Essay On Evidence Based Practice

Week 6
Evidence –based practice and its impact on nursing management and leadership

Recent changes in the American health care system, the challenges to recruit and retain nurses, and other factor observed such as quality of decision making in the work environment have been the leitmotiv encouraging me to conduct this study. I want to conduct a systematic research using interviews, evidence through the literature, the patient determination acts in the context of health care system. I will critique the findings and propose some changes based on data collected after the interviews.
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This work is a systematic review of the literature, which assesses the impact and benefit in using Evidence –based practice (EBP) in nursing management
and leadership. This is an attempt to present what has been done and published, what the managers do not know, what should be done in the future?
I did an electronic literature search and a review of the literature and want to present my findings using Doctor Young recommendations:
The theorical approach leads to admit the importance of EBP.
Ptefferl (2006) stated it is time to start an evidence –based movement in ranking manager, because the challenge is greater in management than medicine. Nurse Managers represent higher management, their decision should be made with the clear goal considering the vision of their organization. Efken (2010) believe a decision support tool should help manager make effective decisions if it is systematic and efficient with consideration of more alternative ways to reach the goal. Could evidence -based practice help meeting that goal? Management is not in opposition to leadership, in fact, if both require the mastery of different skills, they are interacting synergistically. Management focuses on applying policy and procedure, decision making consistency while leadership is showing the way to adapt the unit to
change.
Hauck (2013) in a design, prospective, descriptive, comparative study integrates evidence in practice and prominent issue for hospital nursing such a as knowledge, skills, beliefs, organizational infrastructure and nursing leadership. There have been Successful key strategies were evidence-based practice has helped by training and practice change behavior in management and leadership position. For example, “Transformational nursing leadership drives organizational change and provides vision, human and financial resources and time that empowers nurses to include evidence in practice”. We believe that nurse managers can make a difference in their organization if they are aware of new evidence and if they have been educated about the issues. The research findings indicate room for organizational improvement in hospital or unit care that provide “learning and supportive professional environment” as well as by involving staff in the decision making process.
Such initiatives are also likely to be sources of motivation to augment use of research and evidence-based nursing by floor nurses when they are promoted. The limit of the work is better understanding does not mean real implementation in improving the workplace environment (Wallin, 2006). But there is little evidence on what works and what organizations can do to support best management practice based on my reading. I came across a pamphlet online presenting the Current role and nature of managers in today’s NHS. Although official records state that 3% of staff are managers, new research suggests that around a third of hospital staff have substantial managerial roles. For example, I have observed charge nurse making decision for an entire unit. I will present a definition of different roles play by nurses at my Monroe Hospital. I found managers at bedside doing dressing and charge nurse making decision resulting in a dual role that could impact management of the unit efficiency. Another important finding that I believe exist in some of the literature is management and leadership functions is more distributed from top to bottom among nurses. Unfortunately they do not address the importance of education and constant Training for nurses in the manager
role.
Medical leadership and management varies inside the organization, because of lack of standard criteria. The organization needs to create a structure using a pathway that the use of Evidence-based practice can support. It is a fact as nurses sometimes we cannot separate our role as clinician and manager.
New studies show that manager role capability is seen positively by other nurses as personal experience, and practice from other sites than on formal path such as academic diploma or evidence research-based.
Education in a formal area could be helpful in providing reflective spaces for managers and leaders to transform knowledge into practice. Managers need critical skills to assess the quality of evidence and what might work for them in a particular context.

Bondas, in leadership and evidence-based care, using inductive analysis states: Nursing has not invested enough in the development of nursing leadership for the development of patient care. The path model for nursing is presented. Four different paths were found, according to variations between the nurse leader’s education, primary commitment and situational factors. They are called the Path of Ideals, the Path of Chance, the Career Path and the Temporary Path. Her work leads to “Situational factors and role models of good, but also bad nursing leadership besides motivational and educational factors have played a significant role when Finnish nurses have entered nursing leadership. The educational requirements for nurse leaders and recruitment of nursing management positions need serious attention in order to develop a competent nursing leadership”. Nurses today have tools available to them and can no longer hide only behind the teaching delivery from classroom and clinical experience. Evidence based research and nursing theory have played an important role in the career of a nurse. Nurses can question their practice and find an alternative way to do their job by using research findings for better alternative practices. I am interested to know if evidence based practice changes nursing management and leadership approach in a health care setting. I want to know what the literature has been saying, the recent conclusion of those studies.

References:
BONDAS, T. (2006).Paths to nursing leadership. Journal of Nursing Management, 14,332-339

Spiri, C., W., Macphee, M. (2013).The Meaning of Evidence-based management to Brazilian senior nurse leaders. Journal nursing scholarship, 45(3), 265-272

Gifford, A., W., Davies, B. (2008). Doing the Right things to do Things right: A commentary on leadership and the use of evidence-based in practice. Worldviews on Evidence- Based Nursing-Sigma theta Tau International.

HAUCK S., WINSETT R.P. & KURIC J. (2013) Leadership facilitation strategies to establish evidence-based practice in an acute care hospital. Journal of Advanced Nursing 69(3), 664–674. doi: 10.1111/j.1365-2648.2012.06053.x

Nickitas, D.M. (2009). An interview with Anthony Kovner on Academic-Clinical Partnership: Building the case for evidence-Based Management. Nursing Economics, 27(2), 99-101.

Pfeffer, J. (2006). Evidence-Based Management. Harvard Business. Review. Retrieved from http://hbr.org/2006/01/evidence-based management/ar/1
Roche, .C.D.M., O’Brien-Pallas, L., Catling-Paull, C. (2009). The Implications of Staff ‘Churn’ for Nurse Managers, Staff, and Patients. NURSING ECONOMIC, 27(2).
Spiri, C., W., Macphee, M. (2013).The Meaning of Evidence-based management to Brazilian senior nurse leaders. Journal nursing scholarship, 45(3), 265-272.
Wallin,V., Ewald,U., Wikblad,K. , Scott-Findlay,S. , Arnetz,B.B.(2006). Understanding Work Contextual Factors: A Short-Cut to Evidence-Based Practice? Worldviews on Evidence-Based Nursing- Sigma Theta Tau International, 3(4), 153–164.
Xiaoshi, L. (2008).Evidence-based practice in nursing: what is it and what is the impact of leadership and management practices on implementation? Nursing Journal North Tec, 12, 6-12.