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

A Sample Answer For the Assignment: 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)

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.

References

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, port[1]folios, 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.

References-

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.