Literature Review On Evidence Based Nursing

However, only 10% of nurses actually complete accurate inspections of the skin during their initial physical assessments of the patients (Lahmann et al., 2010). As a result, patients who are at risk of developing pressure ulcers are often overlooked by nursing staff.

The CQC guidance about compliance Essential standards of quality and safety covers pressure care in-

Pressure ulcers occur over bony prominences when skin is compressed for long periods of time, affecting the blood supply to certain areas, leading to ischaemia development (Waugh and Grant, 2001). Compression of skin is caused by pressure, shearing and friction, but can also occur due to pressure exerted by medical equipment (Randle, Coffey and Bradbury, 2009). NICE (2014) states that the prevalence of pressure ulcers in different healthcare settings in December 2013 was 4.7%, taken from data available for 186,000 patients. The cost of treating ulcers can vary depending on severity from £43 up to £374 (NICE, 2014). Evidence based practice skills are essential in nursing as it allows the best available evidence to be used to improve practice and patient care, while improving decision-making (Holland and Rees, 2010). I will be critiquing two research papers; qualitative and quantitative, using a framework set out by Holland and Rees (2010), and will explore the impact on practice. Using a framework provides a standardised method of assessing quality and reduces subjectivity.

This paper will explore a clinical practice guideline from the National Guideline Clearinghouse and will focus on hospital-acquired- pressure ulcers. The development of hospital -acquired pressure ulcers are a great concern in today’s health care. Pressure ulcer treatment is costly, and the development of ulcers is prevented by the used of evidence-based nursing practice. According to the Centers for Medicare and Medicaid Services (2008), announces that they will no longer pay for additional costs incurred for hospital-acquired pressure ulcers. The development of stage 111 and the 1V ulcer is considered a “never event” Therefore, this new change has resulted in an increased focus on preventive measures and institutional scrutiny of pressure

Through use of the Universal Intellectual Standards of Quality Thinking (UISQT) the nurse should use the standards, relevance and significance, to organize and categorize the patient's information and separate the important assessment data that will help to tailor an appropriate plan for the patient (Wilkinson, 2011, p. 70). These skills are important because through relevance one can separate what information is relevant to the patient's problem and through significance one can sort out what data is most important and what data is normal for the relevant data. The assessment data of S.P.’s vital signs and body mass index are normal. The important data sorted for S.P. includes her age, medical history, oxygen saturation and 50-pack-year smoking history, fall at home leading to an intracapsular fracture of the hip at the

Evidence based practice is important in nursing research. By implementing a plan to follow research that has been validated, nurses can create a better chance of having the best outcome possible for their patients. In order to implement a plan, it is important to analyze the research being used, as well as determining how this research can be used in the specific clinical field a nurse is practicing in? It is also very important to determine which patients the evidence based practice plan will help based off of the research. A nurse must “balance the benefits and risk of the evidenced based practice decision” (Godshall, M., 2009).

In any healthcare scenario pressure ulcer has been a concern for the nurses. Magnan 2009 comments that prevention of pressure ulcer has become a serious issue since the new Centers for Medicare and Medicaid policy came. Nurses cannot sit back and wait for improved interventions for pressure ulcers. They may need to modify the existing safety evaluation for pressure ulcer, avoidance interference, avoidance planning, and assessment of outcomes. In fact, nurses have this freedom since 1970’s. So there is permission for the nurses to use any systematic procedure to make the present systems improved. They can do it while dealing with pressure ulcer.

Evidence based practice is a practice that is based upon the best available evidence, patient preferences, and clinical judgments (Schmidt & Brown, 2012). According to Schmidt and Brown the nurse’s standpoint of patient care obliges nurses to form their own body of evidence through scientific research (Schmidt & Brown, 2012). A nurse encounters many patients with various disease processes throughout their careers. Overtime the nurse will be able to see which treatments work and which ones need improvements or can even do without. Nurses are key players when it comes to evidence based practice.

acquired pressure injuries and lack of early signs of patient deterioration. Furthermore this is a

Evidence-based practice has been the focus of healthcare for a long time highlighting the urgency in the need to improve healthcare. Healthcare organizations and regulations, such as the Patient Protection and Affordable Care Act, and the American Association of College of Nursing (2006), require DPN programs to impart sound knowledge of scientific process and content, and research methodology including a research project that is defended as a dissertation research. Notwithstanding, innovative and evidence-based practice underscored by credible research findings has become the bane of DPN program requirements. High level jobs in healthcare require a great deal of knowledge in decision making process, as well as the research process to improve

A pressure ulcer is a preventable adverse consequence of immobility and impaired sensation as frequently seen in spinal cord injury patients. Unfortunately, not every pressure ulcers can be prevented. Witkowski, Parish, Campbell, and Parish (2014, p. 167) believes that some

Nurses use clinical judgement each day when caring for patients. It is essential that nurses have an understanding of the problems associated with each patient’s disorder and possess the knowledge and skill to make concise decisions that will help to deliver better quality care. According to Bussard, (2015) clinical judgement is defined as, “an interpretation or conclusion about patient’s needs, concerns, or health problems, and/or the decision to take action (or not), use to modify standard approaches, or improvise new ones as deemed appropriate by the patient’s response” (p. 451). The writer chose clinical judgement in the care for patients with pressure ulcers because

The purpose of the following case study will use the information provided to carefully evaluate a patient’s physical emergency experience. Using evidence based context, the analysis of the information with provide a rationale for the diagnosis as well as treatment recommendations.

In the scenario provided, Mr. J was receiving nursing care while he was admitted for treatment of a fractured right hip after falling in his home. The passage reveals shortcomings on the part of the nurse, CNA, dietary staff and nurse supervisor in implementing nursing sensitive indicators that are in-place to provide optimal care to patients such as Mr. J. Understanding of nursing sensitive indicators should have begun with the nurse performing a complete assessment

The article that I chose to expound on is, in its fullness, called, ‘Reducing Pressure Injuries in Critically Ill Patients by Using a Patient Skin Integrity Care Bundle (InSPiRE)”. The purpose of this research article was to test if critically ill patients using their InSPiRE protocol fared better than those who receive traditional treatment options. By implement this process they were able to minimize the development of new occurrences of pressure injury in patients who are in the hospital for longer periods of time.. According to the article, a pressure injury is, “localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or