NR 351 Week 3 Discussion Integration of Evidence-Based Practice Into Professional Nursing Practice
NR 351 Week 3 Discussion Integration of Evidence-Based Practice Into Professional Nursing Practice
Integration of Evidence-Based Practice Into Professional Nursing Practice
As the professional nurse, you realize that your nursing care area often sees patients with the same particularly challenging nursing care issue (NOT medical care issue). Include allof the following in your answer to this discussion:
Identify the nursing care issue or problem and justify why it is a nursing care issue in need of implementation of evidence. Remember, this should not be a medical issue.
Explain how you would search the nursing literature for evidence on this topic (including search terms you would use) and how you would critically appraise the evidence found in your search. NOTE: You do not need to perform the search and provide an article for this discussion, but you may do so if you like.
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Nursing as a health care science focuses on serving the needs of humans as a biophychosocial and spiritual being. Its practice requires not only scientific knowledge, but also interpersonal, intellectual and technical abilities and skills. This means a composition of knowledge, clinical work and interpersonal communication. Communication is a vital element in nursing in all areas of activity and in all its interventions such as prevention, treatment, therapy, rehabilitation, education and health promotion. Good Communication also improves the quality of care provided to patients, which is observed in the results. Additionally, it is considered an inalienable right and a prerequisite for building a genuine and meaningful relationship between patients and nurses and other health professionals. Kourkouta (2014). Effective communication between nurses and physicians is extremely important to patient safety. The Joint Commission reports that communication errors contribute to the majority of sentinel events reported. Thomas (2009)
I would like to share an experience I had recently involving poor communication, teamwork and collaboration. It involved a scheduled procedure on a patient’s left hand. This patient was evaluated and diagnosed by her surgeon, seen by him the morning of the procedure, completed all the pre-operative assessments and was ready to be transported to the operating room.
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While performing my assessment and interview, I noticed a bangle bracelet on her left wrist, the operative limb. I kindly asked her to remove the bracelet. Patient stated that the bracelet has been on for the past 20 years and she was physically unable to remove it. She became emotional and tears begin to flow. She shared with me how special the bracelet was to her and if it must be removed she would not proceed with her surgery. By taking the time to listen and sympathize with my patient, I recommended that she reconsider her decision. I pointed out that she had mentally and physically prepared for the procedure. She would still have the pain and problems that she had previously. Upon further dialogue, it was discovered that the bracelet was actually made of glass and therefore, could not be removed safely in the hospital setting. I explained that we would try to figure out a solution together.
I contact the surgeon and he said he would not perform the procedure if the bracelet was not removed. At this point, I communicated the situation to my supervisor. My supervisor consulted the surgeon and explained the predicament. At this point, he decided to perform the procedure with the bracelet left in place but secured and kept out of the sterile field.
Again, I returned to the patient and explained what the plan was moving forward. She was to immediately seek treatment in the emergency department should swelling occur because the bracelet could cause harm and increase the risk for potential loss of hand/limb. She understood and agreed to use ice and elevation to minimize the swelling. I also spoke to the husband and explained the events, the delay and the importance of monitoring for swelling.
My patient was relieved, the procedure safely performed and her bracelet remained in place. The roles assumed by nurses require that they have a repertoire of clinical, cognitive and communication skills. Adaptation to situations is necessary as nurses often encounter complicated patient situations. Hood ( 2018). This event included communication, teamwork and collaboration, safety, patient centered care, quality improvement, leadership and professionalism on my part as a nurse. These core competencies came together to allow me to provide excellent patient care.
Hood, L. J. Leddy and Pepper’s Professional Nursing (9th ed.). Philadelphia, PA Wolters Kluwer
Kourkouta, L. Communication in Nursing Practice (February 2014). https://www.ncbi.nlm/nih.gov/pmc/articles/PMC3990376/
Collaboration is an important factor in any career field. It is especially so for the health care field to provide patients with the best care possible. I thought that collaboration and communication were the same things but, they are different yet codependent. According to Wells (2017), “Collaboration is the action of working with someone to produce or create something. Communication is the imparting or exchanging of information or news.” This is something that nurses and all other members of the health care team do daily to provide the best care for their patients.
While the common goal is to provide the best care possible, there are sometimes barriers. In order to overcome these barriers, nurses can use a variety of collaboration strategies. According to Hood (2018), using SBAR, verifying orders, and using I PASS the BATON are all collaboration strategies for effective communication. SBAR is a template that is used by nurses to communicate with other members of the health care team to explain the situation, background, assessment and recommendations or requests are for the patient. While I communicate this information every shift, I PASS the BATON is a strategy that I haven’t heard of before. Introduction, patient, assessment, situation, safety, background, actions, timing, ownership, and next are all crucial information needed to give in the report to the next shift, (Hood, 2018).
One strategy that I use daily at work is what we call huddle. Around 10 am, Monday-Friday, the nurse, case management, and our manager all meet in the backroom to discuss a plan of care for each patient that we are assigned to. We also discuss what needs to happen to carry out the plan of care for each patient. This includes which doctors need to be contacted, if the case managers need to set up an ambulance ride home or to a facility and making sure they have been approved to go to the facility. This helps make a complex plan more achievable.
Hood, L. J. (2018). Leddy & Pepper’s professional nursing (9th ed.). Philadelphia, PA: Wolters Kluwer.
Wells, K. (2017, November 29). Collaboration vs. Communication: Why the Difference Matters. Retrieved March 10, 2020, from Field Service Digital website: https://fsd.servicemax.com/2017/11/29/collaboration-vs-communication-the-difference-matters/
In discussions, you, as a student, will interact with your instructor and classmates to explore topics related to the content of this course. You will be graded for the following.
Discussions (graded): Discussions are a critical learning experience in the online classroom. Participation in all discussions is required.
2. Guidelines and Rubric for Discussions
PURPOSE: Threaded discussions are designed to promote dialogue between faculty and students, and students and their peers. In the discussions students:
- Demonstrate understanding of concepts for the week
- Integrate scholarly resources
- Engage in meaningful dialogue with classmates
- Express opinions clearly and logically, in a professional manner
Participation Requirement: You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday.
Participation points: It is expected that you will meet the minimum participation requirement described above. If not:
- You will receive a 10% point deduction in a thread if your response to the initial question is not posted by 11:59 p.m. MT on Wednesday
- You will also receive a 10% point deduction in a thread if you do not post at least three (3) times in each thread on at least two (2) separate days.
3. Threaded Discussion Guiding Principles
The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
4. Participation Guidelines
You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday. Discussions for each week close on Sunday at 11:59 p.m. Mountain Time (MT). To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. For courses with Week 8 graded discussions, the threads will close on Wednesday at 11:59 p.m. MT. All discussion requirements must be met by that deadline.
5. Grading Rubric
|Discussion Criteria|| A
Outstanding or highest level of performance
Very good or high level of performance
Competent or satisfactory level of performance
Poor or failing or unsatisfactory level of performance
|Answers the initial graded threaded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week.
|Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.
|Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.
|Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.
|Minimally addresses the initial discussion question(s) or does not address the initial question(s).
|Integrates evidence to support discussion. Sources are credited.*
( APA format not required)
|Integrates evidence to support your discussion from:
Sources are credited.*
|Integrates evidence to support discussion from:
Sources are credited.*
|Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson.
Sources are credited.*
|Does not integrate any evidence.
|Engages in meaningful dialogue with classmates or instructor before the end of the week.
|Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.
|Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.
|Responds to a classmate and/or instructor but does not further the discussion.
|No response post to another student or instructor.
|Communicates in a professional manner.
|Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).
|Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).
|Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).
|Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).
Response to initial question: Responds to initial discussion question(s) by
Wednesday, 11:59 p.m. M.T.
|0 points lost
Student posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.
Student does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.
Total posts: Participates in the discussion thread at least three times on at least two different days.
|0 points lost
Posts in the discussion at least three times AND on two different days.
Posts fewer than three times OR does not participate on at least two different days.
* Credited means stating where the information came from (specific article, text, or lesson). Examples: Our text discusses…. The information from our lesson states…, Smith (2010) claimed that…, Mary Manners (personal communication, November 17, 2011)…. APA formatting is not required.
|** Assigned readings are those listed on the syllabus or assignments page as required reading. This may include text readings, required articles, or required websites.|
|*** Scholarly source – per the APA Guidelines in Doc Sharing, only scholarly sources should be used in assignments. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Wikipedia, Wikis, .com website or blogs should not be used as anyone can add to these. For the discussions, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. Outside sources do not include assigned required readings.|
|NOTE: A zero is the lowest score that a student can be assigned.|
OK…I think I get it now. Here’s take two!
In the article, CMSRNs’ continuing competence methods and perceived value of certification: A descriptive study, by Boyle & Thompson (2020), one of the studies that researched the value of a nursing specialty certification was done by Whitehead and colleagues in 2019. The research included a review of 41 articles published between 2000-2018. The review findings contained several categories for valuing certifications. These included: 1) personal and professional incentives, 2) knowledge and skills, 3) job satisfaction, 4) organizational commitment, 5) empowerment, and 6) confidence. Under the category of personal and professional incentive, the Perceived Value of Certification Tool (PVCT) was used and determined the value was based on two different factors: intrinsic and extrinsic rewards (Boyle & Thompson, 2020).
The top 3 intrinsic rewards for nursing specialty certification:
- enhanced feelings of personal accomplishment (98.45%)
- personal satisfaction (97.93%)
- validation of specialized knowledge (97.13%)
The top 3 extrinsic rewards for nursing specialty certifications:
- promotes recognition from peers (85.96%)
- promotes recognition from other health professionals (78.68%)
- promotes recognition from employers (84.45%)
The findings from the research study by Whitehead and colleagues support Boyle & Thompson’s purpose of determining the value of nursing specialty certification by having the PVCT included within their research. The fact that the value for obtaining certification was more intrinsic than extrinsic is something that I found interesting. From the personal experience of having obtained a certification myself, I can understand how it brings about self-fulfillment, however, the encouragement to pursue the certification came from extrinsic forces (i.e. – my manager and charge nurse).
In regards to a strategy that would help create a strong literature review/search, our textbook mentions to select resources from a comprehensive clinical database (Houser, 2018). While Whitehead and colleagues’ research was thorough and comprehensive, one could argue that the sample size for the base of their research was small (only 41 articles utilized). Using a comprehensive database, such as CINAHL, which has access to thousands of scholarly articles, books, journals, and research papers, one could go delve more into the value of a nursing specialty certification. The importance for a thorough review of the literature is to remember that despite all the evidence presented, it is still an article of opinion. Therefore, providing as much evidence as possible to defend and convince others of one’s hypothesis could only be enhanced by greater numbers.
Boyle, D. K. & Thompson, S. A. (2020). CMSRNs’ continuing competence methods and perceived value of certification: A descriptive study. MEDSURG Nursing, 29(4), 229-254. https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=145282314&site=eds-live&scope=siteLinks to an external site.
Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Jones & Bartlett.
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