Response to nursing discussion board peer responses

Response to nursing discussion board peer responses

Response to nursing discussion board peer responses

Response to peer discussion board-150 words-1 reference within 5 years-NURSING JOURNALS ONLY.

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There is a large push for evidence-based practice to become the main foundation of all clinical practices and  clinical decision making. In order to provide the best up to date quality careevidence-based practice must be used.

“By the year 2020, 90% of clinical decisions will be supported by accurate, timely, and up-to-date clinical information and will reflect the best
available evidence” (Boswell& Cannon, 2017). Though it is ideal to have evidence-base practice driving health care practices there are many obstacles in the way of changing the culture of health care practices.

There are many obstacles to change such as resistance to change from staff, available resources to support changes, lack of support and training from mentors, and “research findings incompatible with the realities of their practice” (Johnston, Coole, Feakes, Whitworth, Tyrell, & Hardy, 2016, p. 392).

Working at Shands Hospital in Gainesville Florida there is most definitely a strong push for
the best quality of care through evidence-based practice. Each unit throughout the hospital has a clinical leader. The unit’s clinical leader’s main job description is to assure the unit is clinically using practices that are evidence-based.

The main obstacle that I have found on my unit has been “research findings incompatible with the realities of their practice” (Johnston et al. 2016, p. 392 ). Working on such a high acuity unit in the cardiovascular intensive care unit a lot of evidence-based hospital driven policies and practices have had to be adjusted specially to fit our unit. Hospital wide practices have had to be adapted because certain practices do not apply to the realities and acuity of our unit.

Response to nursing discussion board peer responses

One main example is the MEWS assessment. “The modified early warning score (MEWS) is an example of a physiological ‘track and trigger’ system designed to identify patients at risk of clinical deterioration in order to provide a timely response to request appropriately-trained nursing or medical staff to assess the patient and provide an interventions required” (Harris, 2013, p.432).

MEWS is an extremely useful tool on floor units, but on my particular unit a majority of our patient population have such a high baseline MEW Score. If following our hospital protocol for our patients’ MEWS we would be constantly calling physicians and bringing them to the bedside. Our patients have extremely high acuity which is one of the reasons they are in the intensive care unit.

Our physicians are aware of the acuity of our patients and therefore the hospital wide MEW score does not really apply to our unit. We had to adjust the triggers of the MEW Scores of when to notify a physician. On the floor a MEWS of 4 a physician is notified and needs to come assess the patient, but in the CICU the score for when a physician has to come to bedside was adjusted to a 6.

Response to nursing discussion board peer responses

MEWS is just one of the many obstacles present in implementing evidence-based practices on our unit. There are many obstacles to implementing evidence-based practices in our clinical practices, but it is imperative that we adjust or policies and practices to reflect the research found in order to provide the best quality care.

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