This is a graded discussion: 50 points possible
Applying and Sharing Evidence to Practice Week 7 NR-439 RN-BSN CHAMBERLAIN, health and medicine homework help
- Choose one of the articles from the Week 5 RRL assignment, and discuss the findings. Would you apply the evidence found to your practice? Explain your answer.
- Translating research into practice is the final and most important step in the research process. Review information you found your nursing clinical issue and explain ways in which you would share the research-based evidence with your peers.
Dear Class,Applying and sharing evidence is important to our professional careers. I hope that you are starting to appreciate the world of nursing research. The importance of research to our profession cannot be underestimated.
This week we consider the conclusions and application of previous assignments. I look forward to reading your ideas to share research-based evidence.
Have a wonderful week!
Dr. TaulbeeDr. Taulbee and class,In the research article, Quantitative Balance and Gait Measurement in Patients with Frontotemporal Dementia and Alzheimer Diseases: A Pilot Study, regarding the balance and gait differences in patients with Dementia, specifically frontotemporal dementia and Alzheimer’s disease, the study conducted was to determine fall risks and prevention. Determining if subclinical differences could be established and how this could be applied to fall prevention training early on in the disease process (Velayutham, Chandra, Bharath & Shankar, 2017)
The findings were such that, in fact, there are differences. Using descriptive analysis, a t-test analysis was performed. A t-test is used to compare measurements and see whether they differ (Houser, 2015) As the neurodegenerative disorders, compared to normal aging process, it was concluded that frontotemporal dementia (FTD) has a uniform balance abnormality compared to mediolateral with Alzheimer’s disease (AD). FTD patients tend to lean forward, AD patients tilt backward, balance is inclusive of stride, step cycle and walking speed. Due to the area of the brain affected, FTD patients are at higher risk of falls due to gait, balance and sensory deficits. In conclusion, gait and stability training in this population might help future falls but a larger sample is needed in repeated tests.
The evidence found was helpful to understand the differences in the dementias and also to take note when ambulating someone and their tendencies. Applying the evidence found in this research is already in place. Fall prevention for everyone is a big deal. Fall risk bands, yellow skid proof socks and bed/chair alarms go on for everyone – even those sedate on ventilators.
Pertaining to my clinical issue of hourly rounds and falls, I would share my information with a trifold display for each unit, to start. Having information available regarding primary unmet needs of patients and the reasons they attempted independent activities and fell. I would include fall rates with prior guidelines compared to new, hourly rounds. Patient satisfaction stats would be displayed before and after and would expect an improvement there also. Costs related to surgery, treatments and increased LOS would be displayed with a facility celebration date, in which a slide show would run, thanking everyone for their efforts and success at keeping our patients safer!
Thanks, Sharon
Houser, J. (2015). Nursing research: Reading, using and creating evidence (3rd ed.). Denver, C.O.: Jones & Bartlett Publishers.
Velayutham, S. G., Chandra, S. R., Bharath, S., & Shankar, R. G. (2017). Quantitative balance and gait measurement in patients with frontotemporal dementia and Alzheimer diseases: A pilot study. Indian Journal Of Psychological Medicine, 39(2), 176-182. doi:10.4103/0253-7176.203132. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=122248443&site=eds-live&scope=site
Sharon,In your clinical issue of hourly rounding, this article/ research is almost perfect because both are related to patient falls. This may help clinicians understand which patients to keep a better eye on, and maybe do even more then hourly rounding on. These patients are already a high risk for falls but having information available to clinicians available about why they fall so frequently could be helpful. “The idea of sharing clinical experiences to improve patient care is not a new to nurses” (Peterson, Barnason, Donnelly, Hill, Miley, Riggs, & Whiteman, 2014). Great ideas!
Kim
References:
Peterson, M., Barnason, S., Donnelly, B., Hill, K., Riggs, L., and Whiteman, K., (2014). Choosing the Best Evidence to Guide Clinical Practice: Application of AACN Levels of Evidence. American Association of Critical Care Nurse. (vol. 34, No,2)
Dear Sharon and Class,I hope you are planning to share your research with the poster presentation. Explain a case study research design.
Thanks,
Dr. Taulbee
Dr. Taulbee and Class,
“Case study research excels at bringing us to an understanding of a complex issue or object and can extend experience or add strength to what is already known through previous research”(Soy, 2006). Frequently Case study designs are using a small number of subjects that are studied in depth. Qualitative and Quantitative measurements can be used. Results can often be helpful in generating hypothesis for future studies.
According to Houser (2016),”Case study designs are often the result of opportunity – that is, a unique or unusual case presents itself to the nurse, who takes advantage of the opportunity to conduct an in-depth study over time. Case study designs may also come about through careful consideration of the criteria that should be present in a subject to test a theory, evaluate an intervention, or appraise responses to a condition over time. Case study designs require commitment on the part of both researcher and subject because these designs are longitudinal, and the subject is followed for a lengthy time period.”(Houser 271).
References:
Houser, Janet. Nursing Research: Reading, Using and Creating Evidence, 4th Edition. Jones & Bartlett Learning, 20161214. VitalBook file.
Soy, Susan K. (1997). The case study as a research method. Unpublished paper, University of Texas at Austin. Retrieved from: https://www.ischool.utexas.edu/~ssoy/usesusers/l391d1b.htm
Dr.Taulbee and Class,According to Houser, a Case study is the thorough assessment of an individual case over time in its real-life environment, which may involve observation, interaction, or measurement of variables. Case Study designs are effective for answering questions about how individuals respond to treatment or react to health conditions. (Houser, 2018).
The first step in case study research is to establish the focus of the study by forming questions about the situation or problem to be studied and determining a purpose for the study. The research object in a case study is often a program, an entity, a person, or a group of people. The second step involves determining what approaches to use in selecting single or multiple real-life cases to examine in detail and which instruments and data gathering approaches to use. When using multiple cases, each case is treated as a single case. After determining the approach, the researcher gathers, evaluates and prepares the report.
Germaine
Reference
Houser, J. (2018). Nursing Research: Reading, Using and Creating Evidence, 4th Edition. [Bookshelf Online]. Retrieved from https://online.vitalsource.com/#/books/9781284138887
Sharon, excellent post and substantial overview of the selected article. Implementing evidence-based safety practices are difficult and need strategies that address the complexity of systems of care, individual practitioners, senior leadership and ultimately changing healthcare cultures to be evidence-base safety practice environment. “Evidence for nursing practice means that nurses are able to practice based on what they know, rather than what they think ” (Houser 2015, p. 321). Implementation of evidence based practice discusses that developing an action plan should be the first course of action. Aroh, Colella, Douglas, and Eddings (2015) argue that using evidence-based methods and performing ongoing research is only going to help our profession continue to excel within the health care arena. I will continue to consider the value of evidence and make sure I understand why I am doing what I am doing as a nursing professional.
Reference
Aroh, D., Colella, J., Douglas, C., & Eddings, A. (2015). An example of translating value-based purchasing into value-based care. Urologic Nursing, 35(2), 61-74. doi: 10.7257/053-816X.2015.35.2.61
Brown, S. J. (2013). Evidence-based nursing: The research-practice connection. Burlington, MA: Jones & Bartlett Learning.
Professor and Class,I chose the article, Making sense of a new technology in clinical practice: a qualitative study of patient and physician perspectives. The article was a study on how patients and physicians perceived the use of new technology in a clinical setting. For this study, the patients were tested for Cardiovascular Autonomic Neuropathy (CAN) using a new handheld device and then given the results of the test. In the study, the researchers found that communicating the results to the patients was difficult, especially in a way that they could easily understand (Pals, et al., 2015). This was a problem because it is more likely that a patient will understand the seriousness of their situation and take any suggestions on lifestyle change to heart if they can easily understand what their physician is telling them. Another finding was that some of the patients did not realize that they were given the CAN test. I would use the evidence found in my practice. I think the study was important in showing that while testing is important, it is just as valuable that the patient understands what they are being tested for and why the test results matter. To use this in my practice I would ensure that patients are always informed of exactly what they are being tested for, that they have a small rundown of the test being used, and then ensure that they are given results in easy terms and answer any questions they have about the results.
My PICOT was how education and screening for mothers post-delivery about postpartum depression resulted in the mothers seeking treatment for postpartum depression as opposed to those who did not receive the education or screening. The findings of the original article used for my PICOT were that education and screening did help with women understanding postpartum depression, but that there were many missed opportunities to educate the women (Farr, Denk, Dahms, & Dietz, 2014). I would present this evidence as a PowerPoint presentation to my peers. I believe a PowerPoint presentation would allow me to give my peers the information they need and then discuss how we could implement a better education and screening program in our facility. If I really wanted to drive the point home, I could include an interview with one or two mothers that sought treatment for postpartum depression because they recognized the symptoms due to their education and screening after giving birth.
Farr, S. L., Denk, C. E., Dahms, E. W., & Dietz, P. M. (2014). Evaluating Universal Education and Screening for Postpartum Depression Using Population-Based Data. Journal Of Women’s Health (15409996), 23(8), 657-663. doi:10.1089/jwh.2013.4586
Pals, R. S., Hansen, U. M., Johansen, C. B., Hansen, C. S., Jørgensen, M. E., Fleischer, J., & Willaing, I. (2015). Making sense of a new technology in clinical practice: a qualitative study of patient and physician perspectives. BMC Health Services Research, 15(1), 1-10. doi:10.1186/s12913-015-1071-1
Dear Kimberly and Class,Do you think that one research article will be enough to present a practice change to your peers?
Thanks,
Dr. Taulbee
Actually, no I don’t think one article is enough to present a practice change to my peers. While some practice changes do not require a whole overhaul of procedures, it is still important to provide enough evidence to support why you believe a change is necessary. In the previous module, we had to choose from a list of articles to read and critique. I found it interesting that one of the articles dealt with postpartum depression predictors (Katon, Russo, & Gavin, 2014). I actually believe that understanding and recognizing the predictors that may lead to postpartum depression are important as well. So, if I was presenting this practice change to my peers, I would definitely include information from this study as well. The predictors such as previous depression history, medical history, and sociodemographic factors would be perfect as part of the screening and part of the education for the women to understand how postpartum depression is not something they choose to have. But as far as answering the question, I believe if someone is to advocate for practice changes they will need to provide more evidence than a single article. Maybe a single article could gather interest in a subject.
Katon, W., Russo, J., & Gavin, A. (2014). Predictors of Postpartum Depression. Journal Of Women’s Health (15409996), 23(9), 753-759. doi:10.1089/jwh.2014.4824
Kimberly,
Nice post. The PPD article had a huge sample. Does a large sample make the result more accurate for the population?
Thanks,
Dr. Taulbee
Dr. Taulbee,
I think the size of the sample when concerning accuracy depends on the study According to Houser (2018), for a qualitative study, it is important to have a purposeful selection. A purposeful selection is one that includes the subjects that are most likely to inform the research question. So, for that, I don’t think the sample size will determine the accuracy as long as those in the sample are right for the study. But, a large sample can also represent a community and show the effects of an intervention on numerous different types of subjects. I really believe that the size of the sample and the importance of the size of the sample is going to be dependent on what the study is covering.
Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones & Bartlett.
Class,I personally do not think that one research article presentation would be enough to change practice. Evidenced-based practice is the use of current best practices. I feel that in order to change practice and to initiate a practice there would have to be an extensive amount of research that proves the research is indeed a best practice. One research article would not be able to convey all of the important components of research that would be needed and it definitely would not answer all of the questions that my peers would ask. The research would also have to be valid and reliable.
Thanks,
Tyangala
