Nursing Research
Nursing is forever evolving due to the development in evidence based practice. Clinical frontline nurses are leading the way of change in practice and culture to improve patient outcomes, it is an exciting time to be a nurse. The nursing profession now has a voice and it is all due to higher levels of education, nurse researchers and innovators; and nurses in the board room as stakeholders for change. Evidence based practice greatly impacts patient outcomes and the decrease in adverse events such as hospital acquired infections, pressure injuries, fall prevention and failure to rescue (Zegers, Hesselink, Geense, Vincent, & Wollersheim, 2016). There are multiple ways of knowing how to care for a patient to prevent pressure
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Pressure injury prevention is a battle nurses continue to fight even today. It is important to remember Carper’s four fundamental patterns of knowing, which include: Empiric, also known as the science of nursing, ideas, and traditions in nursing tasks and practice such as skin care and turning. Ethic, also known as the component of moral knowledge in nursing, which includes doing the right thing for the patient and showing respect for human life. Personal knowledge is the experiences gained in nursing practice, it is information shared from others and nursing education. Finally, aesthetics known as the art of nursing, and the hands on caring and doing for the patient (Themes, 2016). Aesthetics included taking time to turn and provide skin care, all aspects of pressure injury prevention through hands on nursing care. Nurses continue to struggle with pressure injury prevention even with the availability of the many studies and evidence based practice to guide the workflow. Critically ill patients require attentive monitoring and care; nurses who specialize in this area provide support and treatment for patients whose conditions make their overall health unstable, and susceptible to an overall decline in health and …show more content…
(2016). How to critically appraise a research paper. Paediatrics and Child Health, 26(3), 110-113. doi:10.1016/j.paed.2015.09.007
Institute for Healthcare Improvement [IHI]. (2013). Plan-Do-Study-Act (PDSA) Worksheet. Retrieved from http://www.ihi.org/knowledge/Pages/Tools/PlanDoStudyActWorksheet.aspx
Stevens, K., (2013) "The impact of evidence-based practice in nursing and the next big ideas" OJIN: The Online Journal of Issues in Nursing Vol. 18, No. 2, http://doi.org/ 10.3912/OJIN.Vol18No02Man04
Themes, U. (2016). Nursing's Fundamental Patterns of Knowing. Retrieved from https://nursekey.com/nursings-fundamental-patterns-of-knowing/
Zegers, M., Hesselink, G., Geense, W., Vincent, C., & Wollersheim, H. (2016). Evidence-based interventions to reduce adverse events in hospitals: a systematic review of systematic reviews. BMJ Open, 6(9), e012555.
The Johns Hopkins Nursing Evidence-Based Practice Model provides nurses with a system to formulate a practice question, appraise both research and non-research evidence, and to develop recommendations for practice (Dearholt & Dang, 2012). This model guides nurses through the evidence-based research process with ease and minimal difficulty using a problem solving approach.
Burns, N., & Grove, S. K. (2011). Understanding nursing research: building an evidence-based practice (5th ed.). Maryland Heights, MO: Elsevier/Saunders
Polit, D. F. & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (9th ed.). Philadelphia: Lippincott.
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
Werner-Rutledge, C. (2012). Evidence-Based Practice Preparation in Nursing Education: Recent BSN Graduates and Their Experience With Applying Evidence-Based Practice. (Doctoral Dissertation). Capella University. Retrieved from ProQuest Digital Dissertations. (3502734) http://search.proquest.com.ezp-02.lirn.net/pagepdf/993006005/Record/3CA1ED1ED991402DPQ/1?accountid=158614
LoBiondo-Wood, G., & Haber, J. (2014). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice (8th ed.). St. Louis, MO: Elsevier, Inc.
A nurse is required to be responsible and accountable, updating their knowledge and skills continually by using professional development (NMC, 2008). This requires an understanding and awareness of what Evidence Based Practice (EBP) is. Nurses make decisions about their practice using EBP. Ways in which this can be utilized in the improvement of knowledge and practice is, for example; using established sources of evidence. (Marquis et al, 2012). Nursing practice uses a range of approaches to improve and develop patient care so as a nurse the skill of evaluating sources of evidence is necessary to do this effectively. Evidence is gathered through research. EBP consists of research, data collection and nursing research. When searching for evidence to improve your practice the range of information available is vast. A distinction must be made between evidence that is reliable under scrutiny and evidence which is unreliable. Fitzpatrick (2007) asserts that, to understand evidence based practice is to understand where to look and what credible sources of evidence are. Sources that are credible include information published by a government body or academic institution. Fitzpatrick (2007) recommends identifying key aspects of information of the source to ascertain its credibility, for example; who is the author and where did the research come from? Is the article true or false and how long has it been there? (Fitzpatrick, 2007). A journal article is scrutinised by peers and editors and publishers, whereas in contrast a piece of information on a general website could be published by any person and make any claim and may not pass scrutiny under a peer review. Databases like EBSCO for example have articles that are peer reviewed.
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
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...
Cullum, N. Ciliska D. and R. Haynes, Marks (2008;) Evidence – based Nursing: An Introduction.
230) in EBP. Clinical opinion, together with the best relevant research evidence, provides the framework to for the best patient outcome. The nurse’s clinical opinion is acquired through knowledge and skills developed from undergraduate, graduate, or continuing education, clinical experience, and clinical practice (Melnyk & Fineout-Overholt, 2010). Clinical opinion also includes internal evidence, which is generated within a clinical setting from quality improvement outcomes, management initiatives or EBP implementation projects (Melnyk & Fineout-Overholt, 2010). Nurses use their clinical opinion when they identify each patient’s condition, individual risks, personal values and expectations, benefits of possible interventions, and gather evidence for EBP. When searching for the best available evidence, there is a hierarchy in the strength of evidence. The highest level of evidence usually comes from a systematic review or an evidence-based clinical practice guideline based on a systematic review. Systematic reviews provide the strongest evidence through a summary combining the results from many relevant, unbiased studies, to answer a particular clinical question. Nurses critically assess the individual studies, to gather the best evidence available for patient care. Systematic
In health care, evidence-based research is crucial. Nurses revolve their practice on evidence so that they may provide the best health care. Without research, there would be no evidence to prove health care related findings (Shmidt & Brown, 2012). With appropriate
Polit, D., & Beck, C. (2006). Essentials of nursing research: appraising evidence for nursing practice (7th ed.). Phildelphia: Lippencott Wilkins & Williams.
ANA describes “The Scope of Nursing Practice (as) the “who,” “what,” “where,” “when,” “why,” and “how’ (8).’ In other words, it is the responsibility of the nurse to know who their patient is, what the patient’s diagnosis and treatment are, where it is they will be delivering treatment, the rationale behind their actions, and how they will deliver the care. By following the scope of practice, nurses reduce avoidable errors and are aware of the liability their actions entail. The ANA also puts forth a nursing process to guide nurses in treatment. The constantly evolving process is currently assessment, diagnosis, identification of outcomes, planning, implementation, and evaluation (ANA 9). Though this method has dramatically improved nursing care, it may be necessary to repeat steps to adapt to a patient’s changing needs and pathologies. By following guidelines set by the ANA, nurses are able to better connect with their patients and instill the image of professionalism to the public while also optimizing safety