The Therapy For The Reduction Of Congestion

The profession of nursing has, in recent years, been trying to further develop, test and use proposed nursing theory. To utilize theory appropriately, in all domains of practice, education and research, it is important to know how to describe, analyze and evaluate

Evidence-Based Practice Proposal Final Paper Usha Kizhakkedan Grand Canyon Final Paper of Evidence Based Proposal NUR-699 Dr. Debbie Long June 1, 2016 Table of Contents Part 1: Organizational Culture and Readiness Assessment 4 • Introduction to Evidence-Based Practice 4 • Barriers to Evidence-Based Practice 4 • Facilitators of Evidence-Based Practice 5 • Integration of Clinical Enquiry 5 • The Survey 6 Part 2: Problem Description 7 • Description 7 • Identification of change agents in the Health care system 8 • PICOT question 8 • Purpose and Objectives 9 • Rationale 10 • Literature support 10 • Research Method 10 Part 3: Literature Support 11 • Research Questions 11 • Search Method 12 • Organization of Literature 12 • Framework 12 • Nursing Rounds- Patient and Family Satisfaction: 13 • Communication: 15 • Management of Pain, Use of Call Lights and Cases of Patient falls 15 • Data Collection 16 Part 4: Solution Description 16 • Objectives 17 • Change Methodology 17 • Implementation Plan 18 • Evaluation 19 Part 5: Change Model 19 • Change Model 20 • Implementing Change 21 • Rationale 22 Part 6: Implementation Plan 22 • Staff Education 23 • Client feedback 23 • Timeframe 23 • Hiring Process 24 • Implementation 24 • Data collection and Evaluation 24 • Progression 24 • Resource Management 24 • Budget Plan 25 • Outcomes and its impact 25 • Summary 26 Part 7: Evaluation of Process 26 • Objectives 26 • Methodology 27 • Procedure 27 • Collection and Analysis of data

Only when it is absolutely necessary should a catheter be inserted into a patient. Every patient is assessed for the need for a Foley catheter. If the Foley is inserted, assessments are also then done daily to see if the need is still valid. If the reason is not justifiable the catheter must be removed from the patient (Joint Commission releases new NPSG for CAUTI, 2011). Nurses must follow guidelines while inserting indwelling catheters as well. Aseptic technique is critical to maintain during this process. The use of sterile equipment and a sterile procedure helps to reduce the risk of CAUTI. If in any way the catheter becomes contaminated during the process of insertion, the nurse should discard of the entire catheter and start with a new, sterile kit. Proper hand hygiene is very important before and after contact with indwelling catheters to decrease risk of infection. Maintenance of a close drainage is system is also important that way bacteria are not able to get in and cause infection (Revello & Gallo, 2013). Decreasing the number of times Foleys are inserted and how long they stay in for can help reduce the risk of CAUTI since the longer a Foley stays in, the higher the risk of infection becomes. Nurses must keep the catheter line patent, with no kinks to allow urine to flow freely through into the collection bag. When a urine sample must be obtained it must be done in a sterile

The author undertook an electronic search were used to collect the literature. Three electronic databases were used; Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and PsychInfo. These three databases were chosen as they are often used by nurses, allied health professionals, researchers, students and nurse educators to research their subject area (Aveyard, 2014).

Until recently it was not uncommon for patients admitted to an acute care facility to have an indwelling catheter anchored for unnecessary reasons. Patients that came in thru the emergency department typically were sent to the units with unnecessary indwelling catheters in place and it was not unusual for a surgery patient to have an indwelling catheter anchored before or during a procedure. Once a patient was admitted and was transported to the units nursing would also anchor indwelling catheters for multiple unnecessary reasons. These Catheters could be

As part of the literature review, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar, Cochrane, and EBSCOhost databases were used in the search for sources to be utilized in this DNP project. Evaluative criteria were used to determine quality, suitability, and coverage of selected articles. For instance, the aspect of

541). Interventions should be rendered continuously, promptly and appropriately as it can cause life-threatening complications (Holt 2009, p. 26). Apparently, the patient is stable, but continuous assessment and management should be done to avoid recurrences of untoward signs andsymptoms and prevent potential complications. Firstly, continuous assessment and vital signs should be done and these include blood pressure, cardiac rate, respiration, venous distention and skin turgor to assess possible occurrence of fluid overload as a result of rapid administration of large fluid that is often needed to treat the patient with DKA (Smeltzer & Bare 2004 p. 1185). Aside from this, documentation of fluid intake and output should be monitored and documented to assess for circulatory overload and renal function (Holt 2009, p. 61). Significantly, it is integral in the provision of continuous care that nurses reassess the factors that may have contribute or led to DKA, and educate the patient and his family about strategies to prevent its recurrences (Smeltzer & Bare 2004 p. 1186; Lemone, Burke & Bauldoff 2011, p. 551).

In this 21st century, health care is advancing remarkably and achieving various results through research. Research is vital to bring about new inventions, techniques and improvements and create a new body of knowledge. In nursing, research helps to bring about improvements in current practice, knowledge, patient outcomes as well as to create new polices and upgrade the existing ones. For example, a “re-challenge protocol” was created by the researchers to reduce the drug reactions caused by two chemotherapeutic agents. Likewise, numerous research is conducted to improve scientific knowledge in various fields of science. One such knowledge in the field of science is the nursing knowledge.

The procedure was done emergently because of the patient’s critical condition. His right IJ area was prepped in the usual fashion. It was very difficult to visualize his right IJ vein, even though his habitus should have allowed us to do so, but the patient was, I believe, severely intravascularly volume depleted, and his vein was collapsing. I have attempted to access the right internal jugular vein multiple times, both under real-time ultrasound guidance and even later on blindly. I was able to get blood return and hit the vein; however, I was not able to advance the guidewire. I was able to advance it one time and put the catheter in, and it was nonfunctioning. I had to take the catheter out and tried multiple other times on the right IJ vein without success. That procedure was terminated. Pressure was applied. There was no cervical hematoma whatsoever. The patient was uncomfortable because of the length of the procedure but did well otherwise. Hemodynamically, he was unchanged, and his oxygen saturations remained stable.I prepped the IJ vein area in the usual fashion. One percent lidocaine was used for local anesthesia. Again, the left IJ vein was collapsing. With deep inspiration, the vein could be well visualized on the real-time and ultrasound guidance, after which I could get access to the left IJ vein. A wire was advanced without difficulty while the

Evidence-based practice is relied on by professional nurses in order for them to make informed decisions as well as apply critical thinking skills directly to the patient care they provide. The research process allows the nurse to ask and answer questions systematically to ensure the decisions they make are based on sound science. Research provides the evidence needed for nurses to practice based off scientific evidence rather than by tradition (Houser, 2013). Nursing research is fundamental to the practice and is the central principle that defines the nursing profession.

Quantitative and qualitative research studies are both significant in nursing. In this paper, I will be critiquing two articles using both approaches. Using Walden’s database system, the articles will be located and compared to one another. After this assignment, I hope to gain a better understanding if critiquing research articles.

Identifying what factors contribute to occlusion are background questions (Melnyk & Fineout-Overholt, 2015) that should be addressed to ensure the foreground question is appropriately answered. Medication administration, fibrin sheath formation, duration, and frequency of use can each contribute to clot formation (Gabriel, 2011). If a patient is scheduled to receive a specific medication over a duration of time, it is imperative that the central venous catheter is patent and available for continuous use. Encouraging patient compliance will assist with ensuring that duration and catheter access doesn’t increase the risk of clot

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.

The overuse or misuse of indwelling urinary catheters (IUC) is a concern in the emergency department (ED) despite the well-known risks and complications. Although the medically indicated guidelines for use are specific, professionals often ignore the guidelines and insert an IUC without applying evidence-based practice strategies to manage urinary output.

Throughout the past ten weeks, I have grown in my understanding of nursing research on all levels. I feel that the most essential knowledge I have gained is the ability to critically review a research article. Because of this class, I have a better grasp on the necessary components to include, as well as how to determine rigor and validity in research. This is a valuable skill which I will utilize throughout my career as a nurse practitioner. I anticipate applying this knowledge as I review articles to determine which intervention is best to incorporate into management plans for my patients. As an example, if I am