1. Research Issue and Purpose
The research question/issue: Do nurses in the intensive care unit (ICU) experience conflict between their clinical judgment and standardized care?
The purpose of this study was to examine the nurses ' clinical judgments of patient pain and sedative requirements after the implementation of assessment tools.
2. Researcher Pre-understandings
The researchers believe that clinical judgment of pain and sedation management in the intensive care unit is complex. Also, they believe there is a gap between knowledge, attitudes, and practice, reflecting an overall lack of adherence among nurses to standardized care. Lastly, the title of the research study could potentially imply the researchers perceive there may be
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As a result, there were 73% of the referenced articles included in the literature review published within ten years. There was a systematic meta-review and several other independent studies included. There were twelve articles referenced that had greater than ten years noted. However, many of these articles were the original research.
The study did include reported literature findings with an integrated summary. There was a theoretical perspective applied to the understanding of the current body of knowledge. The authors applied Tanner 's 2006 Clinical Judgment Model to the findings to offer explanations for nurse 's intuition, decision-making, and reflection on those decisions.
4. Theoretical or Conceptual Framework
Tanner 's 2006 Clinical Judgment Model was utilized as a framework for this research. This structure is a nursing framework.
5. Participants
There were fourteen ICU nurses were divided into two focus groups for interviews. Two different hospitals were used. The nurses all had at least five years of nursing experience. They were aged thirty-five to sixty years old. Each focus group had six women and one male participant. The setting was appropriately structured in an ICU.
Purposive sampling was conducted. This strategy was appropriate. The sample size was marginally appropriate. However, the researchers rationalized that the purposive selection of experienced nurses would add quality to the content retrieved from the
pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain
The purpose of this paper is to conduct an in depth exploration of the nursing care considerations of patients in a specific clinical area. Through the synthesis of prior knowledge, clinical experiences and skills, evidence based best practices, and care of patients a comprehensive care and teaching plan will be composed. Integration of critical thinking and clinical reasoning skills, combined with evidence-based research will provide confirmation of nursing process comprehension. The inclusion of reviewed literature will further support knowledge and understanding.
Any of these issues have the potential to extend the patients length of stay in the hospital. The restraints have the potential to make the patient more agitated, thus increasing his risk of injury. Understanding the nursing-sensitive indicators can greatly contribute to a better outcome for all patients.
BSN is expected to also use research studies for a basis for their decision making. ADN analyzes assessment data, where BSN synthesizes comprehensive assessment data to solve problems. ADN’s evaluate and report outcomes and plan interventions from evidence based practice, where BSN nurses compare these interventions and outcomes to benchmarks in research and evidence-based practice and plans follow-up nursing care. They both create teaching plans to promote healthy outcomes, although BSN’s go on to assess population risk (BON,
The project made use of the Nursing Teamwork Survey. This study design was meant to measure teamwork as demonstrated by nurses in patients’ settings. The national teamwork survey concentrates on the teamwork demonstrated by the nurses in their work
Over the past 30 years nursing has evolved from a task-oriented to a logical and systematic approach to care, using theories and models to guide practice. According to Jasper (2007, p117) theories of decision making in medicine tend to favour logical, precise analytical models which are held to be testable, unambiguous and repeatable, therefore satisfying scientific principles. These represent important ideas of certainty and rationality that are intended to provide a sense of security and reliability. When used correctly a nursing model should give direction to nurses working in a particular area, as it should help them understand more fully the logic behind their actions. It should also act as a guide in decision-making and so reduce conflict within the team of nurses as a whole. This in turn should lead to continuity and consistency of the nursing care received by patients according to Pearson et al (1999,p ).
Two types of data were collected through surveys, both before and after implementation of the combined approach (Sand-Jecklin and Sherman,2014). The first data was on nurses’ point of view with regards reporting process, and the second on patients view regrading nursing care. The baseline survey included 233 patients and 148 nurses, while the survey three months into the implementation period included 157 patients and 98 nurses. The final survey, 13 months into the impanation, was completed by 154 patients and 54 nurses. The patient survey also included responses from patient families. These were 70, 72, and 53 responses for baseline survey, three-month postimplementation surveys, and 13-month postimplementation surveys.
A study conducted by Young, Minnick, and Marcantonio (1996) compared the opinions of more than a thousand staff nurses, numerous nurse managers, and more than two thousand patients from 17 hospitals regarding certain aspects and perceptions of patient care needs. Interestingly, staff nurse and managers
Nursing assessment is a substantial way of gathering physiological, psychological, spiritual, and emotional condition of the patient. It creates a whole picture of an individual and assist the health care providers to formulate a diagnosis. Assessing the comfort of the patient is equally important as taking the blood pressure or temperature. Pain is the fifth (5th) vital sign that is subjective in nature when performing an assessment of a patient. Various studies were conducted in finding the most appropriate evidence-based nursing practice in assessing and managing the pain of a cognitively impaired patient, whether it is acute or chronic or the underlying cause is cancer or post-operative incision. As emphasized by Song, Eaton, Gordon, Hoyle, and Doorenbos (2015), it is vital to ensure that “pain management is based on the best evidence” (p. 456). Perhaps knowing the causes of inability to assess and manage the pain in a cognitively impaired patient would give a clearer understanding of the practice.
This paper will address and evaluate the research problem itself, the design of the study, the sample, how the data is collected, its limitations, and its findings. Furthermore, how does this study impact the overall nursing process?
I will methodically analyze all parts of the study to assess the validity of the article, by contrasting and comparing the information provided, with previous literature. I will try to make sure that recommendations provided by the authors are congruous with nursing practice and beneficial to the advancement of it. I will as much as possible provide in depth detail of previous studies on the same topic that either support or contradict the analysis provided by this study and its authors.
With nursing staff continuing the medication regime without assessing new needs patient X may have, those goes against the practice standard set out by CNO practice guidelines. Alongside frequent sedation, patient X’s ability to engage in activities of daily living are compromised such as maintaining a consistent sleep schedule, eating at appropriate/regular meal times, and socializing with others. All these factors in patient X’s situation reveal how the deontological theory was not being followed in her care, making chemical restraints an ethical
This essay will aim to look at the main principles of cancer pain management on an acute medical ward in a hospital setting. My rational for choosing to look at this is to expend my knowledge of the chosen area. Within this pieces of work I will look to include physiological, psychological and sociological aspects of pain management.
Does the compliance with a sedation protocol improve after nurses receive a sedation competency over a three month period? The available data supported the hypothesis that nursing education and competency can lead to consistent best practices and positive outcomes for patients. The answers to this research question can help develop interventions that support best practices for patients who are mechanically ventilated and receiving intravenous sedation.
Fourteen staff nurses participated in the focus group. The results of the focus group revealed a lack of clarity related to the intent of the study, documentation was an added burden, some felt it was a punitive measure for something