The Role Of Nurses In Evidence-Based Care For Kidney Stones Patients In The UK

Analyse the role of Nurse in the United Kingdom in Assessment,planning, implemantation and evaluatiom of evidence based car. Examine the key legal, ethical and evidence frameworks used within nursing.

Nurses and Midwives Code of Conduct (NMC) in the UK

A kidney stone is a rare but a dangerous disease that hampers the proper discharge of Urine from the bladder. Sedimentation occurs around the bladder hence preventing an individual from passing out urine (Pearle et al., 2014). The condition is manageable through a variety of treatment methods. The modes of medical care for the disease base on evidence. Moreover, nurses in the UK should use the professional code of conduct when treating patients. Additionally, the nurses should observe legal and ethical means to treat patients. Moreover, treatment methods should base on well-researched evidence to be effective. Healthcare providers use evidence-based practice to form the numerous means of managing the kidney stone disease. The nurses have to observe the ethical and legal issues in their practice. It is also essential for caregivers to work following the professional code of conduct. The provision of health services that obeys the three objectives improves the quality of care. Additionally, best practice improves the therapeutic relationship between the patients and care providers.

The doctors can provide patients with painkillers to prevent the pain that the stones cause (Moyes et al., 2017). The physicians can urge the patients to take an excessive amount of water to dissolve the stone (Ando et al., 2015). Complicated cases call for surgical procedures to eliminate the kidney stone. On the other hand, the operation can reduce the kidney stone into small pieces. Another evidence-based strategy is through the use of drugs such as diuretics and Narcotics (Oddsson et al., 2015). This article discusses the NMC of nurses in the UK, critical legal, ethical and evidence framework used by nurses. Moreover, the paper looks at the role of nurses in the adoption of evidence-based care. Nurses should observe the three protocols above to treat kidney stones patients. The observation improves care.

The Code of conduct consists of rules that every Midwife and nurse in the UK must adhere to when discharging their duties (Gillen, 2015). The health practitioners should apply NMC when attending to individual patients, a group of patients or the entire community. The regulations in the code have to assume center stage during treatment. When the physician goes against any of them, they can be face jail terms (Snelling, 2017). The individual patients use the NMC as a reference point.

The Midwives, Nurses and other health practitioners use the codes as a guideline. They utilize it to focus on the provision of quality and affordable healthcare. The board in different health facilities should encourage their members of staff to follow the legislation strictly. Additionally, medical associations should train nurses on the uses of the codes. Furthermore, the nurses should be aware of the repercussions of not adhering to the laws (Aubyn, and Andrews, 2017). University lecturers should use the codes to train nursing students of what the nursing body requires of them after studies. Furthermore, the students should learn about the rules of getting accreditation to work as a nurse in the UK.

At St. John’s Seminary, the nurses strictly obeyed the codes during their line of duty. A 48-year-old woman suffering from kidneys stones visited the facility. The board of the hospital insisted that they place the needs of the patient first before their interests. Nurses attended to the patient with utmost respect, compassion and with a kind heart. The codes insist that nurses should provide the basics of care to the patients (Whitehead, Owen, Henshaw, Beddingham, and Simmons, 2016). Additionally, a thorough medical examination is necessary before treatment. From the confessions of the patient, treatment should not resume from there, unless laboratory tests prove otherwise.

Legal and Ethical Evidence frameworks applicable to UK nurses

Whenever a kidney stones patient visits the hospital; the nurses attend to them immediately. Any delay in treatment may lead to a complication becoming worse as time elapses. Other critical medical conditions may result in death if care delays. The second code requires that nurses carefully cross-examine patients and ask them about their treatment choices and fears (Ion, Smith, Nimmo, Rice, and McMillan, 2015).  There are kidney stones patients who opted for the Narcotic drugs in the treatment while others preferred the Diuretic drugs. The 48-year-old opted for Narcotic drugs. The nurses listened to her and prescribed the medication that she preferred.

Before the beginning of care, physicians should request the patient to suggest how best they would want the clinician to attend to them. There are patients with in-depth medical knowledge. Their input is vital before the beginning of treatment. Additionally, patients might have experienced the condition before but received inadequate therapy from health practitioners.  Such patients should get the opportunity to share their thoughts on how the previous treatment was insufficient (Carr, and Pezzella, 2017). Therefore, the present nurse can see how to improve the provision of care to ensure a permanent solution to disease. At the hospital, the physicians encountered patients who had previously suffered from kidney stones. Additionally, the clinicians treated nursing students. The two groups of people enabled the caregivers to improve their practice and provide exemplary services to other patients.

Any treatment should happen after the needs of the patients have taken center stage.  Patients have psychological, social and physical requirements (Carr, and Pezzella, 2017). In case the practitioners do not meet those needs, the patients might not respond to treatment. Some patients prefer injections to oral tablets (Whitehead et al., 2016). Other patients have unstable marriages that require the help of a counselor before the procedure. Before treating kidney stones, nurses had to ask patients if they had any problems at home. Additionally, clinicians asked them to choose between injections and oral medicine.

The code of conduct requires that treatment follows the wishes of patients (Carr, and Pezzella, 2017). A nurse should not insist on the mode of treatment because they want to meet their goals (Aubyn, and Andrews, 2017). Before respecting the suggestions by the patients, nurses should advise them on the existing treatment alternatives (Morgan, and Parry, 2017). Moreover, clinicians should explain the benefits and possible side effects of a given treatment mode. The physician should inform their counterparts about a potential clash of treatment choices between them and the patient. Fellow practitioners or seniors should advise on how to handle such discrepancies.

The physician should confidentially keep the medical records of a patient (Whitehead et al., 2016). During the treatment at St. John's Seminary, the nurses followed the medical history of patients. The physician should only display such kind of information with the permission of the patient. However, the practitioner can disclose the patient's information only if pressing issues arise in their line of duty.

In the UK, the statutory criteria include both case and statute laws (Griffith, and Tengnah, 2017). The regulations are uniform across Scotland and Wales (Parahoo, 2014). However, there is a minimal disparity between the nursing legislation in the UK and the Irish region (Parahoo, 2014). Scotland nursing regulations allow an individual to have their attorney to decide the mode of treatment if that individual loses the power of choice (Parahoo, 2014). However, in England, the individual has to participate in deciding the kind of treatment whether incapacitated or otherwise (Parahoo, 2014). The UK uses laws that conform to the international requirements to regulate nursing practice. Examples of the regulations include children, abortion, and mental care laws (Parahoo, 2014). Scotland has an additional rule that guides the confidentiality of the medical records of the patient.

The case laws monitor the adherence to ethics in the medical field. These types of rules have kept law courts very busy of late (Parahoo, 2014). There have been incidences of physicians helping patients in the intensive care unit to die (Griffith, and Tengnah, 2017). Additionally, some incapacitated patients refuse to obtain care (Griffith, and Tengnah, 2017). At St. Johns there were no cases of assisted deaths. Furthermore, patients who could not decide on the mode of treatment involved the family members and the nurse before making an informed decision. Before a practitioner chooses to the method of treatment for the patient, they must seek guidance from legal and ethical standards.

The age of majority starts at sixteen in Scotland, whereas, any individual who has attained the age of eighteen is a major in England (Griffith, and Tengnah, 2017). Therefore, England laws expect the individuals at the significant ages to make treatment decisions independently. Moreover, Scotland laws allow someone who has attained the age of 16 upwards to decide on the method of medical attention freely.

Proper nursing practice requires the application of the principles of ethics to offer treatment. When attending to kidney stones patients at St. John's hospitals, I observed the ethical principles to the latter.

Nonmaleficence is a principle that requires the doctor not to harm the patient in any way during treatment (Preshaw, Brazil, McLaughlin, and Frolic, 2016). In nursing, the proper insight into the principle improves the quality of healthcare. At the Liverpool based health facility, the nurses had to commit to the welfare of the kidney stone victims fully. In case, the health conditions of the patient worsen beyond our understanding, the clinicians had to summon the chief physician to attend to such patient. In seeking assistance from colleague practitioners, the nurses prevented imminent harm to the patient.

The principle requires that medical attention improves the health of the patient.  At the hospital, nurses handled patients with a smile in their eyes (Holloway, and Galvin, 2016). The nurses allowed the patients to choose the best mode of treatment that suits their needs. Furthermore, the nurses ensured that they gave the appropriate medication that satisfies the conditions of the patients.

The principle dictates that nurses prioritize the wishes of patients before administering treatment (Holloway, and Galvin, 2016). Kidney stones patients who opted for Diuretic drugs received the medication. Those that chose for narcotic treatment got the same from the hospital pharmacy. Moreover, those that opted for steroids-free medicines got their wishes.

The principle demands that patients receive equal and fair medical attention from health practitioners (Preshaw et al., 2016). While attending to patients at St. Johns, the nurses overlooked their ethnicity, age, race and financial status. The critical issue is to administer quality treatment to all the kidney stones patients.

Evidence-Based Care (EBC) is a broad spectrum strategy that is appropriate in offering medical attention to patients (Ellis, 2016). Additionally, the care integrates the evidence from research, the competency of the physicians and the preferences of the patient to come up with the best care for patients (Jirojwong, Johnson, and Welch, 2014). At St. John's, I and the other nurses followed a well-outlined framework to attend to Kidney patients. Firstly, before offering treatment, the nurses asked the patients to choose between narcotic and diuretic drugs. Secondly, the nurses came up with a medical question about kidney stones treatment. The issues are relevant and seek to provide the best solution to the patient.

The issue looked at the possible prevention measures and the differences with other treatment strategies. Thirdly, the clinicians looked at the most appropriate sources of information such as the e-libraries. Fourthly, the nursing body critiques the sources and retains only the information that has adequate evidence. Lastly, the nurses used the best methods for treating kidney stones. The modes included the prescription of narcotic and diuretic drugs among others.

Role of Nurse in the United Kingdom in assessing, planning, implementing and evaluation of evidence-based care

Evidence-Based Care (EBC) requires the nurses to look for treatment methods which specialists have carried extensive research on and have given their approval. Most health practitioners have access to EBC ( Jirojwong et al., 2014). However, they find difficulties in using the EBC in actual line of duty. For the practice that relies on evidence to become a reality in the UK, nurses must assume critical roles.

There are two techniques that nurses use to assess the effectiveness of EBC. The health practitioners at St. John's used the same criteria to examine EBC.  The methods are Fresno and Berlin strategies (Gardner, Lahoz, Bond, and Levin, 2016).  The nurses used the Fresno technique to check for the effectiveness of evidence-based care on the nursing students on industrial attachment. Additionally, the Fresno type looks into EBC in a majority of treatment areas (Wexler, Paljevic, Roberts, Drury, and Greenberg, 2016). To access the impact of EBC in nursing students, the medical fraternity of St. John’s used random assessment tests. The essence of the test is to discover how well the nursing students have mastered the basics of EBC. However, UK nurses have come to realize that the assessment methods are insufficient in providing reliable information.

Before implementing the attention, the clinicians came up with a comprehensive plan to carry out the healthcare technique. Firstly, the caregivers developed a competitive framework to establish the care. Furthermore, the nurses examined the various methods of finding solutions to health-related problems. The caregivers developed both quantitative and qualitative strategies to check on the progress of our work. The care providers gathered all the possible evidence on treatment methods. The nursing body decided to retain the collected information for some duration (Wong et al., 2015). The extension in the period is to enable us to sort the best technique to apply when providing medical attention.

After the planning process, nurses should devise methods of implementing the evidence-based practice. There are some implementation strategies that nurses can use to start applying the evidence-based practice. St. John's hospital used the same framework to transform evidence-based practice from a theory to a practical strategy. The first strategy is to set a framework for implementing the EBP (Aarons, Ehrhart, Farahnak, and Hurlburt, 2015). Nurses have to ensure that the libraries have the necessary literature for conclusive research. Secondly, the physicians should urge the administration to avail the resources where they can find reliable information.

The nurses should consult all stakeholders before using an evidence-based framework. A consultation is a powerful tool in the field of healthcare (Aarons et al., 2015). The various practitioners can offer nurses an appropriate strategy to implement the basics of evidence framework. After going through the protocols diligently, the nurses should go ahead and use the evidence framework in treatment (Aarons et al., 2015).  Moreover, the nurses should regularly check on the progress of the implementation. The nurses should purpose to inquire about the impact of EBP on patients and the nation as a whole.

After the inquiry, the nurses should purport to know about the best possible evidence on the techniques of Evidence-based practice (EBP). Furthermore, nurses should enquire to understand the objectives of implementing the framework (Aarons et al., 2015). Additionally, extensive research is necessary to gauge the impact that an evidenced structure has on the members of the society.

After a health facility integrates evidenced-based care into the system, the nurses should check on the effectiveness. The nurses must prepare questionnaires to patients and their families (Melnyk, Gallagher?Ford, Long, and Fineout?Overholt, 2014). Additionally, physicians can obtain the outcome of the evidence-based care from sampling methods (Melnyk et al., 2014). When most patients show significant progress in their path of recovery, the process is successful. However, when the condition of patients remains unchanged, then the operation failed in the implementation part (Aarons et al., 2015). A proper evaluation strategy helps the hospital associations to check on areas to improve on (Melnyk et al., 2014). Moreover, the nurses can gauge the prosperous cities and keep up the stellar job.

A proper evaluation model provides a platform to understand the merits of evidence-based care. The process also points out at possible loopholes in the nursing practice in that health facility (Melnyk et al., 2014). Health organizations can gauge the impediments to the full implementation process (Melnyk et al., 2014). Additionally, the association gets an eye opener on possible deliberations on plans. The hospital uses the evaluation model to devise means of implementing the evidence-based practice. The evaluation provided valuable information for future reference (Melnyk et al., 2014). Therefore, a healthcare facility should use a proper evaluation process to research on evidence-based care.

Conclusion

Nurses and other health practitioners should observe all codes of conduct when administering treatment. Physicians should follow the Nurses and Midwives Codes (NMC) of conduct in carrying out care. The laws of professional manner require nurses to respect the treatment preference of the patient. Additionally, nurses should treat all patients equally, irrespective of their racial, ethnic and financial backgrounds. Nurses should keep the patients records secret. They can only display the records to a third party following the permission from the patient. Even after death, the files should remain confidential. Physicians can only view the patient's information when an emergency occurs. The law prohibits the sharing of patient's data with the third party. Nurses should learn to be secretive to protect their reputations in their line of duty. Patients should believe in the ability of nurses.

Physicians should observe legal and ethical principles when administering treatment. The nursing regulations prohibit them from sharing a patient's record with the third party. The laws permit anybody in the age bracket of the majors to make independent treatment decisions. The clinician should respect ethical principles such as beneficence, nonmaleficence, justice, and autonomy of the patient before offering healthcare.  Clinicians should use treatment methods that base on adequate evidence. Means of medical attention that are evidence-based improve the quality of care. The nurses have a pivotal role to play in ensuring the proper assessment, planning, implementation and evaluation of evidence-based care. The appropriate implication of the three objectives yields desirable health results. Firstly, the therapeutic relationship between the nurses and the doctors improve significantly. Additionally, the observation of the three goals enhances the quality of healthcare. The confidence levels of the patients improve towards the health care system. The reputation of the individual nurses also enhances. Additionally, the hospital gains respect among other health facilities.  

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