Evidence-based practice: a mean for quality nursing care

Health care changes are occurring rapidly and dramatically in this twenty-first century and producing multifaceted challenges for health care providers. The Millennium Development Goals grew out of the commitments made in the United Nations in September 2000, and aim to focus the efforts of the world community on achieving significant, measurable improvement in people's lives. This State of Art aimed to highlight how can evidence - based practice be a mean for providing high quality nursing care with accountability to individuals and families when practice decisions are based upon scientific evidence and data. A proposed strategic plan for implementation of evidence-based practice and the use of the best evidence available, so that the clinician and the patient arrive at the best decision, taking into account the need and values of the individual patient. It is a movement from basing practice upon tradition, authority or past experience to creativity and decision making based on sound knowledge driven from best research evidence to improve outcomes, High quality care and Patient Centered Care. Professional nurses cannot plead ignorance of new knowledge and practices because part of professional accountability requires .keeping up with new practice developments. The requirement for nursing to become a research- based profession has been recognized in a way of not only choosing research-based practice, but taking the further step of selecting suitable "strong research" on which to base the practice. Clinical guidelines are a potential means by which evidence can be incorporated into nursing practice as prerequisite for high-quality care

Nursing documentation in maternity clinical practice: reflection of actual nurse work load, problems and barriers

Reporting and recording are the major communication techniques used by health care worker in directing client based decision making and continuity of care. The medical records serve as a legal document for recording all client activities initiated by all health practitioners its may be paper documents or electronic documents. Documentation allows nurses and other care providers to communicate about the care provided, and promote good nursing care and supports nurses to meet professional and legal standards. However, nursing documentation continues to draw criticism from professional community, and regulatory organizations because of incomplete, substandard charting practices. Studies focused on time indicate that nurses spend a significant amount of time in record keeping. Nurses regularly copied data from the medical record and other documents to create personal records that guided their activities. The purpose of this paper: is to evaluate nurses' attitudes toward documentation for endorsing patient care and its value as mean of communication. Also to identify the problems and barriers in the nursing documentation for reflecting actual nurse work Load from nurses' perspective. An exploratory descriptive study design was used. The study was conducted over three months [March-May 2010] in pre natal, post natal and nursery departments, at Al aziziah Maternity and children hospital, in Jeddah. A total of [160] female nurses working at the wards of the study settings, 60 of them of different nationality were recruited thought simple random sampling 4. Tools; A questionnaire sheet was developed by researchers for data collection, also Likert rating scale consisting of 10 items divided into two sections: documentation barrier [5 items], and Documentation-tension [5 items]. The research tools was generated through review of the literature and consultation with nursing experts. The descriptive statistics of mean was use to analyze the data with a criterion mean at 2.50. The present study findings revealed significant percentages of nurses' agreement upon the benefit of documentation to patient care, [48.7%] reported that nursing notes always facilitate the movement toward the nursing goals, documentation leads to improve patient care recorded [30%]. Furthermore, the majority had reported that documentation is always related to nursing care that provided to patient [61.7%]. On the other hand, 41.7% were thinking that documentation is often an accurate reflection of patient nursing care. Concerning the value of documentation to the nurses, [51.7%] agreed that use of documentation are often more of help for nurses than load, while [3 8.3%] reported that nursing notes are often important to every health provider and documentation is not wasting of time. Regarding documentation barriers, [30%] had agreed upon that documentation is too heavily structured by quality assurance, and Workload demands hinder the completing of patient documentation, while [35%] agreed upon the statement that Shortage of staff work hinder completing of patient documentation. While only [16.7%] agreed upon the statement that Language barrier decrease quality of nursing documentation, and [21.7%] reported that documentation consist a lot of double-charting and repetition. It is concluded that nurses have a positive attitude to ward documentation in the mean of patient care, communication and value. However, nurses are not certain upon documentation barriers and tension. There is also significant relation ship between barriers, tension and Saudi nurses. Therefore, it is recommended for further examination of nurses opinion regarding barriers and tension among Saudi nurses. It is also necessary for hospitals to adopt formal nurses' documentation forms on their charts