NR 500 Week 5 Discussion: Evidence-Based Practice

Sample Answer for NR 500 Week 5 Discussion: Evidence-Based Practice Included After Question

NR 500 Week 5 Discussion: Evidence-Based Practice

NR 500 Week 5 Discussion: Evidence-Based Practice

Discuss the EBP process and importance to nursing practice. Identify your selected specialty track. Provide a rationale on why you selected the specific professional track. Identify a concept or topic you have a passion about or an area of interest related to your future specialty advanced practice area. Provide an example, using the best evidence available, substantiating the significance of your selected area of interest as it relates to your specific specialty track.  

A Sample Answer For the Assignment: NR 500 Week 5 Discussion: Evidence-Based Practice

Title: NR 500 Week 5 Discussion: Evidence-Based Practice

  • Evidenced-based practice (EBP) is a crucial component to the science of nursing. It is the clinical solution to a problem based on research and evidential proof.  Over the last 20 years EBP has brought about positive change to the healthcare and nursing community. With the public’s demand for improved healthcare and the evidence of scientific based research that can provide potentially life-saving benefits, EBP should be of upmost consideration to all care providers (Spruce, 2014). Evidenced-based practice combines clinical expertise, research evidence, patient values, and preferences into the process of decision making for the improved care of patients (Howe & Close, 2016). It is through continued implementation of EBP into the practice of nursing that will benefit those within our care. 

     My specialty is track is that of nurse educator. I chose this track to fulfill the interest I have in educating, encouraging, and mentoring those new to nursing practice or a particular nursing specialty. This interest in education has evolved over my years in nursing practice as well as from motherhood. Since 2012, I have educated my children primarily at home. It has been through these experiences that sparked a desire in me to pursue the education path in nursing. Seeing someone learn something new, master a skill, and grow in knowledge gives me great joy. 

     As an operating room nurse, I have been witness to evidenced-based practice and the impact it can have on surgical patients. One topic that interests me greatly is the prevention of surgical site infections. Surgical site infections (SSIs) are the most common infection that is healthcare associated in surgical patients (Schub & Smith, 2016). SSIs can delay healing and increase morbidity and mortality. Increased hospital stays and readmissions are a huge contributor to rising costs in healthcare. The prevention of SSIs is an evidence based practice focus in nursing care. As a perioperative educator in a hospital based setting, I can contribute to educating nursing staff on proven, preventable measures that can be implemented in surgical patients.NR 500 Week 5 Discussion: Evidence-Based Practice

Educators in individual care settings can work to review the evidence and work closely with healthcare providers to improve practice and increase safety for patients (Spruce, 2014). One example of an educator’s implementation to improve SSIs would be holding pre-procedure huddles with the OR team to improve communication, quality of care, and to empower other nurses to advocate for their patients and speak up when necessary.

The following of surgical safety checklists, surgical skin antisepsis, hand hygiene, minimizing OR traffic, team training, speaking up whenever a break in sterile technique is observed, and timely prophylactic antibiotics are just a few methods that have been researched and proven effective in the prevention of SSIs (Spruce, 2014). Nurse educators will play a crucial role in educating nurses in the academic and clinical setting in improving care based upon evidence based practice. 

Howe, C., & Close, S. (2016). Be an expert: Take action with evidence-based practice. Journal of Pediatric Nursing, 31(3), 360-362. doi: 10.1016/j.pedn.2016.02.01 

Schub, T. & Smith, N. (2016, June). Infections, surgical site: Prevention. CINAHL Nursing Guide. Retrieved from: http://eds.b.ebscohost.com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=4&sid=46d7bc80-e559-482e-80f7-aa7dff360b99%40sessionmgr103 

Spruce, L. (2014). Back to basics: Preventing surgical site infections. AORN Journal, 99(5), 600-611. doi: 10.1016/j.aorn.2014.02.002 

What does the literature say about these pre-surgical huddles? Are they effective? If so, how and why?  Please share with us your findings. 

Huddles have become a popular concept in healthcare settings today. The concept actually comes from football, where the team members come together for about 25 seconds before a game to discuss strategy and execution of their plays. Similarly, a pre-shift or pre-procedure huddle can be an effective way to gather the healthcare team together to discuss safety concerns, staffing plans for the shift, and the promotion of education geared towards improving patient safety and care. Criscitelli (2015) considers huddles as a micro meeting that has structure and focuses upon communication and safe patient care.

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In the perioperative environment, the Joint Commission has reported that poor communication is the cause of over two-thirds adverse events (Criscitelli, 2015). I found that report quite humbling. For huddles to be effective, they should be mandatory, have an agenda and time limit, be consistent at the same times every day, and display a recognizable structure to all who participate (Criscitelli, 2015).  In my department, our team of nurses and surgical techs huddle 5 minutes before every shift to address safety concerns, plans for the shift, staffing assignments, and sometimes a brief in-service is provided by our nurse educator.

Typically, huddles are led by charge nurses or nurse managers. Huddles can improve communication and workflow and are more effective when they are interdisciplinary. Pre-procedure huddles have actually been shown to reduce errors and unintended events (Criscitelli, 2015). In regards to surgical site infections, huddling can improve patient outcomes by increasing timely prophylactic antibiotic administration (Criscitelli, 2015). Huddling helps perioperative team members address the surgical safety checklist, keeping the patients safe care as a forerunner in the plan for the day. 

Safety huddles can reflect the nursing profession’s commitment to improving safe care and thus supports evidence-based practice. It is a very simple concept that carries great benefits by bringing team members together and can inevitably reduce patient harm (Foster, 2017). As a nurse educator, I plan to foster the concept of huddles in the classroom and clinical setting. 

Criscitelli, T. (2015). Fostering a culture of safety: The OR huddle. AORN Journal, 102(6), 656-659. doi:10.1016/j.aorn.2015.10.002 

Foster, S. (2017). Implementing safety huddles. British Journal of Medicine, 26(16), 953. doi:10.1298.bjon.2017.26.16.953 

The last thing a patient wants when going to a hospital for treatment is a hospital-acquired infection or as you mention surgical site infection. Nurses play a key role in helping to prevent infection before it happens by adhering to evidence-based infection-control policies. This includes keeping the healthcare environment clean, wearing personal protective clothing, using barrier precautions and practicing correct handwashing. Although nurses are busy with many responsibilities, the time it takes to control infection is well worth the effort.

Infection control measures can be as simple as hand washing and as sophisticated as high-level disinfection of surgical instruments. Implementing these measures can prevent transmission of disease in health care settings and the community. Most importantly foam in and foam out of patient room. U.S. Centers for Disease Control and Prevention, and every hospital have established guidelines to prevent the transmission of disease. Because if the flu this season, Grady hospital for example have stopped children 14 and under from visiting patients. There are signs instructing visitors not to enter if they are having flu symptoms. 

I really enjoyed reading your post! When I think of a nurse educator my first thought is the academic setting so I enjoyed reading your example of the clinical setting. I think there should be more clinical education implemented quarterly/yearly as refreshers to hospital staff. I know the annual training I am used to receiving seems to be the same monotonous training we learned the year before. I believe new evidence-based practices should be reviewed and taught in these educational events to keep up hospital staff educated in the best clinical practices.

Your example of holding pre-shift huddles is something I think that is very crucial in the OR setting and a great way to prevent mistakes and surgical site infections. This is something I would like to implement more in the emergency department where I work before code situations. Codes are stressful situations and sometimes time doesn’t allow for it but when time allows I think assigning roles and responsibilities will allow for a smoother code and more optimal outcomes.  

I agree that nurse educations hold a fundamental role in educating future nurses as well as current practicing nurses on the importance of implementing evidence-based practices to improve patient’s outcomes. Evidence-based practices incorporates research, clinical expertise, and patient’s values to provide optimal patient care. Evidence-based care delivery is the standard of care for advance practicing nurses. As the nursing profession and technology continue to grow; patients require service excellence and cultural competence amongst health care professionals.

As leaders and educators within the nursing profession emphasizing the importance of evidence-based care delivery to have successful patient outcomes is valuable to creating confidence amongst the community and the patients we serve.  The OR is one of the many places requiring evidence-based practices to ensure patient safety. Evidence-based practices measures in the OR includes: time out, debriefing, marking surgical sites, and prophylactic antibiotics all have proven to be research based measures to improve patient outcomes. 

Evidenced-based practice (EBP) combines evidenced-based research, values of the patient and expertise of the clinician to provide the best care and most beneficial outcomes to patients. EBP is implemented into nursing care daily and is an expected intervention provided by today’s nurses. Our lesson states that the profession of nursing has evolved, and the expectation is that the professional nurse has a scientific foundation to support the care that is provided (CCN, 2018).

My specialty track is family nurse practitioner. I chose family nurse practitioner to be able to help and provide care for people that are sick or in need of health prevention and promotion. Family nurse practitioners are able to see patients of all ages. The diversity of patient population is also something that interested me and helped with my decision of choosing the family nurse practitioner route.  Each patient you see is different and I love being able to communicate with patients and family members to identify their healthcare needs as well as incorporate their beliefs into their healthcare plan. Family nurse practitioners are involved in many facets of healthcare such as treating healthcare issues, promoting healthcare by prevention and preventing healthcare issues. An area of interest that I have been interested in/passionate about is vaccinations for adults and children.

Family nurse practitioners are in a unique position to educate and teach patients/family members about vaccinations and their importance. They can also educate patients who shouldn’t take the vaccinations and why such as contraindications. The family nurse practitioner is in a leadership position to give a unbiased approach to patients about vaccinations and listen to their beliefs. A systemic review was done that reviewed evidence of the effectiveness of standing order protocols for adult vaccinations coverage rates. It was found in the study that implementation of standing orders programs alone or combined with other effective interventions can help improve vaccination coverage by institutional providers (“Use of Standing Order”, 2000). Family nurse practitioners can help implement this evidence-based practice in institutions to increase the number of vaccinations received by patients. 

 

Chamberlain College of Nursing. (2018). NR-500 Week 5: Scholarship and Evidence-Based Practice: A Process for Change.  [Online lesson]. Downers Grove, IL:  DeVry Education Group. 

Use of Standing Orders Programs to Increase Adult Vaccination Rates: Recommendations of the Advisory Committee on Immunization Practices. (2000). MMWR: Morbidity & Mortality Weekly Report, 49(11), 21-26

I enjoyed your post. I am a little confused on your exact topic though. Hopefully you can clarify this for me. Are you interested in giving vaccinations or educating your patients on the importance of vaccinations? Please let us know which topic is your specific interest. Let us know what the literature says about educating patients on the need and importance of vaccines  or about giving the vaccines themselves if that is the case.  You told us about vaccine effectiveness.  Be specific. 

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