availability to telemedicine.

Long-Term Effect

Regarding the effects of telehealth on the specific patient, his/her outcomes, medical expenses, and the workload of medical personnel, one cannot yet speak with certainty  (Kumah et al., 2022). While some of the investigated investigations were performed in the short term and seem to have potential, the deficiency in understanding the long-term effectiveness of telehealth interventions and how they impact chronic disease management is apparent.

Evaluating Ethical and Regulatory Implications in Implementing Telehealth for Heart Failure Patients

Telehealth technology increases the chances of getting efficient, equitable, and safe care; however, the ethical and regulatory consequences of implementing this technology for patients with heart failure must be analyzed (Meng et al., 2022). As mentioned above, there are many benefits of telehealth like fewer readmission rates in hospitals and improved patient tracking but it also has its disadvantages which the health care practitioners have to bear.

Ethical Implications

The privacy and confidentiality that a patient experiences in a face-to-face appointment tend to vanish over video consultation between 2 people (Gómez et al., 2022).  In telehealth, all the sensitive health data is transmitted over digital platforms thereby making it even more prone to cyber threats such as breaches of data and subsequent illegal access or probable misuse. Communication needs to be secure and follow the guidelines of GDPR as well as strong encryption. Additionally, patients must be adequately educated on what to expect in the use and storage of their data as well as how it is secured before consenting to telehealth programs. 

Fair Access

Concerns of justice arise as well when discussing the question of fair access to telehealth services Patients who are in remote or underserved areas may not have a reliable internet connection or the devices necessary to participate in telehealth programs (Meng et al., 2022). Also, some older patients or others with low technological literacy may have problems embracing these new telehealth platforms (Ekvall et al., 2021). These gaps need to be bridged so all patients have access on equal footing with Telehealth services and Healthcare professionals should find ways to ensure this. Examples of this have been providing devices (tech), conducting research on alternative remote care models, or issuing training. 

Degree of Autonomy and Informed Consent

The use of telehealth, especially with the integration for ongoing monitoring can sometimes blur patient autonomy (Kumah et al., 2022). Areas where monitoring may occur, possible impacts on the patient’s daily life, and the possibility of discontinuation at any time shall be indicated to patients. If we are going to uphold ethical principles in telehealth, this means ensuring patients can make informed decisions and that their autonomy is respected.

Regulatory Implications

Licensing and Cross-Jurisdictional Practice: 

As telehealth services often cross state lines (upwards it may also be practiced across country borders), provider licensing is a major roadblock for regulations (Kumah et al., 2022). It is hard for the healthcare professional to get a license and practice in the same environment in which a patient lives, this can be constraining as well. To solve this problem, licensing organizations need to work on identical healthcare practice contracts across jurisdictions that have a required minimum standard of quality.

Data Security and Compliance

Regulatory frameworks like HIPAA in the US place stringent guidelines on how patient data is to be managed (Gómez et al., 2022). Telehealth providers need to ensure that their platforms meet these standards, which can involve stringent auditing and restricted access as well as secure data storage. Breaking these rules can trigger severe fines and harm patients’ trust.

Payment & Financial Ramifications

Telehealth services reimbursement rules are in constant flux. For a service like telehealth, where conditions vary greatly between insurance companies and government programs in the same state knowing how to get paid can be arduous (Griffiths et al., 2019).  The main hurdle to widespread demonstrative acceptance still lies in discrepant reimbursement procedures that regulators are working hard to align together.

Future Ethical and Regulatory Concerns

Technological Developments

Technology in Telehealth will increase representing both new ethical considerations as well as legal implications. As an example, the deployment of artificial intelligence (AI) and machine learning in a telehealth setting introduces questions about algorithmic bias or transparency  (Kumah et al., 2022). It only moves from troubling to alarming if worrying AI-assisted decisions come into conflict with human decision-making grounds such as clinical judgment. If AI in telehealth is going to serve a future where the ethical and responsible use of human technologies is just as important as scientific innovation, then regulations will have to raise this challenge. 

Patients using telemedicine may be more dependent

Many worry that as healthcare is data-fied people will care not just seek it, but demand it—outside the real space in which traditional clinicians operate (Griffiths et al., 2019). This is problematic for the patient-provider relationship and standard of care, especially in an area where a human touch (and empathy) may be important. What it is Rules versus ethics Any rules against morality obviously must have no copyright. 

International standardization and compatibility

Understandably, telehealth (HFE) crosses borders in an unprecedented manner. However as telehealth moves beyond the immediate clinical context international uniform law will have to mandate these systems are compatible with one another (Gómez et al., 2022). Then, the regulatory bodies should work cooperatively at an international level to establish global approaches that foster the sharing of information without compromising on stricter privacy norms along with stringent data security frameworks.

Conclusion

Finally, the main goal of this review is to emphasize how EBP integrated into patient care leads to quality advancements and successful treatment effects. Using EBP in particular patient care technologies helps health professionals in making clinical decisions and meet the vital demands of patients accordingly (Gómez et al., 2022).  The deliberate consideration of imperfect evidence and its implementation in detailing best practices further enhances health results; moreover, it promotes a culture for enhancement and innovation surrounding health care (Kumah et al., 2022). While we move from acceptance to mastery of EBP, it is important that continue our education and workforce readiness in the highest level of scientific research, so patient care can be integrated with scientific discovery.

References

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