Title: Challenges of implementing evidence based practices in the clinical practice

Biography:

 

Manjubala Dash, working as a professor in Nursing. Speciality is obstetric and Gynaecological Nursing. Have 21 years of teaching and research experience in the field of Nursing.  She is organized National and International Conferences, workshops in the field of Nursing.  Participated and presented more than 100 papers in the National and  International conferences. Published articles nearly 50 in the National and International Journals.  She is the co-editor for International  Journal of Nursing Panorama, The Genesis, Contemporary Journal of Microbiology, EC Paediatrics, EC Gynaecology etc. she has credit of  3 books in the field of Midwifery and Word management. Contributed chapters for Midwifery Books. She is a National  Trainer for Infant and Young Child Feeding Counselling Specialit course. Did research projects under DHR and ICMR, DST etc. Main interest is on Research, Education and Administration. Conducted many programmers for antenatal, postnatal mothers in the community level and hospital level. Got opportunity to deliver a talk as speaker in the International and National Conferences. She is guiding the Students of UG, PG and PhD for Research.  She has a recognized guide in different university and examiner for PG and PhD Students too. She have gone for conducting Inspections to various colleges by the Indian Nursing Council.  Her special interest is on family planning, contraceptive methods, reproductive health, promote exclusive breast feeding etc.

Abstract

 “Evidence” is described by Gambrill (2006b, 99) as “ground for belief, testimony, or facts regarding a claim for conclusions,” and comes in the form of empirical data, practice wisdom gained through dissemination of experience between colleagues/practitioners, and client feedback (the client being a collaborative partner in this process, whose knowledge, values, and goals are also considered). IOM has said 90% of all patient-care decisions should be based on evidence by 2020. Study was conducted among Nurses working in the Maternity hospital on practice of “Breast Crawl” as an evidence based practice to initiate breastfeeding immediate after delivery.

Aim/ objectives: To explore the challenges of EBP in the Clinical Practice and barriers for practice EBP

Methodology: Quantitative Research Approach and Non-Experimental Design was used in this Study. Data collection was done with the help of questionnaire among 25 Nurses working in the Labour Room of the selected hospital, those were present during the period of dtata collection and willing to answer.

Result. The mean age of the staffs were 32yrs, 80% had GNM and 10% had Direct BSc Nursing and another 10% had GNM then PB BSc Nursing. Mean years of Experience was 13years. The staffs with more education level tended to have more confidence in implementing evidence-based practice. However, the longer nurses had been working in healthcare, the less interested they were in learning more about evidence-based practice. They feel whatever they practiced till today is best and not like to change themselves to adopt the new concepts in their practice.

The Result regarding whether they were aware of breast crawl method shows that all were unsure about this method, not confident in practice highlights inconsistent knowledge.  When staffs were asked for the reason not following the breast crawl method  in their clinical practice all the staffs 100 % presented their difficulties that lack of time, work over load, lack of staffs for support, fear of any mishaps, No one is there to observe both mother and baby, lack of support from their clinical supervisors etc. When asked what would help them implement evidence-based practice, respondents reported education, access to information and organizational support, Provision of additional staffs etc  among their top needs.

Conclusions

Evidence-based practice starts with a practice/clinical question .It takes professional expertise and patients’ preferences/wishes and the best research evidence into account .It is about decision-making .A number of stakeholders have responsibilities in promoting EBP .Without practitioners/clinicians, there is no EBP.  Implementation of EBP not only involves personal attributes, but also factors related to the organization's context, like culture, responsibility, work load, and resources. Hence, to become effective in promoting EBP, nurses need support to confront personal, interpersonal, and organizational factors that intervene in their capacity to avail of their whole potential. Leaders and administrators have a key role in the implementation of EBP, not only by supporting care based on evidence and by providing the infrastructure for such, but also by modeling evidence-based decisions.