EVIDENCE BASED NURSING

Evidence-based decision-making in nursing refers to the process

of using the best available evidence, along with clinical
expertise and patient preferences, to inform and guide
healthcare decisions. This approach integrates the latest
research findings, relevant clinical knowledge, and the
individual needs and preferences of patients to provide
high-quality and patient-centered care.

Here are key components of evidence-based decision-making in

nursing:

Research Evidence: Nurses rely on the latest scientific research

and studies to inform their decision-making. This involves
critically appraising and applying relevant research findings to
their clinical practice. This evidence can come from various
sources, including systematic reviews, randomized controlled
trials, and other types of empirical studies.

Clinical Expertise: Nurses bring their clinical experience, skills,

and expertise to the decision-making process. This involves using
their knowledge of patient care, understanding of disease
processes, and familiarity with healthcare interventions to make
informed and context-specific decisions.
Patient Preferences and Values: Recognizing the importance of
individual patient needs and values is crucial in evidence-based
decision-making. Nurses engage in shared decision-making with
patients, considering their preferences, cultural backgrounds,
and values when determining the most appropriate course of
action.
NURSING ENVIRONMENT OF LAAKSO
The nursing environment in which I worked during my
surgical placement was Laakso sairaala osasto 7
traumakuntoutus.
It comprised of 25 bed capacity and mostly we received
patients from meilahti, Pejas and also from other
hospitals within the Helsinki region. Patients that we
cared for were postoperative patients who have heard
different types of surgeries due to fractures.
Patients got rehabilitation and conservative therapy in
this ward.
It was observed that most patients we received had
fractures from falls and only a few from trying to commit
suicide.
CLINICAL DECISION MAKING SKILLS
Nurses share accountability for effective decision making
by acquiring the necessary skills and mastering relevant
content , assessing situations accurately and
communicating opinions clearly.
Together with my placement tutor we were able to
observe typical clinical decision making skills used by
nurses in the ward as follows.
● Prioritizing care among patients based on acuity and
how serious the need for care is.
● Development of patient care plans on an individual
basis based on ongoing medical assessments and
expected outcomes.
● The nurse could also delegate tasks while
considering competencies of the different staff
members present and patient needs.
● Advocating for the patients through questioning the
physician for unclear orders.
● Assessing patient symptoms and clinical judgements.

NURSING SITUATION
While working in the trauma ward I realized that
most patients' plans of care are made in advance
while the patient is recovering.
Before discharge clients home is assessed to see if it
has the necessary resources such as elevators, lifts,
wheelchair accessible apartments and home care.
The doctor is responsible for preparing the patient's
medicine list before discharge so that the nurse gets
them ready in the medication room.
One nursing situation I encountered was the doctor's
prescription of a patient was unclear and together
with my placement supervisor we were able to ask
the doctor for clarification.
In doing so it clearly shows the advocacy role of the
nurse on behalf of the patient as a part of decision
making in the plan of care for the patient.

SOURCES OF INFORMATION TO BE USED IN DECISION MAKING

The information that the caregiver may use in

clinical decision making includes providing
background information of the patient .
The information that caregivers provide help the
clinical team to assess and come up with a plan of
care for the patient.
An example of how such information is used in
decision making is for example if a caregiver states
that their loved one experienced a fall and clarifies
that the patient fell and hit their head, the nurse
and the doctor are able to do a more thorough
physical examination to assess and plan care in
regards to this. This may also explain the different
symptoms that the client is presenting with and
provide solutions to it.
Physiotherapists who play a major role in this setting
are also able to provide an input on the patients
movement tactics so as to improve their wellbeing.
EVIDENCE BASED INFORMATION AND CURRENT
CARE RECOMMENDATIONS
Advocacy for patients is a critical component of
healthcare, ensuring that patients receive the best
possible care, support, and information.
Evidence-based information on patient advocacy can
be found in various sources including research
articles, guidelines, and reports. Here are some key
points and resources related to patient advocacy:

Patient-Centered Care: Research consistently

emphasizes the importance of patient-centered
care, where patients are actively involved in
decision-making regarding their health.
Patient-centered care acknowledges patients as
individuals with unique needs, preferences, and
values.
Empowerment and Informed Decision-Making:
Patient advocacy often involves empowering patients
to actively participate in their healthcare decisions.
This includes providing patients with relevant
information about their health condition, treatment
options, and potential outcomes so they can make
informed choices.

Communication and Shared Decision-Making:

Effective communication between patients,
healthcare providers, and caregivers is essential for
patient advocacy. Shared decision-making processes,
where patients and providers collaborate to make
healthcare decisions based on clinical evidence and
patient preferences, are associated with improved
patient outcomes.

Access to Healthcare Services: Patient advocates

work to ensure that patients have access to timely
and appropriate healthcare services, regardless of
factors such as socioeconomic status, geographic
location, or cultural background. This includes
advocating for policies and programs that promote
healthcare equity and reduce barriers to access.

Quality and Safety: Patient advocacy also involves

promoting quality and safety in healthcare delivery.
This may include advocating for measures to prevent
medical errors, improve the quality of care, and
enhance patient safety within healthcare settings.

Legal and Ethical Considerations: Patient advocacy

may involve addressing legal and ethical issues
related to healthcare, such as patient rights,
confidentiality, informed consent, and end-of-life
care. Advocates may work to ensure that patients'
rights are respected and protected within the
healthcare system.

Training and Education: Effective patient advocacy

often requires training and education for both
patients and healthcare providers. This may involve
providing patients with resources to navigate the
healthcare system, as well as offering healthcare
providers training in patient-centered
communication and advocacy skills.

Evidence-Based Practice: Patient advocacy efforts

should be informed by evidence-based practices and
research findings. This includes staying up-to-date
on the latest research in patient-centered care,
shared decision-making, healthcare quality, and
patient safety.

Resources for evidence-based information on patient

advocacy include:

PubMed: A database of biomedical literature that

includes research articles, reviews, and guidelines
related to patient advocacy and patient-centered
care.
The Cochrane Library: A collection of systematic
reviews and meta-analyses on healthcare
 interventions, including topics related to patient
advocacy and healthcare quality.
Agency for Healthcare Research and Quality (AHRQ):
AHRQ produces evidence-based guidelines, reports,
and tools related to patient-centered care, quality
improvement, and patient safety.
Patient Advocacy Organizations: Many patient
advocacy organizations provide evidence-based
information, resources, and support for patients and
caregivers facing specific health conditions.
By utilizing evidence-based information and
resources, patient advocates can effectively
promote the interests, rights, and well-being of
patients within the healthcare system.

EXAMINING EVIDENCE BASED DECISION MAKING IN

PLACEMENT ENVIRONMENT
My placement tutor was able to guide and inform me of
the different evidence based clinical decision making in
the ward and also its implementation.
There are several available websites especially when in
the treatment room where one can confirm things such
as drug class and its adiministration routes.
Duodecim,terveysportti, and pharmacofennica are very
important tools used to clarify drugs and are linked to
the apotti system.
The client and relatives participate in decision making
through being in communication with the
multidisciplinary team.
I also learnt that the in case of decisions such as personal
items on admission the clients relatives are responsible
for taking them home and providing guidance on what is
to be done(eg. Dentures and prothesis) in case their
loved one passes away.
The areas of development that could be of greater value
to planning and implementing care is improving
communication or how information is relayed to the
multidisciplinary care team and relatives as well.

REFERENCES
https://chat.openai.com/c/9e347d04-d99f-40f7-b845-4f
dd7d5f762b