Topic 5: Characteristics of Nursing Research Utilization and Evidence-Based Practice
NRS 433 Topic 5: Characteristics of Nursing Research Utilization and Evidence-Based Practice Tasks
Topic 5: Characteristics of Nursing Research Utilization and Evidence-Based Practice
The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).
Review the PICOT article “Evidence-Based Practice, Step by Step: Asking the Clinical Question: A Key Step in Evidence-Based Practice” along with the “Chapter 18: Using Research in Evidence-Based Nursing Practice” PowerPoint resource.
The first step of the EBP process is to develop a question from the practice problem you drafted in Topic 1. Start with the patient and identify the clinical problems or issues that arise from clinical care. Consider the research and writing you completed in Topics 1-4.
NRS 433 Assignment: Research Critiques and PICOT Statement Final Draft
Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.
PICOT Question
Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.
The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).
Research Critiques
In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.
The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.
Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.
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Proposed Evidence-Based Practice Change
Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.
General Requirements
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Topic 5: Characteristics of Nursing Research Utilization and Evidence-Based Practice
Topic 5 DQ 1
The theoretical foundations of qualitative and quantitative methods are very different, but many researchers believe both methods should be used in the research study to increase validity and reliability. What advantages or disadvantages do you see in using both types of methods in a nursing study? Support your answer with current evidence-based literature.
Re: Topic 5 DQ 1
Nursing research is done to determine what is considered best (evidence-based) practice that will promote optimal clinical outcomes. There are many research methodologies that ultimately serve as the “blueprint” for conducting a study. Qualitative methods are subjective and include descriptive, correlational, quasi-experimental and experimental studies. While quantitative methods are objective and considered primarily exploratory research. Qualitative research explores emotions, opinions, and understanding of underlying reasons which are difficult to quantify. Mixed methods research refers to those studies that utilize one or more qualitative and quantitative techniques. Topic 5: Characteristics of Nursing Research Utilization and Evidence-Based Practice
According to the Agency for Healthcare Research and Quality (2013), the advantages of mixed methods research include:
- Allows for more comprehensive and detailed data collection
- Compares quantitative and qualitative data which can promote understanding of contradictions between studies. (i.e. quantitative versus qualitative)
- Fosters scholarly interaction/multidisciplinary team research
- Provides methodological flexibility
Limitations include:
- Mixed methods studies are complex to plan and conduct
- Relies on a multidisciplinary team of researchers who, in the service of the larger study, must be open to methods that may not be their area of expertise.
- Requires increased resources
In my opinion, mixed methods of research is best because its results can produce a deeper understanding of the quantitative and qualitative data that is collected.
References
Wisdom, J., & Creswell, J. (2013). Integrating quantitative and qualitative data collection and analysis while studying patient-centered medical home models.
Topic 5 DQ 2
According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interactions with clients. How do you see this being applied in your workplace?
Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population. In the neonatal facility where I work, we have a protocol to measure the neonates’ abdominal girth before every feeding, the neonates are fed every three hours. This protocol was instituted because research shows that premature babies who weigh less than three pounds, four ounces (1,500 grams) are more likely to develop Necrotizing Enterocolitis (NEC). Necrotizing enterocolitis (NEC) is a devastating disease that affects mostly the intestine of premature infants. The wall of the intestine is invaded by bacteria, which cause local infection and inflammation that can ultimately destroy the wall of the bowel (intestine). Such bowel wall destruction can lead to perforation of the intestine and spillage of stool into the infant’s abdomen, which can result in an overwhelming infection and death. One of the first signs of NEC is the inability of the infant to tolerate the feedings. This is often associated with abdominal distention (bloating) and vomiting bile (green). Topic 5: Characteristics of Nursing Research Utilization and Evidence-Based PracticeSince this protocol was adopted, a huge drop was noted in the number of NEC cases in the department. This protocol also led to early detection and prevention of this devastating disease.Reference:Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y. L., Chang, Y. K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association : JMLA, 99(3), 229–236. doi:10.3163/1536-5050.99.3.010
Bridging the gap between evidence-based research (EBR) and clinical practice involves the process of assessing the patient’s need for intervention, constructing a clinical question based on the patient’s problem, acquiring valid evidence with clinical expertise, applying interventions and evaluating outcomes. Evidence-based practice (EBP) combines research evidence with clinical expertise while encouraging individualization of care through patient preference. EBP has been adopted by federal, state and local policymakers, as well as recognition actions. For example, the Magnet Recognition Program is a recognition of gold standard nursing care and excellence. (Stevens, 2013) My hospital has been awarded Magnet recognition twice in a row for our quality patient care, nursing excellence, and innovations in professional nursing practice.Guidelines for clinical practice of management of sepsis was developed by the Surviving Sepsis Campaign. Since time is of the essence when it comes to treating sepsis, bundles were created for quality improvement opportunities to move the patient toward optimal health. (Surviving Sepsis Campaign, 2018) Our emergency room sepsis policy is as follows. Patients meet criteria for septic work up in the emergency department (ED) if they meet 2 criteria from either temperature >100.9 or <96.8, hear rate >90, respiratory rate >20 or white blood cell counts >12 or <4 or 10% bands. They must also meet 1 criteria of either systolic blood pressure (SBP) <90 or mean arterial pressure (MAP) <65 or a drop in SBP >40 points, creatnine >2.0 or urine output <0.5 ml/kg/for 2 hours, bilirubin >2mg/dl, platelets <100, INR >1.5 or a PTT >60 seconds, lactate >2.0 or acute respiratory failure in need of a ventilator or BiPap. Time clock for the 3-hour bundle starts and criteria is met for diagnosis of severe sepsis from presentation (any 2+1). Lactate level and blood cultures are drawn, and a repeat lactate level is drawn 3 hours after the initial result. An antibiotic is administered within one hour of diagnosis as well as an intravenous fluid (IVF) bolus 30 ml/kg. If within 3 hours of presentation time, after 1-hour post fluid resuscitation, the initial lactate is >4.0 and if the SBP <90 or MAP <65, the diagnosis is septic shock. The 6-hour bundle includes continuing fluids 30 ml/kg, initiating vasopressors is considered, repeating lactate levels every 3 hours until < 2.0, vital signs are monitored every 15 minutes x 2 hours and tissue perfusion is documented.ReferenceStevens, K. R. (2013, May). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing, 18(2). doi:10.3912/OJIN.Vol18No02Man04
Surviving Sepsis Campaign. (2018). Hour-1 Bundle. Retrieved from Surviving Sepsis Campaign: http://survivingsepsis.org/Bundles/Pages/default.aspx
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