NRS 433V Nursing Practice Problems Holistic Needs HW

NRS 433V Nursing Practice Problems Holistic Needs HW

NRS 433V Nursing Practice Problems Holistic Needs HW

Read Chapter 1 in Nursing Research: Understanding Methods for Best Practice. URL: https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/nursing-research_understandingmethods-for-best-practice_1e.php Read “Exploring the Evidence. Focusing on the Fundamentals: A Simplistic Differentiation Between Qualitative and Quantitative Research,” by Rutberg and Bouikidis, from Nephrology Nursing Journal (2018). URL: https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=12910623 2&site=ehost-live&scope=site Read the strategies and tips located on “Searching Nursing Databases” on the GCU Library website to assist you in searching the main nursing and health sciences databases. View the associated tutorials as needed. URL: http://libguides.gcu.edu/c.php?g=330084&p=2846444 View the “Writing in APA” tutorial,” located in the Writing Center in the Student Success Center. URL: https://www.gcumedia.com/lms-resources/student-success-center/v3.1/#/mediaelement/CHSS;CONHCP/A42DF845-8D41-E811-8B03-005056BD8A06 View the “Library Walk Through Tutorial.” URL: https://tutorials.gcumedia.com/libraryWalkThrough/vp02.swf Read “EBP: Evidence Based Practice,” located in the Student Success Center. URL: https://lc.gcumedia.com/hlt540/ebp/v2.1/#/ Read “Adopting Evidence-Based Practice in Clinical Decision Making: Nurses’ Perceptions, Knowledge, and Barriers,” by Majid et al., from Journal of the Medical Library Association (2011). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3133901/ Read “Formulating a Researchable Question: A Criticle Step for Facilitating Good Clinical Research,” by Aslam and Emmanuel, from Indian Journal of Sexually Transmitted Diseases and AIDS (2010). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140151/ Read “To Make Your Case, Start with a PICOT Question,” by Echevarria and Walker, from Nursing 2014 (2014). URL: https://journals.lww.com/nursing/fulltext/2014/02000/To_make_your_case,_start_with_a_PICOT_question.7.aspx Read “Chapter 7: The Evidence for Evidence-Based Practice Implementation,” by Titler, from the online eBook, Patient Safety and Quality: An Evidence-Based Handbook for Nurses (2008), located on the National Center for Biotechnology Information (NCBI) website. URL: https://www.ncbi.nlm.nih.gov/books/NBK2659/ Reference the “APA Basics” information, located on the GCU Library website, to assist with the APA format and documentation of sources required for the assignment. URL: http://libguides.gcu.edu/CitingSources/APA#s-lg-box-19138654 Reference the “GCU Library Research Guides: Citing Sources” resource for information on how to cite sources properly. URL: http://libguides.gcu.edu/c.php?g=330092&p=2216210 1 Martha Shuemake 1 posts Re: Topic 1 DQ 1 The difference between a nursing practice problem and a medical practice problem is how the problem relates to the patient or population. NRS 433V Nursing Practice Problems Holistic Needs HW

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The medical problem looks at the illness, the injury or deficit that needs to be treated. The best treatment is then selected, for the problem, but maybe not so much for the patient. A nursing problem approach looks at the patient and how he is affected by the illness, injury or deficit. The best treatment for the patient also includes helping the patient live with the illness, injury or deficit. Both practices are needed. A medical practice problem would be x-raying, diagnosing and casting a broken foot. A nursing practice problem would include recognizing and helping the patient with the challenges that he will face with a broken foot: mobility, driving, help at home (Leng, 2013). Each type of practice problem includes how a healthcare provider typically “sees” the patient or problem, and each also includes competencies that are specific to that healthcare provider. A PICOT for nurses must be based on a nursing practice problem for the following reasons. She must be familiar with the problem or practice, what isn’t working and what might work in order to determine what might be best for the patient She must also be competent to carry out all the steps of the process or treatment. Nurses are on the front line of patient care and have the most direct contact. A PICOT based on a nursing practice problem would be most applicable and most successful. Reference: Leng M.D., S. (2013, May 13). The medical model versus the nursing model: A difference in philosophy. In www.kevinmd.com. Retrieved from https://www.kevinmd.com/blog/2013/05/medical-model-nursing-modeldifference-philosophy.html Reply | Quote & Reply 2 Linus Neba 1 posts Re: Topic 1 DQ 1 Medical problems deal with disease and is focused on physical and biologic aspect of disease conditions on a patient (Leng, 2013). It is illustrated with clinical pathology, pathophysiology, and treatment. We think of medical as Doctors and the way they think when working with patients. Doctors diagnosed and prescribe treatment for disease. An example of a medical problem will be misdiagnosing and prescribing a treatment for a wrong diagnosis. This misdiagnosing and treatment can course a serious health problem to the patient. A nursing practice deals with patient response on actual or potential health problem that affects patients. A nursing practice problem looks at the clinical judgement about an individual patient, family, and community in a holistic manner. To develop evidence base practice (EBP) nurse uses PICOT to obtain best practice approach (Grand Canyon University (Ed.), 2018). Nursing practice problems that can be minimize with use of PICOT include medication errors, stress, and lack of communication amongst nurses. PICOT is used to guide us to good clinical question and judgement in our everyday nursing practice. NRS 433V Nursing Practice Problems Holistic Needs HW

PICOT stands for: P Patient population I intervention of interest C comparison intervention O outcome T Time References Grand Canyon University (Ed). (2018). Nursing research: Understanding methods for best practice.Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1 Leng, S. (2013). The medical model versus the nursing model: A difference in philosophy. Retrieved from: https://www.kevinmd.com/blog/2013/05/medical-model-nursing-model-difference-philosophy.html 3 Elizabeth Rowland 1 posts Re: Topic 1 DQ 1 A nursing practice problem and medical practice problems are very different and should be differentiated. A nursing practice problem is associated with human responses to health problems and life processes (NANDA, n.d). Once the patient is diagnosed with a condition, it’s the nurse’s role to care for the patient in managing the disease, provide further prevention and/or provide treatment from the patient’s response to the condition. For example, a patient that is recovering from surgery and requires dressing changes. The nurse is concerned with the procedure involved for changing the dressing in a way that eliminates risk of infection. A medical practice problem is associated with the disease and medical condition itself (NANDA, n.d). Medical practice involves diagnostic tests in diagnosing the condition and/or plan of treatment needed. For example, if a patient is having slurred speech, it’s the physician who chooses the best tests and medication necessary to treat for possible CVA diagnosis. It’s important to ensure one’s PICOT question is based on a nursing problem to keep in one’s scope of practice that will allow the nurse to perform research and develop strong evidence on improved ways of providing patient care. This is now referred to as evidence- based practice and once established requires a multi-disciplinary team with an appropriate strategy to activate into policy change (Majid et al, 2011). Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y. L., Chang, Y. K., & Mokhtar, I. A. (2011). Adopting evidencebased practice in clinical decision making: nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association : JMLA, 99(3), 229–236. https://doi.org/10.3163/1536-5050.99.3.010 NANDA International, (n.d.). Retrieved from: https://kb.nanda.org/article/AA-00266/0/What-is-the-differencebetween-a-medical-diagnosis-and-a-nursing-diagnosis-.html 4 Francis Njinga Njinga 2 posts Re: Topic 1 DQ 1 A nursing problem is any problem noted during nursing assessments often from a condition or disease of a patient. It ranges from care needs of the patient from the moment they come into the healthcare facility, during the provider’s diagnosis, and to the assessment of patient’s needs after the care. The nursing problem assessment requires a comprehensive collection of data on the patient. A nursing problem deals with the human response to an actual or potential health problem. During our assessment we can notice that the patient has an impaired verbal communication, a shuffling gait, or a general weakness. Those are examples of nursing problems. A medical problem deals with a disease or medical condition.NRS 433V Nursing Practice Problems Holistic Needs HW

It is a concept that defines a disease process or injury. Only a licensed provider can determine what a medical practice problem is. If we go back to our previous example, the impaired verbal communication and other related physical issues the patient shows could be caused by a cerebrovascular attack, but only a doctor can make that call. PICOT is an acronym for the elements of the clinical question: patient population (P), intervention or issue of interest (I), comparison intervention or issue of interest (C), outcome(s) of interest (O), and time it takes for the intervention to achieve the outcome(s) (T). Using the PICOT format to structure the clinical question helps to clarify these components, which will guide the search for the evidence. A well-built PICOT question increases the likelihood that the nurse will find the best evidence to inform practice quickly and efficiently. References Mrayyan T. (2007). Nursing practice problems in private hospitals in Jordan: Students’ perspectives. Nurse education in practice (1471-5953), 7 (2), 82. Retrieved from http://xs6th8dt4r.search.serialssolutions.com.lopes.idm.oclc.org/?ID=doi:10.1016%2Fj.nepr.2006.04.007&genre=ar ticle&atitle=Nursing%20practice%20problems%20in%20private%20hospital American Journal of Nursing. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question A Key Step in Evidence-Based Practice. Retrieved from https://www.nursingcenter.com/journalarticle?Article_ID=982283&Journal_ID=54030&Issue_ID=982121 5 Jenna Raila 3 posts Re: Topic 1 DQ 1 A PICOT statement or question is a formula used to develop researchable and answerable questions. PICOT stands for Patients/problem, Intervention, Comparison, Outcome and Time. Nurses use PICOT when developing evidencebased practice. It’s important to use a nursing practice problem when developing a PICOT because it will help to develop evidence-based practice. “Clinical nurses routinely face scenarios in which they encounter more questions than answers: Questions about what works better, why things are done the way they are, or why unusual things happen. Engaging nurses to ask questions encourages ownership of their practice and empowers them to make positive changes in patient care.” (Echevarria & Walker, 2014). A nursing practice problem involves the human response to actual or potential health problems and life processes that affect people. A nursing practice problem looks at the clinical judgment about an individual patient, a family, or a community and how they respond to health problems that they are exposed to. A medical practice problem deals with the actual disease or medical condition and its process. An example of a medical practice problem is a patient that has a seizure disorder- how will we treat this disorder? What medications will be used? A nursing practice problem for a patient with a seizure disorder would be how will this affect their everyday life? Do they have a support system? Does their support system know what to do when the patient has a seizure? References: Echevarria, Ilia M. MS, MSN, RN, CCRN, CHES, NEA-BC; Walker, Susan DrNP, RN-BC To make your case, start with a PICOT question, Nursing2014: February 2014 -NRS 433V Nursing Practice Problems Holistic Needs HW

Volume 44 – Issue 2 – p 18-19 doi: 10.1097/01.NURSE.0000442594.00242.f9 6 Elizabeth Rowland 1 posts Re: Topic 1 DQ 2 A problem or dilemma I have seen in nursing involves nursing fatigue due to the long 12 hour shifts and workload. Shift work, especially night shift can disrupt circadian rhythms, cause sleep deprivation, increase fatigue, health problems and affect job performance which can lead to mistakes on the job (Yu, Somerville and King, n.d.). Chronic fatigue can interfere with one’s mental/physical health, cause weight gain, heart disease and memory loss (Yu, Somerville and King, n.d.). Research has shown that long work hours can increase stress levels, cause sleep deprivation and insufficient inter-shift recovery that can result in medication errors and affect clinical decision making (Yu, Somerville and King, n.d.). Additional research should be performed that can lead to a solution to this overwhelming problem to decrease the risk to the nurses themselves and the patients they care for. Yu, F., Somerville, D., & King, A. (n.d.). Exploring the impact of 12-hour shifts on nurse fatigue in intensive care units. APPLIED NURSING RESEARCH, 50. https://doi-org.lopes.idm.oclc.org/10.1016/j.apnr.2019.151191 Reply | Quote & Reply Objectives: 1. Examine the importance of nursing research in improving patient outcomes. 2. Identify critical elements of evidence-based practice. 3. Evaluate a clinical problem using the PICOT question. Class, I want to make sure you are aware of resources that should not be used in this week’s assignment. Systematic Reviews, Literature Reviews, and Metanalysis articles are useful resources and provide a strong level of evidence but are not considered primary research articles and should not be included in this week’s assignment. All studies should be current (within 5-10 years). Assignment: For this assignment, you will create a clinical guiding question, know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peerrevised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments. Use the “Literature Evaluation Table” to complete this assignment. (Attached) Also found in Topic 1 Study Materials. 1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue. (See the top of the literature table) 2. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. NRS 433V Nursing Practice Problems Holistic Needs HW

The PICOT question should apply to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study). (See the top of the literature table) 3. The PICOT question will provide a framework for your capstone project. 4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem. Make sure you include a working link to your article. I should not have to search for your article. Developing a PICOT Question/Statement Class, The components of PICOT include: (P) Population of Focus – Be specific regarding the particular clinical area where the clinical problem or issue arises from clinical care (I) Intervention – Independent nursing intervention (C) Comparison – Nursing intervention in patients not currently receiving the intervention in the (I) (O) Outcome – Be specific (T) Time – REQUIRED and should specify the timeframe needed to implement the change process. Identify each of the components in relation to your topic. Here is an example. P: acute care intensive care units I: hand hygiene with hand sanitizer C: hand hygiene with soap and water O: reduce hospital-associated Clostridium difficile infections T: over a two-month period (this is required) Then, develop a PICOT question/statement. In acute care intensive care units (P), does hand hygiene with hand sanitizer (I) NRS 433V Nursing Practice Problems Holistic Needs HW


 

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