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 a professional nurse, you realize that your nursing care area often sees patients with the same particularly challenging nursing care issue (NOT medical care issue). Please include all of 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 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)
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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.
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/
Literature Review Section Summary
I chose to discuss the literature findings of continuing competence. There were four categories of literature findings regarding the study of continuing competence from 2012-2020. These categories are validating competencies, international competency assessment, and competencies in disciplines other than nursing. In one perspective of the study, it was found that educational sessions were used as a method to increase knowledge and were perceived as ensuring competency, however, the study also highlighted that professionals might attend cheap and convenient educational courses, but these courses either lack quality, or are not in what is particularly necessary in the practice and in greatest need (Boyle, 2020). Another argument made was that participants “may not be able to understand, retain, or use the information provided in these courses, and the attendance in the courses does not ensure changes in practice” (Boyle, 2020).
The review discussed other means of continuing competence methods for recertification, which included written examination, documentation of practice hours in the specialty, practice hours in the specialty, scholarship through publication and professional presentation, portfolios, and performance of a formal 360-degree assessment (Boyle, 2020). The article also mentioned that simulations on virtual and real patients are also accepted, but there was not enough evidence to support that simulations were used as a means of evaluating continued competence in credentialing and certifying.
Discuss how the author’s review of literature (studies) supported the research purpose/problem. Share something that was interesting to you as you read through the literature review section.
The purpose of the research was to review the continuing competencies for ensuring credentials and certifications. The research conducted did so in four different categories. The research conducted and discussed was over 50 articles worth, and over a significant time span, so accuracy is evident. The author quoted Di Leonardi several times. Di Leonardi was a member of a task force of authors sponsored by an organization that has Accreditation Board for Specialty Nurse Certification (Leonardi et al., 2019). According to an outside article, “The task force identified perspectives on continuing competency and found that although licensing and credentialing organizations addressed the topic thoroughly, little attention was devoted to the perspectives of the public, individual clinicians, and recipients of clinicians’ services.” (Leonardi et al., 2019). Overall, to quote a member of the task force that conducted the study, Boyle did a successful job at contributing research to her review of the studies done by Di Leonardi to address continuing competencies by quoting the researcher several times for support.
Something that was interesting to me as I read the literature review section for continuing competency was that simulations were not used as a means of evaluating continued competence, even though they were accepted. This was interesting to me, because in nursing school we had simulations routinely on virtual patients, and even as I was a new grad in a nurse residency program, we would meet monthly for virtual simulations as a means of ensuring competency. So that was shocking to me that research concluded that statement.
Describe one strategy that you learned that would help you create a strong literature review/search for evidence. Share your thoughts on the importance of a thorough review of the literature.
One strategy I learned was to research members of the studies if possible when reviewing literature or searching for evidence. When remembering the Levels of Evidence in Nursing Research that I learned in my nursing residency program, you want a level 1 if possible. In my opinion, searching for the researcher themselves and their statements on their studies is ideal for resources to review. This lesson only strengthened that strategy for me when conducting research on my own. When discussing studies, I want to be as accurate as possible and deliver truthful information from reliable sources, and in following that strategy I will be doing just that.
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.
Leonardi, B., Search for more papers by this author, Hagler, D., Marshall, D., Stobinski, J., & Welsh, S. (2019, December 17). From competence to continuing competency. Retrieved March 16, 2021, from https://journals.healio.com/doi/10.3928/00220124-20191217-05Links to an external site.
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. NR 351 Week 3 Discussion Integration of Evidence-Based Practice Into Professional Nursing Practice Guidelines and Rubric for Discussions
PURPOSE: Threaded discussions 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 must post at least three (3) times in each graded discussion. These three (3) posts must be on at least two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. M.T. on Wednesday.
Participation points: You are expected to meet the minimum participation requirement described above. If not:
- You will receive a 10% point deduction in a thread if 11:59 p.m. M.T. does not post your response to the initial question 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. NR 351 Week 3 Discussion Integration of Evidence-Based Practice Into Professional Nursing Practice Threaded Discussion Guiding Principles
The ideas and beliefs underpinning the threaded discussions (T.D.s) 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.
TDs provide 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 T.D.’s ebb and flow is based upon the composition of student and faculty interaction in the quest for a relevant scholarship.
Participation in the T.D.s 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. T.D.s 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 must post at least three (3) times in each graded discussion. These three (3) posts must be on at least two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. M.T. on Wednesday. Discussions for each week close on Sunday at 11:59 p.m. Mountain Time (M.T.). 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. M.T. All discussion requirements must be met by that deadline.
5. NR 351 Week 3 Discussion Integration of Evidence-Based Practice Into Professional Nursing Practice 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) by plying experiences, knowledge, and understanding of key concepts.
|Addresses some aspects of the initial discussion question(s) by applying experiences, knowledge, and understanding of some 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:
|Integrates evidence to support discussion only from an outside source without mentioning 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 instructor’s post, furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.
|Responds to a classmate and instructor, furthering the dialogue by adding depth to the discussion.
|Responds to a classmate and instructor but does not further the discussion.
|No response post to another student or instructor.
|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 unclear, logical, professional, or organized information to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and punctuation).
Response to the 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.
The student does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. M.T.
Total posts: Participate in the discussion thread thrice for at least two 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 websites, or blogs should not be used, as anyone can add to them. 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.|
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