Essay on Evidence-Based Practice

The following ssion of this assignment attempts to critically appraise the venUS III randomised control trial (RTC) published in the British Medical Journal.

The key steps involved in evidence based practice come from a thirst for knowledge that once ignited makes the next step to asking a well worded clinical question easier. A well formulated question improves patient outcomes and supports the implementation of change. One such method looks at foreground and background questions. A background question is usually a basic knowledge question and is usually answered by a textbook. Foreground questions are usually specific and once answered can help in clinical changes. An acronym useful for formulating a well worded question is PICOT. ( Stillwell, Fineout-Overholt, Melnyk, Williamson, 2010).

Bradley, S., & Mott, S. (September 2012). Handover: Faster and safer? Australian Journal of Advanced Nursing, 30(1), 23-32.

The John Hopkins Nursing Evidence Based Practice Model (JHNEBP) has three phases that describe the practice question, evidence and translation (PET) for determining the practice problem finding evidence that supports change in current practice and than translating the new information into practice (Newhouse, Dearholt, Poe, Pugh, & White, 2012). The first phase, practice question, is developed used to develop an answerable evidence-based practice question that derived from the PICO mnemonic (Newhouse et al., 2012). The second phase of is conducting the research and finding the evidence to be used in implementation for change of practice. The PET process finds the evidence, makes an appraisal of the findings and provides recommendations for change in practice (Newhouse et al., 2012). The final phase is to determine if the information obtained in research is appropriate for implementing change in the current practice. The PET process within the JHNEBP Model can be used as a means for finding evidence, evaluating and synthesizing the information from the research and evaluating

In order to do this, we need to understand how the research process works, so we can better understand the results. Conducting evidence-based practice or promoting evidence-based practice is important for the graduate level nurse, in my opinion. Providing the best evidence for clinical decisions is essential in delivering appropriate patient interventions.

McDonagh (2013) stated that pressure ulcer is a one of the indicator to represent of quality of patient care. University Hospitals Coventry and Warwickshire Trust in England carried out a special campaign to prevent and to remove avoidable pressure ulcer with use of several strategies such as “Root cause analysis and performance review, equipment gap analysis, “documentation review, review of staff education, 100 Days free campaign, and use of social media” (McDonagh, 2013). McDonagh (2013) mentioned that “Root cause analysis and performance review” is an analyzing tool for patient safety incidents thus it helps to prevent safety incidents. During this special campaign, nursing staff’s education was empathized and Tissue Viability Team developed

Evidence-based practice are methods that have been tested with rigorous and countless scientific and research trials that validate the medical treatment and utilizes the best possible treatment approach known today. I use evidence-based practice in my nursing practice by utilizing standardized tests as much as possible to ascertain the problem areas, research what treatments have been demonstrated to work on the problematic area, reassessing to demonstrate the progress that has taken place due to the treatment and properly document the assessment following the treatment plan. In my nursing practice, I want to always promote safe and thoroughly tested research and give top quality care that is safe so that my resident will have the best possible outcome. I work the floor at a long-term care facility and I incorporate evidence-based practice daily in my practice that is governed by our evidence-based practice policies and procedures. I also do research on my own to make sure that I and the facility are utilizing evidence-based practice for our residents to have the best outcomes. The issues I see the most in my practice that we use evidence-based practice is preventing falls, infection control, managing behavior and psychological symptoms in residents with dementia/Alzheimer?s, pain management in the elderly and prevention of wounds or how to treat wounds.

Although the prevention of pressure ulcers is a multidisciplinary responsibility, nurses play a significant role. Research suggests that when health care providers are functioning as a team, the incidence rates of pressure ulcers can decrease.

Evidence-based practice is a problem-solving approach that integrates systematic search for, and critical appraisal of, relevant evidence to answer a burning clinical, educational or administrative question. In today’s Magnet Monday, I will further explain this approach, why it is important to us at Parkview and how our clinical nurses are making great strides to improve clinical outcomes through evidence-based practice.

(IHI, 2011). The implementation of preventative interventions and assessment of patients at risk for pressure ulcers can decrease in occurrence of pressure ulcers. Implementation of protecting bony prominences, repositioning frequently, redistributing pressure surfaces, bladder and bowel management, and skin assessment are some interventions. Therefore, IDT education and effective communication are essential for the process to be successful. The team will use a check list on purposeful hourly rounding with the intention to keep patient safe, comfortable. The IDT will implement the Plan-Do-Study-Act (PDSA) model as a guide to assess changes for best results ng (Nelson et al. 2011, p. 276). The IDT will identify the patients at risk and will intervene with a patient-centered-care, skin assessment (Plan), the team will then implement the changes, and interventions, using the redistributing pressure surfaces (DO), as a follow up, the team will evaluate collected data from check list and shift reports (Study), and implement what was learned from using redistributing pressure surfaces

The nurse sensitive indicator is measured by The National Database of Nursing Quality Indicators (NDNQI). Pressure ulcer prevalence is one of the nurse-sensitive indicators measured. It’s branched into community acquired, hospital acquired and unit acquired. Through unit base pilot testing, the data is able to be collected and measured. This organization has a skin committee who goes to each patient in the hospital with a pressure ulcer and assesses the condition that’s reported back to the committee for further analysis. They also have developed a new position in the hospital that consist turn team members. These individuals are staffed throughout the hospital 24 hours a day and turn each patient that’s on the turn team list every two hours.

Evidenced based practice research is a crucial part of nursing, in fact, it aids in defining nursing as a discipline. (Davies, 2011), “Questions are the driving force behind evidence based practice (EBP). If there were no questions, EBP would be unnecessary. Evidence based practice questions focus on practical real-world problems and issues. The more urgent the question, the greater the need to place it in an EBP context” (P.75). Through research, we are able to determine the effectiveness of traditional practices and improve on them. By the completion of this project, I am looking forward to improving my skills on identifying researchable problems.

There are many issues in the clinical setting that nurses have to be aware of and be educated on preventing and treating. One of those issues that have to be addressed is pressure ulcers. Pressure ulcers can occur over the bony prominences where the body’s tissue has been pressed against for extended periods of time. There are certain factors that put a patient at risk for the development of these pressure ulcers and it’s the nurse’s responsibility to be aware of these risk factors. The most common places that a patient can develop these ulcers are ankles, sacrum and hips. Patients who have impaired mobility and those who aren’t able to ambulate have and increased risk for developing pressure ulcers.

a moderate amount of gathering of research using databases to find peer reviewed and relevant data for papers. I did not thoroughly study nursing research, but I did gain proficiency in the use of databases to find reliable research. Due to my limited use of research and the study of research, I am not overly confident in initiating and working on research and evidence based practice projects. Throughout this course, I hope to gain a more in-depth study of research and a better understanding of how to develop, implement, and bring forth research studies to help dedicate my current and future careers to the use of research and evidence based practice.

The purpose of scientific research is to produce new knowledge and skills that can be used in society (Gibbons, 1994). Research in the area of sports was initially developed due to a need for optimizing the performance and health of athletes, and individuals engaged in exercise in general.