Nursing
Topic 1:
How does the focus of research and evidence-based practice (EBP) differ? Discuss the application of research findings into evidence-based nursing practice.
Response 1: (lazara)
The nursing profession is driven by research and evidence-based practices. Research differs from evidence-based practices as it involves a strategic method of finding solutions to common problems in the nursing profession (Lum & Koper, 2017). In addition, research ensures that findings are developed regarding the problems and offers ideas for evidence-based practices. EBPs then incorporate the findings of research into nursing practice. However, EBPs incorporate the most effective and safe findings from research into solving the problems in nursing practice (Lum & Koper, 2017). Advance practice nursing relies heavily on research and evidence-based practice.
In nursing care, the major objectives are to deliver cost-effective health care and high-quality through careful integration of the best scientific findings from patient preferences and clinical competence and requirements. Thus, evidence-based practices tend to combine a problem-solving paradigm of research to develop cost-effective, sound, and effective practices that improve the clinical and administrative challenges by integrating the best clinical practices into nursing care. Thus, improving the general patient outcomes (Lum & Koper, 2017). EBPs translate research findings into nursing practice, improve the effectiveness of treatment approaches in practice and improve integration of traditional practice into nursing care practice. Also, at the same time, it ensures that it has impacted practice development by improving practice and translating knowledge into practice. Through the use of tools such as PICO or PICOT, Evidence-Based Practice assesses the Institutional Review Board procedure concerning the intended project and the amount of risk, rewards, confidentiality, generalizability, and publication plans (Lum & Koper, 2017).
Research explores and discovers solutions to practice problems. Thus, research findings offer the principles of EBPs. EBPs use the knowledge of research findings, investigate them, test them, and ensure that it is efficacious and beneficial to the patient without any harm before implementing them into EBPs (Jolley, 2020). Thus, research forms the basis for EBPs by solving nursing problems. In nursing care, advocacy ensures that problems evident in nursing practice are solved through comprehensive research. The research goal is to answer the research question, test the hypothesis, describe, explain, forecast, explore, and discover, but the goal of research on practice is to develop new information for practice and add to the professional literature. Institutional Review Board is evaluated in conjunction with other research methodologies such as Scientific Method (LoBiondo-Wood & Haber, 2021). Methods for answering the research question/hypothesis Data interpretation and practice consequences Qualitative and quantitative research and dissemination of findings. A three-year study studying symptom clusters in patients with congestive heart failure is an example of a research project. Evidence-Based Practice and Research are comparable in that they begin with data analysis, have a defined methodology, commit a team to success, add to knowledge, and assess results (LoBiondo-Wood & Haber, 2021). However, there are differences in organization, methods, intent, goals, and data requirements. Evidence-Based Practice is a research-based approach to finding and applying the best clinical evidence to patient-centered care decisions that reflect high-quality care. I will ensure that I use the stance of EBPs to ensure improvements in practice guidelines and necessitate patient outcome improvements.
Response 2: (Erika)
Research is defined as such, “A planned and systemic activity that leads to new knowledge and/or the discovery of solutions to problems or question (Polit &Beck, 2016).” (Canvas, 2021) and Evidence-based practice (EBP) is defined as, “A process involving the examination and application of research findings or other reliable evidence that has been integrated with scientific theories.” (Canvas, 2021) Another simpler definition or explanation of the difference between EBP and research is, “Research is about generating new knowledge, and EBP is about applying new knowledge to practice.” (Schmidt & Brown, 2019, p.1). I realize there is a lot of quoting here, however, it was how I was able to grasp the meaning and differences.
Research is going through data, information, filtering and gathering of information that may be implemented into practice to verify what works and what doesn’t when actually tested on patients and or volunteer subjects, which is then converted into evidenced based practice. That is what I overall understood what the meaning of it all was and how it works. In the nursing/medical field we most certainly utilize both. We utilize both in our studies and in our actual places of employment. It’s necessary in order to improve patient outcomes, better and safer care. When one practice doesn’t work we continue to work to implement and study better ways to care for our patients.
Topic 2:
Provide a specific example of evidence-based practice used in your work facility or within the nursing profession. Were there any challenges or barriers to implementing the evidence-based practice? If so, how were they overcome?
Response 1 (karen)
Provide a specific example of evidence-based practice used in your work facility or within the nursing profession. Were there any challenges or barriers to implementing the evidence-based practice? If so, how were they overcome?
Ventilator associated pneumonia has greatly decreased with protocols and policies that has been placed in many facilities. Our facility practices evidence-based practice techniques such as elevating the head of the bed between 30-45 degrees. Elevating the head of the bed decreases the occurrence of aspiration that can lead to pneumonia. This also helps decrease aspiration pneumonia with patients who are on feeding pumps.
I did not see or encounter any barriers that prevented nurses or health care providers in adhering to this policy. But there were challenges such as finding someone available to assist with pulling up a patient. Hospital beds are usually electric that can elevate the head of the bed but when a patient is in an incorrect position on the bed, the nurse must pull the patient up and that will require assistance. This can cause injury to the nurse if done alone. To overcome this challenge, our department had a rotation every hour where two nurses or health care workers reposition each patient or assisted lifting on the bed.
Response 2 (Erika)
The best example of evidence based practice that my hand’s on employer utilized was with wound care and treatment. We had to constantly treat diabetics with diabetic feet ulcers and some with amputations from complications of that. From providing antibiotics to specific recommended wound care (e.g. wet to dry dressing, Hydrogel) as these promote healing. I do not recall our management having barriers to implementing any of these evidenced based practices or introducing new ones to our protocol at this time, or at least the management team ever indicating there were any barriers, and therefore that would not be able to share that information if there were. As far as I could tell these best practices were appropriate, helped our patients in healing process and our providers were always looking to make further improvements in these types of treatments. The only barriers I ever noted was that of the patients being compliant with self care.
“The successful management of diabetic foot wounds requires the multidisciplinary teamwork of specialists. The management of diabetic foot wounds needs timely detection of complications and frequent assessment of the wound. No wound should be treated as simple. It is important to take into account all the related causes, identify the problem, and treat it. There are various topical regimes available, but the choice depends only on the treating physicians, podiatrist, or clinical care nurse. While selecting wound care materials one should bear in mind the properties of the ideal wound care dressing which should maintain a moist wound healing environment, absorb exudates, control infection/odor and be effective in treating diabetic foot wounds. In addition to these wound care techniques, antibiotic therapy and offloading plays a very important role.” (Kavitha, et al. 2014)
ORDER A PLAGIARISM-FREE PAPER HERE !!
Solution
Topic 1
Response 1: (lazara)
The nursing profession is driven by evidence-based practice and research. The two concepts complement each other; however, they follow different steps in their implementation. The evidence-based practice relies on research to provide the best available evidence to implement in practice. The research process involves seven significant steps, including identifying a research problem, hypothesis formulation, literature review, selection of study design, actual experimentation, results and discussion, conclusion, and recommendation. The research utilizes quantitative or qualitative methods to generate new knowledge or confirm the existing hypothesis. Research, especially one that comprises human subjects, is highly regulated by Institution Review Board (IRB), which protects the rights and ensures that ethical principles are adhered to. Typically, it takes approximately 2 -3 for a review to be conducted; however, the review can take longer in some cases. The process for Evidence-based practice steps includes Identifying a clinical problem, gathering evidence that can address the problem and critically evaluating the evidence, integrating the evidence into practice, and evaluating the outcomes to determine whether the problem was solved or not. Evidence-based practice, however, incorporates the care provider’s experience and patient preference into the process, unlike research (Chieng, 2019).
Response 2: (Erika)
While there are some similarities between research and evidence-based practice, one of the primary distinctions is their goal. The research objective is to create new knowledge or validate already held beliefs based on a hypothesis. Research is a methodical, scientific study that uses disciplined, rigorous techniques to address specific problems or test theories. Researchers must follow a logical, sequential process for research findings to be regarded as reliable and genuine. EBP focuses on translating evidence into clinical practice and decision-making rather than developing new knowledge or validating existing knowledge. The purpose of EBP is to make well-informed decisions about patient care based on the most up-to-date research. Although research provides the majority of the best evidence, EBP also considers clinician and healthcare team clinical competence and patient preferences and values (Skaggs et al., 2018).
Topic 2:
Response 1 (karen)
An Example of evidence-based practice in the workplace is elevating the head of the bed between 30-45 degrees to prevent ventilator-associated pneumonia. Mechanical ventilation is a standard intervention method in intensive care units to save critically ill patients’ lives (ICUs). However, it can lead to ventilator-associated pneumonia, a type of nosocomial infection that develops after more than 48 hours of mechanical ventilation due to aspiration of contaminated oropharyngeal secretions. In 2018, the ventilator-associated pneumonia mortality rate was about 19.2% in the US and 31.4% in Europe. Several studies have shown that elevating the head of the bed between 30-45 degrees is useful in reducing infection. The head of a patient’s bed is elevated to a minimum of 30 degrees to minimize aspiration of contaminated oropharyngeal secretions and the development of ventilator-associated pneumonia. This had an impact on the way things were done at work. During its implementation, no significant problems were observed except few staff to assist with placing the patients in a semi-recumbent position. The hospital assigned more nurses during the rotation to assist each other (WU et al., 2019).
Response 2 (Erika)
Diabetic foot ulcers continue to be a serious health care problem. They are common among diabetes patients, resulting in severe discomfort, frequently reoccur, and are connected with high mortality rates and high health care expenses. Evidence-based practices commonly utilized in the workplace included surgical debridement and wound dressing, which varied from wet to dry depending on the wound. The main aim of dressing was to maintain a moist wound environment that facilitates granulation, rapid epidermal cells migration across the wound, and managing excess exudates. Hydrogels were incorporated into the practice. They have been shown to degrade wound sloughs and provide a cooling and relaxing effect on the skin, which is beneficial in treating burns and severe wounds (Everett & Mathioudakis, 2018).
For effective management of DFUs, multidisciplinary care is recommended nowadays. Studies have shown that multidisciplinary care positively impacts by reducing wound healing times, amputation rates, and severity. Multidisciplinary diabetic foot care involves a general, vascular, or orthopedic surgeon, a podiatrist, a diabetes specialist, a wound care nurse, and a physiotherapist (Everett & Mathioudakis, 2018).
Refrences
Chien, L. Y. (2019). Evidence-based practice and nursing research. The Journal of Nursing Research, 27(4), e29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6641093/
Everett, E., & Mathioudakis, N. (2018). Update on management of diabetic foot ulcers. Annals of the New York Academy of Sciences, 1411(1), 153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793889/
Skaggs, M. K. D., Daniels, J. F., Hodge, A. J., & DeCamp, V. L. (2018). Using the evidence-based practice service nursing bundle to increase patient satisfaction. Journal of emergency nursing, 44(1), 37-45. https://www.sciencedirect.com/science/article/abs/pii/S0099176717305470
Wu, D., Wu, C., Zhang, S., & Zhong, Y. (2019). Risk factors of ventilator-associated pneumonia in critically III patients. Frontiers in pharmacology, 10, 482. https://www.frontiersin.org/articles/10.3389/fphar.2019.00482/full