Quality and Evidence Based Practice

Hello All,
How are you enjoying the course so far?

We have discussed the definitin of EBP, what EBP is, its understanding, and the strategies that are involved. This week we will put all of what we learned thus far and put it together to see how evidenced based practice can improve quality of life.

To understand how to improve quality of life one must undertand what it means.

     Meeberg (1992) states that Campbell, a sociologist states that the term “quality of life” was first used in America shortly after the Second World War. Quality of life was used to portray that there was more to having a good life than just being financially secure. De Haes & van Knippenberg according to Meeberg (1992) states that “quality of life” (QOL) has come to the forefront of health care realizing that the well-being of patients is just as important a consideration as the treatment of the patient for the sustainment of life. QOL has been used interchangeably with well-being by many. QOL decisions should be leaning towards improving and benefiting patients’ lives as well as their families. QOL is viewed as either subjective, objective, or both, and is conceptualized as either unidimentional or multidimensional (Meeberg 1992).
     Bishop (2008) shows how QOL is used objectively by stating that the objective component addresses norm-referenced measures of function or well-being. Objective indicators may include social indicators or outward material circumstances such as employment status, salary, martial status, ect, or physical function or symptoms that could be assessed by an external observer (Bishop 2008). Subjective QOL indicators provide estimates of satisfaction with life in general or with specific life dimensions as stated by Rosseler in Bishop (2008).
     Feld (2007) states that the Institute of Medicine defines quality as “ the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”
     In nursing the identification of the concept of QOL consist of four critical attributes that are evident:  

Gurland and Gurland (2008) states that the goal is to find a model that most usefully contributes to understanding and improving the QOL of people would be one that is amendable to refinement through: (1) study of the ways in which the model works, (2) construction of methods for evaluation and measurement that focus on details of the models mechanisms, (3) drawing upon established bodies of science, (4) translating understanding of deficits suggested by the model into helpful clinical and self-care actions that can repair or compensate for those deficits, (5) the model should incorporate the preferred values of the whole person. A person’s QOL results from the process of acquiring or accepting potential choices and the choosing among them (GurlandGurland 2008).

QOL is a very important factor in nursing. Patients rely on nurses to help provide them and their families the best quality of life during one’s health care crisis. In order for nurse to provide QOL it is imperative that the nurses understand the importance of what is meant by QOL.
I would like to hear your thoughts on what quality of life means to a patient? How can we as nurse help patient to achieve quality of life?

References:

                                                  

Bishop, M., (2008) Quality of life assessment in the measurement of rehabilitation outcome. Journal of Rehabilitation, 74(2), 45-54. Retrieved October 5, 2009, from Academic Search Premier database.

Encarta World English Dictionary (2009), Retrieved October 5, 2009.

Feld, S., Repairing the healthcare system: What is the definition of quality medical care? (2007). Retrieved from http://stanleyfeldmdmace.typepad.com on October 5, 2009.

Gurland, B., & Gurland, R., (2008, October) The choices, choosing model of quality of life: description and rationale. International Journal of Geriatric Psychiatry, 24 90-95. Retrieved October 5, 2009, doi:10.1002/gps.2110.

Meeberg, G., (1992). Quality of life: a concept analysis. Journal of Advanced Nursing.18, 32-38. Retrieved October 5, 2009 from the CINAHL Plus with Full Text database.