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

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

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

PICOT Draft

Name_____________________________________                                                                                                                                                        

Part 1:

The selected nursing problem for the project is catheter-associated urinary tract infections (CAUTIs). CAUTIs are infections that patients develop following their insertion with urinary catheters. The issue was selected because of it is a safety and quality issue in nursing practice that is preventable (Smith et al., 2019). Statistics shows that CAUTIs affect about 11 million people in America and 150 million people globally annualy. The statistics make CAUTIs the leading type of hospital-acquired infection globally (Flores-Mireles et al., 2019). CAUTIs have adverse health effects. They act as a source of immense disease burden to the population due to their associated costs. CAUTs prolonge the patients’ hospital stay, demand for specialized care, which increase unnecessary costs for them. CAUTIs may also result in complications such as septicemia, which can lead to death. The risk factors associated with CAUTIs include the use of septic techniques, prolonged catheterization, and poor catheter care by the nurses and other healthcare providers. The topic of CAUTIs is relevant to nursing practice because nurses are primarily involved urinary catheter insertion, care, and removal. The actions they take determine the predisposition of patients to urinary tract infections following catheterization (Podkovik et al., 2019). Therefore, the problem should examined to inform the utilization of best practices in catheter insertion, care, and removal.

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	Patients being catheterized
I	Intervention	Use of bundled intervention
C	Comparison	Usual care
O	Outcome	Reduction in CAUTIS rate by at least 50%
T	Timeframe	Eight months
PICOT	Among patients requiring urinary catheterization in the medical and surgical ward, does the use of bundled intervention as compared to usual care result in at least 50% reduction in CAUTIs within eight months?
Problem Statement

References

Flores-Mireles, A., Hreha, T. N., & Hunstad, D. A. (2019). Pathophysiology, Treatment, and Prevention of Catheter-Associated Urinary Tract Infection. Topics in Spinal Cord Injury Rehabilitation, 25(3), 228–240. https://doi.org/10.1310/sci2503-228

Podkovik, S., Toor, H., Gattupalli, M., Kashyap, S., Brazdzionis, J., Patchana, T., Bonda, S., Wong, S., Kang, C., Mo, K., Wacker, M. R., Miulli, D. E., & Wang, S. (2019). Prevalence of Catheter-Associated Urinary Tract Infections in Neurosurgical Intensive Care Patients—The Overdiagnosis of Urinary Tract Infections. Cureus, 11(8), e5494. https://doi.org/10.7759/cureus.5494

Smith, D. R. M., Pouwels, K. B., Hopkins, S., Naylor, N. R., Smieszek, T., & Robotham, J. V. (2019). Epidemiology and health-economic burden of urinary-catheter-associated infection in English NHS hospitals: A probabilistic modelling study. The Journal of Hospital Infection, 103(1), 44–54. https://doi.org/10.1016/j.jhin.2019.04.010

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.

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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.

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.

 

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.

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.

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. t

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.

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
I Intervention
C Comparison
O Outcome
T Timeframe
PICOT

Problem Statement

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

Optional: ThinkingStorm

Description:

For additional information, the following is recommended:

ThinkingStorm is an online tutoring resource that provides flexible support to supplement traditional educational environments. The tutoring center is remotely accessible to GCU learners with a computer and an Internet connection and offers convenient hours for learners with busy schedules. ThinkingStorm tutoring includes a writing center that offers 24/7 submission-based writing support, as well as live writing support across the curriculum.

If you are interested in utilizing ThinkingStorm’s writing support, submit your documents chapter by chapter, rather than as a full manuscript.

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To access ThinkingStorm, click on the link provided and select the yellow “Go to ThinkingStorm” button.

Optional: Grammarly

Description:

For additional information, the following is recommended:

Grammarly is an online writing assistance application that reviews written submissions and suggests context-specific corrections for grammar, spelling, word usage, wordiness, style, punctuation, and plagiarism. The reasoning for each suggested correction is provided, allowing users to make informed decisions about how to correct writing issues.

Grammarly can be installed as free browser extension, though Grammarly Premium requires an annual subscription. This subscription is not a GCU-required purchase.

NUR-550 Course Objectives

Description:

In this course, the student will:

1. Explore research articles, nursing and related theories, applying levels of evidence, and theoretical frameworks to identify quality research studies.
2. Demonstrate understanding of scientific inquiry, knowledge generation, utilization, and dissemination in advanced nursing practice.
3. Evaluate the evidence for potential solutions/innovations that can potentially solve a health care issue and improve patient outcomes.
4. Identify gaps in nursing knowledge and evidence-based practice that can potentially be resolved by planning and implementing a practice change project.
5. Formulate a clinically researchable question amenable to an innovative evidence-based practice change proposal.
6. Write a scholarly literature review that supports a clinically researchable question amenable to an innovative evidence-based practice change proposal.
7. Evaluate health policy and advocacy issues for the purpose of improving health care outcomes.
8. Engage in scientific inquiry into the state of health care delivery, patient-centered care, and ethical principles related to health beliefs, health promotion, and risk reduction of diverse populations.
9. Propose quality improvement initiatives that advance the delivery of safe, high-quality health care.
10. Use principles from epidemiology, biostatistics, genetics, genomics, and cultural competence to guide comparisons of various patient populations.

Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Good (92.00%) Excellent (100.00%)
Content 100.0%

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.

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.”

Re: Topic 1 DQ 1

Evidence-based practice (EBP) is the process of combining evidence from studies, clinical expertise and patient values and preferences to come to a conclusion to promote the best patient-centered care (Nurse.com, 2021). However, it has been noted that much evidence-based practice takes time to be implemented into practice, and often does not progress past being published in a professional journal (Weiss et al., 2018). According to Titler (2018), there is a gap between EBP recommendations and the actual implementation of said recommendations to help improve patient care. Given this, translational research is utilized. Translational research is the process by which evidence-based interventions are incorporated into real-life, clinical settings (Melnyk & Fineout-Overholt, 2019). The process of translational research falls under the umbrella of translational science, in which EBP interventions are utilized and put into place to help improve patient care and outcomes, as well as the health of the overall population (Titler, 2018).

Although both EBP and translational research are related, they are not to be used interchangeably (Titler, 2018). According to Titler (2018), EBP is the application of evidence while translational research is the implementation of the evidence into practice. This includes executing knowledge, research designs and methods into real-life in practice, communities and public health settings. Translational research focuses on applying these EBP interventions to help improve patient outcomes, and to determine what strategies work for whom, why they work, and in what environment they work in (Titler, 2018).

There are five phases of translational research, which are known as “bedside to community” (Titler, 2018). The first phase, T0, refers to basic science research which includes preclinical and animal studies. After this, a phase 1 clinical trial must be done, to test the safety in a small group of humans, which is known as the T1 phase. The next phase of translational research, T3, includes both phase 2 and 3 clinical trials which tests the safety in a larger group of people and allows for comparison of common treatments. Phase four, or T4, includes phase 4 clinical trials and outcomes research which can be applied into practice. Lastly, phase five (T5) consists of a translation to the community, in which the larger population outcomes research is obtained (Titler, 2018). Translational research can be seen with the implementation of vaccinations. After evidence and research is conducted in regard to the particular disease and vaccine components, the application of the scientific evidence can be applied in trials to see how the product of the research can be used effectively in practice (Centers for Disease Control and Prevention, 2020).

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

Centers for Disease Control and Prevention. (2020, December 17). Topic area 5: Translational

          research. https://www.cdc.gov/niosh/programs/review/ecb/topic5.html

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing &

          healthcare: A guide to best practice. Wolters Kluwer.

Nurse.com. (2021). Evidence-based practice. https://www.nurse.com/evidence-based-practice

Titler, M. G. (2018). Translation Research in Practice: An Introduction. Online Journal of Issues

in Nursing, 23(2), 1. https://doi-org.lopes.idm.oclc.org/10.3912/OJIN.Vol23No02Man01

Weiss, M. E., Bobay, K. L., Johantgen, M., & Shirey, M. R. (2018). Aligning Evidence-Based

Practice With Translational Research: Opportunities for Clinical Practice Research.

JONA: The Journal of Nursing Administration, 48(9), 425–431.