STARTING THE RESEARCH PROCESS NURS 8201
STARTING THE RESEARCH PROCESS NURS 8201
STARTING THE RESEARCH PROCESS NURS 8201
Research problem statement:
The efficacy and safety of pairing spontaneous awakening trial and breathing trials as successful weaning modes within the ICU setting.
Working in the critical care setting for about two years now, I can clearly imagine how it feels to be in the shoes of family members who are watching or taking care of their critically ill families; ones that are mechanically ventilated, sedated, and on vasoactive medications. Whenever, I start my shift as an ICU nurse, I always make it a habit to plan how I am going to achieve my patient care goals; which is how to accomplish the most care within a 12 hour shift. Since most of the patients that are admitted in the ICU are critically ill that requires them to be intubated and sedated, I try my best as a nurse to ease their discomfort by promoting plans of care that would help decrease their days of being intubated and sedated. I plan to accomplish these goals through working alongside with other interdisciplinary healthcare team members that play a role in the patient’s daily care.
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Moving forward, my colleagues and I who have been working in the ICU for a significant amount of time should be comfortable in handling mechanically intubated and provide plan of care in decreasing the patient length of stay and length of intubation. In the past few months, we are slowly hiring new nurses from different units that want to take up the challenge of becoming an ICU nurse. With this in mind, our nursing educator has brought it to the attention of the nursing management that the new nurses must be comfortable assessing the parameters that verify that a patient is ready to be extubated. This week, our nursing educator has set up educational information about the importance of pairing up spontaneous breathing trials (SBT) with spontaneous awakening trials (SAT) among ventilated patients in the ICU.
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One of the most recent research EBP measures that our nurse education has presented to us is to learn the importance of incorporating spontaneous breathing trails partnered up interruption of sedation holidays. The rationale behind this to prevent ventilation assisted pneumonia development, which would further increase their length of stay as well as morbidity and mortality rates. According to AHRQ (2017), SATs and SBTs are associated with reduced length of mechanical ventilations, thereby reducing the ventilator assisted pneumonia, resulting in faster extubating time and earlier discharge date. Protocols for weaning from sedation and ventilation should be done in a timely manner to optimize outcomes.
The ICU setting is driven by sedation and analgesia as most patients experience pain and stress within their stay. It is also required to ease the discomfort and adaptation of mechanical ventilation. According to Shinotsuka (2013), prolonged sedation with intubation increases delirium rates, longer ICU stays, and increased mortality rate (p.186). Because of this, the evidence practice gap must be addressed because analgesia based goal is commonly a nurse driven protocol; therefore, educational efforts must be addressed to everyone working in the ICU.
With the current situation of the Covid-19 pandemic, healthcare personnel are now becoming more resilient and accepting to new protocols and education towards combating this new pandemic as well as teaching the community. As the burden of critical care services and its down streaming effects of sedation strategies, according to the Massachusetts General Hospital (2020), targeting less sedation overall is associated with improved outcomes in the critically ill mechanically vented patients including morality and overall stays in the ICU. These principles also apply with the management of Covid-19. Also, with the significant rise in the number of patients suffering from Covid-19 and medication shortages; sedation and analgesia should be saved for supporting care among critically ill patients who are reaching moderate to severe acute respiratory distress syndrome to facilitate comfort and ventilator tolerance. Therefore, research of current literature must be implemented in the ICU educational setting determining the risk of sedation balanced with need for lung protection. As a result, daily evaluation of sedation use should be visited among interdisciplinary healthcare teams and pay careful attention to pain and prevention of ICU delirium.
Reference(s):
AHRQ (2017). Spontaneous awakening trials and spontaneous breathing trial literature review.
AHRQ Safety Program for Mechanically Ventilated Patient Article.16 (17). 18-19. Retrieved from https://www.ahrq.gov/hai/tools/mvp/modules/technical/sat-sbt-lit-review.html
Massachusetts General Hospital (2020). Update in sedation and analgesia management in Covid-
19 ARDS. The General Hospital Article.. Retrieved from https://advances.massgeneral.org/pulmonary/article.aspx?id=1393
Shinotsuka, C. (2013). Implementing sedation protocols: Closing the evidence-practice gap.
Scielo Journal. 25(3). 186-187. Retrieved from https://www.scielo.br/j/rbti/a/hrpnjPwKdvz6kMQ966J5zVD/?lang=en&format=pdf
This is an informative discussion on the issues faced by the LGBTQ community in accessing quality health care services. I have learned from your post that the LGBTQ has poor mental health outcomes due to alcohol and drug abuse, a high noncompliance rate, mental illnesses, and poor continuity of care visits. Fear of mistreatment, bias, and stigma can significantly affect an individual’s health-seeking behaviors, which is why the LGBTQ community has poor healthcare outcomes (Hafeez et al., 2017). The problem is further worsened by having inadequate health professionals, who are well-versed with interventions that can improve the population’s access to health care. Hafeez et al. (2017) explain that stigma and implicit biases can adversely affect the quality of care provided to the LGBTQ community resulting in poor health outcomes compared to the general population.
Your identified problem has a professional significance since health providers need to be well-versed with the health disparities faced by the LGBTQ community. Understanding the disparities can help eliminate them and increase their access to health care (Fadus, 2019). I agree with you that the LGBTQ community is increasing, and competent care is needed to improve compliance and reduce healthcare disparities that they have faced over the years. The problem is also significant to society since identifying and eliminating healthcare disparities will encourage more individuals from the LGBTQ community to seek healthcare (Fadus, 2019). Besides, providing competent care will reduce the social stigma faced by this community and ultimately improve their mental health outcomes. The problem of health disparities in the LGBTQ community has the potential to build EBP by identifying evidence on strategies used to eliminate these disparities and translating the evidence to clinical practice.
References
Hafeez, H., Zeshan, M., Tahir, M. A., Jahan, N., & Naveed, S. (2017). Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review. Cureus, 9(4), e1184. https://doi.org/10.7759/cureus.1184
Fadus, M. (2019). Mental health disparities and medical student education: teaching in psychiatry for LGBTQ care, communication, and advocacy. Academic Psychiatry, 43(3), 306-310. https://doi.org/10.1007/s40596-019-01024-y
You are a pediatric nurse working with a facility to increase awareness and understanding concerning childhood immunizations. You notice there is a lack of understanding from parents about the benefit of these immunizations, and you begin to consider how you might research ways to improve immunization rates. You develop a research problem statement and begin to examine the research purpose for possible solutions.
As outlined in the scenario, a research problem statement identifies an area of need in which there is a gap in knowledge or practice, and interest by a nurse researcher. Either from a hypothetical or real-world experience, nursing research problem statements help to focus the research purpose and guide the study of the problem.
Photo Credit: [kaan tanman]/[E+]/Getty Images
For this Discussion, you will develop your own research problem statement on a topic of interest to you. Reflect on your personal and academic experiences to consider which research problem you might address.
To Prepare:
- Review the Learning Resources regarding research problem statements and consider how you might formulate a research problem statement.
- Reflect on your personal, professional, and academic experiences to identify a topic of interest to focus on for developing a research problem statement
- Consider what study variables and hypothesis would support your research problem statement.
- Consider any ethical considerations that you should keep in mind in relation to your research problem statement.
- Consider how the selected research problem might contribute to positive nurse practice changes.
By Day 3 of Week 2
Post a proposed research problem statement, including your study variables and hypothesis to make your problem statement clear. Explain any ethical considerations you should keep in mind in relation to your research problem statement. Then, explain how addressing this research problem may bring about positive nursing practice change. Be specific and provide examples.
Research topics: The patient-reported data from nursing rehabilitation facilities is centered around the level, and type of care that the resident has received. Collecting the data can be beneficial to determine which education level of a nurse must have in order to perform sufficient nursing duties in this specific setting.
Research Problem: The education level of nurses providing direct patient care co-correlates with resident clinical care outcomes
Variables: The variables in this study can strongly relate to the nurse alone. A Licensed Vocation (LVN) nurse may be as sufficient as a Registered Nurse in the nursing home rehabilitation setting. The level of care that is needed to care for the patients may not require the skill set of a Registered Nurse. The patient-to-nurse ratio may affect the care delivery system and create a non-conducive environment.
Hypothesis: A group of LVN’s were placed to work in an acute rehabilitation hall for 2 weeks. A group of RN’s worked in the same acute rehabilitation hall for two weeks post the first group of nurses. The clinical skill set of LVN was not complex enough which caused an increase in recidivism.
Ethical Considerations: Nurses who have a high level of education have an increased amount of knowledge, broader clinical skill set, and have experience in patient care which increases patient clinical outcomes.
Positive nurse practice changes: The positive changes to nursing practice by having RN’s work in skilled rehabilitation facilities will have better clinical outcomes, decrease the chances of recidivism, and increase quality measures.
By Day 6 of Week 2
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by providing specific feedback and critiquing their problem statement using the following criteria (Gray & Grove, 2020):
- Does the problem have professional significance?
- Does the problem have potential or actual significance for society?
- Does the problem have the potential to build or refine evidence-based practice?
Submission and Grading Information
Grading Criteria
Post by Day 3 of Week 2 and Respond by Day 6 of Week 2
To Participate in this Discussion:
What’s Coming Up in Module 2?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In the next module, you will identify the purpose and use of quantitative research methods. You will examine data, specifically looking at collecting and analyzing quantitative research.
Long-term acute care hospitals serve medically tricky patients who are likely to be hospitalized for weeks or months. These individuals are generally chronically unwell, most commonly after a stint in an intensive care unit following
a hospitalization. This type of facility may care for patients who require a mechanical ventilator, sophisticated wound
treatment, or dialysis. If the facility is affiliated with an acute care hospital, it must meet all the same licensing and
credentialing criteria as traditional hospitals. Physicians in long-term acute care hospitals often visit patients every day to
monitor their health and progress. Patients suffering from surgery, trauma, or an acute disease get treatment in an inpatient
rehabilitation facility. Patients must withstand three hours of physical or occupational therapy every day
to get rigorous rehabilitation at this facility. A physician, often a specialist in rehabilitation medicine, serves on the
multidisciplinary team that oversees the patient’s care. Most patients at skilled nursing institutions are deemed
medically stable, even if they have been diagnosed with a long-term illness. Although some patients do not need to see a
doctor every day, they still need physical therapy or wound care treatments.
References
Gray, J. R., & Grove, S. K. (2021). Burns and Grove’s the practice of nursing research – E-book: Appraisal, synthesis, and generation of evidence. Elsevier Health Sciences.
Long-term care and patient safety. (2019, September 7). PSNet. https://psnet.ahrq.gov/primer/long-term-care-and-patient-safety
Your exploration of the complex challenges in providing ethical and compassionate care for dual diagnosis patients in mental health and addiction treatment facilities is both insightful and comprehensive. You have clearly defined the problem and articulated the intricacies involved in treating patients with co-occurring mental illnesses and substance use disorders, emphasizing the need for specialized care.
Your integration of relevant studies, including those by Warrender et. al. (2020), Tölli et. al. (2020), and McGregor et. al. (2019), is commendable. These references not only strengthen your arguments but also demonstrate your ability to engage critically with existing literature. This adds a robust evidence base to your discussion.
I particularly appreciate your balanced consideration of both patient and healthcare worker perspectives. This approach is crucial in understanding the dynamics of challenging behaviors and the importance of cultural competence in care. Your emphasis on ethical considerations, especially regarding patient autonomy and dignity, highlights a deep understanding of the core values in healthcare.
Your proposed solutions, including a review of services and training, integrating cultural competence, and addressing healthcare workers’ needs and boundaries, are thoughtful and pragmatic. These suggestions indicate your ability to think critically about the practical applications of your research.
The potential positive outcomes you outline, such as reduced suicide rates, fewer overdose incidents, and healthier family dynamics, underscore the real-world impact of improved care for dual-diagnosis patients.
Specifically, what strategies do you propose for healthcare facilities to integrate cultural competence and address the needs and boundaries of healthcare workers while ensuring continuous, high-quality care for dual-diagnosis patients?
Overall, your analysis is well-rounded, insightful, and indicative of a deep engagement with the subject matter. Your writing is clear, structured, and logically presented, making your arguments compelling and easy to follow.
Keep up the excellent work. Your thoughtful approach to this complex issue is a valuable contribution to the field.
Edited by Bob Lee Anders on Dec 7 at 9:57am
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an underastanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
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Lopes Write Policy
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.
Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course.
Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
- Your response needs