...Yanique Scott Evidence Base Health Care Research 20/06/12 A critique of a qualitative study focusing on self- efficacy of staff managing people with learning disabilities who have challenging behaviour. This essay discusses in some details a qualitative study that explores the importance of self- efficacy in staff for managing challenging behaviour (Cudre’-Mauroux, 2010). The purpose of this study is to critically evaluate the article titled ‘’Self- efficacy of staff managing people with learning disabilities who have challenging behaviour’’. A framework devised by Cormack (2000) has been used to help the process of critiquing this article. This particular framework had been chosen as it is comprehensive framework covering most points needed in the critiquing process. It will evaluate the strength and weakness of the article in a systematic way discussing the title, abstract, introduction, sampling method, data collection tool, data analysed, literature and ethical issues, result and conclusion. The evidence retrieved will be analytically discussed in regards to the usefulness to clinical practice. The title of the study is ‘’Self- efficacy of staff managing people with learning disabilities who have challenging behaviour (Cudre’-Maurox,2010). According Grinnel and Unrau (2011) a title succinctly conveys the nature of the study. The title includes central phenomenon and group under investigation which is professional caregivers and person with learning disabilities...
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...Application of Evidenced-based Practice Regarding pediatric Patients and Otitis Media 1 Running head: Application of Evidenced -based Practice Application of Evidence-based Practice Regarding Pediatric Patients and Otitis Media Western Governors University Running head: Application of Evidence-based Practice 2 The nursing practice heavily relies on the evidence based clinical information to determine current standards of practice within the nursing scope of practice. A multitude of informational journals and peer reviewed articles are readily available to help guide the decisions placed into practice. The nurse is responsible for recognizing the quality of evidence collected to improve the standard of care patients receive. This paper will investigate four articles regarding the appropriate care and treatment of the pediatric population with otitis media. In addition, an appropriate recommendation for antibiotic therapy will be made based on information gathered during the research. To answer the question of whether a wait-and -see approach is recommended, an initial validation of the information collected must be determined. Four articles will be assessed based on the type of research collected as filtered, unfiltered, or general information. The source will be investigated as inappropriate or appropriate. Lastly, the articles will be classified...
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...Evidence-based clinical practice guidelines are a potential vehicle to achieve the implementation of EBP into clinical practice. Implementing change in practice has been attempted by a number of direct and indirect methods Implementation depends on clinicians and managers changing a variety of behaviours, and there have been more than 300 evaluations of interventions to improve implementation - Grimshaw JM, Thomas RE, Maclennan G, Fraser C, Ramsay C, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C: Effectiveness and efficiency of guideline dissemination strategies. Health Technology Assessment 2004, 8:1-84. For theory to be used in implementation research, it needs to be seen as relevant, accessible and useful, and researchers need to have expertise in behavioural theory. The relevance of theories of behaviour change would be more apparent if implementation of research findings were conceived in terms of health professional behaviour = Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behaviour of healthcare professions: the use of theory in promoting the uptake of research findings. Journal of Epidemiology 2005, 58:107-112. Make clinical staff more aware of existing research in their specialty areas • Help clinical staff to set up and keep up to date a resource area with relevant research papers • Help clinical staff to interpret and implement research findings in practice • Help clinical staff to locate relevant...
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...Discuss how evidence -based practice is applied in your practice setting and describe the desired outcome achieved through this approach. “Evidence-based practice is an interdisciplinary approach to clinical practice”.(wiki) Its purpose is to improve the quality of patient care and patient outcome In critical care unit the area in which I practice evidence based practice is been developed for reduction and prevention of critical illness neuromyopathy: profound weakness. To accomplish this, a supportive treatment approach has been implemented. The treatment of all sources of inflammation is aggressively treated. Potentials for infections is being addressed by early removal of Foley’s, iv lines out when no longer need, Peripheral iv changed every 72 hours, and piccline are removed when it is evident that the patient is febrile for 24 t0 48 hour period. Another treatment approach is early weaning of patients on mechanical ventilator, also the entire interdisciplinary team is involved in a mobility plan for all patients admitted the unit. Early weight-bearing and ambulation is encouraged. Control of schedule for mobilizing patients out of bed is the responsibility of members in physical therapy department. Each patient may be up for about two hours, the number of patient to be up and the time they should be up is posted for both day and night shift. For vented patients the Respiratory therapist, the nurses and the nursing assistant together as team is responsible for getting...
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...EBP Searchable Clinical Questions Graded Assignment #2 Armon A. Copeland NR 500 Foundational Concepts and Applications Chamberlain College of Nursing June 8th, 2013 Chamberlain College of Nursing NR 500 Foundational Concepts and Applications EBP Searchable Clinical Questions Graded Assignment #2 1. Clinical Question: In patients with AIDS, what is the average life expectancy among those who take single antiretroviral drugs versus those who do the aggressive Highly Active Antiretroviral Therapy (HAART)? P = Patients with AIDS I = HAART C = single antiretroviral drug O = maximum life expectancy The reason I chose HIV/AIDS as a topic of study is that I strongly believe that treatment interventions can eliminate the belief that the diagnosis is a death sentence. I have also worked with patients with HIV/AIDS. When patients with HIV develop AIDS, it is important for them to know what treatment options are available to them. As of now, the treatment options are extreme. They entail the administration of antiretroviral drugs that are often used alone depending on the needs of the patient. Antiretroviral “Antiretroviral therapy suppresses the replication of the HIV virus in the body,” (AIDS, 2011). However, the use of combination therapy and highly active antiretroviral therapy (HAART) are becoming increasingly common in the treatment of AIDS. HAART has the potential to be “very...
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...is often incorrectly regarded as a subset of the medical profession; in reality, the profession of Nursing is a unique, distinct science with its own knowledge base and skillset. In accordance with the requirements of a scientific profession, there is a need for scholarly inquiry and nursing research in order to maintain autonomy and distinction of the Nursing perspective separate from other disciplines. An editorial published in the Journal of Nursing Scholarship noted that “the distinguishing feature of a profession is how its practitioners use knowledge to make a difference” (Hegyvary, 2007). The evidence generated by Nursing scholars influences global health initiatives and policy worldwide. The need for field wide scholarly inquiry, the application of rigorous scientific standards to research, and the importance of stringent ethical and legal protection for research subjects has been the subject of numerous articles, books, and papers. The Nursing Profession has a responsibility to engage in scholarly research for many reasons that will be discussed in depth within this paper. Importance of Nursing Research to the Nursing Profession As noted in the introduction, in order to maintain its status as a unique, autonomous profession, Nursing as a field must continually refine and expand its scientific knowledge base. The AACN position statement summarizes the importance of research to the profession by stating “The essence of a discipline is its body of scientific knowledge...
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...Implications of Evidence Based Practice-Research Patricia Davis Immaculata University The Importance and Implications of Evidence Based Practice-Research Evidence based practice is a way of providing health care that is guided by incorporating current knowledge and clinical expertise. This research and resource information corrects clinical problems, application of quality interventions, and evaluates the outcomes for further improvements in the future. Evidence based practice is an approach that improves the impact of nursing, psychology and social work. It gives research the cause and effect that gives validity to the information. The purpose of evidence based practice is ensuring that patients receive the best quality care and keep nurses, nursing care, and knowledge up to date. The American Nurses Association (ANA) recognizes the importance of evidence based practice (EBP), and that it incorporates the registered nurse to integrate, participate in the formulation, and contribute to the knowledge of research to improve healthcare outcomes (ANA, 2010). Evidence based research results in favorable patient outcomes across various geographic locations. The impetus for evidence-based practice comes from decisions of efficacy, and healthcare facility pressures for cost containment. Evidence practice stresses changes in the education of students, more practice-relevant research, and closer working relationships between clinicians and researchers. The evidence based practice...
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...above initial registration | Descriptor * foster professional growth, personal development and accountability through support of students in practice * demonstrate breadth of understanding of assessment strategies and ability to contribute to the total assessment process as part of the teaching team * provide constructive feedback to students and assist them in identifying future learning needs and actions. Manage failing students so that they may enhance their performance and capabilities for safe and effective practice or be able to understand their failure and the implications of this for their future * be accountable for confirming that students have met or not met the NMC competencies in practice and as a sign off mentor confirm that students have met or not met the NMC standards of proficiency and are capable of safe and effective practice | Suggested Examples of Evidence * Reflective accounts * Anonymous example of student learning contract * Anonymous records of dealing with challenging circumstances and non-achieving students * Anonymous records of feedback given to students * Examples of how to use the student assessment criteria and map to learning outcomes and students individual learning objectives * Examples of evidence used to determine student achievement of competencies and proficiency * Evidence of collaborative working with partners in education * Attendance at mentor forums | Section 3 – Triennial Review – NMC Mentor Outcome NMC...
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...in consistent protocols for central venous access devices accrue an approximately 250,000 bloodstream infections in U.S hospitals yearly (Hatler et al., 2009). An estimated 90,000 deaths a year result from these bloodstream infections associated with intravascular catheters (Hatler et al., 2009). The health care system averages $25,000 to $40,000 per incidence (Mathers, 2011). The identification of proper and/or improper practice and application of evidence-based practice protocols is essential to keeping catheter patency and prevention of infections. Definition of Topic Stated by the authors of Evidence-based Practice to Reduce Central Line Infections, “a catheter related blood stream infection is defined as a positive blood culture with clinical or microbiologic evidence that strongly implicates the catheter as the source of infection” (Render et al., 2006, p. 254). What, besides what we already are taught to perform, can be further done to reduce the percentage of blood stream infection in central venous catheters and access devices? Existing practices used for infection control of central line placement include maximal barrier precautions, which consists of strict compliance with hand hygiene, wearing a cap, mask, sterile gown, and...
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...Reducing the risk of surgical site infection Joy Ibeh Walden University NURS 4001, Section 7, Research & Scholarship for Evidence-base practice September 7, 2014 Reducing the risk of surgical site infection A surgical site infection is a preventable event and also a national concern. There are numerous publication on national awareness and guidelines for infection prevention in different surgical settings. The benefit of providing information and acquiring knowledgeis to prevent patient mortality rate by following the national clinical guideline. Therefore the purpose of this paper is to discuss information from the the clinical practice guideline for preventing and reducing the risk of surgical site infection. Practice Setting Problem The Practice seting problem chosen for this assignment is reducing the risk of surgical site infection by using clinical practice guideline. Surgical site infections (SSI)is an infection patient acquired from hospital after surgery, It has a significant representation of healthcare associated infections. According to Center for Dieases Control and Prevention (CDC) SSI is defines as “ an infection that occurs after surgery in the part of the body where the surgery took place.” (Spruce, 2014). The author, Spruce (2014) addressed the mortality rate of surgical site infection and further noted that SSI is the second most prevalent healthcare associated infection that are estimated to be 40% to 60% preventable. Spruce reported that $28.4...
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...pathways and schools for nurses to complete these requirements. There are vocational Programs, the Associate degree program, and the Baccalaureate programs. Though all are eligible to take the same NCLEX-RN exam to attain licensure for practice as registered nurses, they all practice at different levels of competencies and scopes. Although the cognitive abilities between the associate degree and the baccalaureate degree nurses are similar, the difference between these two practicing nurses is mostly related to the level of preparedness and their role functioning standards. The achievement of BSN by practicing nurses serves to enhance nursing care particularly on individuals, families and community like the ADN, but also extends their expertise to community health, leadership, research and evidence based practice. Although the differences in the abilities may not be evident in the beginning of their nursing practice, it becomes pronounced as these nurses gain experience in clinical areas. On like the associates level, the “BSN education includes additional course work in nursing and a broader range of studies in other disciplines” (McEwen). The BSN nurse receives more extensive preparation in the sciences and liberal arts and broader theories to base their understanding of the psychosocial and physiological behaviors of their patients. This gives them the platform for greater...
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...Core Competency: Evidenced-Based Practic C 08/13 Evidenced-Based Practice is ”the practice of nursing in which the nurse makes clinical decisions on the basis of the best available current research evidence, his or her own clinical expertise, and the needs and preferences of the patient.” (Mosby, 2009, p. 677). Utilizing Evidenced Based Practice is a way to give the best, most effective care to patients. This paper will discuss methods and results of a study and how the results were obtained. Next, I will discuss possible barriers to EBP, and ways to overcome these barriers; and finally, facilitators to EBP. The study that was used was “Clinical Nurse Specialists’ Approaches in Selecting and Using Evidence to Improve Practice.” The purpose of this study was to determine the method that CNS use to incorporate evidence in everyday practice. The method was a telephone survey with a 75% response rate. journals, internet, and online research data bases rather than their peers and experiences. The study also pointed out downfalls or barriers to EBP including financial resources and resistant organizational culture (Profetto-McGrath, Negrin, Hugo & Smith, 2010, p. 38). Although Evidenced-Based Practice is beneficial for improved patient care and outcomes, there are some barriers to using this source. First there is inadequate research that is up to date with some of the more complicated problems, studies that are not complete or hard to read and understand, and studies...
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...can project the performance or quality of the nurse and whether this difference can effect patient outcome. The differences between an associate-degree-prepared nurse versus a Baccalaureate –degree nurse can be discerned through the interpretation and skills performed on a patient. Nursing has evolved through the centuries and has since based its practices on nursing theories that guide the student nurses to perceive the patient holistically. During the turn of the 20th century, hospitals were newly being established creating a new kind of environment that required multi-disciplinary relationships. Nursing was still at its early infancy, with graduate nurses having very little skill set, knowledge of advanced technologies, or experience with the medical field (Friberg, 2016, p.14). One solution was to group the inexperienced nurses with the experienced nurses and doctors in large rooms, giving rise to the introduction of specialty units; ICU, CCU. The experienced nurses observed the great benefits of training and educating the new nurses with this technique and, “formed national specialty organizations…these organizations practice standards and developed continuing educations programs and certification for their respective emerging clinical specialties (Fairman and Lynaugh,1998; Keeling, 2004). The Diploma, ADN, and BSN students who are...
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...HPNA Position Statement Evidence-Based Practice Background Increased attention is being directed toward the development of methods that can provide valid and reliable information about what works best in healthcare. The careful scientific evaluation of clinical practice became a prominent focus during the second half of the 20th century.1 More recently, attention has been paid to methods of determining which of multiple proven approaches to a healthcare problem works best for which patients.2 Evidence-based practice encompasses implementing the best-known practices into the clinical setting using a scientific approach. It evolved from evidence-based medicine, which was developed in Canada to teach medical students. “Evidence-based medicine has been defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”3, p. 3 The National Quality Forum’s report A National Framework and Preferred Practices for Palliative and Hospice Care Quality is a consensus report that is a first step toward introducing evidence-based measures into palliative practice on a formal, national level.4 The Agency for Healthcare Research and Quality (AHRQ) supports organizations in their efforts to improve the quality and efficiency of healthcare by facilitating the use of evidence-based research findings in clinical practice.5 The nursing discipline has also embraced evidence-based practice over the past 25 years, initially through...
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...NU2278 Developing Quality Practice Assignment 1 Guidelines: Teaching Plan Using the Teaching Plan template on WebCt you must plan a 20 minute teaching session, that you will perform in clinical practice with a patient of your choice, during the teaching activity your mentor or patient will complete the Teaching Activity Proforma (available on WebCt). ------------------------------------------------- Step 1 - Plan ahead – You need to manage your own time. Make an appointment to meet your module supervisor well in advance. At your meeting your module supervisor will expect to see a plan of what you want to discuss, they will provide advice and guidance, but they will not proof read your work or correct your grammar as this is your responsibility. Your work should reflect an understanding of: * the evidence base supporting your chosen activity and teaching patients * the need for confidentiality and sensitivity when interacting with patients, clients and carers * patient equality, peoples’ equality, diversity and rights ------------------------------------------------- Step 2 – your plan should consist of a title; introduction / background to the session; teaching plan, reference list and appendices (if applicable). Title – every essay should begin with the title written out in full Introduction / Background to the session (500 words) – this section should include your rationale for selecting the activity and a clear identification of the patient / client...
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