In this task, you will identify a healthcare problem and develop a PICO question that can be answered using evidence. You will identify a single intervention and then search for five research articles and two non-research articles that support that change practice.
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
A. Write a summary of the significance and background of a healthcare problem by doing the following:
1. Describe a healthcare problem that can be used to develop a PICO question. Evidenced Based Practice and Applied Nursing Research Paper & Matrix
Note: You may use the same topic and the same research articles that were used in Task 1 provided they support the proposed intervention. Or you may choose a different topic and select articles focusing on one of the following topics: falls and fall prevention, pain management in children, opioid abuse, hepatitis C, catheter-associated urinary tract infections, and hand hygiene and infections in hospitals.
2. Explain the significance of the problem from part A1.
3. Describe the current healthcare practices related to the problem from part A1.
4. Discuss how the problem affects the organization and patients’ cultural background (i.e., values, health behavior, and preferences).
B. Complete a literature review by searching for a total of seven articles consisting of five research articles and two non-research articles related to the healthcare problem from part A1, and describe the search strategy you used to conduct the literature review by doing the following:
1. Discuss two research evidence sources and two nonresearch evidence sources that you considered.
Note: Please do not use the same primary author for more than two articles. Articles must not be more than five years old.
C. Use your research articles to develop a PICO (patient/population, intervention/indicator, comparison/control, and outcome) question based on the topic.
D. Complete the attached “Evidence Matrix,” using the five research evidence sources from scholarly journal sources you located during the literature review in part B. For each article, address the following points:
Note: You may submit your completed matrix as a separate attachment to the task, or you may include the matrix within your paper, aligned to APA formatting standards.
Note: Upload a copy of the full text of the articles with your submission.
- author, journal name, and year of publication
- research design (e.g., quantitative, qualitative, mixed design, systematic review)
- sample size (e.g., numbers of study participants, number of articles, number of control group participants)
- outcome variables measured (e.g., identify what the research is measuring)
- quality (using the following scale: A, B, C)
- results/author’s conclusions (e.g., briefly summarize the outcome) Evidenced Based Practice and Applied Nursing Research Paper & Matrix
E. Recommend a practice change that addresses the PICO question, using the evidence collected in the attached “Evidence Matrix.” You must use all five research articles from the “Evidence Matrix” attachment to support this recommendation via in-text citations.
F. Describe a process for implementing the practice change from part E in which you do the following:
1. Explain how you would involve three key stakeholders in the decision to implement the recommendation from part E.
2. Describe two specific barriers you may encounter when implementing the practice change from part E in the nursing practice setting.
3. Identify two strategies that could be used to overcome the barriers described in part F2.
4. Identify one indicator to measure the outcome (the O in PICO question) of the recommended change practice from part E.
Evidence Based Practice and Applied Nursing Research
Task 1: Quantitative Analysis
“A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners. Medical Teacher.”
Recently there has been an increase in the prevalence of stress and extreme burnout for practitioners in the medical field. The most affected parties are medical intern practitioners. In most cases, extreme stress results in many problems for the interns; this significantly affects their ability to operate efficiently. Therefore, it is vital to apply the necessary precautions in the training of the medical interns to minimize the causes of stress. Reducing stress is essential in ensuring the medical practitioners provide high quality services and be able to meet their patient’s needs promptly (Ireland et al., 2017). The increased exposure to more stressors for doctors in comparison to the general population creates many challenges. We cannot undermine the role played by doctors in promoting health in society. Therefore, it is advisable to analyze the causes of stress and attempt to provide viable solutions to eradicate and control the stressors and other aspects that lead to burnout. Evidenced Based Practice and Applied Nursing Research Paper & Matrix
In supporting the proof provided on the existence of stress for the doctors, the study conducted an extensive analysis of existing literature in an attempt to shed more light on the issue. The report showed that t stress facing doctors results in problems for the doctors and their families due to the strained interactions. Due to the stress, the doctors are unable to serve their patients in the best way possible. The stress also results in strained relationships between the doctors and their families and friends (Ireland et al., 2017). The analysis also indicated that doctors are more likely to suffer from occupational stress due to the harsh nature of their work. The demand to work for long hours has been connected to the depletion in energy levels, which consequently results in burnouts. The challenges of trying to establish a balance between the tight work schedules and the need to attend to family duties is linked to the increasing stress amongst many medical practitioners.
Ireland et al., (2017), some studies suggested that approximately 75% of intern doctors in the United States are reported to have experienced burnout. The practitioners working in the frontline of providing medical care to patients experienced more burnout. Practices such as emergency medicine, family medicine, and general internal medicine proved to be the most demanding, the doctors working in the departments experienced more stress and burnout. The interventions adopted in addressing the stress issue proved to be inefficient in solving the problem (Ireland et al., 2017). Most of the techniques used in treating the burnout and stress issues failed to examine the effects of the problem. Other strategies that focused on increasing concentration for the doctors were considered to be effective in addressing stress and burnout issues among the doctors.
The research model was quantitative. Data was collected from 44 intern doctors working in Australia in the emergency department. In data collection, the intern doctors were subjected to a 10-week training intervention that sought to establish the efficiency of the method in controlling stress (Ireland et al., 2017). Through the study, various measures were taken in an attempt to the pre and post interventions applied in solving the stress and burnout issue.
Following the research, the data collected was analyzed using different techniques. The analysis indicated that there was internal consistency in the levels of stress and burnout for the students. Through descriptive statistics, the study managed to establish different focal DVs in different timings (Ireland et al., 2017). The interactions involved managed to develop the efficiency of the treatment methods used. Through the study, it was determined that the levels of stress and burnout decreased for participants in the control condition. Stress ad burnout conditions decreased for the participants outside in the intervention condition. Evidenced Based Practice and Applied Nursing Research Paper & Matrix
Through the introduction, the study provided an extensive background on the stress and burnout issues for medical practitioners. The literature review managed to evaluate existing studies and establish gaps that past researchers failed to address in their research (Ireland et al., 2017). The outcomes of the study were supported by the outline provided in the methodology. Based on the results, it was discovered that mindfulness training played a crucial role in reducing stress and burnout for medical interns. The findings gathered showed consistency with past research.
Protection of Human Subjects
The study has taken appropriate measures to protect the individuals involved in the study. The study does not reveal the names of the participants. Also, the study made secured the consent of the participants before enrolling them for the research (Ireland et al., 2017). In summary, the study has done enough to protect the population involved in the analysis.
Strengths and Limitations of the Study
The study manages to establish the efficiency of the mindfulness training in addressing stress and burnout for medical interns. Besides, the research shows the ease of applying the mindfulness solution in treating the stress (Ireland et al., 2017). The study increases the knowledge available on treatment. The study has several limitations; the sample used is small, which compromises the integrity of results. The solution proposed may not be suitable for all professionals.
Role of the Evidence to Nursing Practice
The data provided through the study would be instrumental in addressing various practitioners in nursing. Through the analysis, we get a better understanding of stress and burnout experienced by all medical practitioners. Also, the evidence provided by the research will be essential in addressing some issues facing nursing practitioners.
Task 2: Qualitative Analysis
“Inpatient fall prevention from the patient’s perspective: A qualitative study. Applied Nursing Research.”
Falls of the patients are among the most dangerous happenings in hospitals that can result in many problems for the patients. In most cases, the occurrence of falls increased the patient’s stay in the hospitals. The patients are also forced to incur additional healthcare costs to cater for the treatment of injuries that may have been acquired from the falls (Radecki, Reynolds & Kara, 2018). In some extreme cases, the falls may result in permanent disabilities and even death of the patients. It is, therefore, essential to put the necessary measures to prevent the occurrence of falls in the first place. In getting a better understanding of the falls, it is vital to collect the views of patients.
In developing the study, the researcher consulted past research, which created information on the subject. In many hospitals, it has been reported that falls are the most common events affecting the patients. Past data shows that approximately 1 million patients fall during hospitalization annually (Radecki, Reynolds & Kara, 2018). More than half of the reported falls result in numerous injuries for the patients. This slows down their recovery process. In some instances, the patients experience more complications, which prolongs their stay in the hospitals. It is, therefore, essential for medical practitioners to put more emphasis on mechanisms that can be adopted to minimize the increasing number of falls in the hospitals. Failure to mitigate against the fall will result in many adverse effects for both the patients and the hospitals.
Preventing falls in patients is very complicated. Due to the complexity, there is a need to apply many approaches to prevent falls. The convergence of both the evidence-based practices, patient’s values, and clinical judgment will be essential in minimizing the falls (Radecki, Reynolds & Kara, 2018). Therefore, in enhancing the efficiency of reducing falls by patients, there is a need for the patients to work closely with their nurses and other medical practitioners. The opinions of the patients must be considered before adopting any specific approach that can be used in minimizing the falls. In most cases, the patients have a better understanding of the events that contribute to falls in comparison to the nurses. There is also a need to investigate various interventions that can be used to decrease the number of falls (Radecki, Reynolds & Kara, 2018). Past research has established that the presence of close communication between the patients and the nurses is instrumental in reducing patient falls. Based on earlier studies, there has been minimal research on the barriers that prevent the successful prevention of falls (Radecki, Reynolds & Kara, 2018). Therefore, it is essential to ensure that patients participate in fall prevention.
The study used various qualitative techniques to gather data. In an attempt to understand the patient’s views on the factors that lead to falls, the research made questions that would be answered by the patients (Radecki, Reynolds & Kara, 2018). The researcher organized interviews with twelve different patients. The patients were victims of falls in the past.
After the interviews, the researchers analyzed all the responses from the patients involved in the study. In the analysis, some of the questions used required simple answers such as yes or no, while others required the patients to offer brief descriptions (Radecki, Reynolds & Kara, 2018). The patients gave their opinions on the interventions made by the hospitals in preventing falls. The patients also described their exposure to falling risks. The data also indicated some of the barriers, making it impossible for the patients to engage in fall prevention activities.
Through the analysis, the research establishes the perspectives of the patients in preventing falls during their stay in health facilities. In the introduction, we get an exclusive overview of the study’s objectives and aims. The literature review provides insights into past studies on falls of patients. The report also highlights various gaps that provide openings for further research (Radecki, Reynolds & Kara, 2018). Through the study, it was discovered that there is a need to change the fall prevention techniques to ensure they are more patient-centric. The data analysis provides an articulate procedure that was adopted in evaluating the responses from the patients. The approaches used in data collection and analysis are in line with the required outcomes from the study. Evidenced Based Practice and Applied Nursing Research Paper & Matrix
Protection of Human Subjects
The study ensures that the specific details of the participants remain confidential. Besides, the research meets the ethical standards by ensuring they ask the appropriate questions. The study also ensures that the participation of the patients in the study is voluntary (Radecki, Reynolds & Kara, 2018).
Strengths and Limitations of the Study
The study manages to collect primary data directly from the patients, which is instrumental in enhancing the credibility of the research. The questions used are also structured in a way that eliminates bias from both the researcher and the respondents (Radecki, Reynolds & Kara, 2018). The limitation of the study is that it involves a small population that might impact the outcomes.
Role of the Evidence in Nursing Practice
The evidence provided in the study is vital in guiding nursing practitioners on how to manage and minimize falls. The study also provides nurses with the opportunity of exploring additional interventions on how to reduce falls.
Ireland, M., Clough, B., Gill, K., Langan, F., O’Connor, A., & Spencer, L. (2017). A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners. Medical Teacher, 39(4), 409-414. Doi: 10.1080/0142159x.2017.1294749
Radecki, B., Reynolds, S., & Kara, A. (2018). Inpatient fall prevention from the patient’s perspective: A qualitative study. Applied Nursing Research, 43, 114-119. Doi: 10.1016/j.apnr.2018.08.001. Evidenced Based Practice and Applied Nursing Research Paper & Matrix