CODE OF ETHICS & PROFESSIONAL CONDUCT

Management
(INC) ensures appropriate allocation and utilization of available resources o o participates in supervision and education of students and other formal care providers uses judgment in relation to individual competence while accepting and delegating responsibilities facilitates conducive work culture in order to achieve institutional objectives communicates effectively following appropriate channels of communication participates in performance appraisal participates in evaluation of nursing services participates in policy decisions, following the principle of equity and accessibility of services works with individual to identify their needs and sensitizes policy makers and funding agencies for resources allocation

o o o o o

Professional Advancement
o o o o o ensures the protection of the human rights while pursuing the advancement of knowledge contributes to the development of nursing practice participates in determining and implementing quality care takes responsibility for updating own knowledge and competencies contributes to core of professional knowledge by conducting and participating in research

EVIDENCE-BASED PRACTICE
An integration of the best evidence available, nursing expertise, and the values and preferences of the individuals, families, and communities who are served EBP uses best evidence Scientific knowledge from randomized clinical trials, observational studies Expert opinion, expert consensus

Other ASSUMPTIONS

Nursing is an applied science and the practice of nursing should be grounded in science. Use of EBP contributes to patient/family outcomes that improve health. USERS OF EVIDENCE BASED PRACTICE.

Nurses (RN, LVN, NP) Nursing assistants Physicians Respiratory Therapists Physical Therapists Pharmacists others

WHY USE EBP . Advances quality of care provided by nurses. Increases satisfaction of patients

 Refocuses nursing practice away from habits and tradition to evidence and research HOW TO BEGIN Take our class, Intro to Evidence Based Practice Then take Building Your Skills Around Evidence Join Nursing Research Council Attend Journal Clubs PROCESS OF EBP Asking a clinical question. Searching the literature for relevant research. Critically appraising what has been found. If change is warranted, following steps occur. Implementing a practice change. Evaluating the change in practice. WHAT IS EVIDENCE BASED PRACTICE An approach to clinical practice A way to keep current with new developments a methodological approach to clinical practice where evidence is used to inform decision-making about making a diagnosis (or interpreting a diagnostic test), selecting an intervention, or evaluating prognostic indicators an approach to health care practice in which the clinician is aware of the evidence that bears on her clinical practice, and the strength of that evidence

 Evidence based health care is the integration of individual clinical expertise with the best available external clinical evidence and the values and expectations of the patient. Involves life-long, self-directed, problem-based learning Involves exploring the relationship between clinical reasoning and research evidence Involves practice EVIDENCE BASED NURSING PRACTICE Knowledge Standard Each nurse possesses, through basic education and continuing learning, knowledge relevant to her/his professional practice Knowledge Standard Indicators Providing a theoretical and/or evidence-based rationale for all decisions Understanding the knowledge required to meet the needs of complex clients Knowing where/how to access learning resources when necessary Seeking and reviewing research in nursing, health sciences and related disciplines Using research to inform practice/professional service Knowledge Application Standard Each nurse continually improves the application of professional knowledge Knowledge Application Standard Indicators Ensuring practice is based in theory and evidence and meets all relevant standards/guidelines

 Assessing/describing the client situation using a theory, framework or evidence-based tool Managing multiple nursing interventions simultaneously Evaluating/describing the outcome of specific interventions and modifying the plan/approach Integrating research findings into professional service and practice

5 STEPS OF EVIDENCE BASED PRACTICE Define the Question Identify Question ~ Search and Screen Literature ~ Refine Question Collect the Evidence Critically Appraise the Evidence for Validity and Relevance Integrate the Evidence and Patient Factors Make & Carry Out the Decision

 Evaluate the Process Results ~ Self-reflection PICO A clinical question should incorporate at least three elements Patient Age, sex, ethnicity, etc. Condition, diseases, general health status Intervention Education, diagnostics, treatment plan, self-care, etc. Comparison Intervention Placebo, etc. Outcome Expected and actual effects on patient Do nurse led tobacco cessation interventions result in decreased smoking rates after hospital admission for coronary heart disease? PATIENT (Adult) coronary heart patients Smokers Discharged from hospital INTERVENTION Nurse led tobacco cessation programmes COMPARISON (Non-nurse led tobacco cessation programmes Self-administered, non-nurse administered, etc.)

 No comparison OUTCOME Lower rates of tobacco use among Patient group Not all questions are of a clinical nature Intervention can be interpreted very broadly EVIDENCE PYRAMID