NRS 433 Topic 5 Characteristics of Nursing Research Utilization and Evidence-Based Practice
Sample Answer for NRS 433 Topic 5 Characteristics of Nursing Research Utilization and Evidence-Based PracticeIncluded After Question
According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interactions with clients. How do you see this being applied in your workplace?
Re: Topic 5 DQ 2
Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population. In the neonatal facility where I work, we have a protocol to measure the neonates’ abdominal girth before every feeding, the neonates are fed every three hours.
This protocol was instituted because research shows that premature babies who weigh less than three pounds, four ounces (1,500 grams) are more likely to develop Necrotizing Enterocolitis (NEC). Necrotizing enterocolitis (NEC) is a devastating disease that affects mostly the intestine of premature infants. The wall of the intestine is invaded by bacteria, which cause local infection and inflammation that can ultimately destroy the wall of the bowel (intestine).
Such bowel wall destruction can lead to perforation of the intestine and spillage of stool into the infant’s abdomen, which can result in an overwhelming infection and death. One of the first signs of NEC is the inability of the infant to tolerate the feedings. This is often associated with abdominal distention (bloating) and vomiting bile (green). Topic 5: Characteristics of Nursing Research Utilization and Evidence-Based Practice
Since this protocol was adopted, a huge drop was noted in the number of NEC cases in the department. This protocol also led to early detection and prevention of this devastating disease.
Reference:Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y. L., Chang, Y. K., & Mokhtar, I. A. (2011). Adopting evidence-based practice in clinical decision making: nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association : JMLA, 99(3), 229–236. doi:10.3163/1536-5050.99.3.010
Re: Topic 5 DQ 2
Bridging the gap between evidence-based research (EBR) and clinical practice involves the process of assessing the patient’s need for intervention, constructing a clinical question based on the patient’s problem, acquiring valid evidence with clinical expertise, applying interventions and evaluating outcomes. Evidence-based practice (EBP) combines research evidence with clinical expertise while encouraging individualization of care through patient preference.
EBP has been adopted by federal, state and local policymakers, as well as recognition actions. For example, the Magnet Recognition Program is a recognition of gold standard nursing care and excellence. (Stevens, 2013) My hospital has been awarded Magnet recognition twice in a row for our quality patient care, nursing excellence, and innovations in professional nursing practice.Guidelines for clinical practice of management of sepsis was developed by the Surviving Sepsis Campaign.
Since time is of the essence when it comes to treating sepsis, bundles were created for quality improvement opportunities to move the patient toward optimal health. (Surviving Sepsis Campaign, 2018) Our emergency room sepsis policy is as follows. Patients meet criteria for septic work up in the emergency department (ED) if they meet 2 criteria from either temperature >100.9 or <96.8, hear rate >90, respiratory rate >20 or white blood cell counts >12 or <4 or 10% bands.
They must also meet 1 criteria of either systolic blood pressure (SBP) <90 or mean arterial pressure (MAP) <65 or a drop in SBP >40 points, creatnine >2.0 or urine output <0.5 ml/kg/for 2 hours, bilirubin >2mg/dl, platelets <100, INR >1.5 or a PTT >60 seconds, lactate >2.0 or acute respiratory failure in need of a ventilator or BiPap. Time clock for the 3-hour bundle starts and criteria is met for diagnosis of severe sepsis from presentation (any 2+1).
Lactate level and blood cultures are drawn, and a repeat lactate level is drawn 3 hours after the initial result. An antibiotic is administered within one hour of diagnosis as well as an intravenous fluid (IVF) bolus 30 ml/kg. If within 3 hours of presentation time, after 1-hour post fluid resuscitation, the initial lactate is >4.0 and if the SBP <90 or MAP <65, the diagnosis is septic shock.
The 6-hour bundle includes continuing fluids 30 ml/kg, initiating vasopressors is considered, repeating lactate levels every 3 hours until < 2.0, vital signs are monitored every 15 minutes x 2 hours and tissue perfusion is documented.ReferenceStevens, K. R. (2013, May). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing, 18(2). doi:10.3912/OJIN.Vol18No02Man04
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