Reviews in Evidence-based Practice

Audits in Evidence-based Practice In a period of proof based nursing, care suppliers need to put together their clinical choices with respect to the inclinations of patients, their clinical aptitude, just as the ebb and flow best accessible examination proof pertinent for training (Beaven and McHugh, 2003; Mulhall, 1998; Sackett and Rosenberg, 1995). EBP, as a dynamic procedure which incorporates the best accessible exploration, clinical mastery and patients qualities (Sackett et al., 1997), is accepted to be an important practice which lead to advance in people groups *psychosocial encounters of disease and medicinal services just as in nursing proficient turn of events (Hamer, 2005). Muir-Gray (1996) features that it overcomes any issues between the revelation of information and the time the information is applied practically speaking, and Thompson (1998) trusts it is an assurance for doing the correct things right. On this premise, precise audits has been found as the foundation of EBP, come from Cochranes chip away at proof based medication in the late 1970s. It has been viewed as the highest quality level for estimating the adequacy of a mediation (NHS Center for Reviews and Dissemination, 2001). As an optional exploration technique, it examines the best proof about the clinical issue with the goal that ends can be drawn about viable works on thinking about the expected advantages and mischief (Hamer, 2005). Actually, with SR being a procedure for methodicallly distinguishing, examining, arranging and maybe coordinating every pertinent investigation, in this way taking into consideration a progressively target examination thatn single investigations (Sackett et al., 1997), it has become an essential supporting instrument in improving practice and nature of care especially for occupied wellbeing experts who need more an ideal opportunity for staying up with the latest with all the freshest exp loration (Greenhalgh, 1997). Clearly, SRs are significant in nursing so as to find territories where surveys and exploration are required and limit pointless duplication of nursing research (Sackett et al., 1997). Along these lines, there is a necessity to develop a procedure to give the aftereffects of exploration discoveries in a brief manner (Mulrow and Cook, 1997). SRs assume an essential job in giving quick access to dense forward-thinking information and offering another open door for EBP in nursing (Muri-Gray, 1996). Then, SRs in EBP has a key an incentive as it offer the best way to deal with deciding the best proof so as to address clinical inquiries or understand any clashing discoveries (Roberts and Yeager, 2004). Furthermore, by holding fast near logical techniques, which delimit these predispositions, as per Schlosser (2006), at that point SR remains the best vehicle for professionals to access wide-going proof to help their training. For human services experts, the most significant worry in the different discussions encompassing EBP is the thing that ought to set up the proof for clinical practice (Egger et al., 2001). In this way, in the mid 1990s, the term audit of viability rose and the pecking order of proof dependent on the nature of proof rating was going by randomized controlled preliminaries (RCTs)(Cooke et al., 1992). RCT is a viewed as a quantitative report structure, which expects to lessen the predisposition of confounding issues, control an unequivocal intercession and examine a potential reason impact connection between factors by differentiating various mediations between study gatherings (Cook et al., 1992). Other than RCTs, there have been extra companion considers, case arrangement (either post-test or pre-test), very much planned pseudorandomised controlled preliminaries and case-control contemplates (Cook et al., 1992). SRs of excellent RCTs with predictable outcomes are viewed as top of the order of proof, the most dependable proof for contemplating the impacts of mediations, appearing differently in relation to single RCTs which may infer a bogus end (Kunz et al., 1998). Thornley and Adams (1998) affirmed that a solitary report is once in a while insufficient to distinguish the conviction of a mediation, separate between the impacts of one, or to perceive the causal connection between factors of medicines due to the little example size of patients, which may hinder the arrangement of genuine ends. This could be a clinical peril if human services chiefs base strategies on wrong information from single preliminaries (Jadad and Enkin, 2007). In light of the prior, SR can incorporate more than one examination and encourage the drawing of all the more genuine, objective, straightforward end to help the proof in settling on clinical choices (Sackett and Wennberg, 1998). From this point of view, the propensity was to focus on SRs of RCTs and reject other quantitative, subjective or financial assessment study plans (Dixon-Woods et al., 2004). On the otherhand, it has been discussed that RCTs are not appropriate for all conditions (Dixon-Woods et al., 2004). For example, on the off chance that we need to investigate the lived encounters of tuning in to music as a postoperative agony the board mediation, the proper technique to consider that is through a subjective structure (phenomenology) (Greenland, 1987). Unmistakably, the value of different surveys can't be disregarded on the grounds that, they have an extraordinary impact in finding the basic highlights of discoveries, which can coordinate future examination plan and explain current degrees of information (Sackett and Wennberg, 1998). A more critical glance at the above will uncover that there are two primary methodologies of quantitative deliberate surveys. The first is the SR of a solitary report plan, which incorporates essential investigations having a similar report structure (eg. RCTs). The subsequent kind is the efficient survey, which sums up and consolidates the outcomes from more than one examination utilizing factual procedures and can summarize the results of comparable, however autonomous investigations, to deliver a solitary gauge of treatment impacts (eg. Accomplice considers) (Jadad and Enkin, 2007). This procedure is called meta-investigation, which can give a quantitative combination of the examination. One of the reasons for meta-investigation is to decrease the vulnerability or contention, and to lessen the predisposition and increment accuracy of the determinations of a survey (Sackett and Wennberg, 1998). Nonetheless, the utilization of meta-examination strategy isn't essential in each and every deliberate audit. For example, if the qualities of the included investigations are disparate or sketchy, it might be unseemly or in any event, deceiving to factually pool results to give a negligible synopsis; for this situation, a story rundown ought to be introduced (Jadad and Enkin, 2007). An efficient survey is viewed as a procedure to find all investigations for a particular deliberate inquiry (drawn from research and different assets), basically assess the techniques for the examinations, sum up the results, present key discoveries, recognize purposes behind changed results over the investigations, and distinguish confinements of existing information (Khan et al., 2003). At the end of the day, it is an apparatus to gather and evaluate all important examination proof giving instructive, test answers to logical exploration questions (Evans, 2001). Precise surveys are not the same as customary writing/account/basic audits (Khan et al., 2003). Regardless of frequently being exceptionally useful as foundation perusing, they have various weaknesses. They contrast from the efficient audits in that they are abstract, and not guided by a friend looked into convention, and as such can't be reproduced; in addition, those examinations that help the creators perspective are bound to be chosen (*Ravnskov, 1992). Furthermore, conventional account audits may make various analysts arrive at disparate resolutions from a similar examination bases (Teagarden, 1989). Accordingly, they seem ailing in thorough logical structure to limit the danger of inclinations or guarantee unwavering quality (Khan et al., 2003). The orderly audit defeats the issues which customary account surveys have, through creation the survey procedure self-evident. Along these lines, it is workable for the peruser to recreate the procedure of the audit and set up the all inclusive statement and straightforwardness of logical discoveries (Egger et al., 2001). In addition, it likewise gives objectivity to data by summing up the aftereffects of in any case unmanageable amounts of examination (*Ravnnskov, 1992). The reason for undertaking a methodical survey in the field of medicinal services has been entrenched, as indicated by Torgerson (1998) and is immovably installed in the logical worldview. As the significance of EBP keeps on being advanced, the profile and adequacy of orderly audits thrive, and a continually extending volume of information should be considered by specialists and scientists. In any case, it is difficult to peruse, fundamentally assess and combine the condition of information, not to mention update this routinely (Egger et al., 2001). Hence, the orderly survey has become a basic apparatus for staying up with the latest with the new proof gathering in a field of study. While lessening the ever-expanding downpour of distributed and unpublished examination into sensible parts, Clarkson et al. (2003) clarifies that the orderly audit additionally decreases both efficient blunders (predispositions) and irregular mistakes (those happening by some coincidence). It gives an increasingly objective, extensive perspective on the writing, which is of high caliber and applicable to explicit clinical practice. However unmistakably, this method of reasoning doesn't only apply to medicinal services research. Deliberate audits can likewise give crude material to setting up clinical rules and help plan new exploration by recognizing existing holes (Pearson et al., 2005). Clarkson et al. (2003) include that it very well may be utilized to figure strategy and create rules on social insurance association and conveyance. They are of specific advantage in territories of clinical vulnerability or where there is a wide variety practically speaking. In this manner, medicinal services suppliers, scientists and strategy creators can utilize precise audits to productively incorporate existing data, giving da

The War Powers Act of 1973 Essay Example | Topics and Well Written Essays - 1250 words

The War Powers Act of 1973 - Essay Example President Harry Truman set the trend of going around Congress, and the Constitution, when he conveyed troops to Korea in 1950. Congress endeavored to recapture its sole position to pronounce war when it passed the War Powers Act in 1973 as a reaction to the undeclared Vietnam War. The Act permits the Commander-in-Chief to react to crisis circumstances and convey troops for a restricted measure of time without a proper assertion of war. Nonetheless, presidents from Truman to George W. Hedge have immediately disregarded this Act just as their naturally restricted authority by pursuing extended wars everywhere throughout the world. All have specifically refered to the piece of the Constitution that gives them authority over the military while overlooking the part that specifies they don't have the position to take up arms against their own. As per the United States Constitution Article One, Section Eight, just Congress has the restrictive power to â€Å"to pronounce war [and] award letters of marque and reprisal† (United States Constitution). Presidents don't have this power. In any case, the War Powers Act of 1973 bypassed the Constitution. The Act takes into consideration the President to send troops to a nation for 60-90 days without the assent of Congress (War Powers Resolution, 1973). It is expected to initially permit the president to convey troops in a crisis circumstance however furthermore to carefully authorize Congressional power to proclaim war, to hold fast to the composers of the Constitution’s goal for the people’s agents in Congress to choose if military activity was in the nation’s wellbeing. Given the equivocalness of this permit the workplace of President presently needs to start war, however the President could, theoretically obviously, act without explicit congressional e ndorsement to take up arms against a sovereign country that didn't represent a military danger. This could hypothetically prompt an apparently

Celebrities Reading Why Book Lists and Private Libraries Fascinate Us

Celebrities Reading Why Book Lists and Private Libraries Fascinate Us Books are an essential part of my life, as I believe they are part of yours since you are reading this. However, there is a particular aspect of book-loving that has always fascinated me: collecting books and building a private library. It has always been a dream of mine to own an extensive library in my house. I believe books connect us, and they tell the stories that have shaped humanity for ages. Private libraries, on the other hand, tell the story of an individual, by holding the stories one carefully chooses to accompany them through life. As Walter Benjamin stated in his essay Unpacking My Library: “Naturally, [the collector’s] existence is tied to many other things as well: to a very utilitarian value â€"that is, their usefulnessâ€" but studies and loves them as the scene, the stage, of their fate.” I believe that the books someone holds on to can tell us more about that person than an hours-long conversation ever could. In books, we travel, we become shape-shifters, and we find our true nature. I recently have become more and more fascinated with private libraries, and what they can tell me about their owners. More specifically, the libraries of famous figures. This new fascination came about when I found a copy of A Book of Book Lists by Alex Johnson, in my local bookstore, which in turn made me want to re-read Jorge Luis Borges’s The Library of Babel. So, I started diving into the world of famous private libraries and questioning what we could learn about a person by looking at the books they read in their lifetime. There is an entire industry dedicated to the private lives of famous people. Still, I would argue that there is nothing more intimate than getting a glance into someone’s home library. Even when it is curated for public viewing, you can understand a private part of someones personality just by their books. For instance, you can find out things like how do they want to be perceived and who they want to pay attention to them. As a friend recently mentioned to me, “I never bothered reading celebrity memoirs because I always assumed they had a ghostwriter, or that their names are simply marketable. Seeing their private library gives celebrities a personal depth to me, that otherwise, I would not think of.” I agree with that, even if I have read and loved lots of celebrity memoirs. It’s hard sometimes to imagine what makes that person a writer, what were their inspirations and motivations behind choosing a book as the medium for their story. From Reese Witherspoon to Emma Roberts, there seems to be a new niche in bookish celebrities on the rise. A niche that has always been present but that, until our recent social media dominated years, was only explored by those truly devoted to it. Even so, private libraries are something to cling to, if you are curious about a person’s life. The books someone recommends or collects can tell us much more about someone’s life in private than their public actions ever could. In some instances, it can very well validate, or invalidate, those actions. The first part of Johnson’s book focuses on understanding the motivations behind reading. More specifically, what the books people read/collected during their life can tell us about them. So, of course, the book opens with Osama Bin Laden. Bin Laden was the last person I expected to be featured so prominently in a book like this, to be honest, but alas, he is. From the get-go, I was intrigued, fascinated that someone like the head of a terrorist organization who was always on the run would even care about owning books. And also, if at the end of the section, the breakdown of his reading list was entirely predictable. He read exclusively about military strategy and anti-U.S./anti-western political writers. But it got me thinking again about why we care about famous people’s libraries. I believe our eagerness to get a glimpse of someone’s bookshelf comes from a desire most readers have of empathizing or being closer to a famous figure. Now you might be asking who in their right mind would want to be close to Bin Laden? Well, this brings me to my second thought. I believe we are also fascinated by private libraries because our society has developed the idea that the love of books and reading is an inherently moral thing. That may be because we associate intelligence with knowledge and knowledge as being a positive thing. Thus, bookish people or people that would describe themselves as readers are inherently good. Well, that is, for the most part, not accurateâ€"or rather, it’s just too generous of a statement. Several world leaders and artists were readers; some of them were also terrible people. From Napoleon to Karl Lagerfeld, it is evident that reading doesn’t necessarily equal a good human being. Being a reader has always been a defining part of my personality. So, I have always been the first person to associate reading with kindness, wisdom, and just all-around good stuff, because it made me look wise, instead of antisocial and a bit snobby. If someone had what I thought to be an ignorant or harmful worldview, I would immediately define the problem with that person as being the assumption that they did not read. So when I grew up a bit and started realizing how books and reading can also be used to control or even undermine people, I had to take a good hard look in the mirror. Is being seen as a reader, a well-rounded one no less, more important than actually being one, because you become associated with the myth of inherent goodness? I am certainly not qualified to answer all these questions, but it is a fascinating thing to think about, and there is a lot out there for you to explore on this subject. Both in what it means to be a reader and how private libraries can give us an insight into it through some famous readers, of course. For instance, scholars still trying to recreate  Richard III’s library  in full. How cool is that? Also, several articles focused on  Karl Lagerfeld’ s extensive personal library after his passing earlier this year. Not to mention, I am waiting patiently for the day that we get to see what books Toni Morrison collected during her lifetime. In the meantime, if you have the same questions, several books can help further inspire you as you build your library, and send you on a quest for inspiration. Such as new releases like A Book Lover’s Guide to New York  by Cleo Le-Tan or  Bowie’s Bookshelf by John O’Connell. Many backlist biblio-memoirs are rich in diversity and their approach to reading and collecting books. Two of my favorites are Reading Lolita in Tehran  by Azar Nafisi and  The Library at Night  by Alberto Manguel. I hope these books will tell you a bit more about the lives of some iconic readers and tell you about the moment in time in which they read, worked, and wrote and what it meant to be a reader then. And like Walter Benjamin, I hope the world and people reveal themselves to you as you undertake the pursuit of books.

Judith Wright And Sylvia Plaths Naked Girl And Mirror

Both Judith Wright and Sylvia Plath explore different feminist views in their poetry in order to highlight the freedom that comes with the empowerment of women and the escapement from the boundaries of social expectations. Wright uses stylistic devices such as punctuation, oxymoron, metaphor, and personification to discuss the insecurities she has with her body in her poem ‘Naked Girl and Mirror’. The oxymoron, â€Å"I see you are lovely, hateful naked girl†, depicts the internal struggle she deals with that centres on her self-image. The world has metaphorically detached Wright’s mind from her body and this encourages her to write with a more feminist view in order to remind her listeners that she has a soul and her gender is not all she is.†¦show more content†¦In her poem ‘Ariel’, she describes stumbling on, â€Å"heels and knees†, and compares it to Ariel’s transformation from a mermaid to a human to depict Plath†™s coming out of her shell. The feministic tone of the poem talks about the issue of women being in bad situations and the struggle of trying to find the motivation to escape and transform into an improved version of herself. Both poets use their poetry to explore different feminist views in order to discuss the freedom of empowering women; the poems convey the boundaries of social expectations and how this has limited the authors in their personal lives which serves as an encouragement to all listeners of their poetry. Furthermore, Wright, Plath, and Amy Winehouse explore the limitations of being confined in a mentally abusive relationship in order to highlight the importance of freedom in all of their respective pieces. Winehouse explores being in a relationship with a man who only stays with her for her wealth through techniques such as metaphors, colloquialisms, and similes. In a metaphor, she describes herself going, â€Å"back to black†, whenever her husband is unfaithful in their relationship. Being confined in a relationship with a man who detrimentally effects Winehouse’s emotional health causes her to fall back into the depression she has been struggling with for

An Introduction to Anasazi Puebloan Societies

Anasazi is the archaeological term used to describe prehistoric Puebloan peoples of the Four Corners region of the American Southwest. This term was used to distinguish their culture from other Southwestern groups like the Mogollon and Hohokam. A further distinction in Anasazi culture is made by archaeologists and historians between Western and Eastern Anasazi, using the Arizona/New Mexico border as a fairly arbitrary divide. The people who resided in Chaco Canyon are considered Eastern Anasazi. The term Anasazi is an English corruption of a Navajo word meaning Enemy Ancestors or Ancient Ones. Modern Puebloan people prefer to use the term Ancestral Puebloans. Current archaeological literature as well tends to use the phrase Ancestral Pueblo to describe the pre-contact people that lived in this region. Cultural Characteristics Ancestral Puebloan cultures reached their maximum presence between AD 900 and 1130. During this period, the landscape of the entire Southwest was dotted by large and small villages constructed in adobe and stone bricks, built along the canyon walls, the mesa top or hanging over the cliffs. Settlements: The most famous examples of Anasazi architecture are the famous Chaco Canyon and Mesa Verde National Parks. These areas contain settlements constructed on the mesa top, at the bottom of the canyon, or along the cliffs. Cliff dwellings are typical of Mesa Verde, whereas Great Houses are typical of Chacoan Anasazi. Pithouses, underground rooms, were also typical dwellings of Ancestral Puebloan people in their earlier times.Architecture: Buildings were usually multistory and clustered near the canyon or cliff walls and were reached through wooden ladders. Anasazi constructed typical round or squared structures, called kivas, which were ceremonial rooms.Landscape: Ancient Puebloan people shaped their landscape in many ways. Ceremonial roads connected Chacoan villages among them and with important landmarks; staircases, like the famous Jackson Staircase, link the bottom of the canyon with the mesa top; irrigation systems provided water for farming and, finally, rock art, such as petroglyphs and pictographs, dots the rocky walls of many sites surrounding, testifying to the ideology and religious beliefs of these peoples.Pottery: Ancestral Puebloans crafted elegant vessels, in different shapes, such as bowls, cylindric vessels, and jars with distinct decorations typical of each Anasazi group. Motifs included both geometric elements as well as animals and humans usually portrayed in dark colors over a cream background, like the famous black-on-white ceramics.Craftwork: Other craft productions in which Ancestral Puebloan excelled were basketry, and turquoise inlay works. Social Organization For most of the Archaic period, people living in the Southwest were foragers. By the beginning of the Common Era, cultivation was widespread and maize became one of the main staples. This period marks the emergence of the typical traits of Puebloan culture. Ancient Puebloan village life was focused on farming  and both productive and ceremonial activities centered around agricultural cycles. Storage of maize and other resources lead to surplus formation, which was re-invested in trading activities and feasting celebrations. Authority was probably held by religious and prominent figures of the community, who had access to food surpluses and imported items. Anasazi Chronology The Anasazi prehistory is divided by archaeologists into two main time frames: Basketmaker (AD 200-750) and Pueblo (AD 750-1600/historic times). These periods span from the beginning of settled life until the Spanish takeover. See the detailed Anasazi timelineSee details on the Rise and Fall of Chaco Canyon Anasazi Archaeological Sites and Issues Penasco BlancoChetro KetlPueblo BonitoChaco CanyonKivaChaco Road System Sources: Cordell, Linda 1997, Archaeology of the Southwest. Second Edition. Academic Press Kantner, John, 2004, Ancient Puebloan Southwest, Cambridge University Press, Cambridge, UK. Vivian, R. Gwinn Vivian and Bruce Hilpert 2002, The Chaco Handbook. An Encyclopedic Guide, The University of Utah Press, Salt Lake City Edited by  K. Kris Hirst

The Second Half of Adolf Hitler’s Life Free Essays

The world-renowned dictator of Germany, Adolf Hitler, was actually born as Austrian in 1889. It was during the second half of Hitler’s life that he began to realize German nationalism and anti-Semitism in Vienna, Austria. He had internalized and absorbed these ideas and decided to transfer to Munich, Germany where he gave up his Austrian citizenship by seeking the endorsement from the German nation. We will write a custom essay sample on The Second Half of Adolf Hitler’s Life or any similar topic only for you Order Now This happened in the year 1913. In 1914, World War II broke out and Hitler and used this occurrence to prove his loyalty to Germany which he considered as his new homeland. He served as a corporal in an infantry regiment and was decorated after being wounded in 1917 (â€Å"Adolf Hitler Biography,† n.d.). By 1918, Germany declared defeat and eventually surrendered and attributed this failure to the betrayal and treachery of the Jews as well as the Communist’s political rebellion. Hitler believed that in order to avoid this unpleasant incident from transpiring again, these so-called traitor groups must be abolished. Taking a different direction, Hitler decided to involve himself in politics by the year 1919 in that he signed up for the German Workers Party. In a year’s time he became the organization’s leader and later changed its name to National Socialist German Worker’s Party or more popularly known as the Nazi. Hitler’s platform was simple: create a new nation that included all German people and rebuild the German military forces (â€Å"Adolf Hitler Biography,† n.d.). Following World War I, the German army signed the Treaty of Versailles after which they were trimmed down in number and was obliged to disburse billions of dollars to the Allied powers for war damages thereby downgrading German reputation and resulting to economic depression and downfall. Subsequently, Hitler and the Nazis failed to recapture Germany in the supposed Beer Hal Putsch in 1923. This act was considered treason. As such, Hitler was punished for five years imprisonment, however, he only served it for nine months due to political demands. During Hitler’s stay in the penitentiary, he was able to write Mein Kampf (My Struggle), his political declaration and proposal for a Nazi government. In this manuscript, he proclaimed German superiority above other races and condemned the Jews as tainted among others. After the war, he even ordered the genocide of about six million Jews termed as the Holocaust. Hereon, Hitler advanced a dictatorial leadership to have power over the German population and inhibit those who rebel against him. During the 1930s, Hitler urged for a transformation of the German society upon the advent of political and economic flux and regression and this was heeded by the German people. In 1933, the Nazis gained recognition for these innovative agenda thus Hitler was appointed chancellor of Germany. His leadership was tremendous in that he used media and press propaganda, large security force which used terror and incarcerated Jews in concentration camps to signify Nazi authority in Germany. How to cite The Second Half of Adolf Hitler’s Life, Papers

Individual Position Statement on Evidence Practice-myassignmenthelp

Question: Discuss about theIndividual Position Statement on Evidence Based Practice. Answer: Introduction Evidence-based practice aims at hardwiring available nursing knowledge into making decisions related to healthcare process to improve the provisions of care and the patient outcomes. It holds huge promise to produce the intended health outcomes. Majority of the healthcare deficits lead to significant avoidable harms. The Quality Chasm Report was first developed in the form of a blueprint with the objective of redesigning healthcare processes. The chasm focused on using evidences to inform best practices in a hospital setting (Harolds, 2016). This report aims to elaborate on the effect of evidence-based practice on patient outcomes and the role of nurses in implementing such practice. Discussion Components of EBP Evidence-based practice (EBP) can be best defined as the explicit, conscientious, and judicious use of current evidences while making decisions related to care of individual patients. Clinical expertise is integrated with the best clinical evidence that is available from systemic research. This integration helps to provide a holistic care to the patients and increases patient satisfaction. Nursing knowledge helped me understand that evidence, itself, is not sufficient to make healthcare decisions. However, it plays an essential role in supporting the patient care process. Complete integration of all the three components in clinical decision making process, enhances the opportunity for increased clinical outcomes and better quality of life (Andre Heartfield, 2011). Patient encounters often lead to the generation of questions that are related to the effects of therapy, prognosis of diseases, utility of diagnostic tests, and aetiology of disorders. Therefore, the practice requires nurses to acquire new skills, engage in efficient literature search, and apply formal rules of evidence to evaluate the clinical literature (Courtney McCutcheon, 2010). Figure 1- Components of EBP Role of EBP in improving patient outcome Results from several researches helped me gain knowledge that improved patient outcomes, high care quality, reduced hospitalization costs, and greater satisfaction are achieved when compared to traditional care approaches. The standards of practice set by the Nursing and Midwifery Board of Australia states that a Registered nurse (RN) is entitled with the duty of carrying out evidence-based and person-centred practices and should follow approaches that have a preventative, supportive and curative role (Nursingmidwiferyboard.gov.au, 2017). These standards provided me the information that when an RN is involved in accessing, analyzing and using the best available evidence, which includes research findings, a safer and better quality of care service can be given to the patients, catering to their specific demands. These standards also state that a relevant plan should be developed to appraise the comprehensive research information collected, before documenting and applying the evidence in hospital setting. Mentors of evidence-based practice directly work with clinicians and try to implement the best practices (Daly, Speedy Jackson, 2017). Supportive context of EBP, administrative support and multifaceted education program assistance enhance the effectiveness of EBP in improving the outcomes. An organized setting or environment where the patients receive healthcare services is an extremely important factor in implementation of evidence at care centres. I realized that patient outcomes are greatly enhanced with the implementation of a wide range of strategies such as availability of resources and mentors, enhancement of individual skills of healthcare leaders and clinicians, allotment of sufficient time, tools and resources that enable clinicians to engage in effective research of the best possible care approaches (Stevens, 2013). My nursing knowledge also assisted me to understand that patient outcomes get improved on rewarding or recognizing the staff who are engaged in the effort of implementing EBP and by the presence of healthcare leaders who are responsible for spearheading the teams and creating strategic goals and vision for achieving best patient-centred care (Aarons Sommerfeld, 2012). In order to measure the effect of EBP on patient outcome, a study was conducted that aimed to develop EBP competencies for APN and registered nurses, practicing in clinical setting. These competencies could be used by the healthcare institutions to obtain a high performing system that sustains EBP. Initially, a set of competencies were formulated by national EBP leaders through a consensus building process, followed by conduction of a survey across the nation with the aim to determine clarity and consensus of the developed competencies (Melnyk et al., 2014). From the findings, I can deduce that higher quality and consi stency was observed in patient outcomes and the cost of hospitalization reduced significantly when these competencies were incorporated in the healthcare system. Another research focused on reporting a natural experiment, where an EBP unit was formed by reorganization of the internal medicine service. However, the rest of the services were unchanged. The units were made to attend to similar patients and the outcomes were compared. I deduced that patients who were subjected to EBP, showed a significantly lower death risk and shorter length of hospital stays (Emparanza, Cabello Burls, 2015). This helped me reach the conclusion that implementation of such evidence-based approaches are effective in enhancing patient outcomes. Clinical and theoretical application of EBP My clinical knowledge and the standards of practice helped me understand that a registered nurse plays a vital role in ensuring the engagement and application of evidence-based practice at the point of care. There are several formulations of national competencies that are specific for registered nurses. Before implementing these EBP to a theoretical setting, it is necessary to identify the competencies (Florin et al., 2012). The implementation process involves some essential activities such as, planning a course of action, engaging appropriate individuals in the implementation, executing the implementation following the standards of the plan and finally evaluating the implementation efforts. According to the standards of practice, I can state that an accurate and comprehensive conduction of systematic assessments is essential for RNs. This helps them to analyse data and information and communicate the outcomes (Nursingmidwiferyboard.gov.au, 2017). This forms the basis for our practice. In order to implement such practices theoretically, it is necessary that we should use a wide range of evaluation techniques that will help us to systematically collect accurate and relevant data and assess the resources that are available for our planning (Stokke et al., 2014). We should work in collaboration with other healthcare professionals to determine the factors that might affect the wellbeing and health of our patients (Friesen?Storms et al., 2015). This will help us to identify the patient priorities for future referral. Development of the evidence-based plans agreed upon, I partnership will further help in their implementation. According to the standards of practice, nurses are responsible for constructing nursing practice plans until the goals, priorities and contingencies are met (Nursingmidwiferyboard.gov.au, 2017). We should be involved in effective formulation of the practices until the intended outcomes and actions are agreed upon by all healthcare staff who is involved in the setting. The role of RN also entitles us to assess the time frame of engagement and coordinate the planned actions effectively before implementing the practices. We should work towards providing comprehensive and safe practice to the patients to achieve the desired goals. Moreover, effective implementation of the EBP is achieved when we follow the relevant guideline, policies, regulations and standards to provide safe patient services. Implementing EBP without training Despite the favourable findings, that support the role of registered nurses in applying EBP to improve health outcomes of the patients, nurses often remain inconsistent in the implementation process. My clinical experience helped me realize that there are some nurses, whose inadequate education and training makes it difficult for them to follow EBP that has been incorporated in their nursing curriculum (Gray et al., 2013). RNs often lack basic internet and computer skills, necessary for implementation of these practices. As a result, various misconceptions arise about EBP. These lead to the development of theories that EBP is difficult and time-consuming (Torrey et al., 2012). One of the barriers is the availability of huge amount of healthcare literature that is published in different sources. This makes it difficult for untrained nurses to keep up to date with the new practices that are being discovered (Gerrish et al., 2012). I also identified that lack of access to adequate resource and difficulty in assessing statistical analysis often created barriers for RNs while implementing EBP. Untrained RNs are most often unable to interpret the jargon present in the research findings due lack of information searching abilities and limited IT skills (Dalheim et al., 2012). Therefore, as a nursing student I can conclude that RNs should not be entitled with the complete responsibility of implementing evidence-based practices unless, they show adequate skills and are well trained to search for the best evidence and integrate them with their practice. Conclusion Evidence-based practices empower nurses and enhance their nursing capabilities. However, effective implementation of those practices in hospital setting requires presence of adequate clinical information, skill and judgement abilities. Competencies are necessary to continuously improve the safety and quality of healthcare system with the aim of utilising EBP to provide patient-centred care. As a nursing student, my knowledge helped me understand that several research studies have been carried out, which demonstrated the positive influence of EBP in creating good patient outcomes and reducing hospitalisation costs. However, a thorough research of the barriers that arise in this context helped me conclude that it is not feasible to expect RNs to carry out EBP unless they are well trained and educated in this context. References Aarons, G. A., Sommerfeld, D. H. (2012). Leadership, innovation climate, and attitudes toward evidence-based practice during a statewide implementation.Journal of the American Academy of Child Adolescent Psychiatry,51(4), 423-431. 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