Research and evidence-based practice 5NU519 Assignment Sample

Introduction - Research and evidence-based practice 5NU519 Assignment Sample

Evidence-based practice [EBP] is highly important in healthcare disciplines; it adheres with scientific evidences, clinical expertise and individual’s patient preference (Boltz, Capezuti and Fulmer, 2024). Evidence-based research [EBR] and Evidence-based decision-making procedure guides EBP and enables Nurse Associate [NAs] in improving patient outcomes. Critical appraisal of research is an integral domain in EBP that aims to recognise methodological components and supports in undertaking informed decision in clinical settings (Melnyk and Fineout-Overholt, 2022). Evidence appraisal comprehends with acquiring information, critiquing it in systematic manner, identifying its relevance and implying on clinical research area. This supports in assessing research quality and its application. (Puljak, 2022). EBP is upholding the notion of authentic and scientific evidences required for providing quality services to patients.

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The aim of current assignment is to critically evaluate a primary study and considering this within wider context of EBP. The selected study is “Managing uncertainty in advanced liver disease: a qualitative, multi-perspective, serial interview study” (Kimbell et al. 2015). Emphasis will be made on critically analysing study approach, design, pling, data collection methods, data analysis methods and ethical considerations. The essay will also assess evidence for whether it can impact working practices or not. Based on the analysis, benefits of own role and barriers with regards to implication of practices for healthcare professionals will be explained. Significant emphasis would be made on highlighting organisational role that might require for appraising and sharing research within clinical context.

LO1

Evaluation of primary-based research

The qualitative study by Kimbell et al. (2015) aims to elucidate the experience and support required by people suffering from advanced liver disease and those of their lay carer for informing improvement in palliative care context. As per CASP framework; aim of the study must determine about the context of research, it must be clearly relevant to topic and goal of the research. CASP refers to Critical Appraisal Skills that supports in assessing the trustworthiness, relevance and results of the published articles. (CASP, 2021). Kimbell et al, (2015) study proves to be effective in signifying aim as appropriate terminologies were used that complies with research area and subsequently, notion of research; “experience and support requires in advanced liver disease” and “improvement needed for improving palliative care” was combined in the aim of study. The aim was specifying about the research area, readers can easily identify about research area after reading aim.

Research should ensure the adopted approach in study is suitable with respect to study area or not (Robinson et al, 2021). It can be said that a qualitative approach is suitable for this research aim and study area. The focus of study was on recognising the experience and support of patients; numerical stances does not support in gaining detailed opinions and feelings of people (Tod, Booth and Smith, 2022). However, theoretical insights are suitable for understanding the experience and support; this provides opportunity to researcher in terms of recognising the feelings and emotions of participants (Robinson et al, 2021). Therefore, qualitative approach is suitable in current context.

In the context of design significant insights from study has been revealed; multi-perspective serial interview was conducted and consequently, three qualitative in-depth interviews [each of the patient, lay carer up-to 12 months and single interview was conducted with healthcare professional] Through grounded theory technique information was analysed and findings were developed (Kimbell et al, 2015). The strengths of the design are that is has adopted grounded theory technique and it supporting in discovering and exploring new theories.

In terms of the sample, patients suffering from ascites, common complication of advanced liver disease were selected and those patients who had non-hepatic cancer and other Long-term conditions were excluded. This suggests that the recruitment procedure followed fair practices and the health of patient was prioritised 38 patients were approached and from these 25 were agreed, 10 participants have been withdrawn in first phase of interview due to decline in health efficacy (Kimbell et al, 2015). Thus, 15 patients were finally approached along with 11 lay carers and 11 professionals’ carer. Total 37 candidates selected in the study 37 participants were not an adequate sample size for this research, increasing the participants could have enhanced the efficacy of research. The effective sampling procedure complies with selecting those participants that can provide appropriate information related to research area (Tod, Booth and Smith, 2022). Hence, the author approached patients and carers who were well aware of the experience, support and situation, and this proves that sampling was done by adhering with recruitment protocols.

The primary data collection was interviews, conducted by an experienced qualitative researcher via telephone This method significantly helped the aim of the study as through interview, experience and support of patient identified, areas in which service and resources lacking were also identified (Kimbell et al, 2015). Via primary method direct interaction with the participants can be made and realistic insights could be developed. Same witnessed in the current study and by implementing direct interaction with candidates’ facts were observed. The process was effectively explained however, researcher lacked in providing rationale behind selection of primary method. It is an important domain among high quality studies; justification behind methodologies is essential. Whilst, there was lack of justification in this area, apart from this, whole process was explained in appropriate manner. There are certain strengths of telephone interviews witnessed; it improves validation of respondents and keeps respondents engaged (Robinson et al, 2021). Thus, approaching telephonic interview proves to be an effective option in current study.

While conducting evidence-based research, focus must be implied on selecting such data analysis method that is appropriate in accordance with data collection technique (Haile, 2022), and for this study thematic interpretation is suitable. Thematic analysis is suitable for analysing qualitative data and it provides in-depth information regarding research outcomes. However, limitation of thematic analysis is that it consumes time. Thematic analysis was done by research and via using software themes was developed. The researcher has used appropriate method for analysing the data as this is suitable for evaluating qualitative insights. Thematic representation of the findings was done which has made research effective (Robinson et al, 2021).

Ethics are primary element within study and this proves to be foremost component in evidence-based research. Ethics determines whether the researcher has performed all the practices in authentic manner or not. In current study, ethics was followed and this can be evident via presented information. All the participants were given informed consent form and they were made aware about research context. Informed consent is a crucial process as this determines that candidates were not forced to take part in research (Haile, 2022). Kimbell et al. (2018) study has used consent process by providing consent form to participants and they were made aware regarding research context. Kimbell et al. (2018) also maintained the confidentiality of participants. No disclosure of the personal identity was done and this is pivotal for. Moreover, patient’s health has been prioritised and in initial interview phase certain patients were excluded due to their health complexities. In this manner, safeguarding of the patient was maintained, hence, there is no doubt in stating that ethics within the study was effectively followed and this led to enhance the efficacy of outcomes. Protecting individuals is considered as an important ethical practice and undertaking safeguarding of an individual complies with this (Puljak, 2022). Hence, by protecting participants researcher has followed ethics.

LO2

The findings of the study depicted that living, dying and caring within care of advanced liver disease has dominated through enduring, pervasive and universally shared uncertainties. The Multidimensional patient distress significantly articulating about the need of service improvement within palliative care approach for patients (Kimbell et al, 2015). It is pivotal to ensure that patient receiving timely and appropriate palliative care along with undertaking effective management of unpredictable illness (Kimbell et al, 2015). A systematic review found on this topic suggesting similar insights and revealing that it is important to assure that during palliative care patient receiving consistent care. (Li, Chhabra and Singh, 2021.) The outcomes of research informing practice regarding implication of palliative care principles for patient suffering advance liver disease. Patients and families require better education and information regarding each component (Vijeratnam et al, 2021).

There is need to promote public awareness as this supports in enhancing patient outcomes (Yoshiji et al, 2021). Another research by Yoshiji et al, (2021) informing that public should be made aware regarding serious consequences of alcohol drinking and its drastic impact on liver disease. Education of patients and caregivers regarding advanced liver disease and its potential complication is important due to less level of knowledge regarding cirrhosis (Kim et al, 2022). Thus, there is no doubt in stating that findings of the study informing clinical decision-making regarding inclusion of palliative care principles and improving services within palliative care. Moreover, it is important to create public awareness in this context so that risk related to potential complication can be reduced.

LO3

The analysis of study significantly developed understanding regarding importance of EBP along with the requirement of consistent improvement. Research evidences informing working role in varied context; it is informing about keeping patient’s needs at forefront, this is further specifying about including family members in the care procedure. The upper-level organisational supports is required for implying EBP and undertaking service improvement within palliative care services for patients suffering from advanced liver disease. Important insights developed from the study and it is essential to imply this finding in practice for enhancing patient outcomes (Furuki, Sonoda and Morimoto, 2023). Significance of patient education and public awareness identified in the study and this is informing own working role in clinical setting. It is important to focus on educating patient regarding their disease and severe complication associated. This results in increasing patient involvement in decision making and creates awareness in them regarding the steps that should be undertaken or not (Schmidt and Brown, 2024). Thus, there is no doubt in stating that research evidence has been subsequently informing practices within clinical setting and specific emphasis on patient education and improving services in palliative care requires to be implied. This results in enhancing patient health outcomes to greater extent along with improving patient satisfaction. Hence, evidences can be used within clinical setting as it complies with evidence-based practices and further supports in taking evidence- based decision making.

CONCLUSION

Evidence-based practices consistently update current protocols and enhances decision making process in clinical context. EBP boosting efficacy of patient recovery to greater extent and therefore, it proves to be highly essential. Service improvement in palliative care process specifically for treating advanced liver disease cases is important. Holistic care approach requires to be adopted and consistent monitoring of the services are required so loopholes can be identified and timely actions could be taken. The analysis signified about the importance of patient education; lack of awareness making situation critical and increasing the severity. Outcomes of the study informing clinical practices that complies with current protocols, hence, there is need to involve patient and their family members in decision making process along with increasing awareness regarding the disease and consequences. Thus, evidence-based practices are important for evidence-based decision making within clinical setting, it supports in enhancing patient outcomes while considering patient needs. It focuses on enhancing quality of life and improves patient wellbeing. The recommendations align with undertaking service improvement in palliative care practices while providing care services to advanced liver disease patients. Furthermore, patient education should be promoted regarding the diseases and complications entails with it.

REFERENCES

• Boltz, M., Capezuti, E. and Fulmer, T.T. eds., 2024. Evidence-based geriatric nursing protocols for best practice. Springer Publishing Company.
• Furuki, H., Sonoda, N. and Morimoto, A., 2023. Factors related to the knowledge and skills of evidence‐based practice among nurses worldwide: A scoping review. Worldviews on Evidence‐Based Nursing, 20(1), pp.16-26.
• Haile, Z.T., 2022. Critical appraisal tools and reporting guidelines. Journal of Human Lactation, 38(1), pp.21-27.
• Kim, S., Lee, K., Kim, C., Choi, J. and Kim, S., 2022. How do we start palliative care for patients with end-stage liver disease?. Gastroenterology Nursing, 45(2), pp.101-112.
• Kimbell, B., Boyd, K., Kendall, M., Iredale, J. and Murray, S.A., 2015. Managing uncertainty in advanced liver disease: a qualitative, multiperspective, serial interview study. BMJ open, 5(11), p.e009241.
• Li, W.W., Chhabra, J. and Singh, S., 2021. Palliative care education and its effectiveness: a systematic review. Public Health, 194, pp.96-108.
• Melnyk, B.M. and Fineout-Overholt, E., 2022. Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.
• Patel, J.J., Hill, A., Lee, Z.Y., Heyland, D.K. and Stoppe, C., 2022. Critical appraisal of a systematic review: a concise review. Critical care medicine, 50(9), pp.1371-1379.
• Puljak, L., 2022. The difference between evidence-based medicine, evidence-based (clinical) practice, and evidence-based health care. Journal of Clinical Epidemiology, 142, p.311.
• Robinson, K.A., Brunnhuber, K., Ciliska, D., Juhl, C.B., Christensen, R. and Lund, H., 2021. Evidence-based research series-paper 1: what evidence-based research is and why is it important?. Journal of Clinical Epidemiology, 129, pp.151-157.
• Schmidt, N.A. and Brown, J.M., 2024. Evidence-based practice for nurses: Appraisal and application of research. Jones & Bartlett Learning.
• Tod, D., Booth, A. and Smith, B., 2022. Critical appraisal. International Review of Sport and Exercise Psychology, 15(1), pp.52-72.
• Vijeratnam, S.S., Candy, B., Craig, R., Marshall, A., Stone, P. and Low, J.T., 2021. Palliative care for patients with end-stage liver disease on the liver transplant waiting list: an international systematic review. Digestive Diseases and Sciences, pp.1-18.
• Yoshiji, H., Nagoshi, S., Akahane, T., Asaoka, Y., Ueno, Y., Ogawa, K., Kawaguchi, T., Kurosaki, M., Sakaida, I., Shimizu, M. and Taniai, M., 2021. Evidence-based clinical practice guidelines for Liver Cirrhosis 2020. Journal of gastroenterology, 56(7), pp.593-619.