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... ... middle of paper ... ...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.
What is meant by evidence-based practice and how is this different from an historical standpoint.
Maintenance of an appropriate healing environment is also essential throughout the management of diabetic foot ulcers. The choice of dressing is dependent on many factors including presence of infection, amount of exudate and the required frequency of wound bed inspection.
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
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,
Proper effective wound care is expensive, according to Kaufman and Pahl’s article in Dermatology Nursing (2003), the care of one pressure ulcer can easily cost $23,465 and take an average 247 days to heal. Kaufman and Pahl’s (2003) research showed great success when treating a pressure ulcer with a vacuum assisted closure device, showing closure in 97 days and costing only $14,564. The cost of treatment correlates significantly with the healing time. According to van Anholt, Sobotka,Meijer, Heyman, Groen, Topinkova, van Leen, and Schols (2010), if you decrease wound size, you use fewer dressings, spend less time, and ultimately less money on the wound care.
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.
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.
Ford, S. (2013). List of 12 Priorities for Pressure Ulcer Study Identified by UK Researchers. Retrieved from: http://www.nursingtimes.net/nursing-practice/clinical-zones/wound-care/priorities-for-pressure-ulcer-research-identified/5058364.article
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 ...
The reduction of pressure ulcer prevalence rates is a national healthcare goal (Lahmann, Halfens, & Dassen, 2010). Pressure ulcer development causes increased costs to the medical facility and delayed healing in the affected patients (Thomas, 2001). Standards and guidelines developed for pressure ulcer prevention are not always followed by nursing staff. For example, nurses are expected to complete a full assessment on new patients within 24 hours at most acute-care hospitals and nursing homes (Lahmann et al., 2010). A recent study on the causes of pressure ulcer de...
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
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.
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 week’s clinical experience has been unlike any other. I went onto the unit knowing that I needed to be more independent and found myself to be both scared and intimidated. However, having the patients I did made my first mother baby clinical an exciting experience. I was able to create connections between what I saw on the unit and the theory we learned in lectures. In addition, I was able to see tricks other nurses on the unit have when providing care, and where others went wrong. Being aware of this enabled me to see the areas of mother baby nursing I understood and areas I need to further research to become a better nurse.