Fundamentals of Evidence Based Practices

LO 1: Explain the role of research for evidence-based practice in health and social care

Explain why is evidence-based practice important in Health and Social Care

Evidence based practice is significant in the Health and Social Care perspective in terms of the provisioning of the most efficacious as well as accurate measure of health care which could be availed under specific socio-economic conditions. The emphasis in this regard is concentrated on the improvement of patient outcomes. The evidence, which could be available in the best and most accurate format in terms of clarification and information, becomes the tool through which the patients expect to avail the most potent and fruitful care services. Evidence based practice highlights the intended promotion of the healthcare service based attitude of inquisitive approaches related to the services and functionalities undertaken by the health professionals. This is also significant from the perspective that it is necessary to ponder over the questions regarding the relevance and suitability of undertaking healthcare based decisions and to conduct inquiry into the possibility of availability of evidence of greater accuracy which could be utilized as a guideline to undertake such decisions in the most effective manner. From the perspective of Alonso-Coello et al (2016) evidence based practice is associated with the provisioning of the professional healthcare services which could ensure that the care practices could be based upon the most informed measure of realisations. This could only be achieved through the available evidence utilisation. Finally, the importance of evidence based practices is palpable from the perspective of utilisation of only finite quantity of health resources in the most judicious manner. This process is pertinently assisted through the consideration of relevant evidence whenever decisions are arrived upon regarding resource allocation to specific health services, reflecting the necessity of seeking healthcare dissertation help when required.

Describe the purpose and the process of conducting evidence-based practice in Health and Social Care

According to Arnold and Boggs (2019), the evidence based practice could be comprehended to be the attempt, on part of the healthcare industry, to assist the health and social care service professionals concerning the formulation of the best possible decisions for the service subscribers (the patients). The availability, pertinence and accuracy of the gathered evidence could determine the direction of clinical decision formulation. The factor of clinical expertise is also significant concerning the purpose of such a process. Another purpose of the evidence based practice could be outlined, as per the observations of Arumugam et al (2018), to be that of making the entire healthcare provisioning process justifiable to the healthcare regulatory authorities and comprehendible to the patients. The evidence is collected through the research processes and such evidence could permit the clinicians to evaluate the measure of efficacy and appropriateness of the concurrent healthcare practices. The process of clinical intervention is premised upon the evidence based practice of collaboration in between the elements of clinical judgment formulation, management of patient satisfaction and information update availability.

The process of conducting evidence based practices is inclusive of five steps. The initial one is conversion of the necessity of information relating to prevention, prognosis, therapy, diagnosis and causation of the ailments into effective inquiry. The second one is the development of evidence and finding of pertaining information to provide an answer to such a question. This process further extends into the third process of researching about the best evidence which could define the necessary answer. The fourth step involves the critical appraisal undertaking of such available evidence. This critical appraisal involves the validity evaluation of the evidence in the form of the proximity of such evidence to the actual conditions on the ground, the impact of the evidence and the applicability assessment in terms of the evidence being useful in terms of the existing clinical practices. The final step involves integration of the derived outcomes of such a process, in the form of critical appraisal, with the clinical expertise of the professionals and the circumstances and values as well as physiological conditions of the patients.

Explain which skills and qualities do you need to conduct a literature review

According to Batterham et al (2016), conducting any literature review is incumbent upon the purpose and aim of the study. Therefore, the structure of any literature review has to reflect the key thematic constructs associated with the content thus being researched about. The purpose of such an approach is to establish the most explicit linkage in between the research topic and the collected research literature.

According to Chandler et al (2016), the research literature review requires the multiple skills. The initial one is the identification of the central question which the research process is required to develop an answer to. The next one is the narrowing down of the topic of literature review. The next one is the dividing off the literature review process into multiplicity of thematic construct based approaches. This could assist in the effective segment based information gathering. The final skill is the concentration of focus of the literature review on the evaluation of the key thematic constructs.

Furthermore, the necessary qualities of research regarding the literature review, according to Dang and Dearholt (2017), could be outlined as the possession of extensive depth of knowledge regarding the research problem or topic under consideration, effective ability to compare and evaluate the evidence and literature which could be accessed and integration of the literature review based conclusive synthesis of information into the actual process of development of evidence based understanding of the healthcare based process implications.

Analyse your own skills and knowledge in being able to conduct a literature review

According to LoBiondo-Wood and Haber (2017), the primary skill of mine could be acknowledged as undertaking of the most expansive yet minute survey of the effective, significant and relevant sources of research literature involving the topic of evidence based practices in healthcare. Another skill which I have been consistently attempting to practice has been to develop the independent and logical thinking through which reflection of the existing state of knowledge has been made possible. Another skill has been the ability to synthesize the literature content into definitive formats through which the best possible evidence supporting the notions central to the research processes could be gleaned properly. Another skill has been the effectively performing media literacy which has involved identification and location of relevant literature, critical evaluation of the literary sources and utilisation of ethical means to utilise such literature.

The knowledge factor has been associated with the development of the search strategy for the literature review. This has assisted me to progress with the planning of resource identification. It has been vital for me to know the best manner of articulation of research question, research statement and research topic. My knowledge has also assisted me to outline the default scope of the research literature sources such as books, journal articles and online information repository so as to suit the necessities of researching about the evidence based practice extents at healthcare settings.

Evaluate which skills are required to conduct ethical research which could have a positive influence on practice and provision in Health and Social Care

Ethical values are fundamental in terms of the functionalities and working processes performed by the healthcare professionals. The intention is to impart the most positive influence on the overall conditionalities associated with the health and social care based professional capabilities frameworks. According to Holly, Salmond, and Saimbert (2016) the skills required to undertake ethical research in health and social care regarding ensuring the most positive effect generation from the care provisioning practices, are multifarious.

According to Lund et al (2016), the primary emphasis has to be on the ensuring of protection of the research participants and research inquiry respondents from the risks of any form of harm. The researcher of the health and social care are required to consistently outline the alignment of their work with the ethical principles and guidelines formulated to serve the interests of the research participants. The initial of such guidelines is to gain the maximised measure of approval from the ethics committee regarding the overall research approach and the determined aspects such as the research sample selection and the design of research data collection (both the Primary and Secondary) tools such as questionnaire or interviews. Next, the researchers have to obtain specific permission from the committee of research governance authorisation. The point of significance in this regard is to outline that the field of research of health and social care could be inclusive of extensive variations regarding the necessities associated with the particular conditionalities under which the researchers could be tasked to develop particular methods of imparting the greatest measure of positive effect for the patients. The commitment to healthcare benefit accreditation to the broadest possible patient populace is a vital skill for the researchers of health and social care in terms of evidence based practices. Thus, adherence to the similar codes of professional conduct and operational practice, even under diverging and varying circumstances, by the researchers and the registered healthcare professionals, is another essential skill. The guidelines are mostly provided by the General Social Care Council (GSCC) and the Health Professionals Council (HPC).

According to Harvey and Kitson (2015), the procedural steps of designing an ethical research framework for the evidence based healthcare practices are six in number. The first one is the designing and reviewing of the research in the most qualitative and transparent manner so as to preserve the integrity of the research. The next one is the informing of the research participants and the research staff regarding the methods, purpose and intentional utilisation of the research processes along with the roles and significance of the participation of the research respondents in the entire research process. Furthermore, the involved risks are to be outlined as well. The third step is the ensuring of the confidentiality of the gathered information from the research participants. This involves the maintenance of absolute anonymity of all of the research participants. The fourth step in terms of ethical research is the absence of coercion in terms of research participation and voluntary participation has to be ensured. The fifth and most significant step is to prevent any detriment to the health conditions of the research participants. The final step is the ensuring of the independence of the study research so as to highlight the complete absence of any partiality or conflict arising out of interest based dissensions.

LO 2: Conduct a review of key literature relating to a research topic towards improvements in care practice

Effective communication skills and techniques form the fundamental basis on which the progression of effective and beneficial service outcomes could be achieved in the discipline of health and social care. Credible communication measure, according to Foronda MacWilliams, and McArthur (2016) between the health professionals and the patients is paramount for the establishment of successful outcomes regarding the individualised social and health care service provision to the diverging patient population. According to Riley (2015), it is necessary for the healthcare professionals to properly understand as well as become accommodative to the necessities of their patients. According to Hiller, Guillemin and Delany (2015) this involves courtesy demonstration, practicing of sincerity and exercising empathy towards the conditions of the patients. These factors, in a cumulative measure, could only be applied through communication processes.

Furthermore, O'Halloran, Worrall and Hickson (2015) have opined that the necessity persists regarding the devotion of accurate measure of time and effort by the healthcare personnel regarding their communication process development to better engage with the patients. The emphasis has to be concentrated on the factor of preservation of effective confidentiality and professional approach regarding such challenging communication objective achievement. Kurtz, Draper and Silverman (2017) have specified that the language of exchange of information is of critical significance since this is required to be comprehensible to all and sundry, including the patients and their representatives. The education and experience of healthcare staff could become certainly a determinant in communication skills management to deliver better service outcomes for the patients and healthcare subscribers.

Explain your results of the literature review

The outcomes of the literature review have brought forth the fact that as a scientific approach, communication in healthcare and nursing has to focus on serving the necessities of the bio-psycho-social existence of the patients. The emphasis is consummately necessary to be concentrated on the intangible factors such as interpersonal, intellectual and perceptual communication abilities of the healthcare professionals and their staff. The necessary skills are incumbent upon the composition of interpersonal communication, clinical operations and knowledge based technical process application. Furthermore, the evaluation of the available literature has been effective, from the perspective of the inter-linkage between the process of communication and the patient outcomes, in terms of outlining the fact that the effectiveness of clinical communication could encompass the disciplines such as therapy, treatment, prevention, health promotion and rehabilitation of the patients.

Summarise current knowledge about communication

According to Zaccagnini and Pechacek (2019), the exchange of information, ideas, thoughts and feelings between the health professionals and the health service subscribers could be surmised to be the actual extent of knowledge regarding communication. Oral communication is vital in terms of the therapeutic practices and also involves officials from public health service departments and the nursing staff of hospitals on one hand and on the other the patients and their relatives or representatives. This process is consisted of a dual procedure of flow of information. The patients have to convey their concerns and apprehensions as well as problems to the nursing professionals so as to provide the effective input on the basis of which accurate and evidence based diagnosis of the patients could be performed by the nursing and health professional staff. Transmission of the information from the nursing staff to the patients and to their representatives involves the outcomes of the diagnosis. This further involves the nature of the ailments and diseases afflicting the patient, the explanation of the delicacy of the situation, the complications of the medical intervention based practices, the advises from the health professionals regarding the decided upon treatment and the plan of rehabilitation after the treatment could be concluded.

Evaluate how reliable and valid is your literature review

The literature review consisted of three strategic approaches to achieve the greatest measure of reliability and validity. The first one has been to progressively determine the implications of experimental manipulation of the care features and the ratings of patients. The second one has been the establishment of the extent and measure of agreement between the ratings related to patient satisfaction and hospital staff engagement. The third one has been the establishment of interdependency in between the satisfaction ratings and the variables theoretically exemplified within the communication development procedures such as propensity of returning to the same health centre and health improvement statistics.

LO 3 - Develop a project proposal using evidence-based practice

Explain the benefits of evidence-based practice as a method in carrying out research

According to Melnyk and Fineout-Overholt (2011), the evidence based practices could yield multiplicity of advantages in terms of improvement in the healthcare practices. One could be comprehended as the ability of individualisation and evolving of care disciplines on the basis of specific patient necessity based approaches. Another could be identified as the enhancement of the medical professional expertise while having to institute care services. Melnyk, Gallagher-Ford and Fineout-Overholt (2016) have pointed out that evidence based practices have mostly contributed to the evolvement of the system where every method of care provisioning has to be based on the available and credible evidence which could be authenticated. This has also contributed to the restriction of the practice of the taking the expert opinions and advises on the face value. Now, the aspect of facts which could be proven through the application of evidences could only be termed to be the exact measure of healthcare decision formulation determinant in health and social care practices. Reeves et al (2017) have outlined that credible evidence could only be considered to be the combination of different findings form specific studies which have to be formulated on the basis of accuracy of research documentation, data appropriateness, existence of the validity aspects, opportunity to corroborate and verify the evidence strands independently through multiple different sources in a cross-referential study doctrine. Data findings are required to be validated as well.

Produce a project proposal for a proposed study based on research topic (Communication skills in practice: the influence of communication skills and techniques on outcomes for service users in a health or social care service)

The first phase of the research would be inclusive of target patient population identification for the project. The second phase would be deliberative about identification of the key stakeholders in the form of recipients of the benefits of such research projects. The third step would be to determine the program faculty in the form of organisational assessment performance. This would be also inclusive of the process of identification of curriculum based needs and the necessary changes which would have to be instituted to the therapeutic communication processes. The next step would be to delineate the goal of such a scholarly project in the form of communication simulation module development for client benefit. The final step would be to undertake the analysis of evidence based literature to outline the key components of the techniques and skills associated with therapeutic communication.

Explain what is your proposed research project and how does it relate to communication

With the movement of the patient population from the inpatient to community based settings, the challenge is becoming apparent for the healthcare interns and the student nursing staff to gain greater proficiency in clinical communication skill based practices and techniques for the purpose of development of better patient outcomes. Thus, it is critical to improve the existing skills and techniques related to healthcare communication. The project proposal in this context, has to be inclusive of the standardised communication simulation with scripted methods of research. The thematic construct would be fivefold, such as emphasising upon the self-perception aspects, study of the significance of constant practicing, evaluation of the available opportunities of communication skill management, study of the methods through which surface level engagement between the clinical service staff and the patients could be improved and finally the assessment of the goal setting factors to transform gained insights into tangible outcomes.

Justify rationale for proposed research study based on research on research topic. Why have you chosen your proposed research project and why is it important?

The rationale is palpable from the perspective that qualitative clinical healthcare services could be only built upon the excellence of therapeutic communication which requires utilisation of self-initiatives and ability of the professional to consistently communicate in the most effective manner. Substandard interpersonal communication between carers and patients contributes to the decline in the client satisfaction measures. Thus, it is of inherent significance that therapeutic communication skills and techniques have to be consistently evolved to impart better healthcare service outcomes and this outlines the validity and relevance of selection of this topic as the project study content.

Critically assess the viability of own project proposal in relation to the literature review conducted. Thinking about your literature review, how viable is your proposal?

The reliability and validity factors of the performed literature review could be made palpable through the exclamations of the focus of the literature review. This has been concerned with the delineation of the documented evidence through which patient satisfaction could be gauged as a definite conditional prerequisite for successful communication based patient outcome improvement in terms of clinical services. Apart from this, the validation aspect has been closely associated with the ratings of patient satisfaction based measures and the application of staff engagement ratings. The aim had been to undertake the literature review to identify the diffusion of innovation s through evidence based practices of communication in terms of the key factors which further influence the residential and clinical healthcare prospects. Previously existing literature reviews, the discussions of theoretical and conceptual frameworks and relevant observations all supplemented the primary approach of evidence gathering.

LO 4 - Examine the value of the literature review process in influencing positive change in health and social care Practice

Describe different ways in which the literature review influences evidence-based health and social care practice. What are some examples of how the literature review influences evidence-based practice in health and social care?

Literature review could influence the evidence based practices concerning health and social care in an often equivocal manner. According to Straus et al (2018), the consolidation and analysis of differential factors could be derived from the evidence based practices through the literature reviews and this could lead to the identification of multiplicity of factors. These are the development of receptive context, the formulation of a model of change for the implementation guidance aspect, the assessment of the required measure of resources, the necessary skill requirements, the practices involving commitment, engagement and participation on part of the stakeholders, support systems for evidence based practices and demonstrable benefits.

Explain how recent research has had a positive impact on current practice to improve service delivery. How has recent research had a positive impact on current practice to improve the delivery of service?

The measure of patient satisfaction has been derived from the documented clinical outcomes involving compliance aspects regarding treatment recommendations and keeping of appointments. The dependent variable has been considered to be this element of patient satisfaction and benefit provisioning aspect within the ambit of desirable outcomes. Furthermore, the recent research has highlighted the aspects related to the inclusion of the archived records of views of patients from the different healthcare service centres concerning their experiences of care service communication prospects which they had been exposed to. Especially, the reliability of the research literature review has been further acknowledged through the cross-sectional evaluation of the patient centred approaches being utilised by individual hospitals. Finality, the literature review outcomes have contributed to the betterment of service delivery through the incorporation of the ratings of in-patient satisfaction statistics so as to specify the element of improvement, in different forms, within the overall modes of healthcare services. According to Wilson et al (2015) healthcare communication is especially deliberative in terms of improvement of positive patient outcomes through the application of effective interchange of information in the process of clinical nursing. The communication skills and techniques, when practiced within the framework of an interdisciplinary approach, could yield significant benefits in terms of dialogue improvement between the patients and the professionals, in the development of interpersonal operational environments and in the provisioning of the future scope to develop skills which are necessary such as better mode of verbal and non-verbal communication.

Analyse how the personal research process has an impact on own learning and practice in the workplace. How has your personal research had an impact on your own learning and practice in the workplace?

From a definitive standpoint, personal research process could be categorised through a deceptively simplified measure of characterisation. This could be acknowledged as intervention based practices oriented towards self-development and learning capability improvement. The personal research process is indicative of the exclusion of the basic technical changes which could be comprehended with relative effortlessness. On the other hand, such a learning practice in the workplace, from the personal point of view, has been assistive to me to develop a holistic evaluation approach which could be demonstrated in terms of the outcomes of value based assumptions concerning the effective healthcare practices. The nature and reasoning of any decision have gained further traction on my part to be understood prior to development of any decision.

Evaluated own journey towards contributing to innovation and improvement in evidence based health, care or support practice and service delivery. How have you contributed towards innovation and improvement in evidence-based health, care or support practice and service delivery? How have you performed during this time?

I have considered such learning journey development in the work place to be the upfront learning experiences. This been oriented towards defining the best possible measures through which personal contributions could be made towards diffusion of innovation in terms of evidence based care and support activities. The necessity of contemplation of the opportunities of development has become evident for me. This form of realisation has fundamentally altered my perception of the relation between the academic research based learning and hands on experience based information gathering as the choice of data levels has become the determinant of the appropriate measure of learning and analysis of gained experiences. The impact has been profound on my part and has involved the achievement of a substantial understanding concerning the values which underscore the practices of others and those of mine as well. I have been attempting to understand the measure through which such values could relate to the selected healthcare outcomes. I have arrived to the conclusion that this would require me to consistently strive towards living the values of mine through my practices so the existing void between the actualities and the ideal operational performance could be progressively eliminated. I have managed to undertake the compartmentalisation based approach to discern the differential elements which have formulated the generalizability of practices concerning evidence based healthcare practices. The concentration of focus on the clinical care operations within the social support mechanism context has been vital for me in this context. Hence, the relevance of my observations could be backed up by the contextual evidence in terms of the benefits of client outcomes which could be obtained through improved evidence based operational practices such as interdisciplinary teamwork and communication development. The relative broadened experience and learning of mine have been able to cover the implementation processes as well. However, the factors concerning the learning experience have not been independent of each other.

Reference list:

• Alonso-Coello, P., Oxman, A.D., Moberg, J., Brignardello-Petersen, R., Akl, E.A., Davoli, M., Treweek, S., Mustafa, R.A., Vandvik, P.O., Meerpohl, J. and Guyatt, G.H., 2016. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. bmj, 353, p.i2089.
• Arnold, E.C. and Boggs, K.U., 2019. Interpersonal Relationships E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.
• Arumugam, V., MacDermid, J.C., Walton, D. and Grewal, R., 2018. Attitudes, knowledge and behaviors related to evidence-based practice in health professionals involved in pain management. International journal of evidence-based healthcare, 16(2), pp.107-118.
• Batterham, R.W., Hawkins, M., Collins, P.A., Buchbinder, R. and Osborne, R.H., 2016. Health literacy: applying current concepts to improve health services and reduce health inequalities. Public health, 132, pp.3-12.
• Chandler, J., Rycroft‐Malone, J., Hawkes, C. and Noyes, J., 2016. Application of simplified Complexity Theory concepts for healthcare social systems to explain the implementation of evidence into practice. Journal of advanced nursing, 72(2), pp.461-480.
• Dang, D. and Dearholt, S.L., 2017. Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau.
• Foronda, C., MacWilliams, B. and McArthur, E., 2016. Interprofessional communication in healthcare: An integrative review. Nurse education in practice, 19, pp.36-40.
• Harvey, G. and Kitson, A., 2015. Implementing evidence-based practice in healthcare: a facilitation guide. Routledge.
• Hiller, A., Guillemin, M. and Delany, C., 2015. Exploring healthcare communication models in private physiotherapy practice. Patient education and counseling, 98(10), pp.1222-1228.
• Holly, C., Salmond, S. and Saimbert, M. eds., 2016. Comprehensive systematic review for advanced practice nursing. Springer Publishing Company.
• Kurtz, S., Draper, J. and Silverman, J., 2017. Teaching and learning communication skills in medicine. CRC press.
• LoBiondo-Wood, G. and Haber, J., 2017. Nursing research-E-book: methods and critical appraisal for evidence-based practice. Elsevier Health Sciences.
• Lund, H., Brunnhuber, K., Juhl, C., Robinson, K., Leenaars, M., Dorch, B.F., Jamtvedt, G., Nortvedt, M.W., Christensen, R. and Chalmers, I., 2016. Towards evidence based research. Bmj, 355, p.i5440.
• Melnyk, B.M. and Fineout-Overholt, E. eds., 2011. Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
• Melnyk, B.M., Gallagher-Ford, L. and Fineout-Overholt, E., 2016. Implementing the evidence-based practice (EBP) competencies in healthcare: A practical guide for improving quality, safety, and outcomes. Sigma Theta Tau.
• O'Halloran, R., Worrall, L. and Hickson, L., 2015. Environmental factors that influence communication between patients and their healthcare providers in acute hospital stroke units: an observational study. International Journal of Language & Communication Disorders, pp.1-18.
• Reeves, S., Pelone, F., Harrison, R., Goldman, J. and Zwarenstein, M., 2017. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6).
• Riley, J.B., 2015. Communication in nursing. Elsevier Health Sciences.
• Straus, S.E., Glasziou, P., Richardson, W.S. and Haynes, R.B., 2018. Evidence-Based Medicine E-Book: How to Practice and Teach EBM. Elsevier Health Sciences.
• Wilson, M., Sleutel, M., Newcomb, P., Behan, D., Walsh, J., Wells, J.N. and Baldwin, K.M., 2015. Empowering nurses with evidence‐based practice environments: Surveying Magnet®, Pathway to Excellence®, and non‐magnet facilities in one healthcare system. Worldviews on Evidence‐Based Nursing, 12(1), pp.12-21.
• Zaccagnini, M. and Pechacek, J.M., 2019. The doctor of nursing practice essentials: A new model for advanced practice nursing. Jones & Bartlett Publishers.