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Organisational Factors in Research Utilisation

Evidence-based Nursing Practice enables the nurses in understanding the risk as well as effectiveness of treatments. The application of this practice ensures that the nurses to have a patient care plan (Mathieson et al., 2019). The key areas that will be focused in this report will be barriers and facilitators, clinical practice guidelines and maintaining and sustaining adherence to a policy.

There are several barriers that nurses face during the Evidence-Based Practice, for example, lack of knowledge, lack of motivation, lack of resources, discouragement, hopelessness, and negative thinking. Hurdles during implementation of the evidence-based practices impede in clinical decision-making practices. Some of the barriers and facilitators are divided into organisational factors, individual factors, communication factors, and quality of research (McArthur., 2021).

Organisational factors are the barriers that nurses find difficult in research utilisation. Nurses find it difficult to evaluate, time to read, analyse and execution of research evidence. In a survey, it has been observed that nurses have faced many organisational factors that hinder their practice setting. This aspect was also recognised by Hutchinson and Johnston in Australia and by nursemaids in Hong Kong (Tso et al., 2019). Lack of facilities and insufficient support for implementing research are the major barriers.

Typically recognised individual barriers include a shortage of knowledge about analysis methods, inadequate awareness of analysis findings, and a pessimistic attitude toward research. A study accomplished in Spain discovered that the greatest three obstacles were connected to the unusual aspects of the nurses, specifically, their thoughts about the importance of research and belief in their research dexterities (Barth et al., 2016). Existing incapable of assessing research quality was rated as the most significant obstacle.

Competent communication allows family physicians to show relationships, survey and convey important facts, and work effectively with patients and family members. However, when medics are encountered with the time strains of an engaged clinical workday, careful communication often gets mislaid in the shuffle. Communicational factors are important during nursing practices as this will help the physician and the patients understand the situations. Communication skills are known to be a vital factor in limiting the gap between evidence-based practice and patient-centred care and in enhancing patient health consequences (Proctor et. al, 2011). As such, health practitioners can be expressed as 'frontline facilitators' of evidence execution into practice; how well nurses convey this evidence to patients relies, in part, on their applicable skills, attributes and understanding. Significantly, evidence-based facts should be conveyed clearly and understandably to facilitate patients to create informed judgments. 

A significant aspect may be the quality of published research. Methodological inadequacies, insufficient rationale of research findings, and inconsistent results are all challenging for the beginner researcher. Serendipity of analysis outcomes and articles not publicised quickly enough are also constituents of the quality of analysis and the elements of innovation.

Comprehend each Patient's Medication-Taking Behaviours- Asking the patients whether the patients are facing any hurdles in affording the prescriptions. For example, nurses can ask the patients whether a patient is finding it difficult to take medication regularly (Yoo et al., 2019).

Individual Barriers and Facilitators

Considering the Side Effects- There can be possible side effect while taking the medication, patient sometimes face this problem and this can be quit by providing the proper prescription in advance. Nurses and midwives must discuss about side outcomes and to prevent the further drug reactions.


Collaborate with Patients-
Providers or midwives can ask the patient the best time to take medication, such as providing them specific instruction ( such as specific medicine that needs to be taken in morning). Collaborative approaches support the patient and nurses in to identification of gaps that can hinder medication process. 

Diminishing the Complication-Diminishing intricacy of the drug prescription raises possibility that patients will pursue through with taking prescriptions accurately. Providing the proper medication can help in reducing the complexity (Mathie et al., 2012). Another is to specify medications such as by taking a single medication rather than numerous medications per day.

Financial Burden -Financial burden can be one of the issues that most Patient face during their treatment, many of the patients cannot afford their medication. To combat this, the managerial system of the hospital can provide the link to the patients with various of the services that can reduce burden, for example health insurance and outpatient facilities (Proctor et al., 2011).

Use of Technology- Alarm watches can help enhance patient prescription adherence. One of the important technology known (blue tooth pillbox), this technology helps in providing the notification to a patient every time so that patient can take their medication on time (Proctor et al., 2011). Many obstacles are observed during medication, this can be reduced through a variety of approaches.

Guidelines include useful evidence-based recommendations for experts and patients and aim to enhance the quality of care. Usually, uptake of policies does not occur spontaneously, and often functional performance method is required. Moreover, once an approach is successfully executed in practice, it may be challenging to maintain the quality advancements over a more extended period (Yoo et al., 2019). Individuals usually tend to fall back into old practices, which may influence long-term devotion to approach. Clinical guidelines are meant to provide effective patient care and treatment plans, for example, in cervical cancer patients, it includes recommendations on the diagnosis and treatment. It is also recommended that psychosocial support also help in rehabilitation and follow up care. Systematic patient care can be another recommendation that will support the patient in getting benefits to patients. Recommendations are planned to enhance significance along with good care, reduce divergences in medical practices, and to reduce the cost along with the negative events.

It can be recommended that standards can be maintained through which audit can be done, this will be supportive in providing the nurses to have proper guidance regarding the specified tasks. CPGs (Clinical Practice Guidelines) is known for providing quality advancements that help in identifying the basic results and patient care norms. These guidelines support in getting the potential benefits along with better recommendations from the medical professionals. For example in treatment of anxiety, one of the bodies such as the National Health Institute of Mental Health will support in reduction of anxiety levels in patients.

Nurses can retain best-practice statements for anyone or a mixture of problems regarding screening of specified disorders and diseases, diagnosis of disorder, and monitoring. The term 'protocol' is referred to specific demeanour at prudent and societal circumstances. In medical and health professionals, it has the purpose of rules concerning performing special operations precisely and without mistake. Clinical pathways counter by being better detailed about interventions' sequence, timing, and condition. They are usually established on CPGs and contextualised for usefulness within distinct circumstances. Nurses are recommended that they should first go through the guidelines and policies before their implementation; in another way, they can seek help of their fellow members on how things are carried out during treatment and medication (Tso et al., 2019). Effective execution of the latest clinical practice guidelines, a precise plan for follow-up of the efficacy should be set. This usually takes place in clinical environments as a quality progress assurance protocol. 

Conclusion

The findings in this report have examined hindrances and facilitators using research evidence in nursing practice among nursemaids. Various of strategies have helped decrease non-compliance with a policy. Report has also provided recommendations to be followed by nurses during treatment plans and for care of patients. 

References

Barth, J. H., Misra, S., Aakre, K. M., Langlois, M. R., Watine, J., Twomey, P. J., & Oosterhuis, W. P., (2016). Why are clinical practice guidelines not followed?. Clinical Chemistry and Laboratory Medicine (CCLM), 54(7), 1133-1139.

https://www.degruyter.com/document/doi/10.1515/cclm-2015-0871/html


Mathie, R. T., Roniger, H., Van Wassenhoven, M., Frye, J., Jacobs, J., Oberbaum, M.,  & Fisher, P., (2012). Method for appraising model validity of randomised controlled trials of homeopathic treatment: multi-rater concordance study. BMC Medical Research Methodology, 12(1), 1-9. https://link.springer.com/article/10.1186/1471-2288-12-49


Mathieson, A., Grande, G., & Luker, K., (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20. https://www.cambridge.org/core/journals/primary-health-care-research-and-development/article/strategies-facilitators-and-barriers-to-implementation-of-evidencebased-practice-in-community-nursing-a-systematic-mixedstudies-review-and-qualitative-synthesis/74D8FB3E7561129C8CBBF01207837BCC


McArthur, C., Bai, Y., Hewston, P., Giangregorio, L., Straus, S., & Papaioannou, A., (2021). Barriers and facilitators to implementing evidence-based guidelines in long-term care: a qualitative evidence synthesis. Implementation Science, 16(1), 1-25.

https://implementationscience.biomedcentral.com/articles/10.1186/s13012-021-01140-0


Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., & Hensley, M., (2011). Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and policy in mental health and mental health services research, 38(2), 65-76. https://link.springer.com/article/10.1007/s10488-010-0319-7


Tso, A. W. B., & Lee, S., (2019). Reading the Short Story: A Student's Guide to Selected British, Irish and American Works. McFarland. https://books.google.co.in/books?hl=en&lr=&id=6z67DwAAQBAJ&oi=fnd&pg=PP1&dq=aspect+was+also+recognised+by+Hutchinson+and+Johnston+in+Australia+and+by+nursemaids+in+Hong+Kong&ots=At6CH8qVT4&sig=6MJOissQXxtLOk65Oq2utGbj7nA&redir_esc=y


Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S., (2019). Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS One, 14(12), e0226742. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0226742

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