350 word Discussion Post **Due in 6 hours

Description

For this Discussion, read the book chapter by Titler (2008) presented in this week’s resources that describes evidence-based practice and translational science, as well as the kind of research needed for both. Then, reflect on how the knowledge you gained about research will support your effort as a nursing professional to improve patient quality and safety.

Link to readings

Titler, M. G. (2008). Chapter 7. The evidence for evidence-based practice implementation. In R.G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses (Vol. 1, 113–116). Rockville, MD: Agency for Healthcare Research and Quality.

Describe how you will use evidence-based practice to improve patient quality and safety in your health care setting. Be specific and provide examples. Then, explain how the knowledge gained about research in this course will support your role in practice as a nursing professional. Then, describe how you will use evidence-based practice to improve patient quality and safety. Be sure to include in your Discussion any unanswered questions that need to be considered by your classmates and/or Instructor. Respond with a 150 word response post to at least two of your classmates posts by day 7

Below are two classmates’ discussion to use as a REFERENCE of what this post should simulate and to respond to. .

Also, the response posts must be at least 150 words and resemble something like this which is a response to Natalie C. from another Classmate.

Hi Natalie, You are most certainly correct, evidence-based practice is a lifelong problem-solving approach to healthcare. I couldn’t agree more, that holding ourselves and others accountable for following the latest evidence-based protocols and bundles is a keep step in providing quality care and increasing patient safety. At my facility, we have an employee education department that offers education opportunities throughout the year such as specialty seminars such as ones for OB or our trauma symposium and cardiovascular symposium. The education department does not conduct these, but they send out the information to hospital staff if they were interested in attending. We also have yearly skills fair, not every department is required to complete all areas of the skills fair due to some areas being more special than others. The skills fair changes slightly every year, reinforcing the areas that may have been of more concern throughout the year, such as focusing on isolation protocols when infection rates had increased and concentrate on CLABSI and CAUTIs. Does your facility utilize “change champions” as described by Titler (2018) to be a person who can assist with implementation challenges or troubleshooting of new practices?

References:

Titler, M. (2008). The evidence for evidenced-based practice implementation.Patient

Safety and Quality: An Evidenced-based Handbook for Nurses: Vol 1.

….

Natalie C.

RE: Discussion – Week 6

COLLAPSE

According to Titler (2008), evidence-based practice (EBP) is “the conscientious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide health care decisions” (p.1). As nurses, it is our responsibility to advocate for our patients to help improve their outcomes and ensure the receives the best care possible. Titler writes of multiple steps in implementation of EBP but one facet in particular stood out for me personally. The author discusses the use of “change champions” as a critical part of successful EBP implementation (Titler, 2008). Change champions are practitioners that form a group in order to educate and support staff during a change of practice (Titler, 2008, p.6) This approach was adopted in my facility’s roll-out of the VAP and ABCDEF bundle.

I am interested in ways to initiate quality improvement within my unit by participating in evidenced based projects to improve patient outcomes. I am committed to improving patient safety and quality of care by continuing to proactively support our implementation of our ABCDEF and VAP bundles on my unit. I consider myself to be one of Titler’s (2008) change champions, participating in multi-disciplinary committees that were formed to create the framework, educate the staff through in-services, walking rounds followed by audits. This team would meet on multiple occasions to refine the process and discuss what was working and what was not.

The bundle we implemented is designed to improve our patient outcomes, increase ICU patient-staff interaction, as well as increase patient mobility and family involvement. The bundle is also shown to effectively treat pain, decrease length of ICU stay, Ventilator-Associated pneumonia (VAP) rates, Ventilator (Vent) days, sedation use and ICU delirium. According to a recent article fromCritical Care Clinics, the ABCDEF Bundle is a care pathway used to reduce risks to patients, improve outcomes and speed recovery after an ICU stay (Ely, Marra, Pandharipande, & Patel,2017).

During this research class, I have learned so much in terms of critically appraising research. I have learned how to distinguish different types of research and times when one type is preferred over the other based on the patient population, aims, goals, etc. The knowledge I have gained during this time will assist me in my current facility’s plan to continue implementation of current VAP and ABCDEF bundles. We have also begun to consider a study in treatment medications of hemorrhagic stroke to reduce cerebral edema. The information obtained in this class will allow me to participate in this study.My goals for the near future include increasing my knowledge base and level of practice. I am continually learning and growing as a nurse.

References

Ely, E., Marra, A., Pandharipande, P, & Patel, M. (2017) The ABCDEF bundle in critical care.InCritical Care Clinics. 33(2) doi:10.1016/j.ccc.2016.12.005

Titler, M. (2008). The evidence for evidenced-based practice implementation.Patient Safety and Quality: An Evidenced-based Handbook for Nurses: Vol 1.

Shamara Burrow

Evidence-based practice is a culture of knowledge and wisdom applied to patient care to provide the best outcomes; it is also described as the “conscientious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide healthcare decision” (Titler, 2008). New research and changing of recommendations occur at a rapid rate within healthcare; it is the responsibility of the organization, nurses, and physicians to apply the latest research to our practices to deliver the best care possible. Continuance of education and using new knowledge in everyday care transforms the healthcare teams to workers who have gained wisdom in their field. Evidence-based practice is translating research into practice; this is achieved by putting into practice what is learned from research to provide safer care (Titler,2008).

As a trauma nurse, I will use evidence-based practice to improve quality of care and safety by researching areas of my field that I question, assisting in our performance improvement and patient safety program, as well as being compliant with the latest protocols regarding chest tube insertions, foley insertions, VAP preventions, and TBI protocols. First, research is at the tips of everyone fingers; we must only be willing and have the drive to investigate areas of concern. For example, at my facility we use FAST exams frequently, however lately, we have had an increase in false positives as well as false negatives, this has triggered me to do more research regarding FAST exams. The knowledge obtained provides a better understanding of why this is happening and yet remains beneficial in practice. Secondly, our department strives for improvement and following the latest research for traumatic care. I have started assisting with tracking complications and identifying areas of needed development. Identifying areas of improvement give way to researching better protocols or techniques to implement, or our surgeons will attempt to conduct a study of their own regarding the area identified. Lastly, holding myself accountable for being compliant with the latest evidence-based practice. Healthcare workers can not expect improved quality of care and improved safety if healthcare providers are not applying what the research has shown us to be beneficial.

This course has provided me with a substantial amount of education regarding research. Research and understanding qualitative and quantitative data is an essential area that all advancing nurses must hold. Becoming a healthcare worker of wisdom in your specialty should be what we aim for; which is obtained through gathering data, processing information, and gaining and applying knowledge to everyday practice. As I advance my career to a Family Nurse Practitioner having the knowledge of research will help me stay current on the latest medication, plans of treatment and procedures that will best benefit my patients.

References:

Titler, M. (2008). The evidence for evidenced-based practice implementation.Patient

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Safety and Quality: An Evidenced-based Handbook for Nurses: Vol 1.

References:

Nursing Standards

Nursing and Midwifery Board of Australia. (2018). Code of conduct for midwives. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Clinical Guidelines

Guideline Adaption Committee. (2016). Clinical practice guidelines and principles of care for people with dementia. NHMRC Partnership Centre for Dealing with Cognitive and Related Function Decline in Older People. https://cdpc.sydney.edu.au/wp-content/uploads/2019/06/CDPC-Dementia-Guidelines_WEB.pdf

Living Guideline

Stroke Foundation. (2022). Australian and New Zealand living clinical guidelines for stroke management – chapter 1 of 8: Pre-hospital care. https://app.magicapp.org/#/guideline/NnV76E

Evidence-based practice

BMJ Best Practice

Goldfarb, S., & Josephson, M. (2020). Cystic fibrosis. BMJ Best Practice. https://bestpractice.bmj.com/

Schub, T., & Cabrera, G. (2018). Bites: Head lice [Evidence-based care sheet]. Cinahl Information Systems. https://www.ebscohost.com

Beyea, S. C., & Slattery, M. J. (2006). Evidence-based practice in nursing: A guide to successful implementation. http://www.hcmarketplace.com/supplemental/3737_browse.pdf

JBI: Evidence summary

Swe, K. K. (2022). Blood glucose levels: Self-monitoring [Evidence summary]. JBI EBP Database. https://jbi.global

JBI: Best practice information sheet

Bellman, S. (2022). Experiences of living with juvenile idiopathic arthritis [Best practice information sheet]. JBI EBP Database, 24(1), 1-4.

Cochrane Database of Systematic Reviews

Srijithesh, P. R., Aghoram, R., Goel, A., & Dhanya, J. (2019). Positional therapy for obstructive sleep apnoea. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD010990.pub2

Drug Information

Codeine. (2023, January). In Australian medicines handbook. Retrieved February 2, 2023, from https://amhonline.amh.net.au

Colorado State University. (2011). Why assign WID tasks? http://wac.colostate.edu/intro/com6a1.cfm

 

Dartmouth Writing Program. (2005). Writing in the social sciences. http://www.dartmouth.edu/~writing/materials/student/soc_sciences/write.shtml

Rutherford, M. (2008). Standardized nursing language: What does it mean for nursing practice? [Abstract]. Online Journal of Issues in Nursing, 13(1). http://ojin.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Health-IT/StandardizedNursingLanguage.html

Wagner, D. (n.d.). Why writing matters in nursing. https://www.svsu.edu/nursing/programs/bsn/programrequirements/whywritingmatters/

Writing in nursing: Examples. (n.d.). http://www.technorhetoric.net/7.2/sectionone/inman/examples.html

Perth Children’s Hospital. (2022, April). Appendicitis [Emergency Department Guidelines]. Child and Adolescent Health Service. https://www.pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Appendicitis

Department of Health. (n.d.). Who is being active in Western Australia? https://ww2.health.wa.gov.au/Articles/U_Z/Who-is-being-active-in-Western-Australia

Donaldson, L. (Ed.). (2017, May 1). Healthier, fairer, safer: The global health journey 2007-2017. World Health Organisation. https://www.who.int/publications/i/item/9789241512367

NCBI Bookshelf

Rodriguez Ziccardi, M., Goyal, G., & Maani, C. V. (2020, August 10). Atrial flutter. In Statpearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK540985/

Royal Perth Hospital. (2016). Procedural management: Pre and post (24-48 hours) NPS. Canvas. https://courses.ecu.edu.au

 

 

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