Name: Raquel Alexandra Dores Rodrigues

Student Number: 1472521662

Module title: Application of Evidence Based Practice for Nurses

Module code: NRS200

Module leader: Megan Curry

Word count: 2,100

The purpose of this assignment is to identify a key policy in a clinical practise area and
explore its implications for person-centered nursing care. In addition, the student will
need to critically analyse the evidence used to support the policy and how it links to
evidence based practice. As a result, the student has opted to discuss infection
prevention and control policies for this assignment (Local trust policy2021). The goal of
this policy is to reduce infection risk and improve patient, people, and staff wellbeing in
hospitals and communities (Sunley, et al, 2017). In hospitals, protocols such as regular
hand washing, deep cleaning of all clinical areas, and regular infection and preventive
control checks in ward areas are in place to help achieve this goal (Gould, et al, 2016).
To acknowledge the NMC code and to respect the patient's right to privacy and
confidentiality, all names have been changed to protect their privacy. (Nursing &
Midwifery Council, 2018).

Evidence-Based Practice is a method for improving the delivery of health care to

patients in the most efficient and effective way possible. This combines the best
evidence from studies, patient care data, professional expertise, and the preferences
and values of the patients (Craig and Dowding, 2019, p.12). According to Hoffmann,
Bennett, and Del Mar, (2017, p.17) this allows patients and healthcare practitioners to
discuss and gather information about what is the best suited care for each individual
patient. Besides that, it is the nurse's responsibility to always practise successfully by
retaining the knowledge and skills necessary for safe, evidence-based practise (Nursing
& Midwifery council, 2018). This is important in nursing care since nurses must evaluate
various research evidence and collaborate with their colleagues to increase their
knowledge and abilities. According to Hoffmann, Bennett, and Del Mar, (2017, p.270)
this should then be put into practise in order to improve the quality of patient care.

The student has decided to discuss the policy on infection prevention and control. They
discussed this policy because, as a result of Covid-19, respiratory tract infections
became the leading cause of infection in hospitals between November 2020 and
February 2021 (Sloot, 2021). As a result, measures for infection prevention and control
were implemented to keep these illnesses from spreading further. According to
Andersen (2016) The patient's safety is dependent on the quality of care, treatment, and
protection against potential complications, and having an infection prevention and
control policy in place helps to assure this. In addition, Hospital updates are required in
order for hospitals to comply with infection control and prevention policies. However,
due to financial reasons, this is not always practicable; as a result, this is a policy
limitation (NHS, 2002, Pp. 4-5). Although an infection control strategy was established
to aid in the prevention of infections, there are some aspects that may be improved.
Due to a lack of employees and time, some facilities are congested, and environmental
cleaning such as walls, floors, and surfaces may not always be as clean as they should
be (Weston, 2013). According to Hoernke, et al. (2020) this policy protects and cares for
the public by emphasising the significance of personal protective equipment (PPE)
when dealing with patients, as this helps to prevent disease transmission between
healthcare professionals and patients.

In addition, according to Torjesen (2014), NHS supplies have decreased by two-thirds in

a year, and trusts in severe financial distress continue to rely on Department of Health
financial assistance to pay staff and creditors. Boshier, et al. (2021) suggests that up to
15% of inpatient cases were acquired in hospital facilities during the peak of the Covid-
19 pandemic, according to estimates. Moreover, healthcare associated infections are
estimated to cost the NHS approximately £1 billion a year, and £56 million of this is
estimated to be incurred after patients are discharged from hospital (NICE, 2017).
Furthermore, early rehabilitation may enhance short-term physical outcomes and quality
of life in patients, according to Siddiq, et al (2020). In addition, Siddiq, et al (2020)
suggests that Covid-19 infection resulted in increased length of stay in intensive care
units, higher duration of respiratory support, and increased mortality rates, all of which
cost the NHS a lot of money.

Due to the increased danger of infections in healthcare settings, the Infection and
Control policy was implemented to protect health workers and patients from infections
that could have been avoided (WHO, 2022). In addition, the goal of this policy,
according to NHS (2017), is to support health professionals in the prevention, early
detection, and management of minor and significant infection outbreaks. Furthermore,
according to NHS Foundation Trust (2018), the infection control and prevention policy
aids in infection education and training, as well as protecting workers and service users
from dangerous infections. Moreover, when drafting a policy, for example, plan-making
occurs. Planning policies and decisions should play an active role in guiding
development toward better alternatives (Ministry of housing, community and local
government, 2021).

In this section of the assignment, the student will be interpreting a variety of literature
that was cited in the policy's reference list. Furthermore, the strategy the student
adopted contains eight references, including government standards and NHS
frameworks. As a result, the student believes that this policy was not well-researched,
as seen by the short reference list. There are various forms of research in the policy
they picked. One of the references is the Health and Security Agency (2021), which is a
case report. A systematic review was used on this strategy in the form of NHS (2021).
Expert opinions are also included in this policy. A lot of the references used are
systematic reviews, making this policy repetitious. Also, the fact that a systematic
review summarizes the findings of various professionally planned healthcare research
and retains a high level of evidence on the usefulness of healthcare interventions is one
of its strengths. Moreover, Decisions can be made based on evidence, which can assist
healthcare recommendations (University of Exeter, 2022). In addition, systematic
reviews are found on the top of the hierarchy of evidence, whereas the case report
study is second from the bottom in the evidence ladder, implying that the quality of
evidence is lower than that of a systematic review (Brighton, et al, 2020).

The student has chosen Loveday, Wilson, Pratt, et al., (2014) as their preferred
reference out of the eight available. This qualitative study is a randomised controlled
trial as well as a systematic review. To critique this reference, the student is using
Critical Appraisal Skills Programme (2018). The goal of this study was to find a way to
avoid healthcare-associated infections. It is critical for the study to have a clear focus in
order to inform the readers about what they will be reading, making it easier for them to
locate the study they are looking for. The qualitative method is relevant because the
study focused on healthcare-associated infection; nonetheless, systematic reviews and
randomised controlled trials were also utilised in this study. Ethical theories, according
to Buka, (2020), serve as guiding notions in a variety of situations and enhance
decision-making by differentiating right from wrong. Since this study can be adopted
and used by all hospital practitioners with the purpose of affecting the quality and
clinical effectiveness of infections, ethical considerations were taken into account.
Furthermore, this research was conducted in the strictest confidence with all members
of the staff, in accordance with the ethics committee's objective to safeguard the rights,
safety, dignity, and well-being of research participants (NHS, 2022).

Moreover, evidence-based practise is the objective, balanced, and responsible

application of current research and the best available data to inform policy and practise
decisions that improve consumer outcomes (NIC, 2009). Therefore, this policy links with
evidence-based practice as it was put in place to improve infection acquired rates in
hospitals. In addition, according to Trial Lawyers (2017) overcrowding of patients and
inadequate staff training spreading infection can also lead to an increased risk for
patients and staff.

Furthermore, because these principles can be viewed as the foundation of professional

care, this policy should have an impact on person-centered care. The needed response
to a patient's desire for quality of life is person-centered care (Boggatz, 2020). This
policy has an impact on person-centered care since it aims to safeguard patients in
hospitals by reducing the risk of infection, which is accomplished through the guidelines
staff must follow. This has an impact on person-centered care since staff must wear
personal protective equipment (PPE) to protect patients from infections that may be
spread by staff as a result of interacting with patients with diseases like c-difficile or
covid-19. However, the World Health Organization (WHO, 2020) has cautioned that
increased demand and panic buying are causing significant disruptions in the global
supply of Personal Protective Equipment, placing patients at risk of contracting a
hospital-acquired infection.

This local policy has shown that it involves Evidence-based practice. According to
Daniel, Leffler, Lamont. (2015) C. difficile is a well-known hospital-acquired illness that
is frequently found on health-care workers' hands, linens, phones, toilets, and bedside
equipment. In addition, Daniel, Leffler, Lamont. (2015) show that patients with
suspected or confirmed C. difficile should be isolated in a single room, and health staff
should wear protective gloves, aprons, and wash their hands with soap and water every
time they come into communication with the patient to prevent further transmission. It's
also a good idea to disinfect the room after patient discharge. In addition, following the
infection prevention and control policy demonstrates that evidence-based practise is
included into the local policy, as the policy's rules are followed to prevent future infection
spread. Another option to demonstrate how evidence-based practise is incorporated
into this policy is to use Covid-19. According to Ciotti, Ciccozzi, Terrinoni, Et al (2020)
Covid-19 is a highly contagious viral infection that resulted in a global pandemic and a
devastating loss of human life around the world. The entire world adopted precautions
against the outbreak, including the use of efficient soap or sanitizer and hand washing
on a regular basis, as well as the use of personal protective equipment in hospitals,
such as masks, eye and face visors, and gowns Pradhan, et al (2020). These were not
only utilised in hospitals, but also in communities, as people were so afraid of
contracting the virus that they began to buy or construct homemade PPE to protect
themselves. This demonstrates that infection prevention and control policy uses
evidence-based practise as a technique of infection prevention, and that this is also how
they improve their policy by observing what works and what doesn't, as well as other
approaches that need to be implemented. For example, following Covid-19, all
healthcare staff must now wear a face mask when in hospital settings, whereas this was
not the case previously (Lee, Jeong, 2020).
Finally, the student will discuss the necessity of service user involvement in care.
According to Davis, Rosamond, Sevdalis, Vicent, (2007) Patients can play an important
role in improving patients' safety by becoming actively involved in their own care. This
method emphasises on involving the patient, as well as their family and friends, in
assessing and planning their own needs. Furthermore, Frezza (2020) suggests that by
doing so, experts are utilising a person-centered approach, which aids in the provision
of high-quality health care.

In conclusion, the student has discussed the importance and issues of evidence-based
practise, as well as why it is important in nursing care. EBP allows patients and
healthcare practitioners to debate and acquire information regarding what is the best
suited care for each individual patient, according to Hoffmann, Bennett, and Del Mar
(2017, p.17). Furthermore, the student opted to discuss the infection prevention and
control policy Local trust policy (2021) and provided a compelling reason for their
decision. The student also referenced national recommendations on their selected
policy, such as the fact that treating healthcare-associated infections costs the NHS
roughly £1 billion every year (NICE, 2017). The student then elaborates on their chosen
policy, emphasising how it helps with infection prevention and education, as well as
protecting workers and service users from harmful diseases (NHS Foundation Trust,
2018). By discussing some of the different types of references used, the student then
began to interpret a variety of literature used in the development of this policy. The
student was next required to criticise one reference, choosing Loveday, Wilson, Pratt, et
al., (2014) and using the Critical Appraisal Skills Programme to do so (2018). While
critiquing the reference, the student also explored ethics. Furthermore, EBP and
person-centered care were also mentioned in the closing paragraph, along with the
importance of patient involvement in care, bringing this assignment to a close.

Reference list
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