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

Response to peer discussion board-150 words-1 reference within 5 years-NURSING JOURNALS ONLY.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 care evidence-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 units clinical leaders 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. 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 any 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. 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. . US TODAY AND GET AN AMAZING DISCOUNT The post Response to peer discussion board-150 words-1 reference within 5 years-NURSING JOURNALS ONLY. appeared first on Nursing Homeworks.