ACCESSIBILITY TO EBP AT THE WORKPLACE 6
Accessibility to EBP at the Workplace
My workspace is in a pediatric ward. In a day, I provide care to anaverage of twenty patients. As the name suggests, all our patientsare children. Most of my colleagues are over forty years, with grownup children. The unit’s leadership is not very open to evidencebased practice. The most common excuse is unless it is broken do nottry too hard to fix it. However, sometimes the unit’s leadership iswilling to implement research findings that will make the work ofnurses easier. In other instances, the leadership frowns uponresearch findings that contradict age-old nursing practices.
I would like the implementation of EBP suggested by Makic et al(2013). According to traditional practice, there have been concernsthat giving oxygen to children with COPD will eliminate hypoxicdrive. In other words, the body will not be able to clear itself ofCarbon dioxide because the provision of oxygen will eliminate theneed for the body to perform normal breathing functions. Otherssuggest that there is no harm in providing oxygen because the patientcan survive with higher levels of PaCO2 in comparison to PaO2. Theyconclude by saying that providing oxygen will not eliminate hypoxicdrive and hence the practice should be continued.
Recent scientific studies have confirmed that indeed the provision ofOxygen increases the amount of CO2 in the blood. However, it has alsoemerged that the increase of CO2 is not in any way whatsoever linkedto a low hypoxic drive. Following this research, the debate is nowsettled- withholding Oxygen from OCPD patients in a bid to protectthe patient from adverse effects could turn out to be dangerous inthe aftermath.
I would like to see this EBP implemented in my workplace in itsentirety. Currently, there is no standard approach to providingOxygen to OCPD patients. In some instances, we provide Oxygen whilein others we do not. I do not know who arrives at the decision toprovide or not to provide I also do not know the criteria they use.
In my opinion, the head of our pediatric unit is more open to EBPthan the overall head of nurses. He says that sometimes he is willingto implement change but then his superior would not let him. I havenot had the chance to interact with the overall head of nurses so Icannot tell why she is opposed to EBP suggestions from her juniors.She has been a nurse for the past 35 years and maybe that is why sheis opposed to numerous changes in her practice. However, she isalways willing to implement EBPs recommended by the department ofhealth and the World Health Organization.
At the pediatric unit, nurses are allowed to use their mobile phonesto make research on EBP practices. Nurses are also allowed to consultonline using their phones on matters that they do not have a fullgrasp or in areas that they have seemed to forget the standardpractice. However, changing of current practices to reflect EBPrequires more than just researching information online using one’ssmartphone.
The person doing the research should inform his colleagues of hisfindings and compare them with the current practices (Grove et al,2014). Together with the colleagues, they will identify the areasthat need modification in order to reflect the EBP. The team willthen share the information with other relevant departments. The powerto implement or dismiss the EBP lies with the superiors.
In the pediatric unit, we have a library with a diverse category ofbooks. During tea break, nurses usually take their refreshments inthe reading area. Some who are interested in reading the literaturewill be seen perusing through the books while sipping their beverage.Most of them do not bother at all.
Maybe it is because the department rarely updates its stock. Most ofthe books on the shelves date back to the late 90’s. This haslimited the information that is accessed at the department and thislimited the research that can be done by the users. The commonoccurring subject is the history and evolution of nursing practices.This makes the stock not diverse in terms of topics. If I were tocount the number of books that are less than five years old, I doubtI would get to 20.
Maybe if the administration concentrated on updating the pediatriclibrary, more nurses would be interested in reading. I for one do notlike dwelling on past literature when I am trying to improve myskills. I prefer to read research findings especially on topics thatI find contentious in nursing practice.
My unit has done a lot to ensure its members have up-to-dateresources, which are accessible by the internet. In the library,there are four desktop computers to be used by any member of staffspecifically for research. The computers have internet connection allday long. Most importantly, the institution is a subscriber to theleading healthcare journals including PubMed. Any interested nursecan use the computers to access journals that contain deep cuttingresearch articles. However, I noticed that most of the employees usethe computers for social media and watching cat videos on YouTube.
Journals are only accessible through the department computers duringa nurse’s free time. Anywhere else, it is not possible to read thearticles in paid journals. Nurses who might wish to read the journalsfrom the comfort of their home find it difficult owing to the strictpolicy regarding the issuance of journal passwords to members ofstaff. Apparently, the administration is afraid that members couldshare the password with others who do not work for the organization.This policy limits the accessibility of journals. On average, Iaccess the journals about five times in a month.
We have a medical library but it lacks personnel to assist us withevidence searches. The institution requires all the employees totakes a personal initiative to research on new medical evidence. Somedo not bother because they do not know what they should be searchingfor in the libraries or on the internet.
I would recommend that the institution start an initiative toencourage all members of staff to research on EBP. The use of librarypersonnel would go a long way in encouraging members of staff to readmore. The course of implementing relevant EBPs should be madearticulate to deter seniors from discouraging others from conductingfurther research on EBP (Rousseau & Gunia, 2016).
In conclusion, accessibility to EBP information at the workplace hasa great impact on research. Employees should be encouraged toresearch EBP by setting up the right structures. Libraries, access tomedical journals, and implementation of relevant EBPs, are some ofthe incentives that an institution could use to lure employees intoconducting more research on upcoming EBPs.
Grove, S. K., Burns, N., & Gray, J. R. (2014). Understandingnursing research: Building an evidence-based practice. ElsevierHealth Sciences.
Makic, M. F., et al (2013).Putting Evidence intoNursingPractice:FourTraditional Practices NotSupported by the Evidence.Critical Care Nurse 33(2) 23-45.
Rousseau, D. M., & Gunia, B. C. (2016). Evidence-Based Practice:The Psychology of EBP Implementation. Annual Review of Psychology,67, 667-692