Identification of Nursing Practice Problem Assignment

NUR 550 Evidence-Based Practice Project Proposal Identification of Nursing Practice Problem Assignment

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Identification of Nursing Practice Problem Assignment

Identification of Nursing Practice Problem Assignment

Part 1: Medication errors in nursing as a result of staffing shortage

The selected nursing issue for the evidence-based practice (EBP) project is medication errors in nursing that happen due to staffing shortage. Medication errors are a significant problem in healthcare sector, especially at this time when there is nursing shaortage and high nurse turnovers. With reduced number of nurses working in the healthcare sector, the susceptibility of patients to medication errors increases, particularly adverse drug events that can lead to death and prolonged stays in hospitals (Buerhaus et al., 2017). The project will focus on the effectiveness of implementation of health information technology compared to the conventional ways of medication management to mitigate medication errors in critically ill patients. The selection of critically ill patients as the population of interest emanates from their increased vulnerability to injuries that need high-risk medication and more use of intravenous infusions which rises the possibility of medication errors. Health information technology can play an essential role in enhancing efficiency of nurses to offer required care and reduce medication errors.

While errors are inevitable and lead to detrimental effects on patients, healthcare providers can leverage technological tools to reduce their likelihood through establishing appropriate measures. Health systems and providers can reduce the problem through organization-wide processes and not just through medication administration component alone (Trimble et al., 2017). Due to the increased demand on healthcare services that has resulted in provider shortage, health information technology can offer solutions to the issue. The EBP project will delve into the issue using evidence-based practice intervention and translational research to provide possible solutions to the health systems and practitioners like nurses.

Part II:

PICOT Question
P	Population	Critically ill patients
I	Intervention	Integration of health information technology in the medication administration process
C	Comparison	Use of conventional medication management process
O	Outcome	Reduction of medication errors
T	Timeframe	Duration of hospital stay
PICOT	Among the critically ill patients (P), does the integration of health information technology (I) compared to conventional methods in medication administration process (C), reduce medication error (O) during hospital stay (T)?
Problem Statement	Medication errors remain a critical health challenge which impacts not just the nursing staff but also patients under their care. Medication errors sometimes do not cause harm. However, in most instances, they can be devastating to the nurses and harmful to patients. Nurses play a critical roel in protection of patients against mistakes and errors in the medication administration as they are exclusively responsible for administration, dispensation and monitoring of medications to patients (Trimble et al., 2017). While the healthcare struggles with increased nurse shortage due to high turnover, providers can leverage health information technology to reduce these adverse events and enhance protection of patients under their care. In their study, Alotaibi et al. (2017) assert that health information technology (HIT) offers numerous chances for enhancing and transforming healthcafe that include reduction of human errors, facilitating effective coordination and improving practice efficiencies. Therefore, through levarging on health information technologies like barcode scanning, electronic medication administration record (eMAR) and patient data management systems, electronic incident reporting and E-prescribing among other interventions, health organizations and providers can reduce medication errors and enhance patient safety despite having nurse staffing shortage. The implication is that these technologies reduce the possibility of errors that are mainly human mistakes by providers during the medication administration process.

 

References

Alotaibi, Y. K. & Federico, F. (2017). The impact of health information technology on patient safety. Saudi

            Medical Journal, 38(12):1173-1180. doi: 10.15537/smj.2017.12.20631

Buerhaus, P., Skinner, L., Aurhach, D. & Staiger, D. (2017). Four challenges facing the nursing workforce in

the United States. Journal of Nursing Regulation, 8(2), 40-46. DOI:10.1016/S2155-8256(17)30097-2

Trimble, A. N., Bishop, B., & Rampe, N. (2017). Medication errors associated with transition from insulin pens

to insulin vials. American Journal of Health-System Pharmacy, 74(2), 70-75. doi:10.2146/ajhp150726

Learners will select a valid nursing practice problem for an evidence-based practice project proposal. The project will be completed in sections, beginning in NUR-550 and culminating in a final written paper detailing the evidence-based practice proposal in NUR-590.

The purpose of this assignment is to select a relevant nursing practice problem for your evidence-based practice project proposal. To identify a relevant problem, consider problems generally faced in nursing practice (coordination of health care, assessment, education, patient support, trauma prevention, recovery, health screenings, etc.).  Use the “PICOT Draft” template to complete this assignment.

Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT on NUR 550 Evidence-Based Practice Project Proposal Identification of Nursing Practice Problem Assignment

Use a national, state or local population health care database to research indicators of disparity. Choose a mortality/morbidity indicator to identify a clinical problem or issue that you want to explore pertaining to a population of focus. Use this indicator to begin to formulate a PICOT statement.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments. NUR 550 Evidence-Based Practice Project Proposal Identification of Nursing Practice Problem Assignment

You are required to cite one peer-reviewed source to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. Identification of Nursing Practice Problem Assignment

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.
AttachmentsNUR-550-RS1-EBP-PICOT Draft.docx

NUR 550 Evidence-Based Practice Project Proposal Identification of Nursing Practice Problem Assignment

Topic 1 DQ 1

Identify the different levels of translational research. Explain how translational research is different from evidence-based practice and discuss application to population health management.

Re: Topic 1 DQ 1

As nurses, we all have heard about evidence-based practice and Florence Nightingale. Although back then, the term evidence-based practice was not a common phrase, that is exactly what Florence Nightingale was doing back then. She would examine and experiment with the sanitary conditions of the facilities and look at how it affected the patient’s outcomes (Mackey & Bassendowski, 2017). Translational research is more of a newer terminology. Although it can be confused with evidence-based practice, there is a key distinction. Evidence-based practice is the act of applying the evidence into everyday practice, whereas translational research is more the act of conducting the studies to find the best evidence (Titler, 2018). Identification of Nursing Practice Problem Assignment

There are strict guidelines when conducting translational research or what many of us know as clinical trials. There is phase process where in order to progress to the next phase of clinical trials, they must meet certain criteria. New drugs must undergo in vitro preclinical trials where they are testing it in a laboratory setting instead of human trials. Then they can proceed to in vivo studies where they are studying it in animals and small sample size of human trials (Eske, 2020). Once it has proven to be safe, then they can progress to a phase two or three trial increasing the sample size and comparing it to common treatments or sometimes placebos. Once it has shown safety and efficacy in a phase two or three trial, it can then go for Food and Drug Administration (FDA) approval. There are also phase four and five trials that help with translating the evidence into practice and community settings (Titler, 2018).

In my specialty area of oncology, we are constantly hearing about clinical trials and new therapies coming to market. It is critical to have a good understanding of what each phase of the trial consists of and what the outcomes really mean to the patient.References

Eske, J. (2020, August 31). In vivo vs. in vitro: What is the difference? Medical News Today. Retrieved June 17, 2021, from https://www.medicalnewstoday.com/articles/in-vivo-vs-in-vitro

Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51–55. https://doi.org/10.1016/j.profnurs.2016.05.009

Titler, M. G. (2018). Translation Research in Practice: An Introduction. Online Journal of Issues in Nursing, 23(2). https://doi.org/10.3912/OJIN.Vol23No02Man01

Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Evidence-Based Practice Project Proposal: Identification of Nursing Practice Problem 10.0

Re: Topic 1 DQ 1
Melnyk and Fineout-Overholt (2019) state translational research is often confused with evidence-based practice (EBP). The EBP process involves a critical appraisal of multiple bodies of evidence to make recommendations about patient care. EBP takes clinician expertise and combines it with multiple studies, patient/family preferences and values, to enhance health care quality, improve patient outcomes, reduce costs, and empower clinicians. Translational research, in comparison, studies how EBP interventions translate into real-world clinical settings. Also known as implementation science, translation science focuses on testing implementation interventions to improve the use of evidence to improve patient outcomes and population health (Titler, 2018). It also clarifies what implementation strategies work for whom, in what settings, and why. EBP is the actual application of evidence into practice, or the “doing of” where translational science is research steps to take discoveries “from the bench to the bedside and back again” (Fort et al., 2017). Identification of Nursing Practice Problem Assignment

Although the concept of translational research has been widely used and applied in the scientific literature for more than a decade, and there is little agreement between definitions, five phases (T0-T4) remain as an emerging consensus (Fort et al., 2017).

There are five phases of translational research, including preclinical and animal studies, proof of concept/phase one clinical trials, phase two and three clinical trials, phase four clinical trials and clinical outcomes research, and phase five population-level outcomes research (Titler, 2018). During the preclinical phase basic scientific research is performed. During phase one trials efficacy and safety of the intervention are assessed with a small group of humans. During phase two and three clinical trials efficacy and safety of the intervention are tested with a larger group of humans and is compared to common treatments. In phase four clinical trials translation to practice is examined. In phase five research translation to community is examined.

Translation research is the conduction of research that tests the implementation of interventions with the goal of increasing the uptake and use of evidence to improve patient outcomes and population health (Titler, 2018). Translational research provides a scientific base from which the best implementation strategies can then be selected to promote implementation of evidence-based practice. In contrast, evidence-based practice is the application of a synthesized body of research to guide clinical practice policies and guidelines.

Regarding population health management, the lack of application of evidence-based practice recommendations has been linked to poor health outcomes, thus harming overall population health (Titler, 2018). Since translation research helps healthcare staff to choose the correct implementation strategies based on the staff and setting being impacted along with the reason for the implementation, this increases the likelihood that the implementation will be successful. More evidence-based science driven protocols, policies, and guidelines help to improve patient outcomes and subsequently, population health.

5 Phases of Translational Research

T1 involves processes that bring ideas from basic research through early testing in humans.
T2 involves the establishment of the effectiveness of an intervention in humans and particularly the establishment of clinical guidelines
T3 primarily focuses on the implementation and dissemination of research
T4 focuses on outcomes and effectiveness in populations
T0 phase is relatively rare but involves steps to close the research cycle, wrapping back around to basic research to T1
One reason governments fund research is for the value it provides to society at large (Luke et al., 2017). Benefits to translational research cover four domains: clinical and medical, community and public health, economic benefits, and policy/legislative.

Community and Public Health Specific Benefits

Health Promotion
Disease prevention/reduction
Life expectancy/quality of life
Characteristics of Health Care
Accessibility
Delivery
Quality
Health Activities and Products
Education resources
Community health services
Resources

Fort, D. G., Herr, T. M., Shaw, P. L., Gutzman, K. E., & Starren, J. B. (2017). Mapping the evolving definitions of translational research. Journal of Clinical and Translational Science, 1(1), 60–66. https://doi.org/10.1017/cts.2016.10

Luke, D. A., Sarli, C. C., Suiter, A. M., Carothers, B. J., Combs, T. B., Allen, J. L., Beers, C. E., & Evanoff, B. A. (2017). The translational science benefits model: A new framework for assessing the health and societal benefits of clinical and translational sciences. Clinical and Translational Science, 11(1), 77–84. https://doi.org/10.1111/cts.12495

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: a guide to best practice. Wolters Kluwer.

Titler, M. G. (2018). Translation Research in Practice: An Introduction. Online Journal of Issues in Nursing, 23(2), 1. https://doi.org/10.3912/OJIN.Vol23No02Man01

PICOT Draft

Name_____________________________________
Part 1: Propose a relevant nursing practice problem for an evidence-based practice project. Explain why you selected this topic and how it is relevant to advance nursing practice. Include one research article that demonstrates support for the nursing practice problem.
To provide optimal health care, nurses should work without being overwhelmed and always ready to serve all populations. However, the number of patients visiting health care facilities because of obesity and related complications has surged in the last decade. Some of the most at-risk population segments are school-age children and adolescents. My nursing practice problem for an evidence-based practice project is obesity among school-age children. Robinson et al. (2017) found that vulnerability to obesity has increased among children due to unhealthy lifestyles associated with sedentary living, such as watching television and gaming for a long time. I selected this topic since obesity is among the health care issues increasing mortality and morbidity rates in children as its prevalence increases. Being at risk of obesity implies that school-age children will be more exposed to chronic illnesses, such as heart disease and diabetes, and reduced quality of life (Che et al., 2018; De Lorenzo et al., 2019). Such adverse health outcomes increase illness burden in health care organizations, families, and society and increase nurses’ workload. In response, nurses should explore health care issues affecting population health and directly impacting their work and provide evidence-based interventions. I found the article by Stiglic and Viner (2019) to be relevant to the issue and directly supporting the nursing practice problem. Stiglic and Viner (2019) confirmed that obesity hampers children’s well-being, and interventions such as reducing screen time effectively reduce obesity rates. To improve health outcomes, nurses can also help patients and families to understand the risks of obesity and educate them on the recommended amount of screen time for children while encouraging parents to regulate the time that children spend on the screens.
Part II: In the table below, describe the population and the intervention. (You will continue drafting the PICOT, completing the shaded areas in Topic 3.)
PICOT Question
P Population School-age children with obesity
Obesity among school-age children has reached epidemic levels in the United States. De Lorenzo et al. (2019) described obesity as significant public health concern since it affects the physical, psychological, and cardiovascular health of the affected populations. Data from 2015-2016 shows that 1 in 5 children in the United States aged 6 to 19 years has obesity, and the rate has tripled since the 1970s (Centers for Disease Control and Prevention, 2018). Risk factors include poor eating habits, lack of physical activity, genetics, and negative childhood events. Therefore, immediate, evidence-based, and population-driven interventions are necessary to reduce the surging rates.
I Intervention Reducing screen time
Increased screen time is among the unhealthy lifestyles reducing the level of physical activity among school-age children. According to Robinson et al. (2017), screen media exposure increases obesity levels by encouraging more eating while viewing, reducing sleep duration, and increasing the possibility of taking sugary and low-nutrient foods. In addition, more screen time also exposes children to marketing that influences their eating habits and preferences. As a result, reducing screen time is a perfect intervention to keep children from these dangers to reduce obesity incidence.

Population 25.0% The population is not described. The description for the population is incomplete, or the information for the population is inaccurate. A summary of the population is presented. More information is needed. Revision is required. The population is described. Minor detail is needed for clarity or accuracy. Minor revision is needed. The population is thoroughly and accurately described. No revision is needed.

Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Good (92.00%) Excellent (100.00%)
Content 100.0%
Nursing Practice Problem (relevant to nursing practice, appropriate for an evidence-based practice project proposal, supported by current research) 35.0% A problem was not submitted. A proposed problem is presented but is not relevant to nursing practice. The nursing practice problem lacks support from current research. A new nursing practice problem must be selected. A relevant nursing practice problem for an EBP project proposal is presented and is generally supported by a current research article. Some information or revision is required. The explanation for why the topic is selected and its relevance to advance nursing practice is somewhat unclear. The nursing practice problem is conditionally approved; final approval is contingent upon revision. A relevant nursing practice problem for an EBP project proposal is presented and is adequately supported by a current research article. Minor revision is needed for the nursing practice problem. An explanation for why the topic is selected and its relevance to advance nursing practice is presented. The nursing practice problem is conditionally approved; final approval is contingent upon revision. The proposed problem is highly relevant to nursing practice, strongly supported by a current research article, and excellent for an evidence-based practice project. A clear explanation for why the topic is selected and relevant to advance nursing practice is presented. The nursing practice problem is approved. No revision is needed.

Intervention 25.0% The proposed intervention is not described. The proposed intervention is incomplete, or the proposed intervention is not relevant to the population or problem. The proposed intervention is generally described and adequate to the nursing practice problem and the population. More information needed. Revision is required. The proposed intervention is described and adequate to the nursing practice problem and the population. Minor detail is needed for clarity. Minor revision is needed. The proposed intervention is clearly described and relevant to the nursing practice problem and the population. No revision is needed.

Required Sources 5.0% Sources are not included. Number of required sources is only partially met. Number of required sources is met, but sources are outdated or inappropriate. Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.

Mechanics of Writing (includes spelling, punctuation, grammar, and language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. The writer is clearly in command of standard, written, academic English.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. “The writer is clearly in command of standard, written, academic English.
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.”

Topic 1 DQ 1

Identify the different levels of translational research. Explain how translational research is different from evidence-based practice and discuss application to population health management.

Re: Topic 1 DQ 1

In my experience as a nurse, the terms “evidence-based practice” (EBP) and “research” are frequently spoken. However, the idea of “translational research” is something that I have only recently become aware of. People frequently confuse translational research with evidence-based practice (EBP). However, translational research refers to the investigation of EBP studies, as well as the study of EBP treatments and their translation into practice (Melnyk & Fineout-Overholt, 2019) Evidence-based practice is a guide to practice, and translation science is the translation to incorporate the findings of evidence-based research into clinical settings. Translational research is exactly what it sounds like: it translates how EBP “translates” into clinical settings. (Tilter, 2018). The implementation of different components of translational research, such as preclinical studies, phase one small clinical trials, phases 2 and 3 larger