Evidenced Based Practice In Social Care Social Work Essay

Published Date: 23 Mar 2015

Evidence-based practice is a way that is followed in providing healthcare which is guided by thoughtful integration of the very best of the currently available knowledge with a clinical expertise. This approach of research in nursing practice allows the medical practitioner to have a critical assessment of the research adapt, the clinical guidelines as well as other sources of information to enhance correct identification of the clinical problem and thus application of the most high quality interventions while re-evaluating the outcome for further improvements in the future. According to Cochrane collaboration evidence based health care is a conscientious offing of the current best evidence to make decision about the care given to the patients or in the delivery process of the health and social services (Titler, & Goode, 2001) The concept of evidence is used to refer to range of tangible information that is usable in identifying a problem and the necessity of responding to it forming an essential requirement for later evaluation purposes. The idea of current best evidence is information that is up to date and relevant therefore can be sued in carrying out of a valid research about various forma of health and social care, the possible harm from exposure to certain agents, accuracy of the diagnostic tests and finally the power of the predictability of the prognostic powers. This paper will offer a critical review of the evidence based practice as in concerns to the field of health and social care in nursing profession (Mason & Chaffee, 2002)

The term evidence based medicine was first sued in the 1980s and was used to describe the approaches that were used to in determining the best practice and was alter shifted to become evidence based practice especially after its importance in decisions making were recognized by clinicians and physicians. after that expert begun talking of the evidence based health care as process in which research evidence was used to make decisions regarding specific population or groups of patients hence assuming that the evidence was used in context of the particular group or patients preferences, desires, clinical situation and finally on the expertise of the clinicians. Experts as expect that the healthcare professionals are able to read, critique as well as synthesize the research findings to help them in interpreting the existing evidence based guideline soft e clinical practice.

In recent years funding agencies have been increasing their pressure on the federal, state and local government to incase the effectiveness as well as the accountability of the preventive and intervention programs. The rising demand for increased quality of health and social programs and evidence of such quality ahs fostered for increased interest in the evidence based programs. These programs judge to be evidence based if the evaluation research indicates that the program is producing positive and expected result, and that the result can actually be attributed to the specific program but not on extraneous factor, if the evaluation is previewed by the experts while in the field and finally the programs must be endorsed by a respected research agency or federal agency which have listed it as one of their effective programs (McCarthy, 2007).

The evidence based practice have been getting an increasing attention in the field of health and social care and it focuses on the perspectives of the professionals in the midwifery, physiotherapy, social acre and nursing. This new approach is seen as an optimistic approach and has had wide acceptance as it demonstrates an organization attempts to bridge the existing research practice divide which include in the process of interpretation of research outcomes as concerning the practice protocols, guidelines and standards.

Nurses have often served instrumental roles in the process of ensuring as well as provision of the evidence based practice through a continuous asking of question reading the best evidence for the interventions, provisions of the best practice and finally on the possibility of achieving the highest outcome both for the patient, family and nurse. Therefore they have always been positioned to working with in collaboration with colleagues when it comes to identification of clinical problems and in the use of the exiting evidence in priding an improved practice. There are numerous opportunities that nurses can question in order to ensure that the current nursing practices use the evidence based methods to improve and make provision of health and social acre more effective.

The evidence based practice research has benefited the health and social care service providers and agencies in various ways. Some of the benefits includes: helping nurses to provide patient care that is based on research and knowledge rather than on normality, intuition, traditions, myths, advice of colleague, personal experiences outdated books and hunches. Other benefits include the better and improved patient outcomes, keeps the nursing practice current and relevant, increases confidence when it comes to decision making processes, ensures that policies ad procedures in the practice are current and includes the latest research hence supporting the JCAHO -readiness and finally the integration of evidence based practice in to the practice of nursing is very important for provision of high quality patient care and achievement of the ANCC Magnet Recognition Program designation ((McCarthy, 2007).

Evidence based practice in the filed of social care is defined as the conscious, explicit and judicious process of using the current best evidence in the making of decisions that regards the welfare of the service user and careers.

For the past decade health and social services providers have been under pressure to increase accountability in the provision of their service especially regarding methods of measuring the effectiveness of health and social services for instance on what works the best and on the introduction of diverse range of performance indicators in the field. Some of the question that that nurses and care givers ask themselves regarding the evidence based practice in the field oh health and social care include the types of methods of evidence based that promote the best practice while ensuring that patient get the best and improved health and social services that factor in their personal preference, cultural and social differences. Effectiveness of social provision services under that children are all securely attached to careers that are capable ensuring provision of safe and effective care during the duration of their childhood and the related indicator of performance in the reduction of to no more than sixteen percent of children looked after who have two to tree annual placement (French, 2002).

The concept of effectiveness in the involve the appropriateness and validity of the methods theater used by professionals in their daily work to ensuring that the basic aims of the organization and the overall abilities of the agencies in delivering services they required to while the concept of performance is concerned with the ability of n agency to achieve predetermined targets that are viewed as the determinants of both quality and quantity of the services delivered. The three E's i.e. effectiveness, efficiency and performance were the performance indicators during the 1980's. In the social and health service care the attention of the public was shifted towards the issue spreading child abuse and protection tragedies that were culminated in the enquiry of Cleveland case. This led to an increasing number of question asked concerning the effectiveness of the process of assessment sexual abuses in children and the interventions that were targeted at the victims and the perpetrators.

Social service departments as well as other social acre providers are being increasing expected to be accountable for the effectiveness of the service that that are delivered both at the organizational level as well as on the specific programs used in various interventions (Gray, 1997) Therefore information technology as played a critical role when it comes to providing the means of which organizations and agencies utilize in monitoring the social service it provides and hence becoming capable of providing information that is used to achieve accountability. Focusing on the effectiveness has fostered the raising of fundamental issues regarding the nature of the research of the social work.

When on considers the evidence that emerges from the National Health Service, there is a massive variations in the health service provided both for the cost between identical treatments and also in the duration and provision of the various form of treatments. Such difference can only be explained based o n the different medical or social needs as well as on the questions raised on the electiveness of such treatments. Some of the initiative designed to help in improving the services provided by health providers include the creation of national institute for clinical excellence which is intended to improve service through the use of shared knowledgebase as well as the set standards (Titler, & Goode, 2001)

In addition to that another impact of the effectiveness agenda in the provision of social and health service can be evident in the proliferation of the policy as well as guidance documents as well as the creation of specific initiatives intended to increaser guides in the field for instance the Centre for Evidence-Based Social Services (CEBSS). At a national level there has been development of detailed guidance as well as practice manual both for the social care staff and other professional regarding the procedures that are followed in the handling of cases of suspected child abuse but all these vary specifically on the extent in which they based on research or on other agency priorities.

Finally the most concrete manifestation of the best practice in social care services is the Centre for Evidence-Based Social Services started in 1997 and based at Exeter University. The centre aims at ensuring that the decision take at every level of social service are based on trends and quality research and it conduct training on ways of achieving the stated aims. The Centre for Evidence-Based Social Services is partnership between the department of health and the social services department from corner to corner of England and at Exeter University. The organization has recently expanded to other areas and associations have various aims including the following:

To help in the translation of the results of the existing research in to the service and development of the practice.

Ensures that the findings derived from research are made available to the social service departments especially during the review and changing of the delivery systems

To promote collaboration with other stakeholders like degree and PQ to ensuring that the training conducted in social work incorporates the available knowledge from existing research

Improvement of general informational dissemination especially of research findings to the local policy makers, practitioners, managers, careers and service users

Commissioning of research on areas where information gaps are identified finally is to ensure working towards level where surface user and careers are included as the valuable sources of information especially when it comes on the service effectiveness projects.

Untangling the Web-The impact of internet use on the social care and the physician-patient Relationship

Methods

The current study lies at the intersection process and outcome study, in the process of exploring the impacts of the internet use on the social care as well as the physician-patient relations. It processes insight into the operations by which individuals access and use online social care information. It borrows much from the web based qualitative approaches. Interviews were carried out to investigate people's meanings that are attached to their internet use, in relation to their social as well as day-day life. To ensure that the engagement of the internet user is grasped with the online medium, it was as well much significant to meet the seekers of the information in their location of activity. The initial contact and recruitment of the interviewees were hence situated online.

Email Interviews

With the internet users looking for social care information online, the email interview was conducted. The recruitment of the interviewees was on UK websites for lawyers for low income people, social guidance counsellors, food providers and government officials, amongst others. The reason for focusing on such like web site was because they in most cases address themselves to the public with a multiple to the public in general with multiple social issues. There are even in most cases related topics developed on the similar website. Lawyers for low income as well as food providers for instance provides various general poverty level, while general social care website becomes an important place to government and non governmental organization involvement, and also attracts various profiles of social care information seekers.

These websites were identified through systematic internet research, by the use of 20 search engines as well as directories. The initial search came up with 920 websites. By the use of frequency criteria, as well as presence, 4o websites were selected. Then, they were conducted and invited for the invited to contribute to the research at hand. Amongst them, 10 websites responded positively and the research was advertised either as a web link on one of there pages, or as message in groups of discussions. The researcher posted it, after being permitted by the website administrator. Other ten were later added fin light of evidence about their appropriate content their frequent by the first interviewer.

The advertisement was made to direct internet users to the website of the research where the study goals, methods and privacy were all explained. On top of responding to an online questioner, the internet users were also invited to participate in the interviews by first cond8ucting the research through email, phone or even by the use of conventional mail. As a matter of fact, only two interviewees used phone while none used conventional mails. The initial exchange of around three emails before the base was set, the basis for the undertaking full email interviews, though the participants were all given at any junction of even meeting face-to-face, or even undertake an interview through exposure.

The demographic data like the respondent's age, employment, gender, education, social status, health status, as well as income, were all collected to serve the purpose of statistical controls. Respondents also were asked, if they have ever worked or ever stayed in a social care related units. In addition, they were questioned about their views in non traditional social care services.

Email Qualitative Research

Email interview is just asynchronous online method of interviewing, based generally on several email exchange between the participants and the researcher (Bampton &Cowton, 2002). Such like interviews allows greater flexibility for the interviewee, who might answer at his/her own convenience. Though it lacks the immediacy as compared to face-face interviews, once the basis has been set up, email communications helps in the attainment of conventional interviews and creates personal as well as thoughtful communications. In addition, email interviews allows repeated interactions as time goes by, this has been proved to be much significance for the deeper understanding of everyone's dimension of the participants' doctors relationship, (Mann &Stewart, 2000).

About 20-30 emails had been already exchanged between the each respondent and the researcher. The time of interview time relying on the speed that was adopted by the interviewees for replying the email. The interviewee age varied from 20 to 60 years. The respondents' respondent to questions like what was their level of social help? They were also asked about the source of their social care? Another question was about their social problem that needs social care?

The gender imbalance especially interviewees, especially in favour of females can be attributed to several reasons. One of them being the specificity of the mode of interview; given the gendered use as well as the social purposes of email communication; the initial email contacts might have installed an intimacy level, which in one way or the other might have locked the door out for male audience. Another reason might be the focus on social care issues like lawyers for low income individuals and the general social care websites. Though such like websites are addressed to the public in general and purpose male's social problem topics, the dimension of gender of these social issues as well as their related website has to be recognized, (Saltonstall, 1993). Another reason that can explain is that, females are socially constructed as the social gatekeepers of the family, and the society as a whole. Although according to the survey knowledge, findings proving that online social information seekers are mainly females. However the gender imbalance raises the question of whether the differentiated presence as well as the gendered use of the internet regarding social information, dimensions that need to researched on din another research.

The email interviews were semi-structured, such like interviewing form being characterized by its openness and it's enabling the interviewer to ensure that all themes rose as well as narratives provided by interviewees. The guide of the interview focuses on the three main issues namely; the traits, context as well as the implications of the internet for social information reasons. Though initially, this method was being considered as secondary source of data collection, the relations that interviewees have with their doctors, in real sense constituted the major theme. One after the other, topics was all discussed. The process of exchanging questions, and answers having no pre-judged other than just following a style that is far much conversational style.

Analysis

The most appropriate application to the interview data according to, (Boyatzis, 1998, Flick, 1998) is thematic analysis. The application consists of encoding qualitative information through creation of several themes that usually organises a number of themes that have the capability of organizing qualitative observation as well as describing the data into coherent as well as meaningful ideas and constructs, which forms the foundation for the interpretation for such like data. At first, themes were organized following the interview guide before being elaborated into further subdivided themes that offers the coding foundation, under which further themes that were created inductively were also integrated, (Flick, 1998).

Normally, formal informed consent is much important for all qualitative research methods in social care practices apart from participant observation, no matter the sampling method that was used in the identification of potential participants and the strategies used during their recruitment. The number of project-specific factors at ultimately upon a provably ethics committee, determines whether informed consent is written or oral. At the recruitment stage, obtaining informed consent for qualitative research involves clearly explaining the project to potential study participants.

Ethical Issues for the Conduct

The best protection of the subject interest and well-being is the protection of their identity. If revealing the behavior or the responds harm them then adherence to this norm is important. The two principles involved include anonymity and confidentiality.

The research subject is perceived anonymous when the researcher can't associate a given data with the individual. Anonymity highlights several potential difficulties. The studies that involve field observation methods usually ensure that the research subjects are not known. Researchers might also expand access to nonpublic reports from both governmental and non-governmental organizations agencies in which the names of individuals have been uninvolved. An example is a web based survey in which no log in or other identifying data is needed. The subjects anonymously fill the questionnaires that are then tabulated. Promising anonymity makes it difficult to keep record of which sampled subjects have been interviewed. Sometimes the value of anonymity is worth paying. Other methods of information collection make it impossible to assure anonymity for the respondents. Confidentiality comes in when the researcher links the data with the individual but promises not to do so in public. In a study of self-reported drug use, the researcher is in a position to make it open the use of illegal drugs by a given subject but the subject is guaranteed that it will not happen. Research using police or court reports that contains individuals' names might protect the confidentiality by not including any leading information. All names and addresses data gathering forms should be interchanged by identification numbers and master identification files made to link numbers to names to allow latter corrections missing information, (LoBiondo-Wood, & Haber, 2006).

Confidentiality comes in when the researcher links the data with the individual but promises not to do so in public. In a study of social care practice, the researcher is in a position to make it open so that it can be used by a given subject for the benefit of the respondent, but the subject is guaranteed that it will not happen. Research using reports that contains individuals' names might protect the confidentiality by not including any leading information. All names and addresses data gathering forms should be interchanged by identification numbers and master identification files made to link numbers to names to allow latter corrections missing information.

The Ability to Critique

The research needs to know how to reduce the need of labeling children as for instance disabled so that they can address the learning and behavioral requirements of such like children in a social care program. Most o0f these national psychological as well as social care providers do have ethical standards that require science based practices to air some sort of problems, for instance, the American psychological association ethical standards, amongst others. There has been no agreement upon both quality as well as quantity of evidence that is necessary for the validation as well as intervention as being evidence-based practices in social care practices.

Just the research methods of a single participant design are many convincing illustrations of the casual relationships. Social care practice analysis has been for a long period of time been criticized due to limited generalizability, as an effect of the small number of this taking part in the research study. In real since, there are no established standards within social care practices analysis for the validation of interventions. As an effect, there has been no single resource that decision makers can rely on to provide guidance about the best intervention to take it under practice in case of a particular problem. The identification of evidence-based interventions is much important but not enough to provide assurance that they will be implemented in practice setting. It is nevertheless important to address issues that ought to be complex which are associated with the implementation, (Joyce, et al, 1998).