Research In Clinical Practise
Introduction to Portfolio
The research articles to be critiqued relate to the author’s area of
practice; community nursing and in particular; the cost-effectiveness
of community leg ulcer clinics. The author currently manages a leg
ulcer clinic and an insight into the research underpinning their
cost-effectiveness would be of benefit in her quest to deliver
evidence-based practice in line with the principles underpinning
clinical governance.
Management of venous leg ulcers had advanced considerably over the
last decade. This is due to various factors from greater knowledge of
the aetiology of leg ulceration to more recent developments, such as
dedicated leg ulcer clinics (Dowsett, 2004). However, it is a concern
that leg ulcer clinics are being justified by nurses and organizations
based on uncontrolled studies and narrative accounts (Bosanquet et al,
1993; Fletcher, 1995; Stevens et al, 1997; Thorne, 1998; Audit
Commission, 1999). It has been widely suggested that the establishment
of community leg ulcer clinics could increase healing rates for leg
ulcers and standardise care (Moffatt et al, 1992; Simon et al, 1996;
Stevens et al, 1997). However, research surrounding their cost
effectiveness is extremely limited.
As interest in healthcare research grows, the number of definitions
and explorations of the topic has increased. Most definitions of
research follow a similar theme with the search for knowledge being
emphasised as a fundamental reason for undertaking research studies
(Clifford, 1997). Cormack (2000) defined research as an attempt to
increase the sum of what is known by the discove...
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...rities. BMJ, 312, 1648 - 1651.
Simon et al (2004) Management of venous leg ulcers BMJ Online, Vol.
328 (7452) 2004. [Online]
http://bmj.bmjjournals.com/cgi/content/full/328/7452/1358 (Accessed
Jan 2005).
Stevens J, Franks PJ, Harrington M, (1997) A community/hospital leg
ulcer service. Journal of Wound Care. 6, 2, 62 - 68.
Tingle J, and Cribb A, (2002) Nursing Law and Ethics. 2nd ed. Oxford,
Blackwell Science.
Thorne E, (1998) Community leg ulcer clinics and the effectiveness of
care. Journal of Wound Care. 7, 2, 94 - 99.
Thurlby K, and Griffiths P, (2002) Community leg ulcer clinics vs.
home visits: which is more effective?. British Journal of Community
Nursing. 7, 5, 260 - 264.
Valente S, (2003) Critical Analysis of Research Papers. Journal for
Nurses in Staff Development. 19, 3, 130 - 142.
Willock et al, (2007) developed a detailed questionnaire based on a paediatric and adult pressure ulcer literature. A survey of 265 in patients in a paediatric hospital in the UK was conducted so detailed data could be obtained. The study found anaemia emerged as being a highly significant aspect of determining pressure ulcers. As a result of this study, the Glamorgan scale was
What is meant by evidence-based practice and how is this different from an historical standpoint.
Thomas, D. R. (2001). Issues and dilemmas in the prevention and treatment of pressure ulcers: A
... Even after finding evidence-based practice that would prompt a change in the patients care plan, you may still have problems convincing professional colleagues and the management of your findings and putting them into place. Journal of Wound Care p. 11. Practitioners have a responsibility to ensure their practice is based on sound clinical evidence and that the care delivered is of a high quality.
In social work evidence based practice is considered to be a decision making process and practitioners rely on the evidence when working with clients. According to Aveyard and Sharp (2013), evidence based practice is not easy to put into practice and there are many barriers to evidence based practice such as lack of time, lack of awareness of research, lack of support and cooperation, and lack of authority and inadequate facilities (p. 145). Although there are challenges to implementing evidence base practice this is still a doable task in the field of social work. Therefore, practitioners need to explore the motivation, knowledge and skills needed by the individual, the organizational motivation, learning
Over the last 10 years evidence-based practice (EBP) has grown substantially and is changing the nursing care delivered to patients along with the nursing work environment. Nurses are more involved in the decision making process, and are making clinical decisions with better patient outcomes (Good, Fink, Krugman, Oman, & Traditi, 2011). With technology growing at such a fast pace, new and more effective medicines, medical devices, and procedures are developed daily. Digestible sensors that monitor your bodily systems and 3D printing of embryonic stem cells, blood vessels, and sheets of cardiac tissue that actually beat like a real heart, are significantly impacting the future of healthcare (Honigman,
While working in the field of social work with various diverse groups and cultures, it is crucial to maintain a knowledge of cultural competence and cultural humility. In order to be culturally competent, a social worker needs to have both a background knowledge of the culture, and in order to practice cultural humility a social worker needs to be open to the likelihood that they will learn from their culturally diverse clientele. An example of this can be seen in a client from the Muslim-American cultural group. The client to be discussed here is an Iranian Muslim-American woman with OCD, or Obsessional-Compulsive Disorder. In order to address this client's needs regarding her OCD, the Evidence-Based Practice of Cognitive-Behavioral Therapy will be applied. Because of this client's cultural background, the pre-sessional tuning-in, as well as the obstacles she might face, are important factors when it comes to
Wound healing is very prevalent for a variety of wounds, many of those being pressure ulcers in geriatric patients. The baby boomer generation is very large and within the next 30 years, the aging population will grow enormously, increasing the need for wound care. All nurses must be educated on the most up to date and best practice for healing wounds.
This paper will discuss several different aspects of using evidence research. It will compare and contrast validity vs. reliability and address wither it is possible to have an instrument that is valid and not reliable. It will also examine type I and type II errors as well as examine the differences between parametric and non-parametric. Lastly, this paper will look probability and what the minimum level of significance is for a research paper.
For nursing, research has played a major role in the way clinical practice is done. Research has allowed nurses to provide appropriate care to patients. It allows them to perform their job by providing them the tools and information they need in order to make the decisions on the concerns for caring the patient (Polit & Beck, 2006). Moreover, research can also take focus on the workers themselves in order to improve the practice both on a professional and personal level. An example of a study conducted by King, Vidourek, and Schweibert of University of Cincinnati created a study to determine if there is a correlation between ...
My work focuses on health research methodology and health services research. I am particularly interested in patient-centered outcomes through the methods of synthesizing, evaluating, testing, and implementing the best available evidence about interventions in practice to deliver sustainable and effective healthcare. My goal is to help in reshaping healthcare to one that pursues the goals of the patients using the best available evidence and shared decision approaches guided by the expertise of clinicians and researchers while minimizing the footprint and burden of illness and treatment on patients, their caregivers, clinicians, and the healthcare system. To help achieving this goal, I have worked and developed expertise in rigorously evaluating
Evidence based practice is instilled in many nursing students these days on how patient care should be practiced. For some reason, once school is over, many nurses do not go on to further their learning. They lose the passion to research and take nursing as a job with a paycheck. Maintaining competencies can become a challenge for those who are not passionate about learning and learning new ways of practicing can be a struggle beause they do not care.
Tunis S., Stryer D., Clancy C. Increasing the Value of Clinical Research for Decision Making in Clinical and Health Policy. JAMA. 2003;290(12): 1624-1632
This reflective essay will discuss three skills that I have leant and developed during my placement. The three skills that I will be discussing in this essay are bed-bath, observing a corpse being prepared for mortuary and putting canulla and taking it out. These skills will be discussed in this essay using (Gibb’s, 1988) model. I have chosen to use Gibb’s model because I find this model easier to use and understand to guide me through my reflection process. Moreover, this model will be useful in breaking the new skills that I have developed into a way that I can understand. This model will also enable me to turn my experiences into knowledge that I can refer to in the future when facing same or similar situations. Gibbs model seems to be straightforward compared to the other model which is why I have also chosen it. To abide by the code of conduct of Nursing and Midwifery Council (NMC) names of the real patients in this essay have been changed to respect the confidentiality.
Our approach in managing wounds was far from being optimal in our own setting. After having read the article of Sibbald et al (1) and assisting to presentations during the first residential week-end, our approach at St. Mary 's Hospital Center 's Family Medicine Clinic must change. We were not classifying wounds as healable, maintenance or non-healable. We were always considering the wounds in our practice as healable despite considering the system 's restraints or the patients ' preferences. In the following lines, I will define and summarize the methods one should use in order to initial management of wounds and how to integrate it better to our site. The first goal we need to set is to determine its ability to heal. In order to ascertain if a wound is healable, maintenance or a non-healable wound.