Evidence-based nursing practice is the process through which nurses utilize the most current research to offer the best care to patients, which leads to improved health outcomes and lower costs (Abu-Baker et al., 2021). Evidence-Based Plan (EBP) combines the latest research in nursing literature, practitioner experiences, and the patient’s preferences and values to deliver the best possible care to patients.
EBP saw widescale integration in the 1990s but developed as a nursing concept in the 1970s when it was called evidence-based medicine (Abu-Baker et al., 2021). However, some nursing professionals maintain that it developed in the 1800s when due to unsanitary conditions, nurses tried to improve patient outcomes through accurate observation and analysis (McIlreevy et al., 2020). Nightingale, who pioneered evidence-based practice at the time, tried to improve patient outcomes during the Crimea war between the Russian empire and Turkey by using critical thinking skills, experimentation, and evidence. Therefore, EBP is a process through which patient outcomes are improved by applying the latest in nursing research and clinical experience.
Clinical nursing practice was once based on traditional and established rituals. However, these traditional and established rituals do not always result in the best possible outcomes for patients. Nursing practice based on established rituals is not grounded on scientifically sound evidence and could be detrimental to a patient’s health or lead to suboptimal utilization of resources. In contrast, EBP utilizes up-to-date evidence in nursing practice to recommend a practice change that often results in improved health outcomes for a patient.
Over the years, multiple models have been developed to facilitate evidence-based nursing practice. One such model is the IOWA model, which benefits a patient through enhanced nursing practice and the moderation of the costs of healthcare. This model facilitates the application of the latest nursing practice empirical evidence to patient care for better and improved health outcomes. For this purpose, the IOWA model is recommended for the villa health patient.
The proposed evidence-based plan for the villa health patient is the IOWA model, which was developed by the University of Iowa Hospitals and Clinics. The IOWA model is the most widely used EBP and it outlines several steps that a nurse should take to offer the necessary care for a patient. The first step is to identify a trigger that warrants EBP (Buckwalter et al., 2017). The trigger could be problem or knowledge-focused. The second step is to determine if the trigger is prioritized by the healthcare center, unit, practice, or department. If the identified problem is a priority, the nurse should form a team that identifies, evaluates, and implements the required EBP change.
The team should be composed of professionals from a particular nursing unit and outside it to ensure input from other units is considered when evaluating and implementing the EBP change. The next stage involves gathering and analyzing literature on the desired change. Here, a research problem should be formulated using the PICOT method and related research materials gathered (Buckwalter et al., 2017). After the necessary materials are gathered, a critique and synthesis of the materials should occur to determine if they are scientifically sound.
The nurse and the team should then decide whether there is sufficient evidence to effect the change. If the evidence is adequate, gradual changes should be implemented. Gradual change is recommended instead of full practice change to allow for the evaluation of the change (Buckwalter et al., 2017).
If the implemented change is found to be effective or results in improved patient outcomes, full practice change should then follow. The IOWA model is appropriate for the villa health patient because it applies evidence-based practice before a change in nursing care is recommended. The model recommends a gradual implementation process after evaluation of the previous change in a move likely to lead to better and improved outcomes while taking necessary precautions against any negative outcomes that could ensue following a partial implementation of recommended change. The complexities in the villa health patient would benefit from the meticulousness recommended by the IOWA model.
The IOWA model also fits well with the remote care and diagnosis that the villa health patient received. Through remote care and diagnosis, a collaboration between various medical health professionals was made possible despite being in different geographical locations. Based on the symptoms presented by the patient, the professionals were able to apply their clinical experience to recommend ways the patient’s outcome could be improved.
The fact that they were able to collaborate on such a complex case underlines the advances that have been made in the health sector due to advances in technology. Several years ago, it would have been impossible for clinical professionals to remotely diagnose and offer treatment recommendations. Now, remote care and diagnosis have gone mainstream and were popularized during the COVID-19 pandemic. However, as the vila health patient care shows, remote care, and diagnosis if effective even for non-infectious patients.
Telehealth, as remote care and diagnosing, as it is usually referred to, has several benefits and challenges. The primary benefit is that remote care and diagnosis allow the provision of medical and nursing care to a patient with mobility issues. In addition, it saves on costs and removes the inconvenience of visiting a healthcare clinic (Shen et al., 2021). For these benefits, remote care and diagnosis have seen tremendous growth, with most patients opting to remotely connect with their physicians and nurses. However, several challenges accompany remote care and diagnosis. The first and most obvious challenge is the fact that it is not always possible to diagnose a patient remotely (Shen et al., 2021).
Some conditions, such as the one presented by the villa health patient, are so complex that it becomes virtually impossible for an entirely remote diagnosis. Instead, a nurse is required to be with a patient, especially when collaboration is required for proper care. Therefore, despite its benefits to patients, remote diagnosis and care are not applicable in all situations.
The IOWA model as an EBP is appropriate for the villa health patient because it provides a framework through which patient care can be improved through the application of the latest empirical evidence and clinical experience. The IOWA model recommends the incorporation of clinicians from other nursing units when evaluating and recommending a practice change that matches the collaborative effort done for the villa health patient. Although collaboration was done remotely, the professionals involved managed to recommend practice changes bound to improve the patient’s outcome. However, remote collaboration also showed the limits of remote care and diagnosis. In effect, while it is possible to remotely diagnose and care for a patient, some complex cases require the physical presence of at least one nurse or medical professional to be effective.
References
Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate nursing students. BMC Nursing, 20(1). Web.
Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., Rakel, B., Steelman, V., Tripp-Reimer, T., & Tucker, S. (2017). IOWA model of evidence-based practice: Revisions and validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182. Web.
McIlreevy, J., Rylee, T. L., Shields-Tettamanti, T., & Gee, P. M. (2020). Interdisciplinary optimization of admission documentation. CIN: Computers, Informatics, Nursing, 39(5), 248–256. Web.
Shen, Y.-T., Chen, L., Yue, W.-W., & Xu, H.-X. (2021). Digital technology-based telemedicine for the COVID-19 pandemic. Frontiers in Medicine, 8. Web.