Barriers Associated With Implementing Evidence-Based Care Among Nurses
Evidence based practice /care (EBP) suggests applying the accumulated/acquired practical knowledge for current and future clinical practice. Knowledge may come from within or external sources. Nurses are expected to update their knowledge by cultivating evidence based practice. This is not unique to nursing or for that matter health care profession alone. The need for evidence based practice is all pervasive in all professions. Professionals generally tend to stick to what they learnt in their professional courses and traditional practices. They tend to resist introduction of new practices to replace age-old and time-tested ones. The resistance to change is one of the barriers to implementation of evidence based practice in the nursing profession.
With this background, this paper seeks to examine the potential barriers to EBP including the resistance to change. The aim and objective of this essay is therefore, to identify the barriers in implementing evidence based care/practice among nurses.
In this connection, it is emphasized that the concept of evidence-based care/practice is just the old wine in a new bottle, for any theory is generally grounded based on previous practice. Hence, what nurses learn in their class rooms are the grounded theories based on clinical practices on trial and error basis refined over the years. There must have been resistances or barriers to establish the grounded theories for nursing professional to follow even earlier and new knowledge might have taken longer time than is necessary to get established. If modern day professionals resist to changes or fail to overcome barriers, there will be dearth of new theories for the growth of professional knowledge. This does not augur well for the well being of mankind.
The barriers to EBP are many and have been a nagging problem to the nursing profession basically because of the ever growing body of knowledge. In this project it is proposed to examine two issues. (1) Resistance to change. 2) Other barriers. Resistance to change is a human tendency for tackling which “change management” has developed in the recent years as a separate branch of management practice. Concerns towards resistance to change stem from the need to provide the “highest quality, safest care possible to the greatest number of people in the most effective manner” (Travalgia, et al., 2011, p. 3). Nursing being mainly concerned with patient safety, research in this area draws heavily from the other professions like mining, aviation and rail. As a result, health management now embodies quality movements ranging from “Total Quality Management and Continuous Quality Improvement to Six Sigma and Lean Thinking” (Travalgia, et al., 2011, p. 3) and include managing the change i.e implementing change aimed at improvement in clinical practice (Travalgia, et al., 2011). Resistance to change stems from the feeling of uncertainty related to job security, concerns with increased workload, and the unfounded fears on the impact on patience care (Burke, 2011). (2) Other barriers: Other barriers to EBP include time factors, inaccessibility of the literature, lack of competency to critically evaluate empirical research, lukewarm interest in scientific enquiry among the nursing professionals and work environment that is not friendly towards EBP etc. (Hockenberry, Wilson, & Barbara, 2006).
Burke, L. (2011). How to make successful chnage management easier. Web.
Hockenberry, M., Wilson, D., & Barbara, P. (2006). Implementing Evidence-Based Nursing Practice in a Pediatric Hospital: Barriers to EBP. Pediatric Nursing , 32 (4), 371-377. Web.
Travalgia, J., Debono, D., Thoms, D., Hillman, K., Middleton, S., Hughes, C., et al. (2011). Change Management Strategies and Practice Development in Nursing : A Review of the Literature. Centre for Clinical Governance Research. The University of New South Wales. Web.
Essay on Medical Assistants
This research report is about Medical Assistants. There is no doubt that the main mission of contemporary medicine is to provide high quality medical services to patients of all ages in the most comfortable for them conditions. In such a way, the main thesis is the following: Medical Assistants have a noble vocation, aimed at providing health care for people and improving the quality of patients’ life, in their activity. Thus, the main aims of this project are to observe the activity of Medical Assistants, and to research specific features of their work, explaining the types of knowledge that Medical Assistants explore and the professions to which it leads.
First of all it is important to mention that Medical Assistant is a health care provider who works with a physician or other health professional, and help him in carrying out various procedures and a preliminary assessment of the patient. According to Lindh, et al (2002), “medical assistants perform routine tasks and procedures such as measuring patients’ vital signs, administering medications and injections, recording information in medical records-keeping systems, preparing and handling medical instruments and supplies, and collecting and preparing specimens of bodily fluids and tissues for laboratory testing”. Sometimes the term ‘medical assistant’ may be confused with the term ‘physician assistant’, but it is very important to remember that these terms are quite different in their essence, because physician assistants have a qualification to perform specific clinical, therapeutic and surgical procedures, while medical assistant have other range of their duties.
Observing the range of duties any medical assistant has in his/her work, it is important to mention that exactly medical assistant provides a great number of direct patient care and various medical support services in healthcare facilities. Medical assistants may be considered a kind of versatile healthcare personnel, and that is why they can be assigned on the performing of both administrative and clinical tasks. It is impossible to overestimate the necessity of medical assistants to many healthcare facilities, because they are able to reduce human resource expenses by handling both administrative and clinical duties. BLS (2009) mentioned that exactly to such versatility the demand for well-qualified medical assistants has increased in many times in recent years.
The mission of medical assistants is to improve the health of patients, who come to them for medical care, providing a wide range of medical services of consistently high quality. Medical assistants are called for to balance the goals and interests in achieving the social, medical and economic efficiency. Thus, they can work in various healthcare facilities, ambulatory healthcare centers, such as physician’s office, obstetrics or gynecology clinics, dental clinics, dermatology clinics, etc.
To fulfill all the necessary responsibilities medical assistants must have a certain amount of knowledge and skills that they receive in the process of theoretical and practical training. Observing the types of knowledge that Medical Assistants explore, we can mention that specific courses for this occupation cover not only medical disciplines such as anatomy, physiology, medical terminology, but also accounting, keyboarding, recordkeeping, transcription, and even insurance processing. Students who are going to become medical assistants may learn various types of clinical and diagnostic procedures, specific features of laboratory techniques, pharmaceutical principles, and, of course, be able to provide the first aid in any situation. In addition, each medical assistant may also be an expert in ethics, medical law, patient relations, and even in various office practices.
It is true that disciplined, executive and accurate medical assistant is a good assistant to the physician, and only combining their efforts both health professionals will achieve success in treatment. To be a good assistant to the physician in any healthcare facility, medical assistant needs to understand the meaning of every physician’s appointment and perform it not blindly, but conscientiously and consciously. To do this, a medical assistant should remember that it is not enough to be content with the knowledge gained in medical school, because it is important constantly multiply them to achieve a really good result in own practice by reading medical literature. This principle becomes all the more necessary in the frames that medical science is advancing all the time; more and more new treatments and diagnostics appear in it each year. However, medical assistant also should be able to understand the meaning and the need of a doctor’s appointment for the patient, and has important arguments to convince the patient in the benefits of an assigned treatment. All the doubts that a medical assistant has in own practice should be shared with a physician without any hesitation.
The behavior of medical assistant will be correct, if he/she places the interests of the patient before his/her own ones; while his/her personal interests, for instance, the fear of punishment for a mistake, gain the second position. Breen, Plueckhahn and Cordner (1997) stated that as much as a doctor, a medical assistant is responsible for the mistakes in the work before the court, but not judicial responsibility should guide the behavior of medical assistant, because the most influential responsibility is exactly moral responsibility.
As it was previously said, medical assistant must be able to provide first aid not only in a healthcare facility where he or she works, but wherever she/he is at the moment: at home, outdoors, in transport – everywhere. A refusal to provide first aid may be punished by moral and judicial responsibility.
Adding the question about professional opportunities that medical assistants have in their job, Verlin (2006) mentioned that “working towards gaining good qualifications like a degree, certificate or diploma will work wonders towards getting a top class job in the healthcare industry.” For instance, qualified medical assistants will always find many opportunities opening up for them in various specialized health care sectors, and these career opportunities may be advanced in many areas, such as medical or clinical office manager, transcription supervisor, healthcare administrator, lead medical assistant, executive medical office secretary, clinical team leader, etc. In addition, it is obvious that it is more important to medical assistants to continue own education in this area, because it is much better to become a Certified Medical Assistant than occupy the role of the general medical assistant.
To sum up, we have observed the necessity of medical assistants in our contemporary medical sector, explained the types of knowledge that medical assistants explore and the professions to which it leads, and proved that the main role of medical assistants is to restore, preserve and promote the health of people, and to save their lives in spite of any difficulties on their way.